‘As a clinician, I’ve seen them on that brink’

A decade into her 30-year career in the Australian Defence Force (ADF), Dr Kerry Summerscales already knew nine people who had taken their own lives.
 
She has since lost count.
 
So when asked about the unanimous vote in the Senate and the House of Representatives’ formal endorsement for a royal commission into veteran suicide among both serving and former ADF personnel, there is no hesitation.
 
‘Most definitely there needs to be a royal commission,’ Dr Summerscales told newsGP.
 
‘There needs to be multiple means of inquiry into why veteran suicide is more than double that of the general population. We need to establish why and how we can prevent that, and what changes can be made.’
 
Between 2001 and 2017, there were 419 veteran suicides. That total is now estimated to be as high as 500, including 18 in the past three months alone.
 
More than half of Dr Summerscales’ patients are veterans, and while she counts herself ‘lucky’ that none of them have taken their own lives, some have attempted it.
 
‘Certainly, as a clinician, I’ve seen them on that brink, and it’s not all DVA [Department of Veterans’ Affairs] or army issues,’ she said.
 
‘It’s things like the complexities of family life, if they’ve been through a separation and [have] child custody issues, finding work, or financial issues.’
 
She says the transition from life in the armed forces to the civilian sector is ‘very difficult’, especially if the shift has been forced as a result of a medical or administrative discharge.
 
‘It’s more than just a job; it is a career, but it also becomes your identity. They train us in such a way that it’s a family away from home; it becomes everything, it’s all encompassing,’ Dr Summerscales said.
 
‘The only way I can equate it to doctors would be that you’re at work, you have a trip, and then you end up trying to do your job again and they say “no, you can’t”. You get kicked out of the hospital or the practice, and you lose your licence – and, by the way, you’re not even allowed to use the term “doctor” ever again.’
 
Dr Summerscales counts herself as one of the lucky ones.
 
She entered the ADF at 18, and it was while serving that she pursued medicine, choosing to undergo a slow transition to civilian life. Despite this, she admits she wasn’t immune from the mental health challenges.
 
‘I felt really apprehensive, I felt lost, I felt just like I didn’t belong – and I had a job that has a great deal of purpose and felt I was doing a lot of good,’ Dr Summerscales said.
 
‘So if you don’t have that, it’s even worse.
 
‘I’ve got a few who are transitioning [to civilian life] at the moment and my main role is to ensure that they do that effectively, and that they’ve got a sense of purpose at the end.’
 
On Monday, a number of Federal MPs made impassioned speeches in favour of a royal commission.
 
The push came more than 12 months after the Federal Government proposed a bill to create a National Commissioner on veteran suicide, as an alternative to a royal commission.
 
While Prime Minister Scott Morrison has not opposed the motion, his party is yet to commit to the idea.
 
‘We’ve always thought you need something better than and more than a royal commission – what we need is a permanent arrangement – and that’s what we’ve put into the Parliament,’ he told 2GB radio on Monday.
 
‘I’m sure that these two things can come together, and we can come to some agreement over the course of this week.
 
‘I want to do what’s right for veterans.’
 
Labor veterans’ affairs spokesman Shayne Neumann said given the numbers, the Prime Minister should take action immediately.
 
‘More people have died by suicide than have died by war, or war-like operations, or peace-keeping operations, over the past few decades,’ he said.
 
‘And the situation is getting worse, the numbers are increasing, and I think the problem is under-reported.’
 
Dr Summerscales agrees. But while a proponent of a royal commission, she says the immediacy of the issue would also benefit from the appointment of a National Commissioner to ensure there is greater accountability for change.
 
‘The National Commissioner has the capacity to go back a year later and say “Did you do the recommendations? No? Why not?” And if yes, “Well have the outcomes changed? No? Then clearly the recommendations were flawed, so let’s go again”,’ she said.
 
‘I would be over the moon if they did both.’
 
Along with addressing veteran suicide, Dr Summerscales says optimising veteran’s health in general is also important.
 
It has led the Mackay GP to devise a project to promote veteran’s health to her GP colleagues – a project that saw her receive the RACGP’s 2020 Future Leaders President’s Medal.
 
Current ADF member and Chair of RACGP Specific Interests Military Medicine, Dr Ross Mills, encourages GPs to take the opportunity to ask a couple of additional screening questions during consultations with veteran patients.
 
‘In addition to the usual blood pressure and general health screen, ask about their sleep,’ Dr Mills told newsGP.
 
‘Do they have significant initial or terminal insomnia? [Also ask about] their ability to maintain relationships, their energy levels, their emotional stability [mood swings], and their alcohol and drug consumption.
 
‘As with a lot of general practice, keep your radar honed for the “non-presenting complaint”, which your patient wants an excuse to talk to you about.’
 
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mental health royal commission suicide veteran's health