Mental Health Research and Evaluation (MHR&E)

The Wellness Action Through Checking Health (WATCH) research project was commissioned by Defence to identify what early symptoms are displayed by ADF members when they experience changes in their mental health, and how Defence can better support ADF members to take charge and manage their own mental health.

The WATCH Project was initiated following findings from two of the largest Australian military mental health projects: the Longitudinal ADF Study Evaluating Resilience (LASER-Resilience) and the Transition and Wellbeing Research Programme (The Programme) that identified key factors that contribute to the emergence and progression of subthreshold symptoms.

Subthreshold mental health symptoms are symptoms that do not meet diagnostic criteria but cause functional impairment and can be a precursor to the development of more severe mental health symptoms in the future. Even in the absence of disorder, subthreshold symptoms are associated with negative impacts and outcomes.

Phoenix Australia conducted interviews with ADF members, Command, ADF family members, and Health Service Providers to understand how subthreshold symptoms are experienced in ADF members, how these symptoms present to others, and whether they are being recognised.

Reports

The findings highlight the importance of improving the recognition, identification and appropriate management of early changes to mental health in ADF members to prevent mental health symptoms from progressing.

The results emphasised the roles of family members, leadership, and Health Service Providers in identifying and addressing early changes to mental health in ADF members. This network of support surrounding members should be maximised to ensure optimal wellbeing and functioning across the Defence life of the member.

A total of 3 reports have been released under the WATCH Project. These are:

1. The Main Report - includes an Executive Summary of the key findings across the four groups interviewed and explores the themes identified in interviews with Health Service Providers and ADF members related to identification and management of subthreshold mental health symptoms.

WATCH Main Report (PDF, 7.96 MB)
WATCH Main Report Appendices (PDF, 452.57 KB)

2. The Family Addendum Report – explores the themes identified in interviews with family of ADF members related to identification and management of subthreshold mental health symptoms in ADF members.

WATCH Family Members Addendum (PDF, 3.86 MB)

3. The Command Addendum Report - explores the themes identified in interviews with Command personnel related to identification and management of subthreshold mental health symptoms in ADF members.

WATCH Command Addendum (PDF, 2.95 MB)

Resources

The flyers below provide a summary of the main findings and resources available for each group to access for support.

WATCH ADF members (PDF, 172.18 KB)
WATCH Health Service Providers (PDF, 177.39 KB)
WATCH Family members (PDF, 173.34 KB)
WATCH Command (PDF, 173.83 KB)

In 2014 the Department of Veterans’ Affairs (DVA), in collaboration with the Department of Defence (Defence), commissioned one of the largest and most comprehensive military research programmes undertaken in Australia. The Transition and Well-being Research Programme (the Programme) examines the mental, physical and social health of serving and ex-serving Australian Defence Force (ADF) personnel, and their families.

This research provides valuable information about the mental health needs, access and use of mental health care services by ADF members who were current serving in 2015 (2015 Regular ADF) and those who transitioned from full-time service between 2010 and 2014 (Transitioned ADF). Building on previous research conducted through the Military Health Outcomes Programme (MilHOP), this is part of an ongoing commitment to invest in initiatives designed to will help DVA and Defence enhance improve health services available for serving and ex-serving ADF personnel members and their families.

The Programme was conducted by a consortium of six of Australia’s leading research institutions led by the Centre for Traumatic Stress Studies (CTSS) at the University of Adelaide, and the Australian Institute of Family Studies (AIFS).

The Programme comprises three separate but related studies:

  1. Mental Health and Well-being Transition Study;
  2. Impact of Combat Study; and
  3. Family Well-being Study.

A total of eight reports have been released under the Programme from April 2018 to July 2020. These are:

  1. The Transition and Well-being Research Programme Key Findings Report – provides a summary of the key themes identified across the entire Programme.
  2. Mental Health Prevalence Report – estimates the prevalence of mental disorders across the mental health spectrum, trauma exposure and suicidal ideation and self-reported mental health symptoms amongst the Transitioned ADF members. It also compares self-reported symptom levels in the Transitioned ADF members with most recent community rates as well as a comparison to the 2015 Regular ADF.
  3. Pathways to Care Report – examines how 2015 Regular ADF and Transitioned ADF members access mental health services, usage patterns and pathways to care. This includes help seeking behaviour, services used, satisfaction with services, pathways into care and perceived barriers and stigma to care.
  4. Physical Health Status Report - examines the physical health status of 2015 ADF and Transitioned ADF members, in particular symptom reporting, self-reported pain, doctor diagnosed medical problems or conditions, physical injuries, sleep problems, and satisfaction with health.
  5. Family Well-being Study - examines the experiences and perspective of family members regarding the impact of military service on families and the pathways to available care.
  6. The Technology Use and Well-being Report - is one of the first studies conducted word-wide to investigate use of the internet and new and emerging programs and technologies that support the well-being and mental health of serving and ex-serving military members.
  7. The Mental Health Changes Over Time: a Longitudinal Perspective Report - examines the shifts in mental health status over a five–year period (2010–2014) in those who have transitioned out of regular, full–time military service compared with those who remain in the Regular Australian Defence Force (ADF).
  8. The Impact of Combat Study - is the third wave of data collection of participants of the Middle East Area of Operations (MEAO) Prospective Health Study who deployed to the MEAO between 2010 and 2012. The study examined the changes over time in mental, physical and neurocognitive health and well-being of the cohort.

