I’m an expert on PTSD and war trauma but I won’t do the 22 push up challenge

I’ve taught thousands of brave men and women at the Australian Defence Force Academy for the past six years. I’ve cooked for many of them in my home and shared a river of tea and coffee with others.

Many have been broken by their experiences in the military – for some I have literally taken the rope from around their neck, the pill bottle from their hands and talked them off the edge of a cliff. They are the walking wounded the Prime Minister is seeking to help.

Given all this, it was no surprise a friend invited me to complete the ‘22 push-up challenge’, a campaign to raise money and awareness for PTSD. 22 push ups for 22 days to represent the 22 veterans killed by suicide according to the US Department of Veterans Affairs.

But I’m not going to take part in the 22 push up challenge.

I’m a philosopher currently completing a PhD on the subjects of veteran PTSD and moral injury, so I understand the importance of awareness and support for soldiers currently serving, as well as veterans after they leave the ADF. Awareness raising is crucial for veterans because the feelings of isolation and disconnection from the civilian community can exacerbate the severity of mental health issues proceeding from trauma.

It also reflects on us as a community how well we are willing to care for those who have put their lives on the line to protect our country or innocent people overseas. Our wounded vets deserve the very best treatment, the very best care. They and their families risk everything for our safety. It goes without saying they deserve treatment to help them to heal.  But although the treatment for Australian veterans with mental health issues like PTSD could be better, it is much better than for anyone else with PTSD.

Veterans are overrepresented in media coverage and funding allocations to do with trauma and mental health.

Last year a non-veteran family member suffered from PTSD. They were on suicide watch, requiring me to work from home and balance professional commitments, my academic research and the crucial task of preventing a loved one from dying. During this time hospital services were unavailable – in practice, it feels like there is simply nowhere for non-veterans to go.

If they were a veteran, it would have been different. There are specialised treatment facilities available for them, which I know because we were turned away from each of them.

I take no issue with the fact treatment is available for veterans. As I’ve said, they deserve more than what is presently available to them. However, the media attention provided to veterans is vastly disproportionate to the actual experience of trauma-related mental illness in Australia.

Most cases of PTSD are those recovering from rape and sexual abuse and the majority of sufferers are women. The majority of patients are men, in part because it could re-traumatise female survivors of sexual abuse to be in therapy with men and in part because the professions who tend to receive trauma support are male dominated. Most of our treatment facilities are also allocated for veterans with PTSD, largely because places in these treatment programs are funded by the DVA and veteran-based charities. In short, veterans are overrepresented in media coverage and funding allocations to do with trauma and mental health.

It’s not obvious why a certain group should enjoy special privileges in the civilian healthcare system.

The government recently announced a new suicide prevention initiative for ADF personnel and while it’s true there is also a broader focus on suicide prevention, women’s shelters and rape crisis centres continue to battle for funding despite the strong association between sexual assault and mental health issues.

This seems to fly in the face of standard medical ethical principles, which suggest treatment is provided on the basis of need rather than the social status of the patient. These principles would suggest the cause of trauma – whether war, sexual assault or otherwise – should have no bearing on whether a patient receives treatment in a civilian facility.

While we can make exceptions in cases where the ADF provides special support to its men and women, it’s not obvious why a certain group should enjoy special privileges in the civilian healthcare system. Those suffering the same condition are in equal need of care.

If the recent Royal Commission into Institutional Child Abuse has taught us anything, it’s how many people with severe trauma suffer in silence, unable to access the support they critically need. It’s not clear to me that veterans are the ones most desperately in need of increased awareness.

One of the advantages of awareness raising is its ability to reduce the stigma surrounding mental health and trauma. In the ADF this is crucial, because research suggests there are still high levels of stigma surrounding PTSD in our defence forces.

In the desire to fix this problem we need to be careful not to generate another one. If all our awareness-raising efforts around PTSD are focused on veterans, we risk invalidating the experiences of those suffering trauma-related mental health issues who have never been to war.