Joint Standing Committee on Foreign Affairs, Defence and Trade Inquiry into transition from the Australian Defence Force

Joint Standing Committee on Foreign Affairs, Defence and Trade Inquiry into transition from the Australian Defence Force

Joint Standing Committee on Foreign Affairs, Defence and Trade Inquiry into transition from the Australian Defence Force

Joint Standing Committee on Foreign Affairs, Defence and Trade Inquiry into transition from the Australian Defence Force Joint Submission Department of Defence Department of Veterans’ Affairs July 2018 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

TABLE OF CONTENTS EXECUTIVE SUMMARY . . 1 INTRODUCTION . . 8 Defence Transition Transformation Program - Improvements in the ADF Transition Process ...9 DVA’s Transformation . . 11 Joint Defence/ DVA Transition Taskforce . . 12 The future of transition . . 12 TERM OF REFERENCE 1 - The barriers that prevent ESOs from effectively engaging with ADF members, the Department of Defence and Department of Veterans’ Affairs to provide more effective support to ADF personnel as they transition out of Service .

. 14 Defence engagement with ESOs . . 14 DVA engagement with ESOs . . 16 Ex-Service Organisation Round Table (ESORT . . 18 Recommendations of the Senate Standing Committee Report - Mental Health of Australian Defence Force members and veterans and current programs within the ADF . . 19 Prime Minister’s Veterans’ Employment Program (PMVEP . . 20 Ex-Service Organisation Initiatives . . 20 Conclusion . . 20 TERM OF REFERENCE 2 – The model of mental health care while in ADF Service and through the transition period to the DVA . . 21 Mental Health Reform in Defence . . 21 Defence’s approach to mental health and wellbeing – Fit to Fight, Fit to work and Fit for Life21 Mental Health Services in Defence .

. 22 Data and Evidence of Success . . 25 Health Aspects of Transition . . 26 What is Defence Doing to Improve Mental Health Care and Transition Health Support to Serving ADF Members . . 28 Ongoing Research . . 29 DVA support for transitioning members with a mental health conditions . . 30 DVA activities supporting prevention, early intervention and self-management . . 31 Social health and community connectedness . . 31 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

ii July 2018 DVA funded clinical services . . 32 DVA acute mental health services and PTSD programs . . 32 DVA rehabilitation services . . 32 Strengthening suicide prevention efforts . . 32 Improving access to services . . 33 Breaking down barriers and building pathways to care . . 35 Innovation and emerging treatments . . 35 Continuing to support research . . 35 Strengthening Workforce Capacity . . 36 Veterans and Veterans’ Families Counselling Service (VVCS . . 36 Support for families and carers . . 37 Other mental health awareness training and support . . 38 Post-transition follow-up contact with ADF members .

. 39 Transition for Employment (T4E) program . . 39 Additional information for the Committee’s consideration . . 40 TERM OF REFERENCE 3 – The efficacy of whole-of-government support to facilitate the effective transition to employment in civilian life of men and women who have served in the ADF . . 42 Transition Preparation Phase . . 42 Transition Phase . . 46 Financial support . . 53 Compensation payments . . 53 Income support . . 53 Post-Transition Phase . . 53 External education and training opportunities . . 55 Employment initiatives . . 55 TERM OF REFERENCE 4 – Any related matters . .

58 Women in the ADF . . 58 Reserves . . 58 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

iii July 2018 Eligibility for transition support . . 58 ADF Transition Partnership . . 59 Resourcing in ADF Transition Centres . . 59 DVA/Defence joint initiatives to deliver integrated approaches to transition services . . 59 DVA transition support . . 60 Coordinated Client Support program . . 61 Productivity Commission Issues paper - Compensation and Rehabilitation for Veterans – May 2018 . . 61 ADF Transition – Success stories beyond a military career . . 62 LIST OF ATTACHMENTS . . 64 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

1 July 2018 EXECUTIVE SUMMARY 1.

The Department of Defence (Defence) and the Department of Veterans’ Affairs (DVA) (the Departments) welcome the Joint Standing Committee on Foreign Affairs, Defence and Trade Parliamentary Inquiry into transition from the Australian Defence Force (ADF). 2. The key focus for Defence is on training and retaining ADF members to deliver Defence capability on behalf of Government. Defence has a well-regarded training continuum that seeks to retain individuals with the key skills and attributes to fight and win. However, Defence also recognises that transition is inevitable and that between 5,500 and 6,000 members leave the ADF annually.

Of those, the vast majority do so voluntarily, with approximately 20 per cent transitioning for medical reasons.

3. The Departments recognise that leaving the military is a significant life changing event for many ADF members and their families and that both agencies need to provide sufficient support and management before, during and post transition to ensure our veterans and their families transition successfully into civilian life. 4. Defence retains a duty of care for its members and has a commensurate support role for their family, up to and including the date of transition, and on occasion for a period post transition. A member joining the ADF becomes a DVA client on enlistment or appointment and after one days full time service can access DVA services such as Non Liability Health Care for mental health conditions.

Defence and DVA recognise the need to engage and encourage the broader Australian community to recognise the service and sacrifice ADF members and their families make, and to facilitate better reintegration into civilian life. 5. Within Defence, all Commanding Officers must consider the welfare of ADF members under their command. Transition is a shared responsibility of Command and the ADF member. Participation in the transition process is mandatory for all ADF members regardless of the reason for leaving. ADF members and their families, and by extension Commanders, are supported through a comprehensive transition process and access to transition support.

6. Throughout the 100-years of DVA (including its predecessor, the Department of Repatriation) and the Repatriation Commission, the broad notion of ‘repatriation’ – returning servicemen and women to civilian society and honouring their sacrifice – has informed all of DVA’s primary roles.

7. A fundamental role of DVA has been providing a substantial part of the “offer” made by the Nation to each service member. This offer recognises the willingness of the enlistee to commit to service, be subjected to military discipline, and to be placed in harm’s way for Australia. Veterans and their families enrich our communities, and the Australian Government will look after them during and after service. 8. The experience of transition varies. Noting ADF members receive unique and valuable training throughout their career with Defence, and the skills they have learned during their service are transferable and in demand, many members transition successfully and quickly re-establish civilian lives.

9. For some though, transitioning from the ADF is not as easy or positive as it could be, and these individuals and their families may face complex social, financial, employment and wellbeing challenges. This is particularly the case if they enlisted at a young age with little experience of adult civilian life or employment. 10. Barriers to successful transition can include a member’s level of control over the decision to leave military service, their awareness of, and access to, transition-related information and services, and unpreparedness to manage the differences between the military environment and civilian life, include loss of identity.

Inquiry into transition from the Australian Defence Force (ADF) Submission 33

2 July 2018 11. The Australian Government, through Defence and DVA, is focussed on improving the way veterans’ transition into civilian life. Significant investment has been made to promote and provide further transition support and veterans’ employment services. 12. The departments recognise however, that further work is needed to ensure all transitioning ADF members can access appropriate support when they need it, support services are streamlined and seamless across agencies, and that there are multiple opportunities throughout the transition process for transitioning members to engage with support services.

13. Defence and DVA invite the Chair and members of the Joint Standing Committee on Foreign Affairs, Defence and Trade to visit the Canberra ADF Transition Centre at the Defence Community Organisation (DCO) Headquarters in Deakin, ACT. Defence would be pleased to provide a detailed briefing on the current and planned future state of the ADF transition process. DVA will also provide a briefing on the DVA support provided during and post transition. Background - where we have come from 14. Historically, the Departments have not always operated as collaboratively as could have been the case. For some time there was a marked differential where Defence was responsible for members until they left the ADF, and DVA provided services and support to those who reached out for it post leaving the ADF.

This approach by the Departments resulted in a lack of information sharing and collaboration with each agency focusing on their own processes and systems, rather than ensuring the member’s needs were considered more holistically. It was also borne out in a lack of focus on the families.

15. From 2011, greater collaboration commenced with the establishment of the On Base Advisory Service (OBAS). DVA staff are located at ADF bases to provide advice and information about DVA services to members. Since then, the breadth and tempo of the collaboration between Defence, DVA and others to provide a more collaborative approach to transition support has increased. Current - what we are doing 16. More recently, the Departments have invested in significant transformation programs to improve the interactions of ADF members and their families with each Department. 17. Defence and DVA are: • working together to implement the Government’s 2016 election policy to Support Veteran’s and their Families - Creating a Better Veteran’s Transition Process; • collaborating through a joint Transition Taskforce to identify opportunities to improve the transition process and experience • piloting new initiatives to deliver integrated approaches to transition services, including the Transition Health Assessment, the Special Operations Forces and Case Management pilots • sharing information, increasing the opportunity for DVA to engage with transitioning members to proactively offer support; for example: o under the Early Engagement Model, members who joined the ADF from 1 January 2016, and those who transitioned after 27 July 2016, are now automatically registered with DVA o the information provided under this Model is enabling DVA White Cards to be issued automatically to members transitioning from permanent service, facilitating easier access to mental health support o since 2014, all transitioned members receive a letter from the Secretary of DVA about the services and support available through DVA Inquiry into transition from the Australian Defence Force (ADF) Submission 33

3 July 2018 • better supporting medically transitioning members through a more connected rehabilitation system • working together to improve the mental health and wellbeing support provided to members and their families during and after military service, and • conducting joint research to develop our understanding of veterans’ needs, particularly in relation to mental health. 18. Recently, Defence has made the following significant enhancements to the support available to transitioning ADF members and their families: • reinforced the mandatory engagement by ADF members with the ADF Transition process when leaving Defence • refresh of the nationally delivered Transition Seminars to encourage family participation • targeted family involvement through all aspects of transition • coaching and mentoring support delivered by qualified career development practitioners • one-on-one support provided during transition and for up to twelve months after leaving Defence for ADF members and their families including: o advice and guidance to members in completing Transition Clearance requirements o development of a tailored Transition Plan o transition and career coaching o support to engage with relevant internal and external agencies o referral to Ex-Service Organisations (ESOs), as appropriate.

• support for transitioning ADF members to have access to the following documentation: o an individual transition plan o record of Professional Military Education and Training o Unit posting and employment history o final payment and leave entitlement summaries o copies of medical and dental records o ADF Will (if applicable). • comprehensive and plain language ADF Member and Family Transition Guide – A Practical Manual to Transitioning (ref Attachment 2 – ADF Member and Family Transition Guide) • future employment support under the Career Transition Assistance Scheme (CTAS): o Job Search Preparation workshops (for members with less than 18 years’ service).

o CV Coaching o Career Transition Management Coaching o Career Transition Training o financial counselling o Approved Absence (up to 23 days). • post-transition follow up for 12 months after transition through: o 30-day follow up phone calls Inquiry into transition from the Australian Defence Force (ADF) Submission 33

4 July 2018 o quarterly electronic surveys. • consolidated reporting of transitioned ADF members to internal and external agencies to support early engagement • collaboration with Transition Stakeholders specifically external Government, ESOs, and not for profit organisations • access to the Transition for Employment (T4E) program for ADF members with complex medical conditions 19. An essential component of a successful transition for an ADF member and their family is receiving appropriate recognition for their service to the Nation and for the sacrifices they have made. This recognition should be delivered by the military and, to this end, Defence is strengthening its existing practice by integrating Military Transition Support Officers into the transition coaching model.

The intent is that these military members will provide the military element of transition and achieve a more positive experience for transitioning ADF members and their families through: providing regular and consistent Unit briefings to Commanding Officers and ADF members, supporting the delivery of transition support services and importantly, facilitating recognition of the transitioning ADF.

20. DVA’s transformation to meet the current and future needs of all veterans and their families is of relevance to the inquiry. In the 2017-18 Budget, the Australian Government provided $166.6 million over four years for transformation. An additional $111.9 million has been provided in the 2018-19 Budget. In its first year, transformation has improved the ease and speed with which current and former serving members can submit claims and have liability for conditions assessed. The future – what we intend to do 21. Both Departments are exploring new methods to facilitate better outcomes for ADF members and their families who transition in the future.

22. Defence and DVA are reviewing the current support services provided to ADF members and their families both pre and post transition with a view to streamlining and enhancing support where practical, with a specific focus on improving family engagement and employment outcomes. The Departments will consider international military transition programs to leverage insights and innovative practices. 23. The Departments see significant value in a greater level of partnership with organisations that can offer opportunities to transitioning and transitioned veterans and their families. 24. Under the auspices of the Prime Minister’s Veterans’ Employment Program, business may also play a greater role in the transition process.

Most ADF members will transition with valuable leadership, management and individual attributes that Australian industry should recognise as adding value to their organisation.

25. The Departments are investigating opportunities to better prepare ADF members and their families for transition. For example, having conversations early on in a member’s career about their personal goals. This would provide a platform to have meaningful and goal based conversations about personal and professional development. 26. The Departments recognise that families are a fundamental source of support for the ADF member and they too are impacted by ADF service and transition. • Defence now invites the partners of ADF members to participate in transition coaching sessions. In addition, Defence encourages Defence partners and family members to attend ADF Transition Seminars.

Inquiry into transition from the Australian Defence Force (ADF) Submission 33

5 July 2018 • Defence is currently revising the format of ADF Transition Seminars to make them more family friendly. In addition, Defence is placing transition seminar content online to make the transition information more accessible for family members. • the Government’s Family Support Package provides extended childcare assistance and counselling for veterans’ immediate family members. • the Veterans’ Families Policy Forum provides an opportunity for veterans’ families to engage with Government and DVA about their needs and experiences.

Learnings from forums such as this are informing future DVA policy direction and support arrangements. 27. Defence and DVA aim to provide an optimal transition experience which ensures tailored assistance and easy to access support services, meaningful interactions, simplified processes and person-centric services. The Departments are committed to achieving the best possible outcomes and will continue their reform efforts to address barriers to an effective transition, and provide certainty in what is an uncertain time.

Terms of Reference 28. Term of Reference 1 considers engagement with Ex-Service Organisations. The Departments recognise the importance of the services and support provided by Ex-Service Organisations (ESOs) to ADF members and their families, during service, transition and in civilian life. 29. The 2016 Aspen Foundation report, Ex-Service Organisation Mapping project – Final Report, mapped the services provided by ESOs and ESO-like organisations. This report highlights the complexity of the ESO landscape, identifying approximately 2,780 ESO locations around Australia. The number, location, differing level of skill and differing services is potentially a barrier to effective and efficient engagement with the ESO community as a homogenous group.

30. The Departments continue to work with ESOs using several different methods of engagement to address perceived barriers between ESOs and the Departments, and ADF members while they serve, and as they transition.

31. Some current ADF units and individual ADF members, are members of ESOs, or support ESOs through formal fund-raising and other support activities. Likewise, many ESOs are able to provide support to military units, ADF members and their families while they are still serving, during their transition, and post transition in civilian life. 32. Term of Reference 2 considers the model of mental health care while in ADF service and through the transition period. Defence is an active leader in Australia in the area of workplace mental health reform. The Departments work closely to support transitioning members and their families who require support during and post their transition.

33. Defence invests approximately $53 million each year to provide a range of mental health education awareness, evidence-based treatment and rehabilitation programs, for all ADF members, no matter the cause of their mental health problems. ADF members are provided with health services, including mental health, treatment and rehabilitation support prior to, during and post-deployment designed to enhance their ability to cope with the challenges of deployment and to improve their capacity for effective transition back into work and family life. 34. DVA funds mental health treatment services through the broader Australian health care system.

Annual spending on supporting the mental health needs of eligible veterans is in the vicinity of $200 million. Funding for mental health treatment is uncapped, meaning there is funding available to meet demand, and there are no restrictions on an individual veteran’s access to services.

35. The 2017-18 Budget delivered an additional $58 million in mental health support, including a further expansion of non-liability mental health care to anyone who has served at least Inquiry into transition from the Australian Defence Force (ADF) Submission 33

6 July 2018 one day of continuous full-time service in the ADF. Families of those eligible for non-liability mental health care now also have access to the range of counselling and support services offered through the Veterans and Veterans’ Families Counselling Service (VVCS). 36. Defence, through Joint Health Command (JHC), delivers comprehensive health care to meet all the health needs of its members, ensuring ADF members have access to high quality, evidence-based health care wherever they serve.

37. Defence continues to improve and evolve its approach to mental health and wellbeing in the ADF. The Defence Mental Health and Wellbeing Strategy 2018-23 (the Strategy), consolidates and builds on Defence experience and delivers on its commitment to develop a whole-of-organisation approach to improving the mental health and wellbeing of all Defence personnel. The Strategy reflects the findings of recent reviews and inquiries into issues of mental health and suicide prevention amongst current and former members of the ADF. Importantly it also aligns with the Fifth National Mental Health and Suicide Prevention Plan (2017-2022) and incorporates the latest mental health research.

38. Through Joint Health Command, Defence will maintain a focus on continual improvement of mental health programs and the Defence mental health care model to ensure they remain responsive to the emerging needs of ADF members and support the capability requirements for Defence. 39. The Departments continue to monitor emergent evidence-based practice and use results from its research to improve its programs for current and former ADF members. Defence is working closely with DVA to develop mental health awareness initiatives, research, and improved transition processes that are based on the evidence gathered through these studies.

40. The Departments will also continue to collaborate on research, programs and initiatives to strengthen mental health resilience, increase awareness and early recognition of mental health problems, improve access to care and strengthen continuity of health care arrangements where these are required. This particularly applies to the crucial period during which ADF member’s transition from military service into civilian life. Defence is committed to providing flexible health support to transitioning military members, including those who need to transition at short notice for medical or compassionate reasons.

41. Term of Reference 3 considers whole-of-government support to facilitate effective transition to employment. There have been substantial improvements recently by the Departments focussed on increasing employment opportunities for ADF members as they transition. The introduction of the Prime Minister’s Veterans’ Employment Program, Defence’s Job Search Preparation workshops and the ADF transition coaching service delivery is helping to increase the probability of ADF members securing civilian employment after military service where appropriate.

42. In 2017, Defence commenced a series of surveys post transition to better understand transition outcomes for ADF members.

The survey results are assisting to introduce business improvements and focus on those members who require greater support. Through the new transition service delivery model, 4,608 planning sessions and 4,295 individual coaching sessions have been conducted with ADF members and their families. This includes 50 coaching sessions provided to members after they left Defence. 43. As at 2 May 18, approximately 160 former ADF members have been connected with further support as a result of post-transition contact by Defence. 44. Through these surveys there is now evidence available which demonstrates that the majority of transitioned ADF members are meaningfully engaged with 11 per cent advising that they are ‘looking for work’ four months after they leave Defence.

A few responses have been collected at the 10 and 13 month post-transition point; however they are small in volume. The Inquiry into transition from the Australian Defence Force (ADF) Submission 33

7 July 2018 trends reflected at these points in time indicate that in the first 10 months post transition the ‘looking for work’ rate is about 8 per cent. 45. These statistics align with the findings of the 2017 Transition and Wellbeing Research Programme which indicate that approximately 84 per cent of the transitioned Defence members who participated in the study were either working or engaged in purposeful activity, and a further 5.5 per cent were retired. 46. Term of Reference 4 considers any related matters. The Departments have provided additional matters for the Committee’s consideration, including commentary regarding the transition of women from the ADF, Reservists, and the eligibility for transition support.

