Post traumatic stress disorder

A battle of mind, body, and spirit

 

It’s been called ‘combat fatigue’, ‘shell-shock’, the ‘thousand yard stare’; post traumatic stress disorder (PTSD) has had a lot of names over the years, but not a lot of treatment options.

In 2010, over 4,100 members of the Australian Defence Force suffered from PTSD, yet only 50% of those had received treatment. To this day there is There is significant stigma associated withreporting mental health issues such as PTSD with over half of ADF members citing possible negative impact on career prospects as a reason not to report such issues.

PTSD is a major health problem that is not exclusive to our veterans and defence personnel. More than one million Australians experience PTSD.Emergency services personnel, victims of nature disasters, sexual assault victims and indeed anyone who has experienced a traumatic life event could be at risk of developing PTSD. The long term impacts of this illness are placing an enormous burden on sufferers, their loved ones, the wider community and our health system.

For far too long, there has been a critical gap in recognition and treatment options for PTSD. While comprehensive treatment and rehabilitation options now exist for physical injuries sustained through military service, the same cannot be said for the psychological scars...

 

The PTSD Initiative

Changing the way we look at post traumatic stress disorder

 

Fifty years ago, thousands of young Australians were sent to the war in Vietnam, and many of those who returned home did not come back the same.

Many families have shared their stories on the impact they felt long after the war had finished, and it was by no means an isolated problem. Studies have revealed that one in three of the Australian veterans from the Vietnam War developed PTSD.

The GMRF PTSD Initiative partnered with RSL Queensland for a world-first research into the long-term physical impacts of PTSD that looked at both the physical and physiological toll of PTSD on veterans of the Vietnam War. Never before had researchers looked this deeply into PTSD and its relationship with the physical health of veterans.

The three-year study involved 300 Vietnam veterans who selflessly volunteered to undergo 25 separate clinical tests to paint a detailed picture of their psychological and physical health.

The data was rigorously analysed to unravel relationships between physical illnesses like heart disease, gastric complaints and sleep disorders and the psychological symptoms of PTSD.


Key findings from our Vietnam Veteran study

 

Participants with PTSD had…

  • Four times the chance of having had a heart attack in the past
  • Two times the risk of stomach ulcers
  • More than triple the risk of acting out their dreams while asleep
  • Almost two times the tendency of restless legs
  • Increased daytime fatigue and sleepiness
  • Two times the risk of suffering sleep apnea
  • Double the chance of reflux
  • Greater tendency to report constipation, diarrhoea and irritable bowel syndrome
  • Lower levels of ‘good’ cholesterol which contributes to an increased risk of heart disease

 

 

 

 

MJA Article Link

The GP Education Program

Putting innovative research into action

 


With the Vietnam Veteran Study completed, we're working in partnership with RSL Queensland to implement a national education campaign for general practioners.

Our focus is on equipping doctors and other healthcare professionals with new strategies to better identify the signs and symptoms of PTSD. It is envisaged that by helping clinicians identify PTSD earlier, before it becomes a life-threatening illness, the recovery and quality of life for veterans and the community at large will vastly improve.

It will also aid in the early detection and treatment of physical illnesses associated with PTSD, all of which are preventable or can be minimised through early diagnosis. When an at-risk patient presents with a physical disease that has a strong association with PTSD, the clinician can raise a red flag and investigate whether the patient might be suffering a psychological illness as well.

The GP Education Program has three main components:

  • An Online Education Program available through ThinkGP
  • Expert Videos on how to manage the physical symptoms and comorbidities of PTSD.
  • PTSD Roadshow at General Practice Conferences around the country. Click here to view the GPCE Sydney Presentation. 

“Those suffering from mental health conditions often find it difficult to open up to their GP or health care provider, but now with the right information at their fingertips, clinicians are better equipped to identify the physical signs and symptoms leading to early intervention which is critical ” Miriam Dwyer,GMRF CEO

“This is a critical step towards addressing the physical and mental health challenges faced by those who’ve served our country; it not only sheds a light on PTSD and related physical symptoms but provides knowledge and guidance for the medical community to put to immediate use.” Stewart Cameron CSC, State President of RSL Queensland.

Pre-eminent Australian scientists, researchers and doctors volunteered their time and expertise to undertake this initial research, with funding from RSL Queensland and support from Greenslopes Private Hospital, Sullivan Nicolaides, Queensland X-Ray, University of Queensland (UQ), Queensland University of Technology (QUT) and CSIRO.

