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Foreign Affairs, Defence and Trade References Committee
01/09/2015
Mental health of returned Australian Defence Force personnel

O'TOOLE, Ms Catherine Elizabeth, Chief Executive Officer, Supported Options in Lifestyle & Access Services

[15:00]

CHAIR: Welcome. Would you like to make a brief opening statement before we go to questions?

Ms O'Toole : Yes, thank you. Firstly, I would like to acknowledge the traditional owners of the land upon which we meet today and pay my respects to their elders past and present. Thank you very much for the opportunity to speak here today. SOLAS has its head office in Townsville. As you would be aware Townsville has the largest Army base in Australia, and that is partly what has brought me here. Our organisation was incorporated in 1996 and became a company limited by guarantee in 2013. We are a specialist mental health community organisation. As I said, our head office is in Townsville. We have an office on Palm Island, we have an office in Mount Isa and we subcontract to organisations in Ingham, Charters Towers, Richmond and Hughenden.

Our vision is about supporting people who are living with mental distress to live a life of choice, purpose, meaning and citizenship just as you and I experience. We achieve this by facilitating a person-led approach to working with people to determine what it is they want to achieve in their life and to work with their strengths. We clearly understand that the individual is the expert in their own life.

PTSD is particularly felt in our community. Not that long ago, very tragically and unfortunately, a soldier hanged himself—he had left the services—on the goal posts at the Kirwin State High School. It was a very traumatic experience for our community and particularly for the staff who came to the school to do their job at six o'clock that morning. That was managed incredibly well by the school community. And it was probably just another experience that we have had in our community.

The men and women in the ADF are, in essence, employees of the Commonwealth. As such, I believe—and our organisation would support—that they deserve a work environment that is focused on mentally healthy practices. We believe there needs to be some practical support for families as well as the individuals concerned. We also believe a huge amount of work needs to be done to reduce stigma in the ADF community and in the broader community as well.

What we do know is that the workplace can affect the mental health of employees and this can be either positive or negative. Generally, employment is associated with good mental health because it provides a sense of belonging, access to social supports, networks, status and recognition—key components of being included within the community. However, there are some occupational stresses that can contribute to a mental health condition. These can apply across all workplaces. Job stress is quite common in a number of workplaces, particularly where there are high-demand low-control conditions and other conditions more specific to different workplaces. A good example of this is the ADF. There is likely to be a greater level of exposure to trauma and violence. A significant proportion of the working population—approximately 20 per cent—are likely to experience a mental health condition at any one time. This demonstrates the need for all workplaces to adopt a positive approach to promoting good mental health and supporting those people experiencing difficulties.

Our organisation is not a clinically based organisation; it is an organisation that works from a community perspective. But I see, every day, people who are experiencing post-traumatic stress disorder, people who are living with bipolar conditions, people who are experiencing anxiety and depression, and the clinical supports are vital—there is no argument about that. But we also need to provide supports to people that are more practical, that are more about looking at how they are managing on a day-to-day basis. How are their families supporting them? How are they supporting or working with and living in positive relationships with their families? One of the things that we have experienced in our organisation, because we do work with people who have severe and complex issues, is that very often their relationships are in tatters. Very often they are lonely, they are isolated, they do not have work, they do not have purpose and they do not have meaning. I think it would be a grave tragedy, and a travesty of justice in fact, if this were to happen to the men and women of the ADF who give so selflessly of their own lives to ensure that our communities and our country are safe. So I believe that there is opportunity for us to maybe investigate how we, or the ADF, might use some of the facilities and supports that are available in the broader community.

CHAIR: Thank you very much. Senators, at the outset, we do have a commitment to get our Hansard operator and his many pieces of equipment on a plane tonight, so 10 to four will be the finishing time, half an hour after schedule.

Senator WHISH-WILSON: Just a matter of interest, Ms O'Toole, with the soldier who hung himself, was there any significance with doing it at the school?

Ms O'Toole : I do not think so. Generally speaking, when people are in that state of mind they are not really cognisant of where they are or what they are doing, and it could have just been opportunistic. He did live in that area, I do believe, but I do not think it was about making a statement at all.