Inquiry into transition from the Australian Defence Force (ADF) Submission 33

8 July 2018 INTRODUCTION 1. Within Defence, all Commanding Officers must consider the welfare of ADF members under their command. Transition from the ADF is an inevitable part of every member’s career and is a shared responsibility of Command and the member. Participation in the process of transition is mandatory for all ADF members, regardless of the reason for leaving Defence. 2. ADF members and their families, and by extension Command, are supported through the transition process by Defence (Defence Community Organisation and Joint Health Command) and the Department of Veterans’ Affairs (DVA).

3. Defence provides comprehensive health and welfare support through transition to all ADF members. The ADF Transition support services are available to all members and their families regardless of their reason for leaving. The goal of Defence’s transition support is to ensure that the ADF member and their family are well prepared for civilian life, such as having civilian health care in place, having considered the financial implications of transition, are connected to relevant community groups (including Ex-Service Organisations (ESOs)) and, where appropriate, are able to secure civilian employment.

4. Throughout the 100-years of DVA (including its predecessor, the Department of Repatriation) and the Repatriation Commission, the broad notion of ‘repatriation’ – returning servicemen and women to civilian society and honouring their sacrifice – has informed all of DVA’s primary roles. 5. A fundamental role of DVA has been providing a substantial part of the “offer” made by the Nation to each service member. This offer recognises the willingness of the enlistee to commit to service, be subjected to military discipline, and to be placed in harm’s way for Australia. Veterans and their families enrich our communities, and the Australian Government will look after them during and after service.

6. DVA supports ADF members through their career, transition and after military service by delivering key programs for veterans and their families to: • maintain and enhance the financial wellbeing and self-sufficiency of eligible persons and their dependants through access to income support, compensation, and other support services including advice and information on entitlements • maintain and enhance the physical wellbeing and quality of life of eligible persons and their dependants through health and other care services that promote early intervention, prevention and treatment, including advice and information about health service entitlements 7.

In financial year 2016-17 a total of 5,904 members left the ADF. This included: • 3,045 who left voluntarily (52 per cent) • 1,192 who left for medical reasons (20 per cent) • 839 who completed a continuous full time service contract (14 per cent) • 693 who left for involuntary reasons (12 per cent - includes failure to complete training and disciplinary reasons) • 72 who left through management initiated actions (1 per cent - including redundancy, managed early retirement and command initiated transfer to Reserves), and • 63 who reached compulsory retirement age (1 per cent). Inquiry into transition from the Australian Defence Force (ADF) Submission 33

9 July 2018 Defence Transition Transformation Program - Improvements in the ADF Transition Process 8. Since 2008, Defence has provided a transition support service for all ADF members and their families leaving the military. This includes members leaving for medical reasons, Reserve members on Continuous Full Time Service and ADF Gap Year members. 9. Since 2012, transition support services have been delivered through Defence People Group, managed by DCO, under the banner of ADF Transition. This service ensures that ADF members and their families are well informed regarding transition, and are encouraged to access educational, financial, rehabilitation, compensation and other government services to facilitate sound transition planning.

10. In June 2016, the Coalition published the Coalition’s Policy to Support Veterans and Their Families. The policy was a catalyst for change within Defence and across Government and improved interagency collaboration. The Transition Transformation Program is part of Defence’s response to the Coalition policy. 11. The Transition Transformation Program is ensuring that the level of support provided to ADF members and their families targets its effort towards those most in need, based on criteria such as finding employment, continuity of healthcare and social connectedness. This personalised service helps ADF members better prepare for and integrate into civilian life.

12. The Transition Transformation Program identified a range of business improvement projects for ADF Transition. Each project initiative is designed to improve the transition experience for ADF members and their families (ref Attachment 1 – Transition Transformation Placemat).

13. Improvements to the transition process continue and the following will be implemented by Defence in 2018: • redesign of the ADF Transition Seminar including changing the format to increase participation, changing content to meet contemporary needs and making parallel online content available for ADF members and their families who cannot attend a Seminar in person • development of online transition support tools and interactive content which: o targets families to better inform them of the transition process and support available o provides information and useful lessons on career coaching o promotes and identifies benefits available under the Career Transition Assistance Scheme (CTAS), which is a suite of services to facilitate transition to civilian employment through training and financial support.

• implementation of the Transition National Support team in order to simplify administrative processes, and release Defence’s qualified Transition Coaches to concentrate on the career development and coaching of transitioning members and their families. • continued efforts to improve access to qualifications and training records as well as medical records • delivery of additional resources for transitioning ADF members to assist them in translating and explaining their skills and experience in plain language for civilian employers Inquiry into transition from the Australian Defence Force (ADF) Submission 33

10 July 2018 • review of the Career Transition Assistance Scheme with a view to ensuring that provides contemporary support and is flexible, equitable and accessible by all ADF members and their families regardless of their length of service or reason for leaving, and • pilot of the Transition for Employment (T4E) program. This program will support transitioning ADF members, with complex medical conditions, in the employment element of their transition by building resilience and an enduring capability to secure and maintain employment post transition.

14. The following table demonstrates the significant enhancement in recent years regarding the support available to transitioning ADF members and their families: Transition Support as at 2012 Transition Support as at 2018 • Two-day Transition Seminars delivered nationally for ADF members and their families.

• One-on-one transition support to meet Defence’s mandatory administrative transition requirements including: o Advice and guidance to members in completing Transition Clearance requirements; o Provide final pay and leave checks o Individual confirmation of separation to Career Management Agency via signals.

• Future employment support under the CTAS including: o CV Coaching Career Transition Management Coaching o Career Transition Training o Financial Counselling o Approved Absence (up to 23 days). • Linkages to internal Defence and external agencies, including Ex-Service Organisations (ESOs). • Transition information through the ADF Transition Guide • On base presence of DVA through the On-Base Advisory Service (OBAS). • Transitioning members receive a form allowing them to opt-in to receiving contact from DVA or VVCS.

• Mandatory engagement by ADF members with ADF Transition when leaving Defence.

• Two-day Transition Seminars delivered nationally for ADF members and their families. • Targeted family involvement through all aspects of transition. • Coaching and mentoring support delivered by qualified career development practitioners. • One-on-one support provided during transition and for up to twelve months after leaving Defence for ADF members and their families including: o advice and guidance to members in completing Transition Clearance requirements o development of a tailored Transition Plan o transition and career coaching o support to engage with relevant internal and external agencies o referral to ESOs, as appropriate.

• Support for ADF members to have access to the following documentation: o an individual transition plan o record of Professional Military Education and Training o Unit posting and employment history o final payment and leave entitlement summaries o copies of medical and dental records o ADF Will (if applicable). • Comprehensive and plain language ADF Member and Family Transition Guide – A Practical Manual to Transitioning (ref Attachment 2 – ADF Member and Family Transition Guide), which also details the services available through DVA. • Future employment support under CTAS: Inquiry into transition from the Australian Defence Force (ADF) Submission 33

11 July 2018 Transition Support as at 2012 Transition Support as at 2018 o Job Search Preparation workshops for members with less than 18 years’ service. o CV Coaching o Career Transition Management Coaching o Career Transition Training o Financial Counselling o Approved Absence (up to 23 days). • Post transition follow up for 12 months after transition through: o 30-day follow up phone calls o quarterly electronic surveys. • Consolidated reporting of transitioned ADF members to internal and external agencies to support early engagement.

• Collaboration with Transition Stakeholders specifically external Government, ESOs, and not-for-profit organisations.

• Access to the Transition for Employment program for ADF members with complex medical conditions. • Pilot of the ‘Transition Health Assessment’. • Continued on base presence of DVA through OBAS across more than 40 bases nationally. • All transitioning members are registered with DVA through the Early Engagement Model and automatically provided with a White Card. • Transitioned members receive a letter from the Secretary of DVA and a brochure about the services available through DVA. • DVA participates in individual Welfare Boards to better coordinate support for medically transitioning members.

DVA’s Transformation 15. DVA’s transformation to meet the current and future needs of all veterans and their families is of relevance to the inquiry. In the 2017-18 Federal Budget, the Australian Government provided $166.6 million over four years for transformation. An additional $111.9 million has been provided in the 2018–19 Budget. In its first year, transformation has improved the ease and speed with which current and former serving members can submit claims and have liability for conditions assessed: 16. MyService - provides DVA clients with a simple and convenient way to lodge an initial liability compensation claim online, and it also provides free mental health treatment claims, free needs assessments, and an electronic health card which specifies the conditions it covers.

17. Straight-Through Processing (STP)- training and service data and information provided by Defence are used to immediately satisfy DVA’s specified Statements of Principles factors for certain medical conditions. Where STP applies, claimants do not need to provide information Inquiry into transition from the Australian Defence Force (ADF) Submission 33

12 July 2018 about their specific service activities, reducing the time taken by DVA to assess liability. There are currently 40 conditions that are automatically assessed using STP and streamlining rules. 18. A key priority for DVA’s transformation is engaging with Defence and a broad range of veterans to co-design and implement new services and programs. 19. DVA utilises a variety of engagement methodologies to better understand the experience of current and potential clients, such as focus groups, one to one interviews and other collaborative design engagements.

20. Over the past year, DVA has consulted with over 1,700 veterans about the changes needed.

New engagement fora, such as the Female Veterans and Veterans Families Policy Forum have been created so that issues can be raised and the Government and DVA can gain a deeper appreciation of them. Joint Defence/ DVA Transition Taskforce 21. The Departments are working together to implement the Government’s 2016 election commitment Creating a Better Veteran’s Transition Process to Support Veterans’ and their Families. This commitment included establishing a joint Transition Taskforce to identify barriers to successful transition and develop recommendations to address those barriers. 22. The Taskforce is made up of current and former serving ADF members and representatives from key areas within Defence, DVA and the Commonwealth Superannuation Corporation (CSC), and representatives from the ex-service community.

23. The Taskforce engaged with approximately 600 transitioning and recently transitioned veterans and their families to better understand the transition experience. The Taskforce also sought the views of ex-service organisations, government stakeholders, and other relevant professional organisations.

24. Barriers to successful transition can include a member’s level of control over the decision to leave military service, their awareness of, and access to, transition-related information and services, and unpreparedness to manage the differences between the military environment and civilian life, include loss of identity. 25. A key barrier identified to a positive transition experience is the importance of a formalised military farewell and recognition of a member’s service as part of their transition. Consequently, Defence is strengthening its existing practice by providing a Military Transition Support Officer (MTSO) to be located in each Transition Centre to appropriately farewell an ADF member and recognise their involvement within the ADF.

Defence’s intent is that in 2018 all ADF Transition Centres will have access to an MTSO to support and deliver this approach. The future of transition 47. Defence and DVA are reviewing the current support services provided to ADF members and their families both pre and post transition, with a specific focus on family engagement and civilian employment. The Departments will consider international military transition programs to leverage insights and innovative practices.

48. The Departments see significant value in a greater level of partnership with organisations that can offer opportunities to transitioning and transitioned veterans and their families. 49. The Departments are investigating opportunities to better prepare ADF members and their families for transition. For example, having conversations early on in a member’s career about their personal goals. This would provide a platform to have meaningful and goal based conversations about personal and professional development.

50. The Departments recognise that families are a fundamental source of support for the ADF member and they too are impacted by ADF service and transition.

Inquiry into transition from the Australian Defence Force (ADF) Submission 33

13 July 2018 51. Defence and DVA aim to provide an optimal transition experience which ensures tailored assistance and easy to access support services, meaningful interactions, simplified processes and person-centric services. The Departments are committed to achieving the best possible outcomes and will continue their reform efforts to address barriers to an effective transition, and provide certainty in what is an uncertain time. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

14 July 2018 TERM OF REFERENCE 1 - The barriers that prevent ESOs from effectively engaging with ADF members, the Department of Defence and Department of Veterans’ Affairs to provide more effective support to ADF personnel as they transition out of Service 1.

Defence and DVA recognise the importance of the services and support provided by Ex-Service Organisations (ESOs) to ADF members and their families, during service, transition and in civilian life. Engagement with ESOs is facilitated through a number of individual, collective and Departmental activities across Defence and DVA.

2. The Departments work with ESOs using several methods of engagement to provide effective support to ADF members as they transition. 3. Some current ADF units and individual ADF members belong to or support ESOs through formal fund-raising and other support activities. Likewise, many ESOs provide support to units and ADF members and their families whilst they are still serving. 4. The 2016 Aspen Foundation report, Ex-Service Organisation Mapping project – Final Report, mapped the services provided by ESOs and ESO-like organisations. The report highlights the complexity of the ESO landscape, identifying approximately 2,780 ESO locations around Australia.

The number, location, differing level of skill and services is potentially a barrier to effective and efficient engagement with the ESO community as a homogenous group. Defence engagement with ESOs 5. Defence works hard to build and enhance relationships with ESOs to assist ADF members and their families throughout their military careers, and help facilitate the transition of ADF members back into the community.

6. ADF members and their families are made aware of the services and support available through ESOs throughout their ADF career via various mechanisms such as regional Welcome Events, base open days, unit family days, structured briefings and regional level partnerships. 7. Following are instances where the Departments actively engage with and promote ESOs, including but not limited to providing information on ESO contact details, programs offered and the benefits of engaging with ESO advocates. Engage website – Supporting Those Who Serve 8. The Engage website (https://engage.forcenet.gov.au/) built and hosted by Defence, was launched in August 2017 by the Minister for Defence Personnel.

Through Engage, current and former ADF members, their families and/or those involved in their support are able to navigate a broad range of websites in search of information, support and services from Government agencies, not-for-profit service providers, ESOs and charities that choose to participate. 9. Engage simplifies the process of accessing support by providing a common entry point or ‘one-stop shop’ that is electronically accessible from a range of platforms. 10. Defence encourages ESOs to advertise their employment services for ex-ADF members on the Engage website by registering as a service provider.

ESO service providers are responsible for maintaining accurate and up-to-date data on the site 11. As at 19 June 2018, 36 ESOs have registered as a service provider on the Engage website. ADF Transition Centres 12. The 13 ADF Transition Centres which are located nationally promote, without prejudice, ESOs and the services and benefits they provide.

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15 July 2018 13. Details of ESOs and their services are provided to transitioning ADF members and their families during individual transition coaching sessions and pre and post transition, where there is an identified need for support services. 14. ESOs are also encouraged to provide copies of their promotional material to their local ADF Transition Centre for display and distribution to members. 15. Many ADF members and their families relocate during or after they transition and ADF Transition Coaches share information through an internal online library about the different ESOs and their support services.

This ensures that, regardless of where the member and their family will live after they have left Defence, they have access to information about local ESOs and services. ADF Transition Seminars 16. ESO services and support for ADF members are featured at every ADF Transition Seminars and ESOs are welcome to set up as a stall holder at the trade expo component of the seminar.

17. As part of transition support, Defence offers all members the opportunity to undertake an ADF Transition Seminar at any time in their career and promotes ESO services and support for ADF members through these seminars and ADF Transition Centres. 18. Each year Defence conducts 23 two-day Transition Seminars nationally. Attendance at a Transition Seminar is recommended every five years and in the twelve months prior to leaving Defence. 19. Any ADF member, their family or support person, is able to attend a transition seminar regardless of whether they are transitioning or not. Preference for attendance is given to those who are leaving for medical reasons and those with an upcoming transition date.

ADF members, families and support persons can attend as many transitions seminars as they feel are necessary throughout their military career.

20. Presenters at the transition seminars include representatives from: the ADF Financial Service Consumer Centre, DVA; Veterans and Veterans Families Counselling Services (VVCS); CSC; ADF Financial Services Consumer Centre; Joint Health Command; ADF Rehabilitation Program; and Navy, Army and Air Force Reserve Services (ref Attachment 3 – ADF Transition Seminar Program). 21. At each seminar, a video overview of ESOs and the general services they provide is presented. The video presentation provides details of ESOs, including the RSL and Legacy, which are able to support the member during and after their transition.

This video was produced by Defence to provide consistent messaging of the benefits of ESOs.

22. To support the seminars, Defence invites ESO and other not-for-profit organisations, including ESOs that support veterans, as well as organisations contracted to support the ADF, to participate in the trade expo component of the Transition Seminar for attendees to discuss their needs and the services available in more depth. 23. Organisations that regularly participate include ESOs, such as RSL, Soldier On, Legacy, Women’s Veterans’ Network Australia, Bravery Trust and Mates4Mates. In addition, other organisations which are important for transitioning ADF members and their families are invited as exhibitors.

These organisations include DVA, VVCS, the CSC, the Department of Human Services, Defence Housing Australia (DHA), Defence Housing Relocations Directorate, TOLL Transitions, Defence Community Organisation, Defence Health, and Navy Health. Career Services consultants who have a formal procurement arrangement with Defence are also able to participate. State and Territory Governments and their educational institutions (for example, TAFE) are also able to attend.

24. Transition Seminars are advertised through ADF Transition Centres; DCO’s Transitions website at www.defence.gov.au/dco/transition/; the Defence Restricted Network (DRN) Inquiry into transition from the Australian Defence Force (ADF) Submission 33

16 July 2018 homepage ‘Spotlight’; social media; Defence Families Australia (DFA); Welcome Day events; and regionally through appropriate communication channels. Medical Transition Forums 25. Since 2016 Defence has been piloting Medical Transition Forums in Brisbane and Townsville. The forums deliver targeted information to ADF members who are transitioning from the service for medical reasons.

They are delivered in a more flexible and supportive format than the regular ADF Transition Seminars to accommodate the needs of members with medical conditions.

26. Content is more focussed upon services and benefits through DVA and the Commonwealth Superannuation Corporation (CSC). There is also an enhanced focus on the information and support services delivered by ESOs to members and their families. The pilot will continue until the end of 2018, with a view to implementation nationally. 27. Initial feedback from the pilot Forums indicates the format and content delivered are of benefit to ADF members transitioning for medical reasons. Soldier Recovery Centres 28. Soldier Recovery Centres have been established by Army on a number of Defence bases to support, wounded, injured and ill members.

A number of ESOs, including RSL, Mates4Mates and Soldier On, work in partnership with Defence to deliver programs and information to assist in the effective rehabilitation or transition of ADF members under the Soldier Recovery Centre banner. Although established by Army, the Soldier Recovery Centres can if required also support Navy and Air Force members. Navy also has Personnel Support Units (PSU) around the country that perform a broad range of functions in support of wounded, injured or ill members. 29. DVA provides direct support to the SRCs, including hands-on assistance with program delivery at the Enoggera and Robertson bases.

