Suicides among ex-servicemen are alarmingly high and some believe the side effects of an anti-malaria drug are a contributing factor. By Miriam Cosic.

Calls for outreach program as veteran suicides soar

Chris Stiles.
Chris Stiles.

One evening in early August last year, Cherie Bayly and Chris Stiles sat down to dinner in Townsville with her two teenage boys. They finished, cleared the table and stacked the dishwasher. She went outside for a cigarette and he kept her company, though he’d given up the habit six months before. She had messaged him earlier in the day to ask him to come straight home so they could talk, and he asked what that was about.

She had intended to continue a difficult discussion that, to her, was becoming more and more urgent: his state of mind. But he had become agitated, telling her about an accident he’d had that day, and she decided not to pursue it. She went inside and started work on some accounts. It took a while: the internet kept going down, the boys were yelling at each other about it. Eventually she went to the door. She saw lights on in the shed, though the door was shut, and she vacillated. She would go see him, tell him about the internet problems. No, she wouldn’t, she’d give him some space. Yes, she would. When she opened the shed door, she found what she had long dreaded: Stiles had killed himself.

Chris Stiles was an army veteran. A former member of the First Battalion, Royal Australian Regiment, he had served in Timor-Leste. He had taken part in the controversial trial of an antimalarial drug called mefloquine, which has been implicated in severe mental health side effects. Stiles’s symptoms – anxiety and depression, expressed, among other things, in verbal aggression, self-loathing, constant fidgeting and an inability to sit still – had been worsening. Bayly wanted him to check in to a private clinic that had helped other veterans with post-traumatic stress disorder whom they knew in Townsville, home to a large army base. But Stiles was resistant and the Department of Veterans’ Affairs took forever to issue a White Card, the health card that would have given him access.

Precise suicide rates are difficult to establish. Who knows if that single-occupant car crash, late at night, was deliberate or an accident? Or that fatal drug overdose? What we do know is that the veteran community has long been concerned about the suicide rate among its people, and angry that society is not doing enough to protect those who have risked their lives to serve their country.

An Australian Institute of Health and Welfare report into the incidence of suicide among serving and ex-serving Australian Defence Force personnel found 292 certified suicides between 2001 and 2014. It found the rate to be far lower than the general population for those within the Defence structure, but for ex-serving men it was 13 per cent higher than for men in the general population. Fifty-eight per cent of suicides of ex-servicemen were those aged 18-34. What is not known, of course, is how many deaths have been uncertified suicides.

Loretta Somerville, a former navy servicewoman who says she was raped and had her allegation dismissed before being dismissed herself, has become a veterans’ activist. She has attempted suicide herself, and is now researching figures on military suicide in Australia going back to the 1900s. Trawling through surveys, coronial reports and conversations with bereaved families, she has come to startlingly higher figures: 78 in 2016 alone, and 23 so far this year. She refers to a Vietnam veteran who has been researching suicide among his cohort and claims that 247 have taken their own lives.

A review into suicide and self-harm prevention services available to current and former defence force members and their families, undertaken by the National Mental Health Commission and released by the minister for veterans’ affairs, Dan Tehan, last week, uses the Australian Institute of Health and Welfare statistics. It also heard directly from 3200 people via submissions, group discussions and individual interviews.

The survey found that the ADF’s services were described as fair, good, very good or excellent by 80 per cent of current members and by 90 per cent of former members using them. In discussion, however, the report says it also “heard a broad range of poor experiences of services and general feelings of cynicism, distrust, frustration, abandonment and loss”.

The severest disconnect for many veterans exists between their time in the military and their experience afterwards. While serving, there is structure and assistance on every level, from medical to psychological to logistical, and the minimal suicide rates among serving members of the ADF reflect it. When they leave, everything disappears.

Gary Stone had 27 years as an infantry officer and 22 years as an army chaplain. He was deployed overseas 23 times and set up Veterans Care on his retirement two years ago. He guesses that for every person who manages to suicide, there would be nine thinking about it but not ready to follow through. The “suicide space”, as he calls it, is complex. He says that combat experience is rarely the trigger.

