Recommendation 1: Improve the capacity of future royal commissions to undertake their inquiries

To enable the efficient operation of future royal commissions:

1. the Australian Government should amend the Royal Commissions Act 1902 (Cth) so there are meaningful consequences for non-compliance with a compulsory notice
2. the Australian Government should undertake measures to ensure that royal commissions benefit from more independent representation in government, either by:
   1. setting up protocols that limit the engagement of the Royal Commissions Branch of the Attorney-General's Department with the Australian Government Solicitor (AGS), or
   2. moving the Royal Commissions Branch to a separate agency, for example to the Department of Prime Minister and Cabinet, or:
   3. setting up a liaison person or team in the Attorney-General's Department, whose role is to deal with royal commissions only
3. the Australian Government should apply consistent and transparent arrangements to allow royal commissions timely access to material covered by public interest immunity, and consider legislative amendment to facilitate royal commissions' access to this material
4. The Attorney-General's Department should provide settled advice and options on the operation of public interest immunity, Parliamentary privilege and procedural fairness in the operation of royal commissions.

Recommendation 2: Improve outcomes and access to support for recruits in ab initio training

Defence should improve support for all recruits in ab initio training to build resilience and embed help-seeking behaviours. Developed in partnership with people with lived experience of service, the model of support should:

1. utilise mental health screening conducted during ab initio training (Recommendation 65) to identify and provide support to proactively meet recruits' needs
2. reduce barriers to accessing timely and appropriate care, including physical health, mental health, spiritual health, pastoral care and peer supports
3. ensure that changes to 'recruitment risk appetite' do not jeopardise members' mental and physical health, including for those who enter under reduced physical fitness standards, as waiver recipients or with higher psychological risk, including by:
   1. longitudinal tracking of health, wellbeing and safety outcomes for members from initial training and throughout their Australian Defence Force career
   2. with members' consent, sharing insights about recruits' support needs obtained through recruitment processes to enable ab initio training institutions to offer relevant supports proactively
4. prioritise and promote postings at ab initio training institutions and ensure that instructors have the resourcing, capabilities and personal attributes necessary to lead and educate young people, including vulnerable individuals.

Recommendation 3: Build the capability of career managers

Defence should build the capability of career managers to engage with and respond to member needs and preferences when making posting decisions, including by:

1. improving the ratio of career managers to members
2. upskilling career managers to engage with vulnerable individuals through training in trauma-informed approaches
3. providing the training, resourcing, data and guidance for career managers to identify and mitigate cumulative stressors experienced by members, including psychosocial risk such as exposure to unacceptable behaviour, when making posting decisions.

Recommendation 4: Mitigate the adverse impacts of the posting cycle

Defence should take steps to mitigate the adverse impacts of the posting cycle on members and their families, including:

1. measures to reduce the frequency of relocation
2. improved supports for members and their families moving to a new location that target known stressors, such as housing, childcare and children's education, partner/spouse employment and community ties
3. measures to implement greater mobility across the Australian Defence Force and flexible working options
4. working with state and territory governments to ensure that children of Defence personnel can enrol in educational institutions without having a fixed address as a result of Defence-required relocations of the family.

Recommendation 5: Support all serving members to decompress, rest and reintegrate, especially after high-risk experiences

Defence should:

1. implement a clear and consistent framework for post-deployment supports for members and their families that addresses the psychosocial aspects of reintegration. This should include:
   1. an evidence-based approach to decompression and reintegration that allows for individual needs, informed by experience in comparable industries such as emergency services
   2. training that addresses common issues that arise on entering and exiting operational activities, which may include grief, hypervigilance, sleep issues, excess alcohol use and aggression
   3. with members' consent, a handover from their commanding officer on deployment to their commanding officer at home that identifies stressors experienced by the member on deployment
2. implement a structured and comprehensive approach to respite across the Australian Defence Force (ADF) that is not limited to 'arduous deployments' and that addresses fatigue across the workforce
3. analyse data collected on high-risk experiences, including deployments, to derive lessons for improved risk and fatigue management across the organisation and build a better understanding of the future physical and mental health needs of ADF members and veterans.

Recommendation 6: Improve the procedural fairness of the military employment classification system

Defence should ensure members are treated fairly when making decisions about their fitness to be employed or deployed by the Australian Defence Force. To achieve this, Defence should:

1. publish a guidance direction for decision-makers in the military employment classification system on the requirements of procedural fairness
2. ensure members may review all relevant documents before a decision is made about their military employment classification and have an opportunity to make direct representations to the decision-maker, including at Military Employment Classification Review Board meetings.

