‘There’s lots of suffering’: Supporting veterans amid Afghan turmoil

Anastasia Tsirtsakis

25/08/2021 2:52:05 PM

The Department of Veterans’ Affairs has released new resources to help GPs support their patients.

An ADF member attending to women and children.
A lack of an individual’s direct exposure to Afghanistan doesn’t necessarily mean that they are not going to be traumatised by current events, says Dr Ross Mills. (Image: AAP)

The latest release follows news of the rapid takeover of Afghanistan by the Taliban, just over a month after Australia completed its formal withdrawal of troops.
Concerns have since emerged over the possible impact on the mental health of veterans who served in the 20-year war. 
Dr Ross Mills, a current Australian Defence Force (ADF) member and Chair of RACGP Specific Interests Military Medicine, was among those on the ground. He had two postings as the senior doctor in the Middle East from 2013–15, serving a total of 12 months.
Seeing the events currently unfolding, Dr Mills told newsGP that the potential impacts are multifaceted, including triggered PTSD and moral injury, and is not limited to those who served in Afghanistan.
‘The same event will have different consequences on different people – and it doesn’t necessarily just affect those who are involved; it can be those who witnessed or participated in the periphery,’ he said.
‘So we’re best not to jump to the conclusion that because you have been in theatre you have suffered the most and because you haven’t you suffered the least, because lots of people are feeling stressed for a whole bunch of different reasons and it’s not always going to be obvious.’
To help GPs support the mental health and wellbeing of their veteran patients, the Department of Veterans’ Affairs (DVA) has compiled guidance and resources, encouraging doctors to start by demonstrating ‘an understanding of the military experience’.
‘This can strengthen the therapeutic alliance and the delivery of effective treatment. Veterans are more likely to engage with healthcare practitioners they feel understand, or seek to understand, their mental health problems within the context of their military service,’ the DVA states.
The resources also include a link to CPD-accredited training on veterans’ mental health, and a list of services patients can be referred to.
Dr Mills welcomed the resources, emphasising that they are an important ‘first step in a journey’.
‘One of the things we’re looking at is better ways in which the RACGP can act as a communication and support vehicle for GPs out in the community managing vets and their families,’ he said. 
What is clear, Dr Mills says, is that while the doctor–patient relationship is very important, it requires both effort and time to develop a level of trust.
‘Most patients, unless they’re desperate, aren’t going to just sit down and blurb because by the time they get to that point they’re getting close to tipping point anyway, and you really want to try and catch them before they get that bad,’ he said.
‘So to get them early, you need to get them to open up and they need a safe environment that requires trust and the ability to communicate, [which] is more than just verbal.’
Dr Mills says rather that outright asking veterans about their stress and mood, that the answers about their mental health may emerge through questions about their lifestyle habits.
‘It’s about fatigue, engagement and exercise, alcohol – that sort of stuff, the more subtle questions,’ he said.
This, however, can pose potential challenges for GPs who are time and resource poor, while some doctors themselves may potentially be struggling with PTSD and fatigue as a result of the COVID-19 pandemic.
‘So, in that regard, it’s a two-edged sword,’ Dr Mills said.
‘Yes, the vets might be suffering … but then there’s the doctors themselves, who are not vets, who are potentially also stressed, and this is a case of volunteering to get more stress. So the carers have got to look after themselves.
‘If the GPs can, they need to check in with themselves and make sure that they are okay because they need to be in a good place themselves before they can start effectively managing or helping others through their journeys.’
While some who served in Afghanistan have felt like their efforts on the ground were wasted, Dr Mills’ perspective differs.
Irrespective of the outcome, he chooses to see it as ‘all part of a journey we needed to go through’.
‘It hasn’t caused any particular trauma for me; I’ve got other traumas going on, which put this in perspective. I don’t think our service was wasted,’ he said.
‘There’s lots of suffering going on, but let’s not lose sight. It’s easy to focus on the negatives and get angry and frustrated because you can’t change the outcome, but I’d also recommend that we sit back and balance the negatives against some of the positives.’
The resources for GPs supporting veterans amid recent events in Afghanistan are available on the DVA’s website.
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Dr Peter JD Spafford   26/08/2021 8:41:45 PM

I think the police need the same support for doing the dangerous stuff of arresting an individual doing horrific things, only to see them released on a technicality or some other feeble excuse of the courts. These soldiers are not conscripts, they chose that career. They went to do a job, did it, and that is the end of that. The rest is hype much like the antivaxx campain