The mental health legacies of peace operations
A recently-released research study is further evidence that deployments themselves – whether ‘peace’ or ‘combat’ operations – rarely predict mental health problems in personnel. Rather, it is individuals’ particular experiences or exposure to specific events on deployments that increases risk for subsequent mental health disorders.
Many health providers have little idea that since 1947, over 65,000 Australians have served in more than 50 multilateral peace operations in Africa, the Asia-Pacific, Central America, Europe, and the Middle East, peaking in scope and contribution during the 1990s.
Peace operations can present complex and varied realities for military personnel. Their work may include facilitating diplomatic political processes between previously warring factions; supervising democratic elections; disarming combatants and protecting civilian populations; providing humanitarian aid in crises; and maintaining law and order.
The DVA-commissioned Peacekeepers’ Health Study investigated the mental and physical health status, health service use and quality of life of 1,067 Australian veterans of peacekeeping and peacemaking missions to Rwanda, Somalia, Cambodia, Namibia, Western Sahara and East Timor from 1989-2002.
In this study, 65% of the respondents reported they were in good to excellent health. However, despite being between 10 to 15 year after the peacekeeping deployment, 30% had a diagnosable mental health condition in the last 12 months.
When treating a patient that identifies as a Peacekeeper, providers should look out for symptoms of PTSD, suicide ideation, social isolation, problematic anger and alcohol abuse.
Peacekeepers’ use of health services was high, with 68% having seen a GP in the previous three months, 35% a medical specialist, and 37% an allied health provider.
However, perhaps one of the most significant findings of this study was that the dissatisfaction rate with these treatment services was also high, this dissatisfaction correlated with poorer health.
Understanding the military service experienced by your veteran patient is important to building an effective therapeutic relationship and developing a treatment plan that meets their needs. DVA’s Understanding the Military Experience eLearning programme is a good introduction to Australia’s military history, including peacekeeping missions, and the impact on mental health.
The full report from the Peacekeepers’ Health Study can be found here.
Updated cooking programme for socially isolated patients
The Department of Veterans’ Affairs has recently updated a successful programme focusing on health, nutrition and social inclusion. Cooking for One or Two is a cooking skills programme designed to allow veterans or widow(er)s to learn basic nutrition in a safe and friendly environment, thus improving nutrition while also helping isolated and potentially vulnerable people to leave the house and start making new and important social connections.
One of the stated objectives for the programme is that participants will have completed one or two social interactions per week. By attending classes and eating their meals with fellow participants, attendees can reintroduce themselves into social activities and interact with other people. While the programme was designed for the veteran community, its value has been recognised by a number of community groups around the country, with the programme now being presented by a range of organisations focused on minimising social isolation.
Some financial support may be available for any community group conducting a programme targeted at veteran community members. Clinicians are encouraged to discuss the programme with patients they feel could benefit from participation. Further information or advice on programmes conducted in your local area can be obtained from firstname.lastname@example.org.
Improved access to mental health treatment
Vocationally registered general practitioners, clinical psychologists and psychiatrists are now able to provide a diagnosis for certain mental health treatment paid for by the Department of Veterans’ Affairs (DVA). Previously, psychiatrists only could provide diagnoses.
Under these arrangements, DVA can pay for treatment for diagnosed PTSD, anxiety disorder, depressive disorder, alcohol use disorder or substance use disorder – whatever the cause. The condition does not have to be related to military service. This is available to anyone who has deployed on Australian Defence Force operations overseas, and many with more than three years peacetime military service.
These arrangements are also known as ‘non liability health care.’
These changes streamline processes for health professionals as there is no longer a need for provisional diagnoses to be confirmed by a psychiatrist within 3 months. A full medico-legal report is not required. Health professionals only need to complete the ‘Diagnostic Report’ section of the DVA approved application form (D9213 – Application for Health Care for Certain Mental Health Conditions) available on the DVA website here.
These arrangements are separate from the DVA compensation claims process for service-related injuries, including mental health. Veteran patients can be referred to the following:
- Clinical Psychologists
- Mental Health Social Workers
- General Social Workers
- Mental Health Occupational Therapists
Compensation claims for mental health disorders still require an assessment and full report by a psychiatrist. Full details about these arrangements, including eligibility, are available on the DVA website.
Save time with DVA Webclaim
On 1 July, DVA launched the new medical component of DVA Webclaim; this is great news for mental health providers who provide services to the veteran community.
DVA Webclaim is a no-cost online service that has been developed specifically to help reduce the administrative costs and practice resources required to service the needs of veterans.
The system enables health providers to lodge claims (except hospital and community nursing claims) through an online 'smart form', reducing the resource costs and delays associated with preparing and lodging paper-based claims.
The benefits of using DVAWebclaim include:
- Receive an instant response to submitted claims;
- Receive payment within a maximum of two business days (compared with twenty business days if you submit DVA claims by paper);
- Access up to two years of your electronic DVA statements;
- Download your DVA claiming history for the previous two years;
- Cancel paid claims that are submitted on the same day;
- Use the Health Professional Online Services (HPOS) secure email facility to ask the Department of Human Services (DHS) questions about your claims; and
- Claims are paperless and patient signatures are not required.
DVA Webclaim is available on the DHS HPOS portal.
To access DVA Webclaim Medical you will need a relevant valid Medicare provider number and an Individual Public Key Infrastructure (PKI) certificate.
For further information specific to your circumstances on how to set up registration for PKI and HPOS, contact the DHS eBusiness team on:
- Phone: 1800 700 199
- Email: email@example.com
For further information about this no cost solution, please visit the DVA Webclaim page.