Ex-Service Organisation social media platforms 30. Defence promotes ESO events and activities to ADF members and their families through DCO’s Facebook, Twitter and Instagram accounts, as well as the DCO website. 31. Over the last 12 months there was an average of two ESO-related posts per month across all social media platforms. Posts included events, articles, post-event imagery and video from shares, re-Tweets and bespoke content (ref Attachment 4 – ESO promotion on DCO Social Media). 32. The DCO website also has a calendar of events that includes events and activities for ADF members and their families.

It includes DCO activities and joint events hosted by DCO and ESOs. 33. Due to the high number of ESOs, not all are listed on the DCO website. However, ADF members and their families are able to access information about ESOs through the Defence Engage website (https://engage.forcenet.gov.au/). DCO will continue to support awareness of ESOs through social media and the DCO website.

34. Defence looks forward to continuing to partner and spotlight ESOs, and highlight the support they provide for ADF members and their families. DVA engagement with ESOs 35. DVA formally engages with a range of ESOs through national, state and territory forums under the National Consultation Framework. This formal consultative framework is designed to facilitate effective communication between the veteran and ex-service community and DVA and includes the Ex-Service Organisation Round Table, the Younger Veterans - Contemporary Needs Forum, the National Aged and Community Care Forum, and the Female Veterans and the Inquiry into transition from the Australian Defence Force (ADF) Submission 33

17 July 2018 Veterans’ Families Policy Forums. There are also state forums in each State and Territory, allowing the DVA to engage with the ex-service community. 36. DVA also assists ex-service organisations through a range of grants that can be used to fund programs and activities to better support current and former serving members. These include: • the Building Excellence in Support and Training grants program which supports ESOs to provide compensation and welfare assistance to the veteran and Defence community. It also links closely to the Advocacy Training and Development Program, which provides the essential skills for claims, advocacy and welfare work • The Supporting Younger Veterans grants program which provides funding to ESOs to encourage partnerships that will deliver innovative and sustainable services for younger veterans and build community capacity to meet the needs of younger veterans • The Grants-In-Aid program which aims to encourage co-operation and communication between the ex-service community, ESOs and the Australian Government and also aims to encourage the advancement of the objectives of ESOs • Veteran and Community Grants (V&CG) which provides funding for projects that support a healthy, quality lifestyle for members of the veteran community, assists them to remain living independently in their own homes, reduces social isolation, supports carers and improves access to community services, and • Saluting Their Service (STS) Commemorations Grants which supports projects and activities that directly commemorate Australia’s servicemen and women who served in wars, conflicts and peace operations.

STS grants also promote appreciation and understanding of the role those who have served have played in shaping the nation. 37. Noting the current complex veteran legislative environment, current and former ADF members often rely on the advocates and welfare officers within ESOs when submitting claims to DVA. DVA funds the training of ESO advocates in compensation and welfare through the Advocacy Training and Development Program.

38. Welfare training focuses on providing the skills to assist veterans, their dependents, war widows and former serving members to access the wide array of community services that are available as well as DVA’s health services and other services that are not pensions-related. Training for Compensation focuses on developing the skills required to assist the veteran community veterans, their dependents, war widows and former serving members to lodge claims under the Veterans’ Entitlements Act 1986, Safety, Rehabilitation and Compensation Act 1988 (SRCA) and Military Rehabilitation and Compensation Act 2004 (MRCA).

39. An independent study is currently underway to investigate how veterans and their families access entitlements and services. The Veterans’ Advocacy and Support Services Scoping Study is being led by Mr Robert Cornall AO, former Chair of the Defence Abuse Response Taskforce. The advocacy study is expected to recommend a model to the Australian Government in December 2018.

40. The aim of the advocacy study is to recommend the most suitable advocacy model for Australian veterans and their families so they have: • a sustainable, consistent and reliable advocacy service which is scalable based on demand • an efficient and effective service to assist them to access their entitlements so they can focus on more important things, such as rehabilitation and their civilian life • a level of service which, at a minimum, is comparable in quality and value with other cohorts accessing government entitlements Inquiry into transition from the Australian Defence Force (ADF) Submission 33

18 July 2018 • a service based on their needs, irrespective of age, and which adequately protects their interests, and • if their claim is not accepted, access to advice on why it was unsuccessful and options for appeal. Social media platforms 41. DVA uses social media to communicate with the veteran community, their families, ESOs and other stakeholders in the social media sphere. The primary purpose of this activity is to ensure that veterans are aware of the services and programs that they are entitled to, and how to access them.

42. Social media also gives veterans, ESOs and other stakeholders another channel with which to share information about DVA’s programs and support services and other announcements with their members.

43. DVA also uses social media to heighten awareness of DVA’s services amongst all clients and potential clients by tagging ESOs and other stakeholders in relevant posts and by sharing content posted by ESOs to DVA’s own channels. 44. DVA’s social media channels also provide veterans, their families, ESOs and currently serving and ex-serving ADF members with another mechanism to communicate directly with the department. These direct messages are actioned and responded to. Ex-Service Organisation Round Table (ESORT) 45. Ex-Service Organisation Roundtable (ESORT) meetings are coordinated and managed by DVA.

The ESORT is intended to enhance the capacity of the Repatriation Commission and Military Rehabilitation and Compensation Commission. This forum aims to address issues of strategic importance to the ex-service and defence communities and assist in setting directions for the medium to long term. Specific responsibilities include: • acting as the main forum for dialogue between the Military Rehabilitation Compensation Commission (MRCC), Repatriation Commission, Department of Veterans’ Affairs and the leadership of the ESO and Defence communities • providing advice on how government can better facilitate a common approach to veteran and ex-service issues against the current background of ageing members, declining membership and multiple ex-service organisations not necessarily united in their common concerns • guiding strategic directions for the portfolio; and • serving as the main body for consultation under the Legislative Instruments Act 2003 on the development of legislative instruments impacting members of the ex-service and Defence communities under: o the Veterans’ Entitlements Act 1986 o Military Rehabilitation and Compensation Act 2004 o Safety, Rehabilitation and Compensation (Defence Related Claims) Act 1988 o Defence Service Homes Act 1918 o War Graves Act 1980.

46. Defence supports ESORT through the provision of information about Defence services. Additionally, Defence hosts an annual briefing day when a range of speakers from the Department provide information to the ESORT on topical Defence matters. For example, on 9 March 2018, Defence provided information and factsheets on a range of topics, including: ADF Transition Inquiry into transition from the Australian Defence Force (ADF) Submission 33

19 July 2018 Training and Skills Guide (draft) – the Australian Defence College’s (ADC) ADF Transition Civil Recognition project has developed a series of ADF Transition Skills and Training guides.

These guides provide general guidance on core job tasks and demonstrated skills at ranks across the ADF (ref Attachment 5 – ADF Transition Training and Skills Guide) • Partner Employment Assistance Program (PEAP) Factsheet – PEAP is a Defence program which provides financial assistance to eligible ADF partners to assist with the immediate difficulty of finding employment when they are relocated with their partner (ref Attachment 6 – Partner Employment Assistance Program) • Education Assistance Scheme (EAS) Factsheet – under the EAS, Defence provides a range of financial support services to help members pay for some additional education costs for their children caused by posting to a location within Australia (ref Attachment 7 – Education Assistance Scheme) • In-School Aides and Mentors Factsheet – Defence funds in-school aides and mentors in schools across Australia to provide support to the children of mobile Defence families (ref Attachment 8 – In-School Aides and Mentors) • Childcare assistance information – Defence has a range of programs to support the availability of childcare services to Defence families, who might face difficulties in sourcing childcare.

Defence maintains a network of childcare centres around Australia. The factsheet provides details on childcare options, salary packaging, family day care, and Defence Childcare Centres (ref Attachment 9 – Childcare assistance) • the KidSMART program – Defence provides a series of four-week programs for primary aged kids to help them manage issues arising from posting, relocation and deployment (ref Attachment 10 – KidSMART) • Career Transition Assistance Scheme (CTAS) – CTAS facilitates an ADF member’s transition to civilian employment through training and financial support (ref Attachment 11 – Career Transition Assistance Scheme), and • Other employment and education support – partners of ADF members wishing to undertake higher education courses can apply for funding support through a range of Government funded programs which are outlined in this document (ref Attachment 12 – Other employment and education support).

Recommendations of the Senate Standing Committee Report - Mental Health of Australian Defence Force members and veterans and current programs within the ADF 47. Recommendation 14 of the Senate Standing Committee (SSC) Report – Mental Health of Australian Defence Force members and veterans and current programs within the ADF made reference to the Department of Defence working with ex-service organisations. Extracts from Recommendation 14 state: The committee recommends that the Department of Defence work with ex-service organisations to develop a transition mentoring program, which will connect every veteran with a trained mentor from the ex-service community to assist and guide them through the transition process.

48. The Government noted Recommendation 14 as follows – • The Government notes that engaging with groups like ex-service organisations can be important during the transition process, and Defence recognises this as part of the substantial support it provides to transitioning ADF members... Inquiry into transition from the Australian Defence Force (ADF) Submission 33

20 July 2018 • The Government will also work with ex-service organisations to ensure that our younger veterans are catered for. Working with ex-service organisations, the Prime Minister will convene a forum in Sydney in November 2016 to promote the unique skills veterans can bring to employers and to find more effective ways for organisations to engage veterans and their families in the modern economy.

Prime Minister’s Veterans’ Employment Program (PMVEP) 49. DVA has undertaken research to assist in the design of the Ex-service Organisation Industry Partnership Register.

50. A link to the Defence Engage website has been added to the veterans’ employment website. 51. The Program is further detailed at Term of Reference 3. Ex-Service Organisation Initiatives 52. Defence is working with several ESOs to enhance the support services provided for transitioning members. There are several examples where ESOs – particularly RSL QLD, RSL Vic, Soldier On and Mates4Mates - have implemented initiatives aimed at assisting the transitioning and or recently transitioned member and their families. 53. Over the past few years ESO have increasingly focussed on programs which assist former ADF members and their partners into civilian employment, which complements the extensive work being undertaken by Defence and DVA in this domain.

This includes funding towards training, links directly to employers and employment placement services. 54. One example is the OASIS project in Townsville, which seeks to establish a community hub focusing on wellness and support for transitioning and recently transitioned members and for those members contemplating transition. DVA and Defence are supporting the OASIS project through participation on the Steering Committee and will work with the OASIS Board to submit grant applications.

Conclusion 55. Defence and DVA consider there is a significant amount of engagement with ESOs, which supports and facilitates engagement with individual ADF members and their families. Defence and DVA continue to work with ESOs through the mechanisms identified in this submission, including on specific transition oriented initiatives. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

21 July 2018 TERM OF REFERENCE 2 – The model of mental health care while in ADF Service and through the transition period to the DVA Mental Health Reform in Defence 1.

Since 2002, Defence has been an active leader in Australia in the area of workplace mental health reform. Since 2009, Defence has invested more than $252 million in mental health reform and provision of mental health care and support to ADF members that is command responsive, member centred and recovery focused. Defence has developed a comprehensive and robust approach to mental health and wellbeing, resilience and recovery, to mitigate and manage the unique risks of military service.

2. Through reviews, parliamentary inquiries and Senate inquiries, independent research, encouragement of high profile Defence members and senior leaders to speak about their experiences, and even through the mediums of the Arts and theatre, Defence has engaged in a serious and transparent conversation with our Commanders, members, their families, the public, the media and ESOs about the mental health and wellbeing of Defence members. Defence’s approach to mental health and wellbeing – Fit to Fight, Fit to work and Fit for Life 3. Defence has long recognised that the mental health and wellbeing of its workforce is critical to overall capability.

Defence has demonstrated its commitment to ADF members by providing programs and services responsive to changing needs, which can vary from basic self- care to complex interventions, particularly when people face multiple problems and stressors. 4. Mental health and wellbeing in the ADF operates on a continuum, starting with a person’s entry into the ADF, their selection, assessment and suitability to the right job, through to preparing them to operate in high risk environments. Furthermore, the ADF provides effective treatment and rehabilitation if members become ill or injured so they can return to work as soon as possible.

The mental health model used by Defence is best described as a stepped care approach that is member centred, command responsive and recovery focussed.

5. In October 2017, the Defence Mental Health and Wellbeing Strategy 2018-2023 was released. The Strategy reflects that mental health and wellbeing is more than just a health care responsibility and as such is increasingly part of command and leadership training, personnel management and human performance considerations. It is about how all Defence personnel (ADF and APS) are encouraged to look out for each other. 6. The goal is for Defence to be a trusted and respected organisation that helps and supports ADF members and APS employees in relation to their mental health and wellbeing, and one that responds appropriately when they experience mental health problems or illness.

7. Defence’s approach to mental health and wellbeing recognises that an ADF member’s mental health and wellbeing relies on: Foundation Strengths; Risk Reduction; Early Intervention; Treatment, Recovery and Support, and Transition. From the moment a person joins the organisation, their training is designed to ready them for service. This training is also designed to provide Defence members with the skills to enhance resilience and cope better with any adversity they may face in their career and throughout life.

8. Mental health and wellbeing is determined by a range and complex interplay of factors that include a person’s individual characteristics, biological, psychological, social and environmental factors. 9. This sets a context of shared responsibility for mental health and wellbeing between commanders and managers, the individual themselves, their family, and the Defence health care system. Interventions to enhance the mental health and wellbeing of Defence people must take each of these factors into account and build the foundational strengths of individuals throughout Inquiry into transition from the Australian Defence Force (ADF) Submission 33

22 July 2018 their Defence career and beyond. Defence’s success in promoting mental health and wellbeing relies on nurturing trust and confidence between each of the stakeholders in this system. Mental Health Services in Defence 10. To maintain and optimise mental fitness and health of ADF members, Defence has a dedicated and holistic health care system, which provides a continuum of care from enlistment through to transition from the ADF. 11. Defence invests approximately $53 million each year to provide a range of education awareness, evidence-based treatment and rehabilitation programs, for all ADF members, no matter the cause of their mental health problems.

ADF members are provided with health services, including mental health, treatment and rehabilitation support prior to, during and post-deployment designed to enhance their ability to cope with the challenges of deployment and to improve their capacity for effective transition back into work and family life.

12. Defence’s model of mental health care and rehabilitation, delivered through Joint Health Command, provides contemporary and best practice care and requires a broad range of skills to meet the unique needs of Defence members. This is achieved through a multidisciplinary approach, bringing together the skills of a competent and credentialed on-base workforce including medical officers, psychiatrists, psychologists, social workers, mental health nurses, registered nurses, rehabilitation consultants and Defence Chaplains. This health service delivery capability is supported by the provision of contracted health providers and off-base and specialist services under the ADF Health Services Contract (the Contract) through Medibank Health Solutions and through an Agreement for Services arrangement with VVCS.

13. Defence delivers mental health services through a stepped model of care, which focuses on building awareness of maintaining good mental health, up-skilling members to identify and manage mental health concerns they or their peers might be experiencing, and providing evidence-based treatment and rehabilitation. A description of the stepped model of care is provided in the Defence Mental Health and Wellbeing Strategy 2018-2023. 14. This approach is responsive to and connects with the command and personnel management systems that operate to support commanders to fulfil their responsibility to ensure the welfare and wellbeing of their personnel.

Building Mental Health Awareness and Upskilling Members 15. Defence has in place a range of mental health education, awareness and skills training programs in addition to a suite of self-help web based resources that have been developed in collaboration with DVA. These programs and resources aim to reduce the stigma surrounding mental illness and suicide prevention, help individuals better recognise signs of poor mental health in themselves and others, inform them of the help that is available and how to use various resources, and encourage them to seek help as early as possible no matter the cause of the mental health concern or problem.

16. Information about the range of Defence mental health awareness and skills based programs and the range of self-help information and web based or smart phone application tools is also promoted through the ADF Health and Wellbeing Portal ‘Fighting Fit’ accessible from the front page of both the Defence Protected Network and Defence internet site. Mental Health Screening 17. Early identification and access to self-help information, support and treatment for mental health issues are key priorities for Defence. Mental health screening provides an opportunity for early identification of members with mental health concerns and allows them to seek assistance for mental health problems.

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23 July 2018 18. Defence has a range of mental health screening processes that provide opportunities for Defence members’ mental health problems to be identified. Mental health screening is conducted for all members who have deployed on operations. Defence members complete a Return to Australia Psychological Screen (RtAPS), which consists of a questionnaire and screening interview, within the seven day period prior to returning from deployment. Defence members who are unable to complete an RtAPS prior to their return to Australia are offered the screen upon their return.

Defence members also participate in Post Operational Psychological Screening (POPS) between three and six months following their RtAPS. The POPS also consists of a questionnaire and screening interview.

19. Mental health screening is also available following critical incidents and as part of medical evaluations including the Periodic Health Examination, the Separation Health Examination and Specialist Medical Examinations. 20. Defence recognises that, due to the nature of military service, members who have not deployed are also at risk of developing mental health conditions. To address this, a Periodic Mental Health Screen (PMHS) has been introduced to further enhance the screening continuum. After two successful pilots, the PMHS was implemented within seven Defence primary health facilities in March 2018 and will be rolled out to all health centres by the end of March 2019.

This provides an opportunity for members who have not participated in a mental health screen in the previous 12 months to undergo screening when seeing a medical officer, thereby creating an opportunity to increased awareness, self-help action or referral for early intervention. On Base Mental Health Services 21. The Defence Garrison Health System is coordinated through eight Joint Health Units and delivered through 59 health facilities. Services available include the full range of primary health care, occupational health, rehabilitation, physiotherapy, mental health and psychology and access to specialist treatment and inpatient care.

22. As at 12 June 2018, the on-base mental health workforce included the following: • 78 psychologists ( 19 ADF, 27 APS and 32 CHP) • 9 Social Workers (APS) • 17 Mental Health Nurses (CHP) • 164 Medical Officers (12 ADF, 13 APS and 139 CHP), and • 53 Rehabilitation Consultants (a number of whom are Case Managers) supported by a further 88 full-time equivalent contracted Rehabilitation Consultants. 23. To enhance access to services, Defence has initiated an Intake Assessment, Case Allocation and Treatment, and Case Monitoring and Review process. The Intake Assessment provides a dedicated triage service for entry into mental health and psychology services.

Case Allocation provides a structured approach to allocating mental health referrals for further assessment and treatment.

24. The mental health, psychology and occupation rehabilitation services in JHC are increasingly provided in coordination with Defence Chaplaincy and the Defence welfare agencies including the Defence Community Organisation (DCO) and Single Service Commands. The close working relationship between health, welfare and command is vital to the effective delivery of services. Accordingly, these agencies contribute to the provision of coordinated services. 25. Defence has upskilled its health providers in recent years through the implementation of Mental Health Risk Assessment Training to ensure greater consistency in the clinical assessment of mental health when ADF members present with mental health concerns or are identified as being at risk of suicide, self-harm or harm to others.