He emphasises that most veterans take civilian life in their stride, even those who suffer from PTSD. Both he and a son who served eight years in the Middle East have it, but they manage. “The major factor in suicide has little to do with going on operations and seeing bodies and all that sort of business,” he says. “It mainly has to do with either a loss of hope that things can get better for them in the future, or a very deep-seated shame and guilt.”

The military, he says, has effective indoctrination, drumming into their people that they are special, part of Australia’s best. “They build people up to believe they are uniquely capable.” Some have long dreamed of being in the military and if they are kicked out, on whatever grounds, their life plans collapse. Medical discharge because of physical or psychological incapacity magnifies the problem. Many who join the military, Stone also says, were abused as children and are searching for a new, safe family. “And they pull the shutter down on all that other stuff,” he says. “But then when they leave the military, they cease to be connected to that family, and those memories come back to haunt them.”

South Australia was shocked in March when a policeman, a decorated veteran who had served in Timor-Leste and in Iraq, drove to Cowell hospital and took his own life there. His last Facebook post read: “Fuck the police, fuck the army.”

Like Chris Stiles, that policeman was someone who slipped through an extraordinary net crafted by several thousand ex-service people who have come together in an organisation called Overwatch. It monitors the mood of veterans across the country, via social media, and swings into action anywhere in the world wherever imminent risk of suicide is perceived. “In physical and mental health, there’s a golden window,” Overwatch president Robert Harris, a former soldier, says. “We endeavour to keep our time frames from 30 minutes to two hours on the ground.” The group has sent emergency responses into Mexico three times – for ex-ADF personnel living there, by ex-ADF or American sympathisers in Mexico or the US – and each time the problem was resolved within 49 minutes of being alerted.

A senate inquiry into veteran suicide was due to report by March 30 but has been deferred to June. Activists remain sceptical. “We’ve had previous senate reports; there was one 10 years ago,” Loretta Somerville says. “If they didn’t listen to previous reports, why would they listen to this one?”

Further worsening some servicemen’s problems, according to activists, are the after-effects of mefloquine, trade name Lariam, the drug Chris Stiles had used. They believe that it can have a drastic impact on mental health, causing hallucinations, depression, anxiety, nightmares and suicidal ideation. The worst toll from mefloquine, critics say, comes from large-scale trials conducted in Timor-Leste in the early 2000s.

A report on the trials between 2000 and 2002 by the independent inspector-general of the ADF came out last year. It found the parameters of the trial had been appropriate; that mefloquine did cause side effects, but no more so than the more commonly used doxycycline; and that only three out of more than 1100 personnel who had taken it had had “serious neuropsychiatric side effects”. Two of those three had not disclosed existing medical problems. Among mefloquine’s attractions for the ADF was that it only had to be taken once a week, not daily as required with doxycycline.

Defenders of mefloquine emphasise that taking it is voluntary and that no test is available to link it to mental damage. Nonetheless, the ADF uses it as the drug of last resort, offered only if someone reacts badly to doxycycline.

Mefloquine veterans put forward a proposal for a mefloquine outreach program, which they estimated would cost about $2 million a year over five years. The minister rejected it. “What’s the cost of a life?” asks retired colonel Ray Martin, a veteran and mefloquine activist, though he was never given the drug himself. “If they don’t take this up, we’ll continue to lose more lives. It’s as simple as that. If ‘the loss of one serviceperson or veteran to suicide is one too many’, as the prime minister has said, he would step in and direct the department to pick up the program.”

When Chris Stiles spoke at the world’s first mefloquine forum in Townsville last year, he was passionate, articulate, but obviously at wits’ end. His mates said afterwards that they had never seen him like that. Later, they said they should have picked up the signal. “A lot of his mates are carrying guilt about that,” Cherie Bayly says. “But they are dealing with their own black dogs.”

Postscript: The Saturday Paper would like to acknowledge that Chris Stiles was a loving father to two sons, Wade and Brenden. The coroner has not yet released a report into his death.

Veterans and Veterans Families Counselling Service 1800 011 046; Lifeline 13 11 14

This article was first published in the print edition of The Saturday Paper on April 8, 2017 as "Veteran struggle".

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Miriam Cosic is a Sydney-based journalist, critic and author.

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