Recommendation 7: Increase employment opportunities within the Australian Defence Force for members who cannot be deployed

Defence should implement measures to increase employment opportunities within the Australian Defence Force (ADF) for members who are no longer able to be deployed due to illness or injury. Measures should include:

1. systematic identification, within Defence workforce planning and other policies, of roles that may be suitable and should be considered for members who cannot deploy
2. a commitment to maximising opportunities for continuing employment of ADF members who are no longer able to be deployed due to illness or injury, including by minimising reliance on external service providers and contractors
3. processes to measure and monitor the number of members who can and cannot be deployed, and how changes in this ratio impact on, and are illustrative of, the wellbeing of members.

Recommendation 8: Maximise workforce retention by addressing factors that contribute to voluntary separation

In the next iteration of the Defence Strategic Workforce Plan (or its equivalent), Defence should specifically focus on outcomes-based retention initiatives. The plan should:

1. draw on service-specific workforce experience data, monthly workforce reporting and analysis of factors driving voluntary separation
2. address contributors to voluntary separation, including burnout, fatigue and psychosocial stress
3. establish targets, with accompanying performance measures, to enable evaluation of the effectiveness of retention initiatives.

The plan should inform the evolution of Defence's Employee Value Proposition and be implemented in alignment with the Defence Work Health and Safety Strategy.

Recommendation 9: Improve organisational culture and leadership accountability to increase member wellbeing and safety

The Chief of the Defence Force, Australian Defence Force (ADF) service chiefs and the Chief of Personnel should agree on a suite of ADF culture targets, supported by data-driven metrics. Targets should be outcomes-based and time-bound. At a minimum, targets should be developed for the following cultural priorities:

1. safety, health and wellbeing, with a focus on psychosocial safety
2. unacceptable behaviour and sexual misconduct, with a focus on removing barriers to reporting and improving complaints management
3. senior leadership accountability.

The annual culture report should be publicly available and report on each service's progress against culture targets, as well as ADF-wide results.

Recommendation 10: Develop service-specific action plans to implement the Defence Respect@Work Framework

The Australian Human Rights Commission should undertake an independent assessment of the extent to which underlying drivers, risk and protective factors in the Defence Respect@Work Framework are present in each service, and recommend actions to address gaps and known risks.

Following these recommendations, Navy, Army and Air Force should develop service-specific action plans for the Defence Respect@Work Framework, including implementation timeframes, to be approved by the Minister for Defence and the Minister for Defence Personnel.

Recommendation 11: Assess Australian Defence Force leaders based on upward feedback and performance against culture, health and wellbeing targets

Defence should amend the annual performance appraisals of Australian Defence Force (ADF) leaders (from the rank of Colonel to the rank of General, and equivalents) to include upward feedback from their direct reports, and assessment against outcomes-based targets related to culture, health and wellbeing.

At a minimum, Defence should develop outcomes-based targets for leaders for the following domains and metrics:

1. safety, health and wellbeing
   1. psychological safety climate, based on the new Values and Behaviours Survey metrics related to managers and commanders
2. gender equality
   1. difference in cultural reporting between men and women (KPI 11 metrics, Women in the ADF Report)
   2. women feel equally included (KPI 13 Metrics, Women in the ADF Report)
3. reporting and management of unacceptable behaviour
   1. level of under-reporting of unacceptable behaviour and sexual misconduct (reported separately and disaggregated by gender)
   2. satisfaction with management of unacceptable behaviour and sexual misconduct (reported separately and disaggregated by gender).

Recommendation 12: Consider emotional intelligence and performance against wellbeing targets in selecting leaders to promote

The Australian Defence Force should strengthen its leadership selection and promotion process by:

1. assessing a candidate's performance against culture, health and wellbeing targets (see Recommendation 11) as part of the 'fit and proper person' check for leadership and command selection and promotion
2. including psychometric testing, particularly emotional intelligence measurement, as part of the command selection framework, based on command-assessment programs in the United Kingdom and the United States.

Recommendation 13: Co-design a new doctrine recognising that operational readiness depends on a healthy workforce

Defence should convene a select panel to co-design a new doctrine on 'people, capability and service' with Australian Defence Force (ADF) members.

The doctrine should make it clear that Australia's military capability and operational readiness depend on having a physically and mentally healthy workforce, where prevention, early intervention and recovery are not in opposition to values of service and sacrifice, but are essential for these values to be expressed in a sustainable way that serves our nation's interest.