In addition to the eight reports, two separate research papers have been produced under the Programme:

  • Psychosocial factors associated with psychological distress and functional difficulties in recently transitioned and current serving regular Australian Defence Force members, was published online on 10 February 2020 and examines the factors that contribute to the wellbeing of Transitioned ADF and the 2015 Regular ADF.
  • Military attitudes and belongingness, perceived support, and life stressors and the psychological distress of Australian Reservists, will be released in the near future.

Many members are exposed to stressful experiences, critical incidents and potentially traumatic events in the course of their duty. These experiences impact on members differently, depending on their psychological and behavioural attributes. Understanding these attributes is critical to providing the right training and support for ADF members.

The Department of Defence has collaborated with Phoenix Australia and has invested 1.7 million dollars to conduct the Longitudinal ADF Study Evaluating Resilience (LASER-Resilience). LASER-Resilience is a world class longitudinal research project spanning the last 10 years. LASER-Resilience followed up thousands of ADF members over five different time points in their early career. This study allowed for the investigation of psychological and behavioural attributes that contribute to psychological resilience in the ADF by studying new members as they adjust and progress in their military career.

The results of this study will inform resilience training programs, such as BattleSMART (Self-Management and Resilience Training), and assist in building a stronger and more resilient ADF.

Multiple reports have been produced on LASER-Resilience data. The final two reports addressing the overall aims of the study can be found below.

  1. Patterns and Predictors of Wellbeing Report explores the situational factors and individual characteristics that promote and erode resilience over the first three to four years of a military career.
  2. The LASER-Resilience Summary Report  draws together the themes identified across all eight reports produced under the project.
  3. LASER-Resilience Plain Language Summary draws together the key LASER-Resilience findings in a one page summary.

Additional LASER-Resilience reports will be made available here in due course.

The 2010 ADF Mental Health Prevalence and Well-being Study is the first comprehensive investigation of the mental health of an ADF serving population. The study provides a summary of the 12-month prevalence of mental health disorders in the ADF and identifies subgroups that warrant further investigation. The performance of mental health instruments currently used in the ADF and occupational issues of relevance to the ADF mental health strategy are also examined. The full report can be found along with other findings from the Military Health Outcomes Programme (MilHOP).

The 2010 ADF Mental Health Prevalence and Well-being Study Executive Report of key findings and a detailed technical version 2010 ADF Mental Health Prevalence and Well-being Study Report are available.

    To assist with the recruitment of participants for current and future Defence or Department of Veterans’ Affairs (DVA) approved health research, DVA and Defence have established the Military and Veteran Research Study Roll (Study Roll). This is a database which contains the details of current serving ADF personnel, including Reservists, and ex-serving ADF personnel who transitioned out of the ADF between 2010 and 2014. To protect the privacy of current and former personnel, the Study Roll is being held at the Australian Institute of Health and Welfare (AIHW).

    Current ADF members, including Reserve personnel, were notified of the Study Roll in March 2015, via address details held in PMKeyS. Between March and May 2015, all members were offered the opportunity to opt-out of having their details provided to researchers for the Transition and Well-being Research Programme.

    The details of some individuals on the Study Roll were provided to the Centre for Traumatic Stress Studies, University of Adelaide in May 2015 for the Transition and Well-being Research Programme. Details of any individuals who opted out prior to 7 May 2015 were not provided to the University of Adelaide.

    ADF members still have the opportunity to opt-out of their details being provided for future research. Individuals who do not wish for their details to be provided to researchers can opt-out with no detriment to their career or future medical care.

    Those who wish to remain on the Study Roll do not have to do anything.

    If you wish to opt-out, please email your full name, PMKeyS number and date of birth to optout.studyroll@defence.gov.au and ‘OPT OUT’ in the subject line.

    For further information on the Study Roll, see the Frequently Asked Questions.

      The goal of ADF Mental Health Surveillance is to contribute to improvements in the mental health and well-being of ADF personnel by conducting research in support of the ADF mental health strategy, mental health screening and mental health services provided to ADF members.

      1. The main tasks include:
      2. Managing and analysing all mental health screening related data;
      3. Providing ad hoc data summaries based on mental health screening and surveillance reports;
      4. Undertaking psychometric and evaluation studies of mental health screening instruments;
      5. Providing client sponsored research and project evaluation support;
      6. Supporting mental health research governance, coordination and representation; and
      7. Contributing to the information management and system development of mental health support processes.