Useful Resources

 

PTSD Findings BrochurePTSD Guide Button

 

 



                             PTSD Booklet Button


 Patients

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RSL (Queensland Branch)

Website: https://www.rslqld.org

 Veterans and Veterans Families Counselling Service

Telephone 1800 011 046 (24-hrs)

Website: www.vvcs.gov.au

 DVA ‘At Ease’

 Website: http://at-ease.dva.gov.au/

Phoenix Australia – Centre for Posttraumatic Mental Health

Website: http://phoenixaustralia.org/

Beyond Blue

 Website: https://www.beyondblue.org.au/

 Black Dog Institute

 Website: https://www.blackdoginstitute.org.au/

Mental Health Online

 Website: https://www.mentalhealthonline.org.au/Default.aspx

 High Res

Website: https://at-ease.dva.gov.au/highres/#!/home

App: http://at-ease.dva.gov.au/veterans/resources/mobile-apps/

 PTSD Coach Australia

 App: http://at-ease.dva.gov.au/veterans/resources/mobile-apps/  

Breathe2Relax

 App: http://t2health.dcoe.mil/apps/breathe2relax

 ON TRACK with The Right Mix 

 App: http://at-ease.dva.gov.au/veterans/resources/mobile-apps/

 Clinicians - Diagnostic Resources

DSM-5 Guidelines

 Website: http://phoenixaustralia.org/wp-content/uploads/2015/03/ACPMH-2002-2012-Integrated-Literature-Review.pdf

Manual for the Administration and Scoring of the PTSD Symptom Scale (PSS-I)

Website: http://www.istss.org/assessing-trauma/posttraumatic-symptom-scale-interview-version.aspx

PTSD Checklist (PCL)

Website: http://www.istss.org/assessing-trauma/posttraumatic-stress-disorder-checklist.aspx

Post Traumatic Diagnostic Scale (PDS)

Website: https://www.adaa.org/sites/default/files/Yusko%20_210.pdf

 Clinicians - Management Resources & Professional Development Tools

DVA Trauma Recovery Programs

Website: http://at-ease.dva.gov.au/professionals/trauma-recovery-training-programs-2017/

Mental Health Professionals Network

Website: https://www.mhpn.org.au/

Mental Health Online

 Website: https://www.mentalhealthonline.org.au/Default.aspx

Mental Health in the Australian Defence Force: 2010 ADF Mental Health Prevalence and Wellbeing Study

 Website: http://www.defence.gov.au/health/dmh/docs/mhpwsreport-fullreport.pdf

RACGP GPLearning Module:  ‘Working with veterans with mental health problems’ (RACGP reference 79745)

Website: http://www.racgp.org.au/education/courses/activitylist/activity/?id=54627

                                                                                                                                                                                                                                                                                                                 

Partnering with RSL Queensland

 

For many of our servicemen and women, the physical and emotional scars of service continue long after they have left the Defence Forces. To support research into reducing the prevalence and severity of mental health issues, and assist with the transition to civilian life for ADF personnel, RSL (Queensland Branch) has committed $6.75 million since 2013 to the Gallipoli Medical Research Foundation to provide funding for world-first research.

"The Returned Services League is but part of a wider Australian community. We believe that we have an obligation, certainly to help veterans, but also to help the wider community. We believe that through this research we will do just that." Stewart Cameron CSC, State President of RSL Queensland.


 

The impact of PTSD

 

 

Veteran Mental Health Initiative

Purpose
The purpose of the Veteran Mental Health Initiative is to build a strong foundation of mental health research among the contemporary veteran cohort which will generate evidence to guide developments in procedures and practices to improve the wellbeing of the veteran and ex-serving community.
 
Current Projects
Our flagship research project, proudly supported by RSL Queensland, is focused on the transition process from service to civilian life. We are specifically investigating cultural reintegration in terms of moving from military system and culture to a civilian culture and the psychological adjustment process that goes with that.
 
This is an extremely important area to understand for improving the mental health and wellbeing of veterans and yet there is almost no scientific knowledge in Australia regarding this process.
 
Like the PTSD initiative, the development of this study was sparked by clinical practice within the hospital. Clinical psychologists working within a specialised veteran facility noticed an ongoing pattern of reintegration and adjustment difficulties among the veterans that appeared quite distinct from clinical diagnoses, but were causing significant problems with day-to-day functioning.
 
So the multiple stage Veteran Reintegration & Adjustment study was developed:
 
Stage 1 is a qualitative and in-depth look at the process of transitioning to civilian life following military service. This study will result in a comprehensive understanding of the issues and challenges facing ADF personnel who have recently discharged from the military. It will also help determine the factors that contribute to poor and successful transition.
 
Stage 2 is the development of an assessment and screening tool (based on the findings of stage 1) to determine ‘readiness for civilian life’. The tool will be used to detect those people that may be at risk of poor adjustment to civilian life before they discharge or as early on as possible following discharge.
 
Stage 3 is the development of a reintegration training program using applied knowledge from stage 1 & 2, so that those flagged as being at risk can access targeted support.
 
The Veteran Reintegration & Adjustment Study is a 5 year undertaking, and will continue until 2020, in partnership with RSL Queensland Branch.  
 
“This project is very much translational with the potential to improve practices and policy across veteran services nationally. We must do better for ex-service personnel who struggle to adjust to civilian life, and this is the first step in preventing this pattern occurring within the next generation of returning and separating service men and women.” Dr Madeline Romaniuk, Senior Clinical Psychologist & Project Lead of the Veteran Mental Health Initiative.


For more information about the Veteran Mental Health Initiative or to express interest in participating in the study, email us at enquiries.gmrf@ramsayhealth.com.au