The select panel should:

1. consist of ex-serving members and represent experience at both the commissioned and non-commissioned officer ranks, across Navy, Army and Air Force
2. undertake a co-design process including representation from a broad range of age groups, ranks, bases and services, and maximise involvement of members who have experienced physical and mental health issues
3. present the new doctrine on 'people, capability and service' to the Chief of Personnel and the Chief of the Defence Force for endorsement by no later than December 2026
4. identify any other single-service or ADF cultural norms, symbols, systems, policies or processes identified by members or commanding officers as barriers to the prioritisation of member health and wellbeing, and suggest changes in a report to the Minister for Defence and the Minister for Defence Personnel.

Recommendation 14: Understand the prevalence and effects of military sexual trauma and improve responses to support victims

The Australian Government should commission independent research on the prevalence of military sexual trauma among serving and ex-serving Australian Defence Force (ADF) members. This research should examine:

1. the link between sexual misconduct and suicide and suicidality, other impacts experienced during service, and specific needs of victims at the time of transition, and benchmark the ADF response with best practice approaches to inform recommendations for improvements
2. the terminology 'sexual misconduct' used by the ADF, compared to 'military sexual trauma and violence', and the impact of terminology on victims.

Recommendation 15: Clarify definitions and processes related to sexual offences

Defence should amend its Complaints and Resolutions Manual to:

1. include definitions of sexual offences aligned with the Crimes Act 1900 (ACT) sexual offence provisions, that clearly describe the types of behaviours and actions that constitute each offence
2. provide clear and explicit instructions that managers and commanders who receive a report of sexual misconduct should consult with the Joint Military Police Unit to determine whether the conduct constitutes an offence, before taking any further action.

Recommendation 16: Evaluate training on managing sexual misconduct and make it mandatory for all leaders

Defence should commission an independent evaluation of the Sexual Misconduct Incident Management Workshop as a matter of priority. Following any required improvements identified by this evaluation, sexual misconduct incident management training should be mandatory for all commanders and managers.

Recommendation 17: Prioritise the prevention of sexual misconduct in the Australian Defence Force

The Australian Defence Force should develop a comprehensive sexual misconduct prevention strategy that includes primary prevention and early intervention, as well as targeted behaviour change programs for perpetrators of sexual misconduct.

The strategy should be:

1. developed in partnership with the Australian Human Rights Commission and Our Watch, include specific actions for implementation, including timeframes, and be tailored to the ADF context
2. submitted to the Minister for Defence and the Minister for Defence Personnel for endorsement, and published on the Defence website.

Recommendation 18: Strengthen workplace protections during sexual misconduct investigations

The Australian Defence Force should develop a dedicated policy that applies when sexual misconduct incident investigations are underway in the administrative, disciplinary or civilian justice systems.

The policy should:

1. provide that the commanding officer must immediately apply one of the following interim actions to the alleged perpetrator, neither of which imply any finding of guilt or wrongdoing:
   1. amend their work arrangements to ensure no contact between the victim and the alleged perpetrator (depending on the nature of the work, this may require re-assignment to a different location), noting that the arrangement must not restrict the victim from accessing any common areas
   2. allow suspension with pay
2. ensure that the commanding officer's decision must be informed by a comprehensive risk assessment of the safety, health and wellbeing of the victim, the alleged perpetrator and the broader workplace, with the reasons for the decision being recorded
3. ensure that interim actions are reviewed on a regular basis until the matter has been resolved through both the disciplinary (or criminal) and administrative systems.

The policy should not preclude the commanding officer from:

4. suspending an alleged perpetrator without pay (either in full or part), in accordance with the Defence Force Discipline Act 1982 (Cth) and the Defence Force Regulation 2016
5. taking any additional interim actions as necessary.

Recommendation 19: Protect victims of sexual misconduct from disadvantage over the course of their careers

To ensure there are no inadvertent career consequences for victims of sexual misconduct and to support the safety of victims over the course of their careers, Defence should:

1. develop a neutral label to signify where a change in working hours, or a short-notice or out-of-cycle posting, has occurred to protect a member's health and wellbeing, in a way that protects individual privacy and clearly signals that no career penalty should apply. Similar amendments should be made to the military employment classification system and in guidance to promotions boards
2. report to the Minister for Defence Personnel by no later than 30 June 2025 on whether career management, human resources and Defence housing systems have been updated to ensure victims of sexual misconduct are not posted with their perpetrator/s over the course of their career.

