JCU review goes ‘beyond the uniform’

In a recent comprehensive review of 65 studies from around the world, lead researcher and JCU Clinical Psychologist Carolyn Heward said the team found four key groups of military identities, highlighting the need for a cultural shift to accommodate the unique mental challenges each veteran faced.

"What this scoping review suggests is that there are individuals for whom the traditional idea of what a soldier is, such as the stoic, warrior type, does not apply, and there are individuals who have had to suppress their own identities to fit in," she said.

"If the Australian Defence Force as an organisation, and the culture that accompanies that, can be accepting of that diversity and recognise those veterans who feel they have to hide their identities and suffer the mental health consequences associated with that, the hope would be that we can intervene at a much earlier stage."

The familiar 'Loyal' and 'Warrior' identities - characterised by a strong sense of duty, comradeship, and belonging - are the first two identities highlighted by Ms Heward in her review.

"People with these identities often report feeling proud, confident, and resilient. They're the ones who might say, "The military is my family" or "I was born to be a soldier."," she said.

"One participant in one study said "it was about becoming "a warrior, and being strong, and being prepared to fight and suffer and do things that most people would only watch in the movies"."

But lesser-known identities were found to be common too.

The 'Hidden' identity encompasses service members who feel they need to suppress parts of themselves to fit in.

"This might mean hiding emotions or, for women, downplaying their femininity. While this can help them feel part of the group, it often comes at a cost to their mental health," Ms Heward said.

The fourth group of identities are those that are 'Disrupted', with the most common being the 'Morally Injured' identity. This develops when a service member experiences something that violates their core values, such as a soldier who had to make a difficult decision in combat which saved lives but also caused harm.

"They might struggle with guilt and shame, even if they did what was necessary," Ms Heward said.

Within the 'Disrupted' identities is the 'Lost' identity, occurring during a service member's transition back into civilian life, whether post-deployment or post-discharge.

Many veterans describe as feeling disconnected and struggling to find their place in society.

With the final report of the Royal Commission into Defence and Veteran Suicide highlighting a previous study which found the suicide rate of veterans is 26 per cent higher than the national average for men and 107 per cent higher for women, Ms Heward said it was imperative the ADF changed the way it approached treating the mental health of its servicemen and women.

"For military leaders, this research highlights the need for a culture that values diversity while maintaining the cohesion necessary for military effectiveness," she said.

"For healthcare providers, looking beyond the uniform and understanding each person's unique experience of military identity is key to providing effective care."

Ms Heward said the review also underscored the need for policymakers to design programs that not only support the physical, but also the psychological wellbeing of service members, both during and after their service.

"The Royal Commission has brought to light the struggles that veterans experience. For our ex-serving ADF members, almost 50 per cent report experiencing mental health difficulties, which is significantly greater than the general population," she said.

"The suicide rates are quite alarming for ex-servicemen and women as well. From a broader community perspective, a part of it is us appreciating more greatly the diversity of identity and cultures that exist within our own backyard, and perhaps having a little more openness to that diversity and where people have come from."

Ms Heward said the 'Lost' identity represents the biggest mental challenge for veterans as they return to a world that is now unfamiliar to them - something she hopes to address in her upcoming PhD focused on Australian veterans.

"What I hope to create is a better understanding of how individuals go from civilian to soldier, which will assist us with much clearer guidance on how we then support them going from soldier to civilian," she said.

"If we only focus on the soldier to civilian transition, we're missing a part of the story."