Military Health Outcomes Program : Defence Health : Department of Defence

Military Health Outcomes Program

The Military Health Outcomes Program (MilHOP) is a significant body of research commissioned by Defence to determine the impact of operational deployment on the health and wellbeing of service men and women.
MilHOP includes:
1. the 2010 ADF Mental Health Prevalence and Wellbeing Study conducted by the Centre for Traumatic Stress Studies University of Adelaide which consisted of diagnostic interviews with participants from the Prospective and Census Health Studies and a sample of non-deployed personnel, to determine the prevalence of mental health conditions in the ADF. (Launched October 2011; more information on this study is available on the Mental Health Reform page);
2. the Middle East Areas of Operations (MEAO) Census Health Study, measuring the current health of ADF members who were deployed to the MEAO within the last 10 years;
3. the MEAO Prospective Health Study, measuring the health of personnel prior to deployment and again after returning home; and
4. the MEAO Mortality and Cancer Incidence Health Study, which collected relevant data on deaths and cancers from the Australian Institute of Health and Welfare for personnel who have participated in the Deployment Health studies.

Mild Traumatic Brain Injury (mTBI) in the Australian Defence Force: Results from the 2010 ADF Mental Health Prevalence and Wellbeing Dataset

The ADF Mental Health Prevalence and Wellbeing Study conducted in 2010 examined the prevalence of psychiatric disorders and a range of risk factors for these conditions, including mild traumatic brain injury (mTBI).

In the Defence Force, the most prevalent cause of mTBI was motor vehicle accidents, with these incidents and falls carrying a greater risk of mTBI than blast exposure. Furthermore, mTBI was associated with a significantly increased risk of all domains of psychological disorder, highlighting the public health importance of this issue and the need to assess mTBI in the context of an individual’s psychological health.

It is worth noting the study found the prevalence of mTBI or concussion in ADF personnel in their lifetime could be as high as 28.3%. However the report also acknowledges the significant limitations of the study dataset, in particularly its reliance on self-reported data. The estimated prevalence for blast/IED and rocket propelled grenade exposures is a gross over-estimation due to the original study’s over-representation of soldiers deploying to Afghanistan.

The issue of mTBI has proven a particular challenge for researchers, with questions remaining about the extent to which the condition might explain post-deployment symptoms experienced by soldiers returning from combat. It is well accepted that certain symptoms can occur following mTBI, including problems with memory, balance, concentration, headaches, tinnitus, sensitivity to light, fatigue, irritability and others. However there are real difficulties associated with diagnosis, especially noting that if mTBI is diagnosed on the basis of these post-concussive symptoms alone then it may misattribute symptoms that have other causes.

Key Messages

The MilHOP studies are a significant investment in the early identification of health issues of ADF personnel, enabling a strategic approach to future healthcare planning.

The results of MilHOP Census Health Study and Prospective Health Study suggest that ADF members deployed to the MEAO are generally physically and mentally healthy.

However, ADF members repeatedly exposed to traumatic experiences, either at home or on deployment, are more likely to develop mental health concerns.

Certain groups were shown to be more at risk, including those leaving full-time service, and the results will allow Defence and Veterans' Affairs to target resources to these groups.

We are better prepared than we have been following previous wars and conflicts to manage the mental health effects of operational service.

Significant investment has been made to improve preparation, early intervention, treatment and rehabilitation programs to ensure that our people are prepared and supported throughout their careers.

Defence continues to improve mental health awareness, reduce stigma and barriers to care, and encourage individuals to seek help early.

MEAO Census Health Study

The MEAO Census Health Study examines the current health status of ADF members deployed to the MEAO between 2001 and 2009.
Over 14,000, veterans voluntarily participated in the Census Health study and the response rates of this study compare favourably with similar studies.

MEAO Prospective Health Study

The MEAO Prospective Health Study collected data on personnel prior to deployment and again after returning home, allowing us to determine causes for onset of health concerns.
The study examined life experiences, lifetime trauma exposure and information on previous military service.
A sub-set of primarily combat personnel also participated in physical tests and neurocognitive assessments.

Key Findings of the Studies

The results of MilHOP suggest that ADF members deployed to the MEAO are generally physically and mentally healthy.
Certain groups, such as those in direct combat roles, were shown to be more at risk of health concerns and the results will allow Defence to target resources to these groups.

Trauma

Defence accepts that deployments can expose ADF members to traumatic events.
The studies show not all ADF personnel will be exposed to trauma on deployment and that most will not develop mental health concerns.
However, ADF members repeatedly exposed to traumatic experiences either at home or on deployment are more likely to develop mental health concerns.
The findings support the work Defence is doing in ensuring risk-based intervention and screening to maximise support for those most at risk, not just on deployment.

Families

Results support the long recognised impact of separation and military commitments on ADF families and a range of support options are available.

Transition

Members who transition to reserve or civilian roles were more likely to report mental health concerns than ADF members who remained in full-time service.
Defence recognises that members transitioning from full-time ADF service may require additional support.
Defence and DVA are committed to supporting personnel through enhancing early identification programs and appropriate access to mental health care services.

Physical Health

While the studies indicate that ADF members are generally healthy, the most common health concerns were respiratory and gastrointestinal illness.
Defence and DVA have a range of prevention, identification, treatment and support programs for individuals in these circumstances.

Where to now

These independently reviewed studies, based on robust data collection methods, have provided a substantial resource from which Defence and DVA will be able to continue future research programs.
These studies will inform the way we plan health care services for ADF personnel and veterans into the future.
The findings reinforce the significant investment already made by Defence to improve mental health and rehabilitation services through the Mental Health Reform program and implementation of the ADF Mental Health Strategy.
We are now better prepared than we have been following previous wars and conflicts to manage the mental health effects of operational service.
Defence has improved preparation, resilience training, screening, reintegration, treatment and rehabilitation programs to ensure that our people are prepared and supported throughout their careers.
The findings have implications for programs that may benefit from review and expansion, including:
- improved support and monitoring during and following transition from the ADF;
- review of mental health screening to better capture exposure to potential traumas, regardless of where or when they occur;
- establishment of a Defence and DVA strategic research framework to prioritise the further analysis of the data.

Select a document to download. (PDF)

MEAO Census Health Study Report

Census Study Summary Report (PDF, 1.38MB)
Volume I - Census Study Report (PDF, 4.3MB)
Volume II - Census Study Report - Supplementary Tables and Analytical Methods (PDF, 2.6MB)
Volume III - Census Study Report - Supplementary Material (PDF, 5.8MB)

MEAO Prospective Health Study Report

Prospective Study Executive Summary Report (PDF, 3.3MB)
Volume I - Prospective Study Report (PDF, 7.9MB)
Volume II - Prospective Study Report (PDF, 12.9MB)
Volume III - Prospective Study Report (PDF, 2.7MB)

MEAO Mortality and Cancer Incidence Health Study

MEAO Mortality and Cancer Incidence Health Study (PDF, 1.3MB)

Defence Health