Senator WHISH-WILSON: Are SOLAS's services purchased by the ADF, or do you do any work with DVA or the ADF at the moment in terms of outreach?

Ms O'Toole : No, we do not. It is actually quite difficult, I have to say, and I think we have something to offer. We are currently tendering with Mates4Mates with the Commonwealth, to see if we can work in that peer support area. I know, in our work with the broader community, and particularly in Aboriginal and Torres Strait Islander communities and CALD communities, peer support work is really valid. It is very powerful and very useful and we have experience in that space of having developed a peer support workforce. But, no, we do not, and part of why I asked to have this hearing in Townsville, for the very reasons that I outlined at the beginning, was that there are a myriad of supports in our communities that are not being used that I think could be very useful. Our focus is very practical.

Senator WHISH-WILSON: With PTSD, do you have experience at the moment with emergency services or police or rape victims—what is your operational—

Ms O'Toole : In general, we work very closely with mental health services in our community. As I said, we are not a clinical service; however, our director of service development is a mental health nurse by trade, so that is useful. We do have some clinical people on our staff but they are working in lifestyle support roles at the moment. Our job really is to look at: how is the person managing to live their life as best they can in the community? When we see a need for clinical intervention, then we would assist that person to achieve that intervention. What I observe is, generally, if there is any focus it will be really clinically focused and we tend to forget that the person lives most of their life in the community and their family is intrinsically linked in that space.

Senator WHISH-WILSON: So that would cover regional areas as well?

Ms O'Toole : Absolutely.

Senator WHISH-WILSON: That is something we have not heard much about, to be honest, so far in the inquiry—services available in regional areas.

Ms O'Toole : Specialist mental health services are very light on the ground in regional areas. Our organisation made a commitment, when we got federal funding some time ago, that we would work to build the capacity in our regional areas. That is why we subcontract in Charters Towers, Ingham, Ayr, Burdekin, Richmond and Hughenden—because there were no specialist mental health services. We have been able to build that capacity in that community. It is much more financially viable as well. We have also created jobs and built skill bases in those communities.

Senator WHISH-WILSON: In terms of your clinical services, or other services, do you tend to take an evidence based approach to what you prescribe, or do you accept alternative therapies? We have heard some different evidence around that.

Ms O'Toole : In the work that we do, I suppose you would say the community sector is not really funded to research and evaluate to the degree we would like to. But yes we do take evidence based practice into account and that informs our practice. We look at the national recovery oriented practice framework for mental health services. It is a national framework. We follow that. We also use evidence based tools when we are trying to assess how people are travelling, how they are going. We do that. But in terms of the clinical support we do not have any impact on that. We are just supporting people to access those services.

Senator LAMBIE: Your organisation wants to get in to help Defence—is that the big picture?

Ms O'Toole : That is not why I am here. I am here because I have lived all of my life in Townsville and watched the defence services grow. The impact of poor mental health in our defence service community impacts on our community—absolutely it does. It impacts on our schools; it impacts on our workplaces. Families are moving in and out of Townsville all the time. What I do believe is that there are some services that are available in our community that the defence services may not be aware of and that may be very useful. There is no point in reinventing the wheel and doing again what is already existing in the community. I do not see any value in that.

Senator LAMBIE: So you are not registered with DVA or Defence?

Ms O'Toole : No, we are not at the moment. It has been quite difficult for us to get into that space.

Senator LAMBIE: Which organisation up there—and I am very aware that there are quite a lot of soldiers up there—is helping them on that side, outside the gate? Who is helping them?

Ms O'Toole : We have Mates4Mates now in Townsville. I think the DVA support them in whatever services they provide—

Senator LAMBIE: No, I am asking who is helping the family. I understand what Soldier On does and Mates4Mates does; I understand all that. I am asking who is doing the holistic approach up there.

Ms O'Toole : I am not sure. I do not think anyone is—I am not sure. I would take that on notice. What I do understand from the conversations I have with my colleagues—and we work very closely with the Mental Illness Fellowship North Queensland, and they do a lot of work with families—is that we do not seem to be seeing people or families from the defence community, and we have something to offer.