Recommendation 20: Amend the legislation related to sentencing perpetrators of military sexual offences

The Australian Government should amend Section 70 of the Defence Force Discipline Act 1982 (Cth) to:

1. expressly require service tribunals to consider the impact of a sexual offence on the victim as a factor during sentencing, including a victim impact statement if one has been made, and allow the victim to read their statement aloud if they choose to do so, in a closed or open court
2. make it clear that if an offender is of higher rank than a victim, this should be considered an aggravating factor for the purpose of sentencing.

The Australian Defence Force Chief Judge Advocate should amend Practice Note 6 – Part IV Sentencing to require the prosecution counsel to invite victims to make a victim impact statement for consideration by the service tribunal during sentencing.

Recommendation 21: Implement a 'presumption' of discharge for Australian Defence Force members found to have engaged in certain forms of sexual misconduct

The Chief of the Defence Force should issue a directive providing for a presumption that anyone in the Australian Defence Force (ADF) who is found to have engaged in certain forms of sexual misconduct will be discharged.

1. The directive should apply to specified forms of sexual misconduct including, but not limited to, sexual harassment, sexual offences, related offences including intimate image abuse, stalking, and any other offence involving conduct of a sexual nature against an ADF member including prejudicial conduct, assault and obscene conduct.
2. The standard of proof is the balance of probabilities. For the directive to apply, there needs to be a finding, either by a criminal/disciplinary tribunal or administratively by command, substantiating that sexual misconduct has occurred. Where a sexual offence allegation has been made but has not proceeded to prosecution, or has been prosecuted but has not resulted in a conviction, the behaviour must be assessed on the balance of probabilities to determine whether the directive applies.
3. Procedural fairness should be afforded to the member before a decision on whether to retain or discharge them is made. The directive should provide guidance on factors to be taken into account by the decision-maker. The decision must be approved by the relevant service chief.
4. Discharge statistics related to decisions made under the directive should be provided annually to the Minister for Defence and the Minister for Defence Personnel. Statistics should be disaggregated by service and be accompanied by an analysis of common themes, lessons learnt, and actions taken in response.

Recommendation 22: Adopt a policy of mandatory discharge for Australian Defence Force members convicted of sexual and related offences

Defence should adopt a policy of mandatory discharge for Australian Defence Force members convicted of sexual and related offences (including stalking and intimate image abuse) in the military and civilian criminal justice systems, subject to further legal advice on the legislative barriers, if any.

Recommendation 23: Record convictions of sexual offences in Australian Defence Force records and civilian criminal records

As a matter of urgency, the Australian Government should:

1. ensure the Australian Defence Force has a complete and reliable record of all serving members who have been convicted of sexual offences and related offences (including stalking and intimate image abuse) in civilian courts
2. work with state and territory governments to ensure that civilian criminal records include convictions of sexual offences and related offences (including stalking and intimate image abuse) made under the Defence Force Discipline Act 1982 (Cth).

Recommendation 24: Annually publish anonymised data on outcomes of all incidents of sexual misconduct

Defence should publish data on administrative and disciplinary outcomes for all forms of sexual misconduct incidents. At a minimum, this data should:

1. be published on an annual basis, disaggregated by service
2. identify the nature and type of all sexual misconduct incidents, including:
   1. the nature and type of sexual offences and related offences, including intimate image abuse, stalking and relevant service offences that include sexual misconduct as an element
   2. other forms of sexual misconduct, including sexual harassment and sex discrimination
3. include demographic information of victims and perpetrators, including age, rank and gender.

Recommendation 25: Conduct a formal inquiry into military sexual violence in the Australian Defence Force

The Australian Government should commission an external, independent, expert inquiry into military sexual violence in the Australian Defence Force (ADF), with a report that includes recommendations provided to the Minister for Defence, the Minister for Defence Personnel and the Attorney General, and made public.

The terms of reference for this inquiry should be developed in consultation with victims of sexual violence in the ADF (serving and ex-serving), and at a minimum should include:

1. the effectiveness of the military justice system compared to the civilian justice system in receiving, investigating and adjudicating on sexual and related offences. This should include an examination of the Joint Military Police Unit's investigative powers and capability to conduct sexual offence investigations; the referral of matters to civilian police; any barriers faced by civilian police investigating sexual offences on ADF bases; sentencing outcomes; recidivism rates; decisions not to prosecute and conviction rates
2. the underlying reasons for the reduction in actions (including making a report, and agreeing to reported matters being investigated) taken by victims of sexual violence, including the role of alcohol and other barriers, and the adequacy of ADF policies in addressing these
3. the effectiveness of anonymous reporting options including awareness, uptake and impact compared to alternative approaches (including but not limited to the approach taken in the United States).