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24 July 2018 Off Base and Specialist Mental Health Services 26. On base providers coordinate access to a range of health care services available in the civilian community, including access to psychiatrists and inpatient and outpatient hospital based services or treatment programs, and specialist second opinion support from the ADF Centre for Mental Health. 27. Defence currently has access to over 300 psychiatrists, a large number of allied health professionals (including 1,725 psychologists), and a broad range of outpatient and inpatient programs through its ADF Health Services Contract (the Contract).

Forty-four of these psychiatrists are currently providing off base services to ADF on a regular basis. Of these, 11 have previously served in uniform or are current reservists and 12 are civilian psychiatrists with substantial experience in treating ADF members over many years. Due to difficulties in accessing civilian psychiatrists, particularly in rural and remote areas, Defence has established three on base psychiatrist clinics in Canberra, Townsville and Brisbane. An on-base clinic will begin at the Holsworthy Health Centre in July 2018 and plans are progressing for a clinic to be established in Darwin.

28. Defence also refers ADF members to VVCS for counselling on a fee-for-service basis. This referral arrangement has been operating since 2005 and has been the foundation for promoting access to VVCS amongst serving members and their families. Complex and acute care 29. To manage more complex cases, a case management process has been implemented which adopts a standardised and nationally consistent approach to patient management for complex cases via Health Care Coordination Forums. These Forums ensure health care is holistic and coordinated. Health providers such as, medical officers, other mental health providers and rehabilitation consultants also provide advice to Command and participate where necessary on Command Individual Welfare Boards.

30. Where in-patient care or comprehensive extended treatment programs are required, these are accessed through the most appropriate civilian specialist centre or inpatient service. This includes referral to DVA accredited hospital based Trauma Recovery Programs for those serving members diagnosed with Post Traumatic Stress Disorder (PTSD). 31. In recognition of the difficulty in accessing in-patient mental health services in some locations, Defence has sought to purchase guaranteed access to beds. For example, Defence has purchased two ADF dedicated mental health in-patient beds in the Townsville Private Clinic and is currently finalising arrangements to purchase a mental health in-patient bed in Albury Wodonga Private Hospital.

Meaningful Engagement during Rehabilitation Program 32. Defence provides comprehensives rehabilitation to its members across the physical, occupational, and psychosocial (wellbeing) domains. The Meaningful Engagement during Rehabilitation Program, initiated in 2012, aims to prevent the development of secondary mental health problems associated with a lack of purposeful activity. 33. Rehabilitation consultants may refer members for Meaningful Engagement during times when a member on the ADF Rehabilitation Program is deemed clinically fit by their medical officer to return to work, however suitable duties in their unit or an alternate unit are not immediately available.

34. Meaningful engagement can include, but is not limited to, leisure and hobby activities, and adult-education and vocational courses. These activities must be structured, supervised and undertaken in standard business hours. Since the program commenced, 1,224 members have participated in Meaningful Engagement activities. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

25 July 2018 ADF Centre for Mental Health 35. The ADF Centre for Mental Health is a Joint Health Command national resource that provides mental health consultancy services, training and up-skilling of the mental health workforce, and expert advice for Defence health providers, Command and ADF members.

36. The Centre’s team of mental health professionals includes a Director, senior Army psychologist, a senior consultant psychiatrist and a clinical psychologist. Both the psychiatrist and clinical psychologist are also reservists with a depth of military mental health experience. The team is supported by a range of subject matter experts across JHC covering topics such as suicide prevention and alcohol and other drugs.

37. Programs currently available through the ADF Centre for Mental Health include the RESET program, (a two-day prevention and early intervention adaptive coping skills training program) and the revised Acute Mental Health on Operations course. The Centre is also the Technical Authority for Mental Health Risk Assessment Training (MHRAT). 38. Tele-psychiatry services at the ADF Centre for Mental Health commenced in 2011 and are provided nationally and in support of deployed personnel. One of the services offered in person and by tele-psychiatry is the tertiary level, Second Opinion Clinic which aims to assist ADF Medical Officers and consultant psychiatrists in the management of ADF members who are experiencing difficult, complex or treatment-resistant mental disorders.

Other mental health consultancy services include the provision of ad hoc advice and more formal clinical supervision to a number of mental health professionals across Garrison Health Services and the single Services.

Helplines 39. Additional support available to ADF members and their families includes a range of telephone helplines that provide triage services inclusive of mental health. These helplines include 1800-IM-SICK, the All-Hours Support Line, and DCO’s Defence Family Helpline, and the Reserve Assistance Program and the VVCS helpline. 40. DCO services are accessed primarily through a centralised intake service model through the Defence Family Helpline, which is a 24/7 service with several international free call numbers allowing it to provide support to members and families posted overseas. 41.

The Defence Family Helpline currently receives an average of 1,200 calls and 3,000 emails per month. On a monthly average, approximately 800 outgoing calls are made by Defence Family Helpline staff.

Data and Evidence of Success 42. A number of inquiries and reports provide evidence that Defence has made very good progress in the area of mental health reform and suicide prevention. This includes: • The review of the Dunt Review implementation showed increased mental health awareness amongst Command and members • The assessment that Defence mental health services were ‘adequate’ by the 2016 Senate Inquiry • The National Mental Health Commission’s findings that 80% of Defence members rated mental health services as fair to excellent • The Australian Institute of Health and Welfare finding that the age-matched suicide rate for serving men was 53% lower than the general population.

43. Data from other sources also reinforces the extent and outcomes of Defence mental health services. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

26 July 2018 Mental Health and Psychology services through the Garrison Health System 44. Data obtained from the Defence electronic Health System (DeHS) shows that 15,118 referrals for mental health and psychology services were made in FY16-17. Just under half (49.7%) of these referrals were for mental health services, with 63% of these self-referrals and 37% medical referrals.

Psychology services constituted the other half, with 46% of these referrals Mental Health Screening requests, 23% Command referrals, and 31% requests for in-Service occupational psychology suitability assessments. The high rate of self-referrals is indicative that mental health awareness and confidence in seeking help amongst ADF members is increasing. Second opinion consultations and tele-psychiatry services provided through the ADF Centre for Mental Health 45. As at 22 March 2018, 126 members have been the subject of a second opinion assessment at the Centre. Between 2011 and 22 March 2018, 170 hours of tele-psychiatry services have been provided with over two-thirds (n=121 hours, 71 percent) used for direct clinical care, either as assessments by the Second Opinion Clinic, assessment of deployed personnel on initial referral from a medical officer or other patient consultations.

Use and Satisfaction with Defence Mental Health Care by ADF Members – findings from the Transition and Wellbeing Research Programme 46. This Programme is jointly funded by DVA and Defence and is the most comprehensive study ever undertaken in Australia of the impact of military service on the mental, physical and social health of serving and ex serving ADF members and their families. 47. The Programme is made up of three major studies: the Mental Health and Wellbeing Transition Study; the Impact of Combat Study; and the Family Wellbeing Study. The first two reports, the Mental Health Prevalence and the Pathways to Care were released on 5 April 2018.

48. The Pathways to Care report provides an understanding of how individuals who are concerned about their mental health access care. The research showed the majority of 2015 regular ADF members with a mental health concern will take the initial steps to seek care within the first 12 months, with a considerable number doing so within the first three months. That care is most usually provided by psychologists, Medical Officers and also by psychiatrists and other allied mental health providers.

49. Once in care, there were high rates of satisfaction with the services delivered, including effectiveness, competence, friendliness and confidentiality of services. Satisfaction reported by 2015 Regular ADF members for services delivered by medical officers, psychologists, psychiatrists and other mental health providers was very high, at rates between 70% and 90%. 50. The rates of engagement and uptake of services exceed community and international standards in veteran and military mental health, however more work is needed to ensure those with a current disorder engage in and remain in evidence-based care.

Health Aspects of Transition 51. Defence recognises that the process of transition out of the services and into civilian life can be challenging and may impact on a member’s mental health and wellbeing, and that of their family. JHC recognises that it has a role in caring for “future veterans” to ensure that ADF members are successfully transitioned into post-ADF service health care where this is required. It is therefore working closely with DVA to ensure this process is as streamlined as possible to reduce stress and ensure that no-one slips through the cracks.

Transition Health Assessment (THA) 52. There are many initiatives underway to assist ADF members and their families undergoing the transition process including the development and pilot of a Transition Health Assessment Inquiry into transition from the Australian Defence Force (ADF) Submission 33

27 July 2018 (THA) process. The THA was developed to provide a single simplified pathway to assist separating members navigate the requirements of Defence, DVA and the CSC. 53. As part of the THA, ADF members undergo a review by a DVA representative and where relevant, an assessment by a specialist Occupational Physician.

The process is designed to facilitate the early and effective submission of claims and establish any initial liability and compensation requirements prior to transition. 54. A six month pilot at Holsworthy Health Centre began in October 2017 and ended on 3 May 2018. Evaluation is being conducted through survey of separating members and their health providers and through consultation with the relevant agencies and is expected to be completed by 1 October 2018. The pilot will continue at this location until completion of the evaluation. The Separation Health Examination (SHE) 55. A key component of the transition from military to civilian life is the Separation Health Examination (SHE).

All ADF members must undertake a SHE before they transition from military to civilian life. This provides an accurate assessment and recording of health status, Medical Employment Classification and any ongoing healthcare needs of the member at the time of transition.

56. The Separation Health Examination: • ensures that members are transitioned under the appropriate mode of separation • provides evidence for compensation and other claims • facilitates hand over of their health care to the civilian health sector, and • provides a baseline against which future health assessments can be compared. 57. Assessment of mental health is also undertaken via the member health questionnaire, physical examination and formal mental health screening. The Kessler 10 psychological distress scale, the Post-traumatic Stress Disorder Check List – Civilian, and the Alcohol Use Disorders Identification Test are included to ensure alignment with the Post Separation General Practitioner Health Assessment, covered under the Medicare Benefits Scheme.

58. For those members transitioning on medical grounds, the examining medical officer completes an Invalidity Retirement from the Defence Force Medical Information form. The completed form and supporting documentation is sent to the CSC for receipt no later than six weeks prior to the member’s transition. Occupational Rehabilitation 59. Joint Health Command works closely with DVA to ensure continuity and coordination of transitioning members who require ongoing rehabilitation services. 60. For transitioning members who are on a rehabilitation program, their Rehabilitation Consultant will liaise with all key stakeholders, including the treating doctor, DVA and DCO to ensure required ongoing services, such as medical assistance and vocational rehabilitation, are in place before their transition to civilian life.

61. When rehabilitation authority is to be handed over to DVA, a transfer handover report is completed and provided to DVA outlining the occupational rehabilitation provided by Defence and ongoing rehabilitation requirements post transition. It is identified in this report if a handover case conference is recommended. For those members where a case conference is required, this is done in person with DVA, where logistically possible, and otherwise via teleconference. Access to Medical records 62. Members can access a copy of their medical records as a normal part of the process of transitioning from the ADF and this is actively encouraged.

Defence also encourages all members Inquiry into transition from the Australian Defence Force (ADF) Submission 33

28 July 2018 to clarify any concerns with the information in the record with a Defence health professional and to provide these records to their community health professionals as required. 63. Health records for transitioning members who are transferring to the active Reserve are retained by Defence at a supporting health facility. For those not transferring, health records will be sent to Defence Archives. Former serving members can apply for their service or health records by completing a ‘Request for Records’ form. The form is available on the Defence website at http://www.defence.gov.au/records/docs/request-for-service-records-form.pdf or from the Defence Service Centre on 1800 333 362.

64. The implementation of the DeHS in 2014 has significantly simplified the transfer of health records. Both DVA and CSC now have access to DeHS in order to obtain up to date health care information on transitioning members. What is Defence Doing to Improve Mental Health Care and Transition Health Support to Serving ADF Members? 65. Defence has come a long way since establishing its first mental health strategy in 2002 and is much better prepared and able to respond to the mental health needs of our people. Continuous Improvement Framework for mental health programs 66. A focus of continuous improvement has been an important component of the evolution of model of mental health care currently used in Defence.

This continued evolution and improvement of the model of care is important to ensure current and ex-serving ADF members have access to the right kind of mental health support, at the right time. 67. Under the Defence Mental Health and Wellbeing Strategy 2018-2023 all Defence mental health programs including provision of mental health care will be monitored and evaluated through the Defence Mental Health & Wellbeing Continuous Improvement Framework (the Framework). This will inform Defence as to whether the activities being provided are contributing to positive outcomes for Defence personnel in an efficient and effective manner, and identify opportunities to engage in continuous improvement on our programs and services.

68. As a priority, Defence has commenced implementation of the Framework to evaluate the Defence suicide prevention program.

Defence e-Health System (DeHS) Enhancements 69. New Mental health Protocols were added to DeHs in early 2018. The protocols will support mental health professionals in documentation of their assessments at intake, during case formulation and treatment planning, and at any time when determining risk. This allows improved data collection of mental health related episodes of care. 70. Defence is digitising the physical ADF health records created prior to the introduction of the DeHS in 2014 for all regular, active and standby reserve ADF personnel, as a 2016 Defence White Paper initiative. These digitised records, when combined with the Defence eHealth System, will create a complete electronic health record for ADF members.

This will improve records accessibility and usability for a variety of Defence stakeholders. The records of those transitioning on medical grounds will be digitised as a priority commencing in July 2018. Mental Health Workforce Enhancements 71. The 2016 Defence White Paper included the addition of seven new positions for ADF uniformed psychiatrists, and one individual has been identified to take up a registrar position. As the uniformed psychiatrist positions are engaged they will contribute to the expansion of the ADF Centre for Mental Health as it is planned to create a “hub and spoke” Centre of Excellence.

72. Defence and DVA have recognised the need to increase the cultural competency of psychiatrists in the field of military and veterans’ mental health, to ensure serving and ex-serving Inquiry into transition from the Australian Defence Force (ADF) Submission 33

29 July 2018 members have access to specialists who understand the military environment. The Departments are currently working with the Royal Australian and New Zealand College of Psychiatrists to improve awareness and training in this area. A Network of Military and Veterans’ Mental Health has recently been created within the College with the senior consultant psychiatrist at the ADF Centre for Mental Health being appointed the inaugural Chair of the network. Our approach to addressing mental health stigma 73. Despite the positive findings of the Transition and Wellbeing Research Programme Pathways to Care Report detailed above, it was evident that many people still hold stigma related beliefs around mental health.

The most common reasons for not seeking assistance in both Transitioned and 2015 Regular ADF members were a perceived preference to self-manage, and ability to function effectively and feeling afraid to ask. Despite this, the vast majority of those with mental health concerns still engaged in care.

74. The Defence Mental Health and Wellbeing Strategy 2018–23 (the Strategy) signals our intent to maintain mental health awareness, prevention and early intervention initiatives that target the stigma surrounding mental illness. The goal is to equip our people with the confidence to find and engage with comprehensive, coordinated and customised mental health care and rehabilitation programs, ensuring access to the right kind of mental health support at the right time. 75. New Initiatives include: • Utilising the lived experience and recovery stories of ADF members with mental health concerns • Developing options for peer support so that ADF members can support each other to access the right information and care when it is needed • Implementing better ways to engage families when we provide treatment and rehabilitation for ADF members with mental health conditions, and • Improving support and access to specialist mental health services.

Next Generation Health Services 76. Recommendation 5 from the 2017 Senate Inquiry into Suicide by Veterans and Ex-service Personnel recommended “the Department of Defence and the Department of Veterans’ Affairs align arrangements for the provision of professional health care.” 77. DVA is a key stakeholder in the Next Generation Health Services project, in which Defence is establishing new supply arrangements for health services. This will include a network of health providers that are Defence aware and that support continuity of care for serving and transitioning members.

78. Specific requests of industry in this procurement process include closer alignment of specialist, allied and hospitals service provider lists between DVA and Defence; and the identification of a network of Defence friendly General Practitioners to aid in the transition of ADF members. Industry has also been requested to assist Defence in identifying further opportunities to support transitioning members over the life of the contract. Ongoing Research 79. Defence and DVA have an ongoing collaboration in military and veterans’ health research, formalised under the Memorandum of Understanding for the Cooperative Delivery of Care and Support to Eligible Persons.

80. Collaborative research projects include: • Transition and Wellbeing Research Programme • Military Rehabilitation and Compensation Act 2004, Rehabilitation long-term study Inquiry into transition from the Australian Defence Force (ADF) Submission 33

30 July 2018 • RESTORE (Rapid Exposure Supporting Trauma Recovery) Intensive prolonged exposure therapy for the treatment of post-traumatic stress disorder • Incidence of suicide among serving and ex-serving ADF Personnel 2001-2015 • Development of a Moral Injury Outcomes Scale • Stepping Out: Attention Reset (SOAR) trial, and • Whole-of-population approach to health and welfare of Australia's veterans.

Transition and Wellbeing Research Programme 81. To enhance our knowledge of the transition pathways, Defence and DVA have funded the Transition and Wellbeing Research Programme (the Programme), the most comprehensive study ever undertaken in Australia of the impact of military service on the mental, physical and social health of serving and ex serving ADF members and their families.

82. The Programme is made up of three major studies: the Mental Health and Wellbeing Transition Study; the Impact of Combat Study; and the Family Wellbeing Study. 83. The research is being conducted by the Centre for Traumatic Stress Studies at the University of Adelaide in collaboration with a range of Australia’s leading veteran research institutions, including the Australian Institute of Family Studies, Monash University, the University of New South Wales, Phoenix Australia – Centre for Posttraumatic Mental Health, and Sydney University. This body of work represents a government research investment of $5.96 million over five years, with $4.47 million from DVA and $1.49 million from Defence.

84. On 5 April 2018, the Minister for Defence Personnel and Veterans’ Affairs, the Hon Darren Chester MP, released the first two of eight reports that will be delivered under the Programme, the Mental Health Prevalence Report and the Pathways to Care Report. 85. The two reports released respond to the first three objectives of the Programme, which are to: • determine the prevalence of mental disorders amongst ADF members who have transitioned from regular ADF service between 2010 and 2014 • examine the self-reported mental health status of transitioned ADF and the 2015 regular ADF, and • assess pathways to care for transitioned ADF and the 2015 regular ADF, including those with a probable 30-day mental disorder.

86. The remaining reports, which will be completed later in 2018, will inform how Defence and DVA continue to provide relevant, responsive and recovery focused mental health care initiatives and support during and after transition, particularly targeting those most at risk. 87. Many of the findings so far confirm what Defence and DVA already know through their daily operations. That is, more needs to be done to address veteran mental health concerns, particularly during transition from military service and in the early months, post transition. DVA support for transitioning members with a mental health conditions 88.

DVA spends around $196 million a year on a wide range of services and treatments to provide mental health support to current and former ADF members. 89. Funding for mental health treatment is demand driven, and is not capped – this means that if an eligible person requires treatment, it will be paid for. This includes funding across the stepped care continuum for: • online mental health information and support Inquiry into transition from the Australian Defence Force (ADF) Submission 33

31 July 2018 • general practitioner, psychologist, psychiatric and social work services • pharmaceuticals • in-patient and out-patient hospital treatment • Non-liability Health Care mental treatment (refer to paragraphs 126-129) • services through the Veterans and Veterans Families Counselling Service (VVCS). DVA activities supporting prevention, early intervention and self-management 90. For members of the serving and ex-serving community who have some mental health need, but not a current mental illness, or who may have previously had a mental illness and are at risk of relapse, prevention and early intervention through GPs, digital mental health and self-help services are the first step on the care continuum.

