warrior care in the 21st century—day 1 australia · warrior care in the 21st century—day 1 st...
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WARRIOR CARE IN THE 21ST CENTURY—DAY 1 W
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AUSTRALIA
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Joint Health Command Warrior Care Symposium 19 Oct 15
Individual Resilience in the Australian Defence Force
Air Commodore Tracy Smart Director General Strategic Health Coordination,
Joint Health Command
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Joint Health Command Warrior Care Symposium 19 Oct 15
Overview
• Background - Mental Health in the ADF • What is resilience? • What do we and don’t we know about
resilience? – Longitudinal ADF Study Evaluating Resilience
(LASER) • How do we enhance it?
– BattleSMART • The role of leadership • New developments
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Joint Health Command Warrior Care Symposium 19 Oct 15
The ADF Health System
• Joint Health Command provides: – garrison health services (including MH) for
59,000 + FT personnel and 20,000+ reserve from health centres and clinics on all ADF bases
– Joint health capability coordination – Strategic health advice and input
• Single Services provide Deployable/operational health
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Joint Health Command Warrior Care Symposium 19 Oct 15
Mental Health Plans and Strategy
• 2002 ADF MH Strategy • 2009 Dunt Review • 2010 MilHOP Research • 2011 ADF Mental Health
and Wellbeing Strategy • 2012-2015 ADF MH and
Wellbeing Action Plan • 2014 ADF Alcohol
Management Strategy and Plan • Working on our new Strategy with Services
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Joint Health Command Warrior Care Symposium 19 Oct 15
2010 ADF Commitment: Capability through mental fitness by
• Promoting good mental health and wellbeing through leadership at all levels
• A culture that supports personnel to recognise MH issues and assist themselves and others
• Prepare to meet unique risks of military service • Evidenced based treatment and recovery • Partnerships between individuals, families,
command and health providers • Innovation and research to improve
understanding of needs and delivery of care • Support effective transition and continuity of
care for those leaving the ADF
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Joint Health Command Warrior Care Symposium 19 Oct 15
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Joint Health Command Warrior Care Symposium 19 Oct 15
The greatest glory in living lies not in never falling, but in rising
every time we fall – Nelson Mandela
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Joint Health Command Warrior Care Symposium 19 Oct 15
Resilience
The sum-total of psychological processes that permit individuals to maintain or return to previous levels of well-being and functioning in response to adversity. – The Technical Cooperation Panel (TTCP)
Technical Panel 13
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Joint Health Command Warrior Care Symposium 19 Oct 15
What we know about resilience
• We know resilience – is a dynamic process – requires a range of coping strategies – is helpful in everyday life
• What we don’t know – Is resilience stable over time? – What factors influence resilience? – Is the ADF approach to building individual
resilience effective?
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Joint Health Command Warrior Care Symposium 19 Oct 15
Longitudinal ADF Study Evaluating Resilience: Study Goals
• To examine changes in MH and psychological resilience during training and military service
• To determine the personal or situational characteristics that build or erode psychological resilience
• To examine changes in behaviour and psychological processes relevant to psychological resilience Crane, M.F., Lewis, V., Cohn, A., Hodson, S.E. , et al. (2012) A Protocol for the Longitudinal Study of
Psychological Resilience in the Australian Defence Force. Journal of Military and Veterans' Health, 20(4).
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Joint Health Command Warrior Care Symposium 19 Oct 15
Longitudinal Methodology
• Data collection points
1 2 3 4 5
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Joint Health Command Warrior Care Symposium 19 Oct 15
Where are we now?
• Time 1 – data collection complete • Time 2 - data collection complete • Time 3 – data collection complete • Time 4 – to conclude Oct 2015 • Time 5 – to conclude Oct 2016
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Joint Health Command Warrior Care Symposium 19 Oct 15
Reporting
• Three Reports have been generated and disseminated – Pre-enlistment Report and Initial Training Report – Contributors to Change Report – Early Careers Report
• Future detailed reports – Relationship between prior trauma exposure and mental health
outcomes – Relationship between smoking and drinking behaviours and
mental health outcomes – The role of social psychological factors in relation to the health
and wellbeing of ADF members
• Reports will inform training and policy
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Joint Health Command Warrior Care Symposium 19 Oct 15
How do we enhance it? How do we enhance it?
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Joint Health Command Warrior Care Symposium 19 Oct 15
Emotions
Physical Reactions Thoughts
Behaviours Situation
Optimal Reaction and Performance
Test
Initial Reaction
Adjust
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Joint Health Command Warrior Care Symposium 19 Oct 15
BattleSMART Training Continuum
ALSO FamilySMART for ADF families based on the LifeSMART package
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Joint Health Command Warrior Care Symposium 19 Oct 15
Tailored Training: OP Resolute
• Does not fit the phased approach • Program commenced in June 2011 for
assigned Navy crews and other personnel • Comprises a biennial group SMART
resilience brief, annual Questionnaire, screening interview with a psychologist
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Joint Health Command Warrior Care Symposium 19 Oct 15
What we know resilience training won’t do
• No evidence that training in resilience will stop development of PTSD
• Will not stop the harmful impact of bullying and workplace harassment
• A ‘one off’ presentation on resilience will not increase resilience
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Joint Health Command Warrior Care Symposium 19 Oct 15
Leadership and resilience
• Support from others • Reinforce principles of BattleSMART • Link between morale and resilience • Expectations regarding resilience
– Variable – Situation dependant – Needs to be practiced
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Joint Health Command Warrior Care Symposium 19 Oct 15
New developments
• ‘High Res’ smart device app and website
• BattleSMART website • Keep Your Mates Safe (KYMS)
– Peers • The Technical Cooperation
Program (TTCP): Action Group 21 – Resilience
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Joint Health Command Warrior Care Symposium 19 Oct 15
Summary • We need our personnel to be resilient • Want to assist personnel to build and maintain
their mental fitness at all stages of their career • Research to tell us what components of
resilience we need to identify, develop and foster in individuals – LASER-R
• Need to build and foster resilence through entire career - BattleSMART
• Shared responsibility: role of leadership in maintaining resilience