The inquiry should have regard to all lived-experience testimony, statements, exhibits and published submissions made to this Royal Commission that are related to sexual violence in the ADF.

Recommendation 26: Foster a strong culture of reporting unacceptable behaviour

Defence should foster a strong reporting culture to:

1. proactively identify at-risk locations, cohorts, ranks or roles where toxic subcultures are flourishing
2. implement risk mitigation strategies to address unacceptable behaviour directly in the locations, cohorts, ranks or roles identified
3. report publicly on identified hot spots of unacceptable behaviour and what actions have been taken to address unacceptable behaviour.

Recommendation 27: Evaluate outcomes to ensure that Defence has addressed the intent behind recommendations

Defence should evaluate the outcomes of actions taken to implement the recommendations made by the Commonwealth Ombudsman in its review Does Defence handle unacceptable behaviour complaints effectively? Defending Fairness, to ensure that the intent of the recommendations is achieved.

Recommendation 28: Coordinate governance, assurance and policy functions of the military justice system

Defence should establish a home for military justice governance, assurance and policy and provide sufficient resourcing to achieve the following functions:

1. monitor qualitative and quantitative data and analyse trends across the range of military justice processes and outcomes
2. prioritising strategies to improve military justice record-keeping and data input issues to remediate data quality and facilitate analysis
3. monitoring the effectiveness of implementation of recommendations from various military justice reviews (including Inspector-General of the Australian Defence Force), including activity and impact evaluation
4. continue to define military justice metrics and align them with health and wellbeing metrics, and in so doing, to:
   1. identify and monitor risks of misuse and abuse of military justice processes
   2. track complaints and trends related to termination, offence type and investigation outcomes
   3. identify members who are repeatedly subject to military justice processes
   4. identify officers who apply disproportionately high numbers of administrative sanctions
5. establish and implement effectiveness measures for military justice reforms / key actions on the Military Justice Steering Group action plan
6. review current-status reporting on initiatives in line with good-practice governance principles.

Recommendation 29: Establish a new role to improve training and communication on conducting inquiries

Defence should establish the Joint Workforce Capability Employment Manager as a priority, whose scope of work should include:

1. reviewing the effectiveness of training in how to conduct 'fact finds' and inquiries and ensuring that trauma-informed principles are embedded throughout the training
2. reviewing the effectiveness of policies and communication material related to 'fact finds' and inquiries.

Recommendation 30: Prioritise the Inspector-General's inquiry into the weaponisation of the administrative system

The Inspector-General of the Australian Defence Force should initiate an own-initiative inquiry into the weaponisation of the military justice administrative system by the end of 2024.

The inquiry should consider how to improve accountability of commanders who are found to misuse and abuse military justice processes. Measures to identify misuse and abuse may include monitoring trends in administrative sanctions and locations, cohorts, roles or ranks found to be associated with disproportionately high rates of sanctions.

Recommendation 31: Consider how mental health may contribute to poor conduct before recommending administrative termination

That it be mandatory for Defence, when recommending administrative termination of a member under Section 24 (1) (c) of the Defence Regulation 2016 (Cth) 'retention-not-in-service-interest', to consider the member's current mental health and/or the role that mental health may have played in the behaviour that attracted administrative action.

Recommendation 32: When requested, conduct a merits review when a member's service is terminated for the reason 'retention-not-in-service-interest'

Defence should implement a merits-review process for involuntary separation under Section 24 (1) (c) of the Defence Regulation 2016 (Cth) 'retention-not-in-service-interest' through consultation and collaboration with the Inspector-General of the Australian Defence Force (ADF) and the Administrative Appeals Tribunal/Administrative Review Tribunal.

1. Defence should introduce an enhanced merits-review process in the Redress of Grievance Directorate of the Inspector-General of the ADF.
2. The Australian Government should consider giving jurisdiction to a specialist division of the Administrative Appeals Tribunal/Administrative Review Tribunal to manage a fast-track method for conducting external merits reviews. It is proposed that an external merits review would only be considered after the independent merits review process of the Inspector-General of the ADF had been completed.