91. DVA understands the critical role of GPs in the success of prevention and early intervention of severe mental health concerns. GPs are typically the first point of clinical contact for people seeking help for mental health concerns and are the gatekeepers to other service providers. 92. In addition to funding approximately $22.1 million each year in GP services through DVA Health Card arrangements, any ex-serving ADF member is able to access a comprehensive physical and mental health assessment by a GP through Medicare since 2013. From 1 July 2019, separating ADF personnel with at least one day of continuous full-time service, including Reservists, will also be able to receive a comprehensive health assessment in each of the first five years after transition, expanding on the existing health assessment which has been available since 2013 to transitioned members.

93. DVA has also invested in a broad range of resources to increase mental health literacy, encourage early help-seeking, build resilience and direct those experiencing mental health concerns to the appropriate information and services. At Ease is DVA’s mental health promotion portal, which provides simple and relevant self-help information and access to resources, such as DVA’s four mobile apps specifically designed for current and ex-serving ADF members. These apps are free and use basic cognitive-behavioural therapy.

94. In addition, the VVCS has continued to evolve and adapt its online and social media presence to build a mental health aware and resilient community.

Sharing posts about client eligibility, services and stigma reduction, is helping to increase community awareness about available support. Today, VVCS has Facebook, Twitter and LinkedIn accounts as well as a website. Additionally, DVA and VVCS is utilising videos on demand and webinars to increase community literacy, with a focus on building on the lived experience of clients to de-stigmatise help seeking behaviour.

Social health and community connectedness 95. In addition to early intervention and self-help resources, DVA recognises the benefits of a healthy lifestyle and social connectedness in maintaining the health and wellbeing of the ex- service community. For those experiencing mental illness, social participation can also aid recovery. Research demonstrates that there is a correlation between good social health and good mental health. As a result, DVA continues to invest in a range of social health programs and initiatives to support health and wellbeing in the ex-service community. 96. Evidence shows that individuals experiencing mental illness who are well supported by their community, have a sense of control in their illness management, and envisage a path to wellness, are more likely to complete recovery.

As such, DVA has recognised the important role that ex-service organisations (ESOs) can play in supporting members of the ex-service community and has designed and developed a Peer to Peer Support Network pilot program. This pilot Inquiry into transition from the Australian Defence Force (ADF) Submission 33

32 July 2018 provides a vehicle for ESOs to support those experiencing mental illness. It has been designed to facilitate the recovery of ex-serving members with a mental health problem by linking them with a trained volunteer Peer Mentor and supporting that relationship. 97. The Veteran and Community Grants Program is a program that supports activities and services that sustain and/or enhance health and wellbeing. The program is available for the benefit of all veterans, their spouses, partners, widows/widowers, carers, dependants and other members of the ex-service community. This grants program provides seed funding for projects that promote a healthy, quality lifestyle for veteran community members.

Importantly, these grants also provide funding for initiatives that reduce social isolation, support carers and improve access to community services.

DVA funded clinical services 98. For ex-serving ADF members with mild to moderate mental illnesses, DVA provides access to a range of low intensity clinical services, including face-to-face services from GPs and allied health practitioners, such as psychologists. These clinical services are supported, where necessary, by access to psychiatry services and pharmaceuticals. 99. DVA does this predominantly by purchasing treatment services through the broader Australian health system. DVA clients access this treatment through the Gold and White Health Card arrangements. These arrangements work much the same as a Medicare card.

100. In addition to the range of clinical services available through DVA Health Card arrangements, members of the veteran and ex-serving community and their families who are experiencing service related mental health and wellbeing conditions can seek help from VVCS. More information about VVCS is provided at paragraphs 133 to 139. DVA acute mental health services and PTSD programs 101. For people with complex or episodic severe mental illness, DVA provides access to comprehensive treatment responses through inpatient and outpatient services provided through public and private hospitals nationwide.

102. Due to the higher incidence of PTSD among military populations, DVA also funds a number of private and public hospitals throughout Australia to provide evidence-based trauma recovery programs for PTSD on an outpatient basis. These programs are not intended to be stand- alone services that meet all the treatment needs of ex-serving members. Rather, they aim to provide highly specialised, time-limited, evidence-based treatment for PTSD and its common comorbidities. DVA rehabilitation services 103. DVA also promotes the return to good physical and psychological health for injured personnel by providing rehabilitation assistance to entitled serving and former ADF members, reservists and cadets.

This rehabilitation program aims to provide early and appropriate assistance to suit the needs of injured members. The rehabilitation program aims to help DVA clients identify areas of their life that they wish to improve and set out a plan and activities to help reach those goals. No two people are the same, which is why each rehabilitation plan is tailored to the individual.

Strengthening suicide prevention efforts 104. Research into the incidence of suicide among serving and ex-serving ADF personnel indicates that ex-serving men are more vulnerable to suicide risk. Veteran mental health and suicide has been the subject of a number of recent inquiries and reviews, including the Senate Inquiry report The Constant Battle: Suicide by Veterans. These inquiries each found this is a complex issue that requires a multi-faceted service response. A number of new initiatives Inquiry into transition from the Australian Defence Force (ADF) Submission 33

33 July 2018 focusing on strengthening suicide prevention and mental health support have been announced in direct response to these reviews and inquiries.

105. DVA is committed to strengthening suicide prevention efforts for ex-serving ADF members, by identifying at risk populations and building protective factors around them. DVA’s multi-faceted strategy to prevent suicide, Operation Life, supports the ex-serving community to identify and support those at risk of suicide. This strategy includes community workshops delivered though VVCS to members of the ex-service community, so that they can identify and assist at-risk individuals, programs to build resilience, self-help and educational materials, a 24- hour support line, and access to mental health treatment.

106. Funding of $9.8 million was provided to pilot two important suicide prevention initiatives, providing new approaches to supporting vulnerable veterans experiencing mental health concerns. The Mental Health Clinical Management Pilot (also known as the Veterans’ Suicide Prevention Pilot) and funded at $6.2 million, will assess the benefits of providing intensive support to those who have attempted suicide, are experiencing a suicidal crisis or are at risk of suicide following their discharge from hospital.

107. The Coordinated Veterans Care (CVC) Mental Health Pilot, funded at $3.6 million, will support veterans with mild to moderate anxiety or depression and physical conditions associated with pain.

The pilot will build on the existing CVC Program which uses a team-based model of care led by a GP, supported by a practice nurse, to provide improved clinical management with planning and care coordination. 108. In addition to progressively expanding access to VVCS over the past four years, a number of initiatives are underway to strengthen the ability of the service to support suicide prevention including: • additional options for suicide prevention training; • additional funding for the 24 hour support line; • enhancing the clinical case management capability of the service through the recruitment of new senior clinicians in all regions; • training to enhance the skills of 1,200 clinical staff across the VVCS network; and • a trial of lived experience peers within the network and the establishment of a peer support network.

109. Finally, DVA and VVCS are continuing to work across Government on suicide prevention activities. DVA and VVCS have provided dedicated support the Department of Health initiative trialling localised suicide prevention activities for ex-serving members in Townsville. Improving access to services 110. Evidence shows that early intervention and easy access to treatment offers the best chance for recovery and leads to improved mental health outcomes. The Government has consequently been focused for a number of years now on increasing the ex-serving community’s access to care. Non-Liability Health Care for Mental Health Conditions 111.

The non-liability health care program allows DVA to provide serving and ex-serving ADF members with treatment for mental health conditions without needing to establish that the condition was caused by their ADF service. This treatment is delivered through the provision of a DVA White Card and allows ex-serving ADF members to access a range of treatments, including GPs, psychologists, psychiatrists, medication, public or private hospital, and VVCS counselling services.

112. Since 1 July 2014, non-liability health care has covered treatment for five common mental health conditions: PTSD, depressive disorder, anxiety disorder, and alcohol and substance use Inquiry into transition from the Australian Defence Force (ADF) Submission 33

34 July 2018 disorders. The Government provided $46.4 million in the 2016-17 Budget to extend and streamline eligibility for these arrangements to any ex-member who has ever served at least one day in the full-time ADF. The 2017-18 Budget provided $33.5 million to further expand the non- liability health care program to cover all mental health conditions.

The 2018-19 Budget further extends these arrangements to reservists with domestic or international disaster relief services, border protection service or a serious training injury.

113. As a result of the previous expansions to non-liability health care, between 2014-15 and 2015-16 the number of veterans receiving mental health treatment grew by 48% and the number of services provided through the program increased by 68%. This achievement demonstrates that more veterans are not only able to access the care they need, but are seeking help. 114. The recent expansion of the non-liability health care has separated the provision of health care from compensation and liability processes, lessening the impact of linking mental health treatment access to the need for a compensation claim determination.

The 2017-18 Budget provided funding for a pilot of the provision of rehabilitation services before liability is determined in an effort further improve access to services, and promote early intervention. Streamlining Access to Incapacity Payments 115. Streamlining access to incapacity payments is also a new initiative that is providing additional support to certain veterans with mental health conditions who are vulnerable to moving in and out of employment due to their episodic mental health conditions. The initiative provides for a specific veteran’s rehabilitation plan to remain open for twelve months after they return to employment.

Keeping the rehabilitation plan open, and being monitored by a rehabilitation provider for twelve months, removes the requirement for the veteran to lodge a claim to have their incapacity payments reinstated if they need to leave their employment 116. Currently, once a veteran finds employment, any incapacity payments they receive may cease or be reduced due to their earnings from employment. Rehabilitation supports and services also cease. Veterans with episodic mental health conditions will sometimes be unable to continue to work for periods when their symptoms are acute. This requirement can create a barrier to clients with episodic mental health conditions being prepared to test their ability to participate in the workforce.

117. By keeping the rehabilitation plan open, incapacity payments can be reinstated as soon as possible after the veteran leaves their employment, without the need to provide a medical certificate. This measure also ensures that support from the rehabilitation provider is available to assist with resolving issues in the workplace if needed, and providing additional rehabilitation services to address the veteran’s changed circumstances. This measure extends the separation of access to rehabilitation and income support from compensation and liability to improve mental health and wellbeing and enhancing labour force participation.

118. This initiative recognises that younger veterans are likely to have a longer worker life ahead of them. The ability to access the health benefits of safe and meaningful work, whenever it is possible to do so, is therefore very important for these veterans. 119. Since 2014 the Government has also been progressively increasing access to mental health treatment by expanding eligibility to VVCS. While under its duty of care, VVCS will never turn anyone in the veteran and ex-service community who is in distress or crisis away, there are a number of eligibility categories for those who can access VVCS services on an ongoing basis.

In recent years the cohorts of ex-serving members who can access VVCS has been extended to include current and former ADF members who served in domestic or international disaster relief operations; served in border protection operations; served as a submariner; medically discharged; or were involved in a serious training accident. VVCS is now more accessible than ever before. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

35 July 2018 Breaking down barriers and building pathways to care 120. While there is an extensive system of support available to the ex-service community, DVA wants to understand what stops people from seeking the help, to put in place strategies to improve pathways to care. In response, the Government is working hard to build the evidence base. 121. The Transition and Wellbeing Research Programme, a joint research initiative of DVA and the Department of Defence, is the largest and most comprehensive study undertaken in Australia. This study is examining the impact of contemporary military service on the mental, physical and social health of serving and ex-serving ADF personnel, and their families.

122. The Pathways to Care Report investigated self-reported pathways to care in transitioned and currently serving ADF members with mental health care needs, to ensure they have access to and receive appropriate mental health care. Approximately, 3 in 4 ex-serving members have received assistance for their mental health in their lifetime. For around 60% of ex-serving ADF members, who were concerned about their mental health and sought assistance, someone else had suggested they seek care for their mental health, usually a partner or friend. The most common barriers to seeking help for ex-serving ADF were concerns about the impact on career and expense.

123. By building DVA’s understanding of how and why people choose or not choose to seek help, DVA is now able to specifically design services and programs for the ex-serving community that build strong pathways to care. For example, using digital technology through the At Ease mental health portal and VVCS website to address barriers to care and allowing ex-serving personnel and their families to access information, advice and treatment when and where ever they feel comfortable, is one way in which DVA is improving pathways to care. Innovation and emerging treatments 124. DVA is also continuing to invest in initiatives that seek to broaden our understanding of best-practice veteran mental health services, treatments and interventions.

125. The Government is providing $6 million to Phoenix Australia – Centre for Posttraumatic Mental Health to develop the Centenary of Anzac Centre. The Centre provides expert advice, consultation and supervision through a network of national specialists to guide practitioners who are supporting veterans with complex mental health conditions. The Centre is the nation’s leading centre of research in veteran and military mental health especially trauma, and integrates and translates research findings from Australia and around the world to generate policy, program, and treatment improvements in veteran and military mental health services.

126. Defence, DVA and VVCS have also partnered with Phoenix Australia to conduct the Rapid Exposure Supporting Trauma Recovery (RESTORE) Trial to investigate whether an intensive delivery of prolonged exposure therapy, involving 10 sessions over a two-week period, will deliver outcomes which are comparable to the gold standard prolonged exposure treatment protocol. If successful, this intensive form of prolonged exposure therapy could remove barriers to accessing treatment for both serving and ex-serving personnel and enable recovery sooner. 127. Current and ex-serving ADF members eligible to participate will be randomly allocated to either a standard ten week Prolonged Exposure or the Intensive Prolonged Exposure program.

The aim is to recruit up to 200 serving and ex-serving ADF members to participate. 128. The RESTORE trial originally launched in Brisbane, Sydney and Melbourne and is now expanding to Perth, Darwin, Adelaide, Townsville and Canberra. Continuing to support research 129. Defence and DVA also work closely in the development of strategic research to support the development of robust, evidence-informed policy to meet the needs of the serving and ex- serving community. In particular, both agencies continue to seek ways to better understand self- Inquiry into transition from the Australian Defence Force (ADF) Submission 33

36 July 2018 harm and suicide and to improve our mental health response, including key joint research initiatives such as the Transition and Wellbeing Research Programme. The Programme will help DVA and Defence gain a better understanding of those who have transitioned from the ADF, with particular focus on the impact of military service on the mental, physical and social health of serving and ex-serving ADF personnel and their families. 130. DVA and Defence are committed to ensuring the range of rehabilitation services provided to the current and ex-serving community are appropriate and meeting the needs of DVA clients.

The Military Rehabilitation and Compensation Act 2004 Rehabilitation Long-Term Study is a joint DVA-Defence research project that will examine the effectiveness of rehabilitation arrangements within both the ADF and DVA, over the long term.

Strengthening Workforce Capacity 131. DVA also works with mental health professionals so they are attuned to ex-military needs. DVA has continued to strengthen the veteran mental health capabilities of service providers through the introduction of e-learning programs. 132. DVA has also recently collaborated with the Mental Health Professionals Network to develop a series of free webinars, designed to better help clinicians support the mental health needs of veterans. Each webinar involves a number of Australian and international experts and participants have the opportunity to pose questions to the panellists.

Webinars are scheduled on a quarterly basis, with podcast recordings being made available 2-3 weeks after the live event. Veterans and Veterans’ Families Counselling Service (VVCS) 133. VVCS is a nationally accredited (against the National Standards for Mental Health Services), military-aware, mental health service. VVCS offers a wide range of treatment options and programs for service-related mental health conditions. VVCS’ free and confidential services are accessible nationally and are delivered through a flexible and agile 24/7 clinical service model comprising: counselling centres in every capital city and across a range of major regional centres, as well as satellite offices close to Defence bases or near veteran concentrations; a strong outreach provider network with over 1,100 private clinicians; and video and online counselling and an after-hours phone counselling service.

134. VVCS has been the cornerstone of the Government’s veteran mental health support response for 35 years. Its structure and function has evolved, in line with the expectations of its expanding client base and the increasingly sophisticated understanding of best practice treatment of military trauma. To ensure it is well placed to respond with agility and client-centricity to future demands, VVCS continues to evolve and adapt its service offering. VVCS counsellors have an understanding of military culture and can work with clients to find effective solutions for improved mental health and wellbeing.

135. For transitioning or recently transitioned members, and their partners, VVCS offers a two-day Stepping Out (Transition) program. In the program, members will examine their transition process and what it means to go from military life to civilian life as an individual and as a family – in both practical and emotional terms. This free program is considered as ‘on duty at another location’ for current ADF members attending the program. 136. VVCS are about to commence an innovative addition to this program, the Stepping Out: Attention Reset (SOAR) trial. The SOAR trial will evaluate the efficacy of a computer-based attention control training program.

The training program is designed to re-calibrate an individual’s attention and threat detection system to prevent, and reduce existing, anxiety and traumatic stress symptoms. If proven effective, the training program will offer a simple, affordable, accessible and preventative intervention for transitioning personnel.

137. VVCS also delivers a Residential Lifestyle Management Program. The program is designed for veterans and their partners who want to improve their wellbeing and enhance their Inquiry into transition from the Australian Defence Force (ADF) Submission 33

37 July 2018 relationship. It provides an opportunity to take time out from the daily routine and focus on a range of lifestyle subjects, such as stress management, communication skills and relationship building. Topics covered include: adjustment to civilian life; communication; relaxation and stress management; relationship skills; building resilience; impact of military service on families; diet; motivation, problem solving and goal setting.

The full program is generally held over five days. There is also a modified program held over two weekends.

138. VVCS delivers services from 25 centres and through a national network of more than 1,200 outreach providers. VVCS provides: • counselling for individuals, couples and families; • case management for those with more complex needs; • group programs to develop skills and enhance support; • after-hours telephone counselling - ensuring support is accessible 24/7; • information, education and self-help resources; and • referrals to other services or specialist treatment programs as appropriate. 139. A calendar of VVCS programs can be found at: www.vvcs.gov.au/Services/GroupPrograms Support for families and carers 140.

Veterans’ families play a critical role in the story of veterans in Australia. Family members can be affected by the veteran’s service and are often fundamental to the veteran’s re-integration following deployments and transition from military service.

141. The Report of the Senate Inquiry made a number of observations reinforcing the crucial role that veterans’ partners play in supporting them in their transition to civilian life. As a result, Recommendation 19 of the Senate Inquiry confirmed the need for DVA to review support for veterans’ partners, and stated the Review should include services such as information and advice, counselling, peer support and options for family respite. 142. In response to this recommendation, on 1 May 2018 the Family Support Package was introduced. This measure provides extended child care assistance and counselling for the immediate family members of veterans who have served in recent overseas conflicts.

It also provides support to spouses/partners of veterans with warlike service who have subsequently suicided or had a service death, through the provision of counselling, child care and household assistance.

