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Think Piece: PTSD – then and now

Thursday 20 October, 2016

the-hon-leesa-vlahosHugo Throssell was awarded the Victoria Cross for his “most conspicuous bravery and devotion to duty” at Hill 60 on the Gallipoli Peninsula on August 29-30, 1915.

His story of courage and heartache is highlighted in Peter Fitzsimons’ brilliant book Gallipoli. In late 1933, Throssell committed suicide, leaving a note explaining that he had never recovered from his experiences during the Great War.

One hundred years ago military psychiatry was in its infancy. We believed that soldiers suffered from shell shock – literally a concussion to the brain from exploding shells.

Australia’s Unknown Soldier was perhaps the most well documented case at the time. So badly affected by his experience of war, he returned home in 1916 and for 12 years had absolutely no recollection of his own identity.

Freud talked about “war neuroses” and, even as psychiatrists began making links with soldiers’ emotional experiences, they still characterised anyone suffering from psychological disturbances as weak.

Next came the terms “battle fatigue” and “combat exhaustion” with the realisation that all soldiers were susceptible to mental suffering. In World War 2 the American Army adopted the slogan “every man has his breaking point”. Soldiers were treated with rest, barbiturates, and liquor.

Post-traumatic stress disorder (PTSD) was finally formally recognised in 1980, well after the Vietnam War, with its inclusion in the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM).

Finally, the blame began to move away from the individual and on to the external trauma. However the years of stigma still leave a shadow for some people.

Thankfully, our knowledge and treatment continues to improve.

The mental wellbeing of our veterans is a true focus for me, as South Australia’s Minister for Mental Health and Substance Abuse, but also personally.

I grew up with my grandfather, a Wing Commander in the 30 Squadron of the RAAF, who didn’t talk about his service very much.

I maintain a strong sense of connection with the RSL and the veteran community. I feel privileged to have worked at two repatriation hospitals, and now to have the Edinburgh RAAF base in my electorate of Taylor.

The threads of military association through my life have fostered a personal passion and commitment to ensuring our veterans receive the best possible care while acknowledging their sacrifice, service and unique traditions.

The latest version of the DSM includes a whole chapter on trauma related disorders, describing a broad range of symptoms and features. It is clear that the experience, suffering, and life impact is unique to every individual.

In order to best care for these individual needs, the South Australian Government has created the Framework for Veterans’ Health Care 2016-2020. This was developed through a collaborative partnership between SA Health and the Veterans’ Health Advisory Council, and I had the honour of launching it in August this year.

The Framework recognises that, in South Australia, the largest age group of veterans remains the 90 and over group, with more than 4000 receiving some form of treatment. At the same time, we are seeing an increase in younger and female veterans.

The Framework recognises the impact service can have on the lives of families and dependants, as well as the common intergenerational patterns of military life.

Most importantly, it recognises the bond between veterans and the critical role of the veteran community in an individual’s wellbeing.

It brings together health providers, research, policy, funding, and links to emergency services, and makes numerous specific guarantees to veterans around their care.

One of these guarantees is the new $15 million Veterans’ Mental Health Precinct at Glenside, with construction to begin in the coming weeks. The precinct will include a 24-bed inpatient facility in addition to outpatient services, memorial gardens, and a separate building for ex-service organisations that provide advocacy and support services to veterans and their families.

We have also launched a new veterans’ health portal to connect veterans with information on health services available to them at

Veterans deserve health care that not only meets their needs but truly honours the sacrifices they have made in serving our nation.


Leesa Vlahos was first elected to the South Australian House of Assembly in the March 2010 election as the Member for Taylor. Prior to becoming Minister for Disabilities, Mental Health and Substance Abuse, she held office as the Parliamentary Secretary to the Minister for Health and assisted in the portfolio areas of Defence Industries, Veterans’ Affairs, Health, Mental Health and Substance Abuse and The Arts. Minister Vlahos was born in Queensland in 1966 and studied Health Administration at the Queensland University of Technology. Her passion for the community began as a young Guide and continued with her involvement with the scouting movement. She has worked in public and private hospitals both in Brisbane and Adelaide, including the Repatriation General Hospital at Daw Park.
Bibliography: Fitzsimons, Peter, Gallipoli, William Heinemann, Sydney, 2014

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