The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts

Abstract

The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross‐sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.

Complex psychosocial distress postdeployment in veterans: Reintegration identity disruption and challenged moral integrity.

“…The catalyst for change has been dominated by a medical model approach, which focuses on the biological cause and treatment of mental illness, and periodic remodelling of diagnostic interpretations of post-traumatic stress in the Diagnostic Statistical Manual of Mental Disorders (DSM;APA, 1980APA, , 1987APA, , 1994APA, , 2000APA, , 2013. Current government support for military personnel in many countries includes mental health screening (Rona, Hyams, & Wessely, 2005), research on post-deployment issues (Barton, Treloar, Dobson, McClintock, & McFarlane, 2008;Van Hooff, McFarlane, Davies, Searle, et al, 2014;Samele, 2013) and specific programs to target reintegration of personnel, such as the BATTLEMIND program (Adler, Bliese, McGurk, Hoge, & Castro, 2009). However, criticisms exist around the lack of evidence regarding the efficacy of such programs and a tendency for them to focus on mental health disorders such as Post-Traumatic Stress Disorder (PTSD) (Rona et al, 2005;Samele, 2013, Sayer, Noorbaloochi, Frazier, Carlson, et al, 2010.…”

“…; 2013). Current government support for military personnel in many countries includes mental health screening (Rona, Hyams, & Wessely, 2005), research on postdeployment issues (Barton, Dobson, Treloar, McClintock, & McFarlane, 2008; Samele, 2013; Van Hooff et al, 2014) and specific programs to target reintegration of personnel, such as the Battlemind program (Adler, Bliese, McGurk, Hoge, & Castro, 2009). However, criticisms exist around the lack of evidence regarding the efficacy of such programs and a tendency for them to focus on mental health disorders such as posttraumatic stress disorder (PTSD; Rona et al, 2005; Samele, 2013; Sayer et al, 2010).…”

Considering Exposure Assessment in Epidemiological Studies of Chronic Health in Military Populations

“…This variability can be viewed as a rich opportunity for health research, since epidemiology relies on heterogeneity in exposures across groups in order to assess risk. It can also present unique challenges in differentiating exposure groups, since exposure contexts range from very broad (e.g., deployments that may affect entire regiments, battalions, or ship crews) to specific (e.g., occupational groups or other subsets within the larger population) ( 14 ).…”

Caring for veterans in US civilian primary care: qualitative interviews with primary care providers

“…Worldwide, significant attention has been given to the well-being of military service members, in particular post-deployment mental health needs (1)(2)(3)(4)(5). Several countries, including the USA, Canada, the UK and Australia, engage in post-deployment screenings to help identify service members in need of support and treatment (4)(5)(6)(7). However, connections to ongoing healthcare remain problematic, even in countries with national health services; recognition of patients who are veterans and provider understanding of their unique experiences as military members remain universal challenges (2,(7)(8)(9).…”