143. The Family Wellbeing Study, part of the Transition and Wellbeing Research programme, is due for release later in 2018. The findings of this Study will inform the development of future policies and programs to provide support for families. 144. The VVCS service delivery model recognises that military service rarely impacts on an individual in isolation. As such, eligibility to VVCS programs extends to the current or former ADF member’s partner and children. VVCS provides support to manage the psychosocial impact of military service, and supports war widow/ers as they work through grief and other issues associated with the death of a partner.

VVCS provides support to manage the psychosocial impact of military service, and supports war widow/ers as they work through grief and other issues associated with the death of a partner.

145. Client eligibility for VVCS has expanded, most recently in 2017 and 2016. The most recent expansion, part of the 2017 Budget, extended access to: Inquiry into transition from the Australian Defence Force (ADF) Submission 33

38 July 2018 • The partners and children of current and former ADF personnel who hold a Repatriation Health Card - Gold or White for an accepted mental health condition. This will assist with early engagement and intervention both for ADF personnel and their families, and • The former partners of current and former ADF personnel for a period of five years following transition, or for the duration of co-parenting responsibilities for a minor.

This will minimise the ongoing adverse effects of family breakdown on all parties. 146. Facilitated by the expansion of non-liability healthcare to all mental health conditions, also announced in the 2017 Budget, the families of personnel with at least one day of continuous full- time service now also have access to VVCS services. This expansion formally took effect on 1 July 2017.

147. This followed the 2016 Budget expansion, which came into effect on 1 April 2017, and extended access to: • Family members of current and former ADF members who die by suicide or reported suicide • Siblings of ADF members killed in service-related incidents • Defence Abuse Response Taskforce complainants and their families, and • Adult children (over the age of 26) of post-Vietnam War veterans. Other mental health awareness training and support 148. Defence is responsible for ensuring that members of the permanent forces and their families remain well informed, and are encouraged to access educational, financial, rehabilitation, compensation and other government services to facilitate sound transition planning.

149. Defence informs DVA of members transitioning from permanent service and the reason for transition. This includes members who transition for medical reasons, and for any reason associated with the use of prohibited substances or the misuse of alcohol. DVA is also informed if an ADF member is classified as seriously, or very seriously, injured or ill at any time during their service.

150. This advice allows the DVA to engage with the member to determine what assistance may be required. Defence also advises the CSC about medical transitions. 151. As part of Defence’s Transition Transformation program, the APS workforce of ADF Transition is being professionalised through a Certificate IV in Career Development. This course was specifically designed to increase the skills of APS staff to providing support to ADF members as they transition from Defence with a focus on career coaching and mental health. The course design includes two mental health focussed modules titled ‘Work with People with Mental Health Issues’ and ‘Respond Effectively to Behaviours of Concern’.

152. Defence has invested heavily in training that will support its staff in providing the best possible service to ADF members. Staff who provide transition support to ADF members are able to access to a suite of training which enhances their ability to identify and support ADF members with mental health concerns. Training includes: • vicarious traumatisation training courses delivered by Blue Knot Foundation and Phoenix Inc.

• Accidental Counsellor and self-care training delivered by the Centre for Community Welfare Training • ASSIST training • mental health first aid training Inquiry into transition from the Australian Defence Force (ADF) Submission 33

39 July 2018 • recognising mental health in the workplace • suicide awareness • mental health essentials for all staff, and • mental health essentials for people leaders. LifeSMART 153. The LifeSMART (Self-Management and Resilience Training) program has been designed to enhance ADF members’ individual psychological resilience as they make the transition out of the ADF.

154. Recognising that transitioning can be stressful, LifeSMART is delivered at ADF Transition Seminars, and looks at how to identify those signs and the strategies to help ADF members make that adjustment.

Post-transition follow-up contact with ADF members 155. Under the ADF Transition service delivery model, introduced on 10 July 2017, Defence continues to provide transition support for up to 12 months after transition for ADF members and their families. 156. Once an ADF member has left Defence, a Transition Coach will conduct a 30-day follow up telephone call. The purpose of this call is to confirm how the member’s transition has progressed and if there have been any issues that Defence can provide assistance with, including referral to mental health support and access to further employment support.

157. If the ADF member does not answer the call and there is no response, a follow-up text message and email are sent to engage with the former member.

158. This contact is the first in a number of engagements with the member. These include post- transition surveys at the 4 month, 7 month, 10 month and 13 month timeframes to gain an understanding of how the member and family are progressing and determine if further support and advice can be provided. 159. It is important to note that, if Defence identifies that additional support is required for the member, then additional contact will be made with the member and appropriate support services will be engaged.

Transition for Employment (T4E) program 160. The 2016 Defence White Paper called for the implementation of a program to assist ADF members separating from the military with complex medical conditions, including mental health conditions.

161. The aim of this program is to support members with complex medical conditions in the employment element of their transition by building the member’s resilience, and enduring capability to secure and maintain employment post transition to enhance their rehabilitation and reintegration outcomes.

162. The Transition for Employment program provides an enhancement to the existing transition process. It will be piloted for a 12-month period commencing in the second half of 2018, with approximately 15 ADF members nationally. 163. Further details of the T4E program are provided under Term of Reference 3. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

40 July 2018 Additional information for the Committee’s consideration Limitations of the current services being provided by the private and state health systems 164. Defence health care arrangements are not immune to community supply issues – in particular inequities of provision in regional and remote areas.

This is why we have entered into arrangements such as on-base psychiatry clinics and purchase of access to mental health beds in these regions. Whether the waiting times and service limitations of the state systems, particularly mental health care, are acceptable for veterans needing treatment.

165. All ADF members who need treatment are provided access to the treatment and services they need. The nature of Defence’s off-base supply arrangements through the Contract assists in facilitating access for members within prescribed clinical and operational priorities. However the nature of specialist and hospital services across Australia requires these providers to determine triaging priorities for all their clients and ADF members’ priorities for access are determined by service providers among the priority for their other clients.

Documentation of treatment response for PTSD and improvements of treatment outcomes, given limitations of current evidence based interventions.

166. All serving members who present with symptoms of PTSD or other mental health conditions are supported and given access to the full range of mental health and rehabilitation services, regardless of the cause of the condition or how and when they were exposed to trauma. 167. Treatment for ADF members diagnosed with PTSD is provided in accordance with the Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder 2013, and typically consists of a combination of psychotherapy and medication. 168. As identified earlier in this submission, Defence and the DVA have identified the need to improve access to, and availability of, effective evidence based care for PSTD for both current and former ADF members, particularly in the provision and uptake of prolonged exposure therapy.

Phoenix Australia, Defence, DVA and VVCS have partnered under Project RESTORE to trial a modified form of prolonged exposure therapy that delivers the treatment over a shorter period.

169. Should intensive prolonged exposure prove to be equivalent to standard therapy, it has the potential to significantly reduce barriers that personnel may experience when attempting to access and complete treatment for PTSD. The responsiveness of Defence and DVA to emerging international knowledge in the care of veterans and advice of health professionals 170. Defence monitors existing and emerging treatment guidelines through research and exchange of information with partner military organisations and national and international Centres of Excellence monitoring.

171. A current example is the collaborative initiative (previously discussed) being undertaken in July 2018 by Defence, DVA, VVCS and the Centenary of ANZAC Centre (Phoenix Australia) to conduct a two day Forum on Military and Veterans Mental Health – Innovations in Treatment.

The Forum is aimed at mental health practitioners with an interest in military, veteran and posttraumatic mental health. It will feature two world experts from the United States of America presenting on cutting edge treatment for trauma and cover: • Using evidence-based therapy with military, veteran and other clients • Expert tips and guidance on using therapy • Working with more complex cases Inquiry into transition from the Australian Defence Force (ADF) Submission 33

41 July 2018 • Flexible use of therapy in clinical practice, and • Recent innovative applications of therapy Inquiry into transition from the Australian Defence Force (ADF) Submission 33

42 July 2018 TERM OF REFERENCE 3 – The efficacy of whole-of-government support to facilitate the effective transition to employment in civilian life of men and women who have served in the ADF 1. Gaining meaningful employment or meaningful engagement after leaving military service is a crucial element for the long-term health and wellbeing of veterans and their families, and particularly to achieve positive mental health outcomes.

2. Defence and DVA have implemented a range of enhancements and programs to assist transitioning and former ADF members to increase the likelihood of them securing meaningful employment, where appropriate.

3. Defence provides the opportunity for ADF members to benefit from a range of education, accreditation and training designed to develop the individual throughout their career and prepare them for opportunities both in the ADF and to be competitive in securing employment when leaving the military. 4. Through the DVA-led Prime Minister’s Veterans’ Employment Program, the Government is promoting the unique value, skills and attributes of veterans and the transferability of their capabilities into civilian employment.

Transition Preparation Phase 5. Defence continues to be an employer of choice with respect to the ongoing training and education of military members from enlistment, throughout their career and during transition.

Accordingly, ADF members possess skills, training and attitudes that are valuable to civilian employers. 6. Transition is an inevitable part of every member’s career. As detailed in the following, throughout a member’s’ career Defence provides a range of opportunities and programs which directly, or indirectly, enhance an ADF member’s probability of securing civilian employment upon transition.

Total Workforce Model (TWM) 7. The ADF Total Workforce Model (TWM) enables serving ADF members to have civilian employment at the same time as serving in the military. The TWM promotes retention of military identity through continued service after transition from permanent service, and streamlines pathways to change the mode and amount of service which an ADF member can make to Defence through their life. 8. It is a contemporary workforce model that offers a different way of thinking about how ADF members serve and contribute to capability. The TWM provides Defence with the ability to meet changes in the workforce environment and provides different ways of serving as circumstances change.

9. The TWM assists members to maintain their military identity upon leaving permanent service and to continue to contribute to Defence capability through flexible service options which can allow ADF members to balance their military careers and personal obligations. 10. As part of the transition process, all ADF members automatically transfer to Reserves for a minimum of five years. Exceptions include members who: • have not completed initial recruit, officer, or employment training • are subject to disciplinary action • are leaving because of medical reasons • reached compulsory retirement age (65 years) Inquiry into transition from the Australian Defence Force (ADF) Submission 33

43 July 2018 11. The TWM enables greater mobility between full-time and part-time service and enhances the Services’ ability to draw efficiently upon different workforce mixes to meet their capability needs. 12. The TWM complements the Flexible Work Arrangements already in place. Significantly it introduces a new service category that provides Permanent/Regular members with the opportunity to serve flexibly. When approved by the Service, members have the option of remaining in the permanent force while serving on a part-time basis. Flexible service can be undertaken by serving ‘days per fortnight’, ‘weeks per month’, ‘months per year’ or a combination of all three.

13. The Service Spectrum is the central component of the TWM. It comprises both full-time and a range of part-time service categories (that is, ways of serving) across the Permanent/Regular and Reserve components. The TWM also recognises the contribution made by certain Defence APS employees, when in direct support of ADF operations.

14. The Service Categories (SERCATs) group members together, according to their service arrangements, conditions of service and obligation to serve. SERCAT descriptions are as follows: • SERCAT 7 – Permanent members rendering full-time service. • SERCAT 6 – Permanent members rendering less than full-time service for an approved period, who are subject to the same service obligations as SERCAT 7 members. Members can serve flexibly in this SERCAT in patterns of ‘days per fortnight’, ‘weeks per month’, ‘months per year’ or a combination of all three.

• SERCAT 5 – Reserve members rendering a specified pattern of service typically across more than one financial year, with the level of service obligation (i.e.

number of days and pattern of attendance) applied at the Service’s discretion. They are liable for call out. • SERCAT 4 – Reserve members who are available for voluntary service to provide capability at short notice, with the length of notice and service obligation applied at the Service’s discretion. They are liable for call out and available to be ‘called for’. • SERCAT 3 – Reserve members who are available for voluntary service, or are rendering service, typically within a financial year to complete a specific task with the level of service obligation applied at the Service’s discretion.

They are liable for call out. • SERCAT 2 – Reserve members who have no service obligation and do not render service. They are liable for call out. Members in SERCAT 2 who wish to undertake Reserve service must transfer to SERCAT 3, 4, or 5 before doing so. • SERCAT 1 – Employees of the Defence Australian Public Service (APS) who are force assigned.

15. Service Options (SERVOPs) provide the Services with a means of grouping members who provide capabilities where arrangements that are different to the ‘standard’ conditions covered in each SERCAT are appropriate. SERVOPs are applied in addition to a member’s SERCAT. SERVOPs cannot be used separately or instead of a SERCAT. SERVOP Descriptions are as follows: • SERVOP C – applies to Reserve members serving in SERCATs 3, 4 or 5 who are rendering Continuous Full-Time Service (CFTS).

• SERVOP D – applies to Permanent members in SERCAT 6 or Reserve members in SERCAT 5, typically with skills and experience that are in high demand, who are serving part-time in the ADF while alternately working part-time for a civilian employer under a formal arrangement between the member’s Service and the civilian organisation.

• SERVOP G – applies to Permanent or Reserve members rendering service in the ADF Gap Year Program. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

44 July 2018 16. The ADF Total Workforce Model is illustrated below. 17. Under the TWM all ADF members providing permanent service automatically transfer to a Reserve category for a minimum of five years (exclusions apply). This allows members to maintain their military identity, continue to contribute to Defence capability and provides members the flexibility to balance their military careers, civilian and personal obligations. 18. The TWM is enabled by: • access to a communications and information sharing internet platform, ForceNet. Members are encouraged to register for ForceNet (forcenet.gov.au) • a Defence Employment Package that remunerates members for the capability provided to the ADF • a smoother transfer process to enable efficient movement across the SERCATs as individual and Service needs change, and • career management support.

Australian Defence College (ADC) 19. As part of the ADF Transitions Transformation program, the Defence Registered Training Organisation, part of the Australian Defence College (ADC), is working to ensure that, at the time of transition, an ADF member has been awarded those qualifications earned during their service to assist their transition to civilian employment. This is an ADC initiative. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

45 July 2018 20. The Defence Registered Training Organisation will ensure timely awarding of certification and will work closely with Industry Reference Committees, of which it has membership, to identify any future Defence skilling outcomes that would be attractive to civilian employers. 21. Defence recognises that some transitioning members have faced difficulties in having their ADF qualifications mapped to equivalent civilian qualifications. Defence is working to improve this through the ADC’s ADF Transition and Civil Recognition Project. ADC is supporting ADF transition to employment through the following activities: • provision of 12 ADF Transition Training and Skills Guide, providing generic skills at rank, along with tasks undertaken at rank, against key priority job skills (refer Attachment 5 - ADF Transition Training and Skills Guide) • provision of the ADF Transition Training and Skills Guides to the Department of Jobs and Small Business to be added to the current Jobactive employment site to support employers interested in employing transitioned ADF • mentor Defence Community Organisation ADF transition coaches in the effective use of ADF Transition Training and Skills Guides, to support transitioning ADF members in preparing for civilian employment • provide support, advice and Recognition of Prior Learning (RPL) assessment services, where possible, to transitioning ADF members, through the Defence Registered Training Organisation and ADF.civilrecognition@defence.gov.au • develop an external website for ADF Civil Recognition.

This will be accessible by internal and external parties, including ESOs, transitioned members, Reservists and other Government departments. This website will contain the support material noted above, civil recognition advice, and links to key resources, including veteran’s employment programs developed by State and Territory governments, and • work collaboratively with the Department of Education and Training and the Department of Jobs and Small Business to provide additional support to transitioning members. This includes the provision of employment data that would assist in identifying job growth areas, when seeking areas of potential employment.

Defence Assisted Study Scheme (DASS) 22. The Defence Assisted Study Scheme (DASS) is available to all permanent ADF members and ADF Reservists on continuous full time service (CFTS), provided the study is undertaken and completed during the period of CFTS. 23. The Defence Assisted Study Scheme (DASS) supports Defence members who meet the eligibility criteria to access training and education at external Secondary and Higher Education Institutions and Registered Training Organisations. All Australian Defence Force (ADF) rank levels, regardless of seniority and employment group, are eligible to apply for DASS.

24. DASS support may take the form of financial assistance, work release and release to attend examinations. Studies must be completed prior to transition and provided by a Registered Training Organisation.

25. If personnel have served less than 12 years and are able to provide proof that they are transitioning within 12 months, they may be eligible to receive a one off offer of financial assistance up to $1,000 for studies associated with their future careers through DASS Level 3 (Transitioning out of Defence). DASS Level 3 applications may be submitted at any time within the last 12 months of service and prior to the course commencing. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

46 July 2018 Defence Civilian Accreditation Program 26.

Defence provides members with nationally recognised civilian qualifications for the training and experience gained during their service, where relevant to do so, such as to meet legislative, regulatory and licensing requirements. These are issued upon successful completion of courses, with Navy and Air Force issuing electronic accreditation and Army issuing hard copy certificates. The new enterprise Defence Registered Training Organisation (DRTO) is the current issuing RTO for all Defence personnel, with all issuance being provided upon successful completions.

Transition Phase 27. All ADF members will transition out of the military and back into civilian life at some point. Transition is a significant change to the life of the member and their family. The ADF Transition process is compulsory and ensures that a member and their family are informed and ready to enter the next phase of civilian life. Transition Coaching Model 28. Defence provides tailored transition coaching services to help members become competitive for civilian employment, where appropriate, as part of their transition to civilian life. 29. As part of the ADF Transition service delivery model, introduced nationally on 10 July 2017, all ADF members and their families who cease permanent service are provided with comprehensive transition support, through unlimited access to transition coaching which has a strong focus on securing civilian employment and developing a civilian career.

30. Through the ADF Transition coaching service delivery model (ref Attachment 13 - ADF Transition Service Delivery Model), ADF members and their families are able to access transition support from the time there is an intent to transition (or the member has been identified for potential transition for non-voluntary transitions). Under this model, support includes: • assistance to develop a comprehensive Transition Action Plan • support to ‘Discharge with Documentation’ (2016 Coalition Election commitment) • unlimited Transition Coaching Sessions, accessible pre and post transition • access to the Career Transition Assistance Scheme including: o two-day Job search preparation workshops o career transition training o career transition management coaching (develop an employment plan, develop interview skills and learn effective job hunting) o curriculum Vitae coaching o financial counselling, and o approved absence to undertake all career transition activities including job interviews, appointments and on-the-job experience.

• referral to relevant internal and external support organisations (including ESO) • 30-day follow up phone call • post-transition surveys. 31. Since the implementation of the new model (from 13 March 2017 for three launch sites and 10 July 2017 for all other sites), Defence has supported 4,608 transition planning sessions and a further 4,295 tailored coaching sessions for ADF members and their families (note that this data Inquiry into transition from the Australian Defence Force (ADF) Submission 33

47 July 2018 is as at 2 May 2018 and does not cover a full financial year).

This includes 50 transition coaching sessions conducted after the member had left Defence. 32. The ADF Transition coaches maintain contact with transitioned members for up to 12 months after they leave. This allows Defence to continue to provide support, and in particular career transition services where a former member’s employment status changes or if a need arises. 33. Twelve months on, feedback from transitioned members is being used to adjust and strengthen the model to continue to meet the needs of the members and their families. Transition (Discharge) with Documentation 34. Another initiative in response to the Coalition’s Policy to Support Veterans and Their Families is supporting ADF members to ‘Discharge with Documentation’.

