The Royal Commission into Defence and Veteran Suicide
Provocatus Closing Statement
Monday 9th September 2024
Background
The Australian Government launched the Royal Commission (RC) into Defence and Veteran Suicide on 8 July 2021 to investigate the significant occurrence of death by suicide amongst members of Australian Defence Force (ADF) and the ADF veteran community.
Between the period 1997 and 2021, there were 1677 reported suicides amongst current serving and retired ADF members, 20 times more than the number of servicemen and women killed on active duty during the same period.
On average, three veterans have taken their life each fortnight over the last decade.
On 28 August 2024 during the closing ceremony of the RC, Commissioners Mr Nick Kaldas APM, Dr Peggy Brown AO and The Hon. James Douglas KC, urged the public to “fight for our veterans” on the basis of damning evidence tendered during the hearings, pointing to a failure of successive Australian governments to address the problem of suicide amongst ADF veterans.
Submission to the Royal Commission into Defence and Veterans Suicide
As an Australian and Veteran Owned company who actively employs ADF veterans and their family members, many of us at Provocatus Pty Ltd (Provocatus) have felt the effects of losing someone we have served alongside to suicide.
Indeed, what many people may not know is that it was the suicide of a patient, who we shall refer to as “Darwin Digger” (“DD”), that influenced the decision to establish Provocatus in November 2020.
At the time that DD engaged with Provocatus’ Medical Director, Dr Michael Mumford MBBS FRACGP, he had been prescribed 328 tablets per month to treat major physical and psychological trauma suffered when he was blown up by an improvised explosive device in Afghanistan whilst serving in 2 Commando Regiment.
While Dr Mumford immediately started to work with DD to develop a safer, goal oriented management plan, DD was unfortunately so overcome by his circumstances that he tragically ended his own life in 2018.
At the time that Dr Mumford took over his care, DD’s monthly prescriptions and daily milligram dosing was as follows:
120 Endone (20mg daily)
56 Targin (20mg daily)
56 Palexia (200mg daily)
56 Sertraline (200mg daily)
28 Mirtazapine (30mg daily)
56 Seroquel (125mg daily)
120 Panadeine Forte (up to 120mg daily)
From the outset, Provocatus has not been silent on the issue of veteran suicide. Working at the coalface of primary healthcare and our experience in uniform means we are uniquely positioned to leverage our understanding of the ADF operating environment to advise government on the management of veteran patients in this setting, including where medicinal cannabis can be a useful therapeutic treatment option if appropriately prescribed and managed.
We have proactively engaged in research including to understand how medicinal cannabis can be used as a harm reduction tool to deprescribe opiates, benzodiazepines and anti-depressant medications, as well as other studies centred on veteran healthcare.
We also regularly engage with the Department of Veterans’ Affairs (DVA) to discuss medicinal cannabis treatment amongst the ADF veteran cohort and provide our perspectives on the Australian medicinal cannabis industry, trends and research.
Our Submission to the Royal Commission
In 2023, we tendered a submission to the RC to formally document our insights and provide recommendations regarding ADF veterans and medicinal cannabis treatment for service-related chronic pain and mental health conditions.
We have amassed a significant following of veteran patients from across Australia who are keen to improve their healthcare knowledge and understand whether medicinal cannabis therapy is a good option for them to help manage injuries sustained during military service.
It is notable that, with respect to medicinal cannabis treatment, many of our patients have tried other forms of pharmaceutical pain relief and in some circumstances, like DD, they have been exposed to the harmful effects of polypharmacy and addiction.
Three factors ultimately led to Provocatus’ decision to make a submission to the Commission
Safety risks to veterans considering medicinal cannabis treatment for health conditions that are compounded by the current regulatory framework in Australia, and other drivers such as those associated with the market landscape.
Reported improvements in pain scores and quality of life indicators for veterans who are under the care of experienced doctors. Examples of reported health outcomes include improvements in sleep and reduced reliance on alcohol for pain management.
The role of medicinal cannabis in deprescribing addictive pain medication and therefore reducing the risk of polypharmacy overdose amongst veteran patients.
Our commitment and Focus
Provocatus’ submission made several recommendations to the RC regarding medicinal cannabis treatment amongst veterans, as well as veteran healthcare more generally. Pertinently, these recommendations centred on safe and ethical prescribing practices, consolidated and holistic veteran healthcare, and improving DVA and veteran health literacy amongst doctors and other healthcare providers in Australia.
While it is our hope that these recommendations are reflected in the Royal Commission’s final report, due to be handed to the Governor General today, irrespective of how the Australian Government chooses to handle the findings and recommendations of the Royal Commission, Provocatus is committed to playing its part to create a brighter future for the health and wellbeing of ADF veterans.
As such, our focus remains to:
Ensure ADF veterans have access to the medication and appliances required to manage their health conditions so they can live their best life.
Provide education and support to veterans, family members and healthcare providers to ensure these veteran patients can receive timely, quality care within their local community.
Engage with research institutions to further academic literature, including whether medicinal cannabis has a role in improving veteran health outcomes and if so, what this role is.
Liaise with the Australian government about veteran healthcare, patient safety and policy.
Connect and work with likeminded organisations in the best interests of veteran patients and their family members.
Kasey Mumford, CEO Provocatus Pty Ltd
“Provocatus is committed to playing its part to create a brighter future for the health and wellbeing of ADF veterans.”
Help is available
If this is an emergency please dial 000.
Open Arms: Veteran & Family counselling can be contacted for 24-hour crisis support on 1800 011 046
Lifeline: If you need to speak to someone immediately, please call Lifeline on 13 11 14 or SMS: 0477 13 11 14
1800-IMSICK is a national 24-hour call service providing health support for all serving ADF personnel within Australia if they become ill or injured after hours or are not in close proximity to an on-base health facility.
Suicide call back service
Call 1300 659 467 to speak to someone if you are considering suicide or know anyone who is. The Suicide Call Back Service can be contacted and can help anyone who is affected by suicide, which includes: anyone who is feeling suicidal, anyone who is worried about someone, anyone who is caring for someone who is feeling suicidal, anyone who has lost someone to suicide or Health professionals supporting people who are affected by suicide.