Funeral of Corporal Douglas Hughes, found to have taken his life in Afghanistan in 2012. Photo / Michael Cunningham
Our military's gaps in mental health care for uniformed personnel have been exposed through internal inquiries carried out into six suicides in three years.
A slew of recommendations to improve management of mental health in the military came through Courts of Inquiry into the deaths.
Not all recommendations have been picked up but NZ Defence Force has offered an assurance it takes mental health care for its people "very seriously" and is lifting its game.
The assurance has been supported through interviews with former service personnel but they also say more needs to be done.
The NZDF initially tried to stop details of gaps in the safety net being made public to shield families of those who died.
The gag was lifted after the New Zealand Herald gave new Defence Minister Mark Mitchell an assurance our reporting would focus on the issues and not the individual cases.
Investigations by the Herald have found NZDF suffers the loss of one solider, sailor or air force service member to suicide each year.
But in 2012 there were three deaths from suicide and two in each of 2013 and 2014. The six inquiry reports supplied to the Herald came after the first in the string of fatalities - Corporal Douglas Hughes - was found to have taken his life in April 2012.
While the increased number is too small to suggest a statistical trend - there was one death in each of 2015 and 2016 - it did result in twice as many Courts of Inquiry being held into mental health-related issues and an increased focus on NZDF's mental health care.
Those inquiries led to recommendations for change - the most significant being a call for an audit of NZDF's mental health needs.
Director of Defence Health Brigadier Andrew Gray said the audit has not been carried out but there had been significant change in the last three years.
"We're trying to look at how we create a positive mental health climate. (Asking) what is mental health within NZDF and how do we influence that care.
"We took a step back three-to-four years ago and said 'what can we do to support our people better'."
Steps included training for key staff - a recommendation that was carried out - and how to assure personnel that it was okay to ask for help.
Gray said there was a "macho culture" in wider New Zealand that was reflected in the Defence Force, with uniformed staff feeling they needed to "toughen up" to get through issues which emerged.
Coalition partners efforts were studied, leading to the development of support and training aides.
That included a video of staff throughout the organisation talking about their mental health issues and attempting to cut through the stigma of needing help.
While the audit was not carried out, Gray said it was necessary. "I do believe we do need to look at our population and provide that more robust research. We don't want to be the ambulance at the bottom of the cliff."
Other recommendations included greater sharing of information between medical, chaplain and community organisations, training civilian staff to create options for uniformed staff to ask for help outside the command chain and for enlistment information to include details on mental health so personnel could be supported throughout their service.
The OIA request for Courts of Inquiry also drew details of the 2016 suicide after which NZDF was again urged to continue to work to remove any stigma attached to mental health issues.
It stated uniformed personnel were still reluctant to seek help "as it may affect their career or ability to deploy".
There was also evidence of systems not working, with an assessment carried out by a civilian doctor not passed to military commanders depriving the person of "increased vigilence and screening".
It included recommendations there be better oversight of medical waivers which allow people to with conditions to serve offshore, and training for medical officers to follow processes which would better inform commanders.
While coalition militaries have suffered a surge in suicides after deployments to Afghanistan and Iraq, there was no information released showing the New Zealand cases were linked to offshore deployments.
NZDF also had no information about suicides among former personnel because it did not collect data about those who had left the service. Suicide among veterans who have left service has been a prominent issue among coalition partners, with Australia currently holding a Senate inquiry into the issue.
Mitchell, who has been Minister of Defence since April, said former uniformed personnel could seek support and treatment through Veterans' Affairs New Zealand.
He said he believed NZDF was meeting its responsibilities to personnel and working to improve in areas it needed to.
"The first priority is delivering the right care to those who need it, for whatever reason.
"A proactive audit is a possibility in the future, but defence is constantly auditing mental health through pastoral, social and medical providers to gain an understanding of mental health issues in the defence force, to ensure the required care for those in need."
The Herald has spoken to former uniformed staff who say there have been noticeable improvements in mental health processes in the last few years.
Former staff sergeant Aaron Wood, who helps lead a charitable organisation helping veterans called No Duff, said NZDF had yet to approach mental health as a whole organisation.
He said there were pathways but the value of them largely depended on the commander.
Wood said when he sought assistance with PTSD in 2008, he was forced to consider his 17 years of service in countries such as Timor, Somalia and Afghanistan and the opportunities that lay ahead.
There was the stigma of "being seen as weak by your mates" and the impact it could have on future postings, hesaid.
But there was also a concern if he needed more than the assigned level of mental health session, NZDF might start pushing him to take a medical discharge.
It would have meant the difference of a few hundred thousands dollars because he had three years to go before he completed 20 years of service and qualified for superannuation.
Wood said there had been "serious in-roads", noting the Sergeant-Major of the Army urging troops in a recent Army News: ""There is no stigma in seeking help, only pride and mana in stepping forward to seek assistance."
* This article originally stated there were no self-inflicted deaths in 2015 when there had been one death by suicide. The story has been updated to reflect information originally supplied by NZDF.
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call 111.
If you need to talk to someone, the following free helplines operate 24/7:
NZDF 24/7 HELPLINE: 0800 NZDF 4U (0800 693 348 or 0800 189 910) VETERANS AFFAIRS NZ: 0800 483 8372 (0800 4 VETERAN) VITAE (NZDF civilians): 0508 664 981 NODUFF (volunteer Veterans NGO): 022 307 1557 (noduff.ngo@gmail.com) RSA: 027 217 2608 DEPRESSION HELPLINE: 0800 111 757 LIFELINE: 0800 543 354 NEED TO TALK? Call or text 1737 SAMARITANS: 0800 726 666 YOUTHLINE: 0800 376 633 or text 234
There are lots of places to get support. For others, click here.