This initiative ensures that transitioning ADF members have access to copies of relevant records and qualifications to enhance their transition to civilian life. This includes: • a comprehensive transition plan (Transition Action Plan) • a copy of the ADF Member and Family Transition Guide • health and dental records • leave and pay records • ADF licences • ADF Will • training and employment records, and • evidence of military qualifications. Pre and Post Transition Surveys 35. ADF Transition has introduced a post-transition follow up telephone call which occurs four weeks after the member has left Defence and an electronic survey to be conducted quarterly over 12 months post transition (ref Attachment 14 – Pre and Post Transition Employment Outcomes).

36. The follow-up phone call is a measure that allows Defence to continue to provide timely support after the member has left the ADF, and in particular to ask how the member and the family are going after their transition. It is an opportunity to discuss career transition services, where a former member’s employment status changes or if a need arises, assist with referrals to support services such as ex-service and community organisations. 37. As at 2 May 2018, following successful contact through the follow-up call with former members, approximately 160 transitioned members have reached back into Defence for transition support services, including attending Job Search Preparation workshop and additional transition coaching.

Defence continues to support these people.

38. The design and delivery of the post-transition online survey allows Defence to engage with the former member quarterly after the follow-up phone call period. The survey also allows Defence to capture feedback on the effectiveness of the support provided to individuals during their transition process and after they leave the ADF. The survey is sent to former ADF members at the four, seven, ten and thirteen month period after their transition from Defence. 39. The survey questions address the status of a former member’s employment, their employment industry and role; whether they are undertaking study; as well as and identifying participation in, and rating satisfaction of, services undertaken throughout their transition from the ADF.

Inquiry into transition from the Australian Defence Force (ADF) Submission 33

48 July 2018 40. Access to the online survey dashboard is provided to a select number of recipients in line with the support services outlined in the survey to highlight opportunities for development in the provision of holistic transition support. The access list is closely managed and includes Defence Community Organisation senior leadership, ADF Transition Management, Career Management Agencies, Joint Health Command, CSC and Defence Housing Australia. 41. A key data set from the survey is the employment outcomes.

The following table provides the percentage breakdown of employment outcomes collected through pre and post-transition contact with ADF members (as at 2 May 2018).

Transition Outcome Pre- transition (intent and/or achieved) 30 days post- transition 4 months post- transition 7 months post- transition Full-time work 40% 48% 45% 47% Part-time work 4% 6% 10% 12% Studying or training 9% 9% 7% 7% Working and studying or training 5% 5% 4% 4% Not looking for work 13% 16% 9% 8% Looking for work 26% 11% 13% 11% Retired or not disclosed 3% 5% 12% 11% *Note on the data source: • Data as at 2 May 2018. • Pre-transition and 30 days post-transition data includes cases from three transition coaching launch sites (Adelaide, Holsworthy and Townsville) from March 2017 and remaining ADF Transition sites from July 2017 as recorded in the ADF Transition Data Tool.

Post transition employment outcomes for the four and seven months after transition are based on Post Transition Survey responses.

• ‘Not looking for work at present’ includes members who are not currently looking for work due to medical or personal reasons (including travel and family responsibilities) but may do so in the future. • It is important to note that the number of respondents declines as time after transition increases. 42. The table above includes all transitioning ADF members, irrespective of gender. Defence has recently commenced an analysis of the data to determine if there are any noticeable Inquiry into transition from the Australian Defence Force (ADF) Submission 33

49 July 2018 differences in transition outcomes for males and females.

Of note for the Committee is that in the 2016-17 financial year, 921 female members transitioned out of the ADF, which represents 16 percent of the total transitioned population. 43. A few responses have been collected at the 10 and 13 month post-transition point; however they are small in volume. The trends reflected at these points in time indicate that in the first 10 months post transition, the ‘looking for work’ rate is about 8 per cent. 44. Overall trends across the cohorts that have transitioned since March 2017 indicates that post transition, the number of respondents in work or study increases, and the number or respondents looking for work decreases.

45. As further post-transition survey data becomes available, post-transition outcomes will be able to be reported to a greater level of detail. This includes outcomes by Service, gender, reason for leaving and employment industry. 46. At present the transition success appears to be measured by the proportion of members ‘seeking employment’; the lower the better. Consideration needs to be given if this is the most appropriate metric to measure success in transition. For example, a different measure could be the former member’s satisfaction with their overall circumstances, accounting for lifestyle and other factors, in addition to employment, post-transition.

Career Transition Assistance Scheme (CTAS) 47. The Career Transition Assistance Scheme (CTAS) is an eligibility based scheme, which provides access to career and employment benefits upon transition from the ADF. The intent of the Scheme is to enhance the transitioning member’s civilian employment opportunities and attractiveness. Defence provides training and financial assistance through the Scheme (ref Attachment 15 – Career Transition Assistance Scheme matrix). 48. Support available under CTAS includes: • Job Search Preparation (JSP) Workshops - a two-day workshop covering all aspects of applying for a job.

Members can also access up to two hours of individual coaching to prepare for job interviews and reinforce skills learned at the workshop (ref Attachment 16 – Job Search Preparation Flyer) • Career Transition Training (up to $5,320) - access to vocational education and training to enhance the member’s employment prospects after they transition • Career Transition Management Coaching (up to $2,820) - coaching to help members identify their skills, career options, develop an employment plan, develop interview skills and learn effective job hunting techniques • Curriculum Vitae (CV) Coaching (up to $253) - teaching members to develop and maintain their CV • Financial Counselling (up to $518) – to allow the ADF member to seek professional financial advice, and • Approved Absence (up to 23 days) - leave for all career transition activities including job interviews, appointments and on-the-job experience.

49. By maintaining contact with transitioned members for 12 months after they leave, Defence is able to continue to provide support, and in particular career transition services where a transitioned member’s employment status changes. If a member has not accessed their CTAS benefits before they transition, their benefits (excluding approved absence) are automatically preserved for up to 12 months after they have left Defence. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

50 July 2018 50. The number of ADF personnel who have accessed CTAS over FY15-16, FY16-17 and FY17-18, together with CTAS expenditure over those three financial years, is outlined in the table below.

Financial Year Number of ADF personnel accessing CTAS Expenditure for CTAS FY15-16 1,261 $2,767,707.55 FY16-17 1,738 $3,264,655.95 FY17-181 1,466 $2,535,438.87 1 As at 5 June 2018. Review of Career Transition Assistance Scheme (CTAS) 51. Defence has commenced a review of CTAS with a view to ensuring that it is flexible, equitable and accessible by all ADF members and their families. The review will provide training and financial support to members to assist in their transition to civilian employment. 52. The review of CTAS will provide support and services to members transitioning from the ADF that enables the member and their family to achieve their transition goals.

Members will be supported through coaching to identify the support that will best enable their employment, financial, wellbeing, identity, family and education/training outcomes for life outside of the ADF. 53. This objective will be achieved by aligning the design of transition support services from entitlement-based to needs-based, from complicated to simple, and from an employment focus to a whole-of-transition focus.

54. The review commenced in December 2017. Activities undertaken to date: • worked with a diverse range of stakeholders to develop options for future support needs • mapped user needs through: interviews with veterans and transition coaches; survey analysis; data analysis • conducted two days of ideation workshops with key stakeholders in late April 2018. Workshops were conducted over two half-days with 74 participants who put forward many ideas. The ideas spanned key themes of family support, sense of identity, embracing technology, mentoring, life skills, job seeking, training and emergency assistance.

Some of those ideas were broad principles and concepts, for example, removing the CTAS tier-based eligibility system. Other ideas are based around specific products that, before being progressed, were market tested with members, veterans and other stakeholders to determine their level of desirability • ideas were prototyped with members, veterans and other stakeholders, and • conducted a two-day collaboration workshop with stakeholders to reach a clear set of recommendations for consideration by Senior Defence Leadership.

Professionalisation of Defence Transition Workforce 55. In order to deliver the new Transition Coaching service delivery model all staff, who deliver transition coaching, have been upskilled through a Certificate IV in Career Development. This certificate included modules on the following subjects: • Use communication skills to build relationships • Analyse and apply information that supports employment and career development Inquiry into transition from the Australian Defence Force (ADF) Submission 33

51 July 2018 • Work legally and ethically • Deliver services consistent with a career development framework • Conduct Career Guidance Interviews • Provide support to people in career transition • Work with diverse people • Develop and maintain networks and collaborative partnerships • Provide Workplace Mentoring • Promote and represent the service • Work with people with mental health issues • Provide workplace coaching, and • Respond effectively to behaviours of concern 56.

In addition, all transition coaching staff have been provided membership to the Career Development Association of Australia (CDAA) which is the largest cross sectoral community of career development practitioners across Australia. This membership provides access to additional resources, training, events and advice, which greatly increases their skill level and expertise, and ability to assist transitioning members and their families.

Transition for Employment Program (T4E) 57. The 2016 Defence White Paper called for the implementation of a program to assist ADF members transitioning from the military with complex medical conditions. Under the Transition for Employment program (T4E), Defence People Group is working closely with Joint Health Command, the three Services and DVA on strategies to achieve a smooth transition for these ADF members. 58. This T4E program has been developed following a single Service initiative undertaken by Army. The new program is tri-Service and has built on the lessons learnt from the Army initiative, and will be piloted for a 12-month period commencing in the second half of 2018, with approximately 15 ADF members nationally.

59. The objective of the T4E program is to support eligible members in the employment element of their transition by building the member’s resilience, rehabilitation and an enduring capability to develop their career once transition support is no longer available. 60. The program will be available to nominated and approved military members, due to transition from the ADF for complex medical reasons. Participants may be suffering from either physical, psychological or sensory health issues or a combination of all three. 61. The T4E program provides a seamless and closely managed transition for employment capability for eligible participants, incorporating both transition coaching and specialist employment services.

This comprises a vocationally based service to deliver an assisted resettlement route and focused specialist employment support for those with complex needs. 62. Participation in the program is by referral only by either - • the member’s Chain of Command (CoC) • the member’s rehabilitation consultant • the Medical Employment Classification Review Board (MECRB), or • a combination of all three.

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52 July 2018 63. A member’s suitability to participate is established through an Eligibility Calculator designed specifically for this program. The calculator considers a combination of the member’s health issues and various psychosocial elements. 64. Once approved, the member (‘participant’) will participate in the program which has been designed in four phases. Each phase is outlined below and includes the party responsible for full or partial delivery of services (ref Attachment 17 – Transition for Employment Pathway).

Phase 1 - Entry Phase 65. This phase 1 identifies and approves the member for participation, establishes the member’s case file and aligns the member to a contracted consultant to commence Phases 2 and 3. The consultant has no formal role in this phase. All interactions are between the T4E team, the single Services, Joint Health Command, Rehabilitation Consultants and the participant. Phase 2 - Establishment Phase 66. This phase focuses on ensuring that the participant receives one-on-one vocational based support which includes mapping a participant’s competencies, capabilities and qualifications, identifying their civilian career goals and any barriers that may challenge the participant in achieving meaningful civilian employment.

It is likely that a member will undertake vocational training to increase their ability to achieve their employment goal. Where required, the consultant will assist the member to apply for funding for training from the Defence Career Transition Assistance Scheme (CTAS).

Phase 3 - Employment Phase 67. The consultant and the participant together will develop a bespoke employment plan and strategy to achieve the participant’s employment goal. This will include developing and maintaining a résumé, interpreting a job role advertisement, developing an application and covering letter for a job vacancy. The consultant will also assist the participant in understanding the value they bring to organisations, coach the participant in preparation for interviews, and identify and facilitate work experiences as required for the member. 68. The program focuses on achieving successful vocational outcomes centred on the member attaining meaningful employment.

Employment in this instance can be defined by, at a minimum, one of the following: • Apprenticeships • Internships/Graduate Programs • Paid Employment (Full/Part Time/Casual/Contractor) • Volunteering, and • Small Business/Franchise Owner. 69. The following options are available for a participant to experience a job role prior to developing their employment strategy to ensure a participant’s goals are achievable: • Insight Visits (no more than 1 day) • Work Experience Placements (2-5 days), and • Work Placement (2-4 weeks).

Phase 4 – Exit Phase 70. In consultation with the T4E team, the consultant and the participant will decide the point within the program when the participant will exit the program. A member can elect to exit the program voluntarily. Where a member experiences a change in their medical, psycho social, family circumstances, has further career questions or is seeking assistance for other job roles, the Inquiry into transition from the Australian Defence Force (ADF) Submission 33

53 July 2018 consultant will make available, and continue to deliver, specialist employment support to the participant for a period of up to two years from the date of initial enrolment in the program.

71. Pending the success of the T4E pilot, this model will inform the future transition arrangements for all medically transitioning members and potentially all transitioning members regardless of their reason for leaving the Military. Financial support 72. Attaining financial security is vital for transitioning ADF members and their families. Through their career and the transition process ADF members and their families are able to access financial education through the ADF Financial Services Consumer Centre. All transitioning members are encouraged to consider obtaining financial advice. Funding support is provided towards professional financial counselling for those leaving for medical reasons, redundancy and management or command initiated transitions.

Compensation payments 73. Current and former service ADF members may be eligible for compensation payments if they have sustained physical or psychological impairment or incapacity related to their military service. DVA encourages the lodgement of claims for any health condition veterans believe are caused by their military service. On Base Advisory Service (OBAS) advisors are on most military bases to support current and transitioning members to understand their entitlements prior to separation. There are a range of compensation payment types including disability pensions; permanent impairment payment; incapacity payments; and war widow/ers pension.

74. Of particular note for transitioning members, current or former ADF members who are totally or partially incapacitated for service or work as a result of a service related injury or illness may be eligible for incapacity benefits. These benefits are payments for economic loss due to the inability (or reduced ability) to work because of an injury or disease that has been accepted as service related under the Military, Rehabilitation and Compensation Act 2004 (MRCA) or the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA). Income support 75. Medically separating members may be eligible for the invalidity service pension.

This pension provides income support to Australian, Commonwealth and allied veterans and mariners who are considered permanently incapacitated for work due to medical factors, and who are not yet entitled to an age pension.

76. The Veteran Payment is also available to provide interim income support for those who have lodged a claim for a mental health condition under either MRCA or DRCA, are under age pension age, and are incapable of working for more than eight hours per week. Post-Transition Phase Improving employment opportunities 77. Gaining employment after leaving military service is a crucial element for the long-term health and wellbeing of veterans and their families, and particularly to achieve positive mental health outcomes.

Prime Minister’s Veterans’ Employment Program 78. In recognition of the importance of civilian employment to veterans, the Prime Minister launched the Prime Minister’s Veterans’ Employment Program in late 2016, with funding of $2.7m provided in the 2017–18 Budget.

A further $8.3m was provided in the 2018-19 Budget. 79. This program aims to raise awareness of the unique skills and experience that veterans can bring to civilian workplaces, and to increase employment opportunities for veterans in the private sector.

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54 July 2018 80. The Minister appointed 14 members to an Industry Advisory Committee (IAC), taking into account the need for the IAC to represent a wide cross-section of industry, including small, medium and large businesses. 81. The IAC is providing advice on practical measures to embed veterans’ employment strategies into the recruitment practices of Australian business. In its first year, it has focused on five priority areas, including: • data, research and targets • human resources policies, accreditation, retention and translation of skills • communication (branding, awareness, transition seminars, website, job fairs) • spouse employment of serving ADF members, and • the Prime Minister’s Veterans’ Employment Annual Awards.

82. The inaugural Prime Minister’s Veterans’ Employment Awards were held in March 2018, and will be conducted annually to recognise the achievements of Australian businesses and other organisations in supporting and employing veterans and spouses of serving ADF members, and veterans who are making significant contributions to their workplace. 83. A dedicated website has been launched at www.veteransemployment.gov.au. The website will be improved over the second half of 2018 and will become a hub for information on veterans employment.

APS Employment 84. The Australian Public Service Commission (APSC) is supporting the Prime Minister’s Veterans’ Employment Program through the development of its website which contains information specific to veterans seeking employment in the APS. 85. The APSC has developed a guide that aligns ADF ranks to APS classifications, and a practical toolkit to guide veterans through the process of applying for an APS job. 86. Defence is also aware of the Australian Tax Office pilot to provide a small number of non- ongoing contracts to transitioning or recently transitioned ADF members. A positive aspect of this pilot is that it provides opportunities for veterans in smaller regional centres such as Albury and Townsville.

Jobactive website 87. The Federal Department of Jobs and Small Business’ jobactive website is the Australian Government’s employment service which assists people to find work and help employers find the right staff for their business. 88. The jobactive website provides comprehensive support tools and information specifically for veterans seeking employment. The website contains information on labour market advice, employment planning tools and government employment assistance. 89. The Jobactive website has been enhanced to allow veterans to filter their job search with the special vacancy type ‘Defence Force Experience Desirable’.

Vocational rehabilitation support 90. Vocational support is part of DVA’s whole-of-person rehabilitation framework and assisting eligible veterans return to sustainable and meaningful employment when ready, as explained in Term of Reference 2. This may include training and education, job preparation assistance, employer incentives and work trials.

91. The goal is to get veterans back to at least the same physical and psychological state and social, vocational and educational status they had before their service injury. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

55 July 2018 External education and training opportunities 92. Whilst ADF members receive training through their career, some ADF members require further training and qualifications in order to make a successful career transition. Defence builds relationships with external education entities in support of this need.

Universities and TAFE 93. A number of universities and TAFE institutions are invited and attend the ADF Transition Seminars to provide ADF members with information and advice on training and courses that would support them to transition back to civilian life.

94. Some of these institutions have restructured and/or aligned their courses to maintain a close relevance to an ADF member’s training and career needs. These institutions continue to recognise the qualifications, training and experience that ADF members have as a result of their service, and support the recognition of prior learning (RPL) process against specific qualifications. 95. TAFE NSW is proposing to launch an ADF personnel reskilling pilot program. This program is not an ADF initiative, but an initiative of TAFE NSW. There were six recommendations from the ADF Skills and Apprenticeship Forum held in March 2017 and recommendation 4 directly links to this initiative.

The designed outcomes are laudable and supported by Defence.

Prince’s Lead Your Own Business (PLYOB) Program 96. The Prince’s Trust Australia in partnership with RMIT University supports transitioning ADF personnel to start a small business or consultancy through the Prince’s Lead Your Own Business program. 97. The program is underpinned by the nationally accredited Certificate IV in New Small Business. The program will build upon the intensive training skills, self-discipline, resilience and commitment to excellence developed and matured through participants’ military service in the ADF.