Recommendation 33: Seek to understand whether/how involvement in military justice processes contributes to adverse outcomes

Defence should undertake further research to better understand the stressors that are both associated with, and lead to, involvement in administrative and disciplinary processes, including:

1. identifying prevalence rates of suicide and suicidality for serving and ex-serving members who have been exposed to military justice administrative and disciplinary processes
2. exploring the connection between members' use of alcohol and other drugs as a numbing strategy to help them cope with trauma and service-related stressors, and involvement in administrative or disciplinary processes
3. identifying opportunities to intervene when members are engaging in maladaptive coping strategies before their behaviour leads to administrative or disciplinary action.

Based on the outcomes of this research, Defence should implement policies to support members involved with military justice processes and minimise the risk of adverse outcomes, including suicide and suicidality.

Recommendation 34: Prioritise the review into the regulations governing court martial panels

Defence should prioritise the review of current provisions relating to court martial panels not being required to provide reasons for punishments being imposed.

Defence should document this in the 2024/25 Military Justice Steering Group workplan.

Recommendation 35: Determine whether support mechanisms for members involved with military justice processes are effective

Defence should evaluate the effectiveness of the key support mechanisms for those involved in military justice proceedings, including but not limited to:

1. support officers
2. individual welfare boards.

In its evaluation, Defence should consider members' experiences of the supports provided.

Recommendation 36: Trial a model outside the chain of command for supporting members involved in military justice processes

The Australian Defence Force (ADF) should fund and pilot a model for automatic, opt-out referral to both legal and welfare support services for members engaged in certain military justice processes that is separate from the chain of command (for example, the Workplace Behaviour Adviser Network, the Sexual Misconduct Prevention and Response Office, and the Employee Assistance Program).

In developing the pilot, the ADF should:

1. consider the role of individual welfare boards in the process
2. make it clear that once the referral is received, the relevant service would be responsible for initiating contact
3. consider thresholds for referral, and focus on increasing support for members exposed to factors known to contribute to higher risk of psychosocial harm, suicide and suicidality for example:
   1. those involved (both as victims and accused) in unacceptable behaviour complaints, sexual misconduct incidents, and disciplinary proceedings for offences under the Defence Force Discipline Act 1982 (Cth)
   2. those who are being considered for administrative termination.

The ADF should evaluate the pilot at its conclusion to assess the demand impacts and benefits in order to inform the decision for a broader roll-out.

Recommendation 37: Develop a charter of minimum standards for all members involved in military justice processes

The Australian Defence Force (ADF) should develop a charter of minimum standards for all members involved with or subject to disciplinary processes, or involved in matters handled by the Inspector-General of the ADF. It should include commitments to:

1. treating members with courtesy, compassion, dignity and respect, and consideration of their welfare needs
2. providing members with information that is clear and understandable about:
   1. the relevant military justice processes
   2. the legal, welfare and victim-support services available to them
3. referring members to relevant support services
4. providing updates at key stages of the process, including explaining the outcomes at its conclusion
5. giving victims of unacceptable behaviour the opportunity to provide a victim impact statement to inform sentencing, where the accused has been found guilty.

The charter should also contain defined roles and responsibilities for meeting the minimum standards.

The charter should be publicly available and members may refer to these minimum standards via the existing appeals and complaints processes where they feel these standards have not been upheld.

Recommendation 38: Improve governance processes related to accountability and continuous improvement

To improve accountability and continuous improvement regarding mental health and wellbeing outcomes, Defence should:

1. continue to work towards including health, wellbeing and safety measures in its Budget Paper performance measure, and ensure these measures cascade into future corporate plans
2. prioritise the development of the Monitoring and Evaluation Framework in partnership with the Department of Veterans' Affairs, for the joint Mental Health and Wellbeing Strategy 2024‒2028, and set out what success would look like for that strategy in terms of outcomes in the short, medium and long term, against the wellbeing domains
3. continue to develop a clear performance logic, including the translation of performance measures from budget papers, the corporate plan, and the joint strategy into clear accountability measures for senior leaders in Defence
4. once the Enterprise Reform Program has been implemented, assess how improvements in the collection, sharing and use of data may better support performance measurement, in line with the Defence performance logic model.

Acknowledging the challenges in improving performance measurement, and the risk of unintended consequences, the Australian Government should assist Defence to build performance management experience and expertise at the unit, service and enterprise level by:

5. prioritising Defence in the broader Australian Public Service performance management capability uplift
6. prioritising Defence in the Australian Public Service Commission Capability Review program
7. supporting a coaching and mentoring program in areas (identified by Defence) that have responsibility for developing and implementing reforms in performance measurement.

Recommendation 39: Address risk factors for suicide and suicidality and