- Title
- Mental health of contemporary ex-serving Australian Defence Force personnel
- Creator
- Jubelin, Jake Gary
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: The Australian Defence Force (ADF) consists of approximately 80,000 medically selected and highly trained employees, with approximately 5,000 people joining the ADF per year. A similar number of people transition from the ADF each year, with approximately 20% of those transitions attributed to medical reasons. Ex-serving ADF personnel report significantly higher rates of suicide and mental health disorders compared with both the general Australian population and those still serving in the ADF. The Swiss 8 app has been developed as a tool for veterans to manage their routine around positive lifestyle factors including fitness, nutrition, mindfulness and sleep. These lifestyle factors have been shown to improve or prevent various mental health symptoms. Aim: This thesis aimed to (i) explore the prevalence rates of mental health disorders in the ex-serving ADF population; (ii) evaluate the effectiveness of the Swiss 8 app for improving ex-serving ADF personnel’s psychological distress and quality of life, as well as the role of peer-support and app engagement; (iii) explore ex-serving ADF personnel’s experience transitioning from the ADF; and (iv) determine ex-serving ADF personnel’s perceptions and attitudes towards the use of the Swiss 8 app during their transition from the ADF. Methods: The research commenced with a scoping review to determine prevalence rates of mental health disorders in the ex-serving ADF population. This was followed by the Swiss 8 Research Project which used a mixed-methods, randomised parallel group-controlled trial to evaluate the effectiveness the Swiss 8 App. This was followed by a reflective thematic analysis to determine participant’s attitudes towards the Swiss 8 app, and their experience with mental health and the transition process. Participants were recruited online and included 156 ex-serving ADF personnel who joined the ADF after 1991. Participants were randomised to the App Only group or the App plus brief fortnightly peer follow-up. Participants completed the pre-Swiss 8 survey, including demographics, ADF service history, the Kessler Psychological Distress Scale (K10) and the EUROHIS Quality of Life—8-Item Scale (QoL-8). The post-Swiss 8 survey was completed after three months of app usage and included the K10, QoL-8 and the User Mobile App Rating Scale (uMARS). Data from the Swiss 8 app were collected to measure the frequency and duration of participants’ app usage. Consenting participants completed the post-Swiss 8 interview to describe their experience with transitioning from the ADF, their mental health, and their perceptions of the Swiss 8 app. Results: Two reports were considered eligible for the scoping review and showed increased prevalence of anxiety and affect related disorders and greater risk of suicidality in the ex-serving ADF population compared to both the general Australian population, and those still serving in the ADF. Temporal relationships between separation from the ADF and the onset or worsening of mental health disorders highlighted the need for early intervention during the transition period. Findings from the Swiss 8 research showed participants in the fortnightly peer follow-up group reported statistically significant improvements in psychological distress (25.9 v. 22.3, p < 0.001) and quality of life (25.8 v. 27.3, p = 0.022), whilst those in the app only group did not show statistically significant improvements. This was despite no statistically significant difference in app usage between the two groups. Those in the first two years of their transition used the app significantly more than those who transitioned more than three years ago. Participants rated the Swiss 8 app in the ‘Good’ range for mean app quality using the uMARS. Qualitative data showed participants perceived the Swiss 8 app as a veteran-oriented app that helped support their mental health by building a routine and increased their accountability to maintain positive lifestyle and behaviour change. Participants described themes related to transition from the ADF, including preparedness, lack of support from within the ADF and the pursuit of a new purpose. They described their experience with mental health in terms of their symptoms and experiences, the barriers to help-seeking, professional mental health support and self-care strategies. Conclusion: The findings of this thesis support the use of the Swiss 8 app in the contemporary ex-serving ADF population to help individuals manage their mental health. Themes around transition from the ADF are discussed and provide a snapshot of the current issues faced by veterans making the transition. The findings lead to recommendations and implications for the organisations responsible for the mental health of veterans, the mental health clinicians working with this population, and the veterans making the transition from the ADF to the civilian space.
- Subject
- Veteran mental health; Australian Defence Force; psychological distress; quality of Life; peer support; mHealth
- Identifier
- http://hdl.handle.net/1959.13/1500397
- Identifier
- uon:54916
- Rights
- Copyright 2023 Jake Gary Jubelin
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 5 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 350 KB | Adobe Acrobat PDF | View Details Download |