Employment initiatives 98. Further to the Prime Minister’s Veterans’ Employment Program initiatives, there are a range of other employment initiatives which are, or have been, implemented to assist ADF members and partners seek employment post transition.

Shipbuilding and submarine employment opportunities 99. Defence is aware, and supportive, of career/job fairs that have been, and are planned to be, undertaken by Defence Industry as part of the build-up of the shipbuilding and submarine workforce.

100. These events will involve Defence participation, but are aimed at individuals with required qualifications and the necessary skills to assist Defence Industry with the shipbuilding program. These opportunities will be highlighted to transitioning ADF members who may then wish to engage with the shipbuilding industry partners. State and Territory Government employment initiatives 101. Defence engages directly with several State and Territory Governments regarding their assistance to transitioning members, and is working closely regarding the various employment programs and other initiatives within their remit.

In addition, State and Territory Government representatives attend ADF Transition Seminars and provide information directly to ADF members.

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56 July 2018 102. In 2017, Defence worked on a 90-day project with the South Australia Government and various stakeholders to develop a Veterans Portal on the SA Government’s employment website. The project has been finalised and a veteran specific portal on the ‘I Work for SA’ employment website has been established. In addition, the South Australia Government has a stall at the Adelaide ADF Transition Seminar. Job fairs, career expos and other known initiatives 103. The Federal Department of Jobs and Small Business advertises a schedule of job fair events being held in various locations in Australia on its website.

Transitioning ADF members and their families are able to attend these events.

104. The aim of the job fairs is to give people the chance to explore employment opportunities in their local community and provide job seekers with an opportunity to talk directly to a range of employers about the skills they are looking for, and find out about available job opportunities. 105. Regular careers and employment expos are held nationally and include information on careers, training, and education and employment opportunities for students, job seekers and those changing careers. 106. Career fairs and employment events are increasingly being targeted towards transitioning and former ADF members.

For example: • regular Veteran Career Expos conducted by WithYouWithMe • regular Soldier On Pathways Networking events • Australian Veteran Employment Coalition employment events, and • various veteran-focussed industry open days, for example, further detail is included below of one recently conducted by SAAB Australia.

107. In March 2018, SAAB Australia hosted their inaugural Veterans’ Employment Open Day in Adelaide. The open day was delivered as an informative workshop for veterans seeking employment in industry and the public sector and was also attend by support organisation representatives and potential employers. Given the interest shown the first veteran open day, a similar event is being planned for September 2018 which will have broader industry involvement and align with the ADF transition seminars. 108. In early December 2017, a career expo was held by the Ipswich Jobs and Training Forum in Queensland designed to arm job seekers with information to enable them to secure a job in the Ipswich area.

The event was hosted by the Queensland Department of State Development in conjunction with the Ipswich Chamber of Commerce, and attendees included ex-Defence employees, mature-aged persons looking for work, and those seeking to change their career path. 109. In November 2017, the South Australian Government held JOBEX, South Australia’s largest free employment and careers exhibition. JOBEX was held in Adelaide over two days during which 120 of the State’s leading businesses showcased career pathways and job opportunities in five emerging industries: Defence and shipbuilding; renewable energy and mining; health and biomedical industries; tourism, food and wine; and information technology and high-tech manufacturing.

Employers included Tesla, BAE Systems, Fleet Space Technologies and SA’s leading tertiary institutions.

110. In November 2017, JP Morgan Australia launched the Australian Veterans Employment Coalition, which is modelled on the program run by the company in the United States. Companies involved in the coalition include Westpac, Australia Post, Qantas, Boral, AGL, Wesfarmers, Fairfax Media, Snowy Hydro and Incitec Pivot. 111. The Northern Territory’s Department of Trade, Business and Innovation holds an annual skills, employment and careers expo which travels to several locations across the Territory. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

57 July 2018 112.

Details of job fairs being held in Victoria are advertised on the Victorian Department of Employment website, and Defence notes that the Victorian Government has developed a veterans’ employment program. Financial support ADF partner employment 113. Defence provides funding for initiatives aimed at contributing to the employability of ADF partners when they are relocated as a consequence of their partner’s military service. 114. Under the Partner Employment Assistance Program (PEAP) partners of ADF personnel can apply for up to $1500 funding on each posting to access the following employment-related initiatives: • mandatory fees for professional re-registration required under legislation • professional employment services o development of a personalised resume and/or resume coaching o identification of transferrable skills o employment options and job placement advice o job search techniques and strategies o development of an online employment profile o application and selection criteria coaching, and o preparation and presentation coaching for interviews.

Defence Families Australia (DFA) 115. In addition, Defence Families of Australia (DFA), in conjunction with a working group of the IAC has launched additional partner employment information on its website. 116. DFA has developed a checklist for the ‘gold standard’ of what it entails for an organisation to be a recognised Defence partner friendly employer.

117. Employers involved in the Prime Minister’s Veterans’ Employment Program who self-identify as meeting the standard of the checklist, will provide a link to the employment section of DFA’s website for inclusion in the initiative. The following employers will feature in the launch: SAAB, Westpac, BAE Systems, Thales, and PwC Australia. Employment initiatives summary 118. Numerous employment initiatives have been implemented to assist ADF members and their partners seek and secure employment post transition. Defence provides comprehensive transition support, including targeted assistance to increase employability of ADF members during the transition process.

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58 July 2018 TERM OF REFERENCE 4 – Any related matters 1. The Departments consider the following additional topics of relevance for the Committee’s attention. Women in the ADF 2. Transition support is provided based on the needs of the individual and their family. To date, Defence treats all ADF members the same during the mandatory transition process. Within the transition process, Defence has not identified any unique requirements for transitioning female members. However, as Defence continues to collect information from transitioned members, the needs of female veterans and other veteran cohorts (i.e.

young veterans, administrative and medical transitions) may be able to be more readily discerned. As at June 2018, the size of the data set is not yet large enough to allow such analysis.

3. The Female Veterans Policy Forum (Forum) was established in 2016 to provide female veterans and veteran family members the opportunity to raise issues with the Australian Government. The Government and DVA are gaining a deeper appreciation of issues facing female veterans and veteran families which is helping to inform DVA’s transformation. Ideas and themes flowing from the Forum are available on the DVA website. The 2018 Forum is scheduled for 11 and 12 September 2018. These dates coincide with an event honouring the contribution and sacrifice of women as veterans and veterans’ family members.

Reserves 4. ADF Reservists are a mix of former permanent/regular members (who went through a transition process when they completed their permanent service), or abinitio Reservists - mainly Army - who already have a full-time or part-time civilian job. As a result, there is generally a much lesser need to support Active Reservists (non-CFTS) transitioning, because the majority are already in civilian employment.

5. Transition Coaches discuss with eligible members the opportunities and benefits of transferring to the Reserves, including the continued connection to the military service and ongoing engagement with their colleagues. 6. Each of the Reserve elements attends the Transition Seminars, to provide additional information and advice to members and their families. Defence Reserve Support Council 7. The Defence Reserves Support Council (DRSC) promotes the benefits of Reserve service to employers and the community, and creates an effective link between Reservists, employers, the ADF, all levels of Government and the community.

8. The DRSC was established at the direction of the Minister responsible for the Reserves and is supported financially and in management terms by a Memorandum of Understanding between the Department of Defence and the National Chair of the DRSC. 9. The mission of the DRSC is to establish and maintain a flexible and supportive partnership between Defence and the community, industry and employers to sustain and enhance the availability of the Reserve component of the ADF. 10. The role of the DRSC National Executive is to provide senior level advice to Government and the ADF on matters affecting Reserve availability, including employer support.

Eligibility for transition support 11. Defence provides transition support to all permanent ADF members when they leave Defence. This includes Reserve members performing continuous full-time service under SERVOP C and ADF Gap-Year members.

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59 July 2018 Reserve eligibility 12. When a Reserve member provides continuous full-time service for less than 6 months their transition is managed by their unit and supported by their Chain of Command. ADF Transition can provide additional support to these members on request. For example, to access transition planning and coaching services if a member has no permanent employment to return to. 13. When a Reserve member provides continuous full-time service for 6 months or more transition support is provided by ADF Transition as per the service delivery model including access to the Career Transition Assistance Scheme dependent upon the individuals’ eligibility.

ADF Transition Partnership 14. The diagram at Attachment 18 – ADF Transition Partnership shows an ADF member and family transition experience (left-hand side of the diagram), ‘A Day in the Life of a Transition Centre’ (right hand side of the diagram), and the Transition Partnership between the member and the transition centre (centre of the diagram).

15. The document provides a high-level visual representation of the work involved in supporting an ADF member and their family through transition. Resourcing in ADF Transition Centres 16. As at 19 June 2018 the Directorate of ADF Transitions, within Defence Community Organisation, has a headcount of 52, which is made up of 42 Australian Public Service (APS) employees, and five military and five contracted staff. These resources are distributed across the 13 ADF Transition Centres, and Defence Community Organisation Headquarters. 17. Of the staff mentioned above, 36 APS and 4 contracted staff are responsible for delivery of client facing transition coaching services.

To support the ADF Transition service delivery model, Defence has professionalised the role of the Transition Coach. To meet the requirement of the role, staff are to a hold a Certificate IV in Career Develop (or equivalent) or have experience (5+ years) in the employment services industry.

18. Under the Transition Transformation program, Defence provided all existing ADF Transition staff the opportunity to undertake the Certificate IV in Career Development. This course built on the existing skills and experience of these staff, a number with over 10 years’ experience in the role, with a focus on career coaching and mental health. 19. In the current resource constrained environment, the ability of Defence to deliver transition support to approximately 6,000 transitioning members per year, utilising a coaching and mentoring model, is a delicate balance.

20. The implementation of the coaching and mentoring model, requires a greater amount of preparatory and client facing time investment from the Transition Coach than the previous administrative model.

Defence has implemented business process improvements to lean administration and allow Transition Coaches to focus on client facing service delivery. 21. With an increasing number of transitions on an annual basis, Defence is continually reviewing resource priorities to deliver transition support. DVA/Defence joint initiatives to deliver integrated approaches to transition services 22. DVA and Defence are trialling innovative and coordinated approaches to delivering assistance and support to members leaving military service.

23. In mid-2017, DVA was approached by the then Special Operations Commander, ADF, to develop a more holistic, veteran-centric way of providing DVA services to ADF members and their families as they transition to civilian life. The DVA-led Special Operations Forces (SOF) Inquiry into transition from the Australian Defence Force (ADF) Submission 33

60 July 2018 Pilot model tests an improved approach to DVA’s support services in transition, for ADF members and their families, by looking at wellbeing and whole-of-person outcomes. 24. The Pilot includes: • a dedicated DVA Liaison Officer for SOF members and their families • a dedicated case manager where required • a streamlined claims process focussed on the transitioning member and their family, and • early engagement and awareness to support understanding of DVA services and earlier lodgement and decision making of claims.

25. The learnings and feedback from this pilot will assist DVA to continue to improve how DVA provides services to Special Operations Forces veterans, and will assist to inform a repeatable, scalable model across the ADF. The goal is to empower and enable the member through the DVA claim process to support transition into a healthy, productive civilian life for themselves and their families. Early Engagement Model 26. Improved information sharing between Defence and DVA through the Early Engagement Model has facilitated DVA establishing a relationship with ADF members early in their career and increases the number of current and former serving members known to DVA.

Prior to the Early Engagement Model the majority of veterans were not known to DVA once they left the ADF as the relationship was predicated on the veteran submitting a claim. 27. Members who joined the ADF from 1 January 2016, and those who transitioned after 27 July 2016, are now automatically registered with DVA. Over 14,500 current and former ADF members who have not made a claim or approached DVA have been registered. Over time, new triggers for registration will be added. The next of these will be when a member becomes eligible for Qualifying Service.

DVA transition support On Base Advisory Service (OBAS) 28. OBAS provides a DVA presence on more than 40 ADF bases nationally and offers members information and advice about the support and entitlements that they might be able to receive through DVA. OBAS advisors also provide information about DVA services at Defence Transition Seminars. Current serving members are encouraged to meet with an OBAS advisor before they transition from the ADF. Stepping Out 29. The VVCS offers a free two-day program for all ADF members, and their partners, who are transitioning from the ADF or have transitioned in the last 12 months.

The program focuses on skills that will assist members and their partners in their transition, including: • planning • motivation and adaption techniques • expectation and attitude management • maintaining relationships, and • knowing where to go to seek professional help. 30. This program is offered in addition to the full range of VVCS services provided to transitioning members and their families outlined in Term of Reference 2. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

61 July 2018 Case management pilot 31. The DVA case management pilot aims to provide a whole of life case management service delivering personalised, tailored assistance. Recently transitioned veterans who were medically or administratively transitioned and who have complex medical and non-clinical needs will be included in this pilot. 32. The pilot will involve 100 veterans in the first year and 200 in the second year. DVA will use both internal and external case managers who, with the support of a multi-disciplinary clinical team, will help the veterans participating to achieve personal goals for the immediate period.

The pilot is planned to commence in mid-2018.

Coordinated Client Support program 33. DVA’s Coordinated Client Support (CCS) program is a specialised time limited program aimed at streamlining communication between clients and the Department. The CCS program, which commenced in February 2016, combined a number of DVA client service models into one program, providing a clear pathway for clients to access support through a primary or single point of contact for the whole of the Department. 34. The majority of DVA’s clients are able to navigate the Departments services, however some may require an additional level of support and/or referral to CCS where they are appointed a Coordinator.

35. Transitioning clients who require support are identified by ADFRP, OBAS or their DVA claims manager, and are appointed a Case Coordinator to help them navigate DVA’s processes and connect with community and health care supports. The Case Coordinator will also attend Individual Welfare Board meetings during the transition process, and will work with ADFRP to ensure a warm handover from ADF to DVA supports. Productivity Commission Issues paper - Compensation and Rehabilitation for Veterans – May 2018 36. The recent report titled The Constant Battle: Suicide by Veterans, by the Senate Foreign Affairs, Defence and Trade References Committee (SFADTRC)1 , highlighted concerns with the legislative framework for compensation and rehabilitation for veterans.

The Committee found the legislative framework to be complex and difficult to navigate, and noted concerns about inconsistent treatment of claims for compensation, and lengthy delays in the processing of claims with unwarranted stress for veterans and their families.

37. A particular concern of the Committee was that the current system, being complex and challenging to navigate, would compromise any efforts by DVA to make the claims process ‘veteran centric’. 38. The Committee recommended a review of the veterans’ compensation and rehabilitation system, stating that ‘it is time for a comprehensive rethink of how the current system operates and will operate into the future’ (SFADTRC 2017, p. 68), and the Government has asked the Productivity Commission to undertake this review.

39. Defence and DVA is providing a response to the Productivity Commission Issues paper (ref Attachment 19 – Productivity Commission Issues Paper – May 2018).

1 The Constant Battle: Suicide by Veterans, by the Senate Foreign Affairs, Defence and Trade References Committee, 15 August 2017, Commonwealth of Australia 2017, ISBN 978-1-76010-620-1 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

62 July 2018 ADF Transition – Success stories beyond a military career 40. Through the Transition Coaches, Defence has interviewed a number of ADF members who have recently gone through the transition process and also those who are currently in the process of transitioning. 41. Below are examples of statements made by some of those members who have transitioned, or are in the process of transitioning, and describe their positive experience both during and after their transition from the ADF. • Navy member for four years, transitioning July 2018, female, currently looking for work – “The ADF has supported me throughout my transition by providing me with the two day seminar.

I also utilised the job search workshop which was beneficial for not just myself and my own confidence, but seeking jobs with future employers”. • Navy member for sixteen years, transitioned May 2018, female, currently looking for work – “When I decided to transition out of the Navy, I had no clear plan. I knew that I needed to go and where I wanted to go, but no clear plan to get there. My transition coach was awesome. Anytime I had questions of anything I could just drop off an email or make a phone call and they were always happy to help. The advice I’d give to ADF members currently transitioning is to get on to Defence Transitions, utilise your transition coach and take all the information you can get”.

• Navy member for twenty years, transitioned May 2017, male, currently running own business - “The Transition Centre staff made sure I was aware of my entitlements and what I needed to do to transition. They also led me through the Career Transition Assistance Scheme process and then gave me a list of milestones to work towards”. • Army member for thirty years, transitioned May 2018, female, currently working for State Emergency Services – “Defence made me feel like I wasn’t alone in my journey in my transition; I felt supported by my Transition Coach and Defence in general”. • Army member for ten years, transitioned February 2018, male, currently working in the mining industry and training to be a supervisor – “When I left the ADF I felt like I had so many options for where to find support.

My Transition Coach supported me and reinforced what was available for me to utilise. I’m now at the place I am, with their help”.

• Army member for eight years, transitioned April 2018, male, currently working for John Holland Railway – “The most valuable thing I've taken from my ADF career is to be more understanding and patient as everyone is different. My Transition Coach was very professional and very educational. She laid out a plan for me that was easy to follow”. • Army member for fourteen years, transitioned April 2018, female, currently working for the private sector - “Making a career change was a big step for me. The combination of my studies the experiences and skills I developed in the ADF, and the support I received from my chain of command, gave me the confidence and a strong foundation to make the move to a civilian career”.

• Air Force member for eight years, transitioning July 2018, male, currently a Reservist - “With the transitioning, it was up in the air for the first few days to start with, but then I felt some relief as well [getting some control back in my life]. The biggest thing with transitioning is having a bit of leave prior, so then you have some time to re-set yourself and get back into civilian life”. • Air Force member for twenty years, transitioned July 2016, female, currently running own business - “Defence was incredibly supportive from day one. I was lucky enough to be chosen for The Prince’s Charities Australia Program which is offered to members leaving Inquiry into transition from the Australian Defence Force (ADF) Submission 33

63 July 2018 the ADF to complete some business studies. The program really assisted me in my transition”. Inquiry into transition from the Australian Defence Force (ADF) Submission 33

64 July 2018 LIST OF ATTACHMENTS Attachment 1 – Transition Transformation placemat Attachment 2 – ADF Member and Family Transition Guide Attachment 3 – ADF Transition Seminar program Attachment 4 – ESO promotion on DCO Social Media Attachment 5 – ADF Transition Training and Skills Guide Attachment 6 – Partner Employment Assistance Program (PEAP) Attachment 7 – Education Assistance Scheme (EAS) Attachment 8 – In-School Aides and Mentors Attachment 9 – Childcare assistance Attachment 10 – KidSMART Attachment 11 – Career Transition Assistance Scheme (CTAS) Attachment 12 – Other employment and education support Attachment 13 – ADF Transition Service Delivery Model Attachment 14 - Pre and Post Transition Employment Outcomes Attachment 15 – Career Transition Assistance Scheme (CTAS) matrix Attachment 16 – Job Search Preparation flyer Attachment 17 – Transition for Employment (T4E) Pathway Attachment 18 – ADF Transition Partnership Attachment 19 – Productivity Commission Issues Paper May 2018 Inquiry into transition from the Australian Defence Force (ADF) Submission 33

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