Senator LAMBIE: So they are getting their help inside? Or are they just not coming out?

Ms O'Toole : I am not sure what is happening on the inside, internally. I am not in a position to comment on that. But I certainly do not see a lot of it happening in the community space.

CHAIR: Could that be because of the posting cycle, that people are not there long enough to—

Ms O'Toole : It could be. And I sometimes wonder if the ADF is really aware of what exists in the community—to step outside of where they normally operate and the services that they offer. I think stigma has a huge impact.

Senator LAMBIE: Maybe Defence does not want them to step outside the gate.

Ms O'Toole : It is possible; I do not know. It is just that when I see the number of quality services we have in our community that are funded—and maybe they could be used to provide the supports to people that they may not be getting. I am sure their clinical services and their clinical supports are really very well taken care of. But very often the practical supports that people need are not and the family based—looking after the whole unit. So it is difficult. It is difficult for children too. They are struggling. We have families, as you would well know, moving in and out of our community on two- and three-year rotations. People are doing many deployments, so kids are home with mum, struggling.

Senator LAMBIE: Do you get much feedback about what is going on with the kids on those rotations? Do you get much feedback from the schools that you can talk about here today?

Ms O'Toole : I know there are some schools that work very well in this space and really do look after their students, in primary school and in high school. I know there are some schools that really engage very well with the mothers or the fathers, depending on which parent is involved on deployment. Some of that work is done very well, but I only know isolated instances.

CHAIR: How does your organisation get interaction? How do you pick up—

Ms O'Toole : People can self-refer to us if they wish. We get referrals through the health system. We also support people who have severe and chronic mental health issues that cause them to be homeless, so we might get referrals from housing. Our referrals come from broadly across the community. But we are always keen to make sure that when people are referred to us it is of their choosing and they are not being coerced.

CHAIR: Basically your premise is that you are established in Townsville and you have a track record of success, but there is a large military component of Townsville's population that may be missing out on the benefits of your organisation because they do not know where it is?

Ms O'Toole : It could well be that they are not made aware of it. We are not funded to deliver those services, and we are not the only one—I just happened to write in because I think that it is a really big issue for our community.

CHAIR: We have taken evidence that sometimes the last people to know they have a problem are the people with the problem and that the first people to know that there is a problem is the family. You have made that point very clear. So somewhere along the line we need to encourage families to have greater access to the support in the communities to get the help they need. Your submission is basic common sense, but quite often we discover a lot of that in these Senate inquiries. What we have to do is make it actually go into practice.

Ms O'Toole : That is right.

Senator WHISH-WILSON: I think that is interesting. We heard from beyondblue the other day and raising education and awareness is their critical issue. You have been assisting with services and looking at where things are failing. It is good that you have different approaches and I think it has been very constructive.

Ms O'Toole : I think that very often the valuable role that the community sector plays is overlooked. We also do work in the corporate sector around workplace mentally healthy practices, which are really important.

Senator FAWCETT: One of the things that has come up frequently is getting information and support to families of serving members. Do you engage at all—whether it is through schools, playgroups and other opportunities like that—with spouses, partners and families of serving personnel? Is that an avenue where we could collectively work to reach those people?

Ms O'Toole : I think it is. One of the key places is schools, particularly where families have children at school. I think mothers or fathers groups are also really useful. We have a meeting of all of the mental health services—whether they are government or non-government—once a month. We host that by way of sharing information. We have not, to date, had any people from the defence services come along to that, and that is not without our trying. Again, I know everybody has their priorities and people are busy and often short-staffed, but there are those ways. In particular, when we start to look at the rollout of the NDIS, where some of these young men and women—or any men and women—may be eligible for services and where the community will play a much more significant role in terms of mainstream services, I think it would be a very good opportunity to do that.

CHAIR: Thank you very much for that very positive submission.

Ms O'Toole : Thank you for the opportunity.

Senator LAMBIE: Before we wrap up, I would just like to mention that today we have the Australian Peacekeeper and Peacemaker Veterans Association and the women's groups in the room that, at this stage, we have not designated any time to speak to. I just wanted to recognise them for being in the room today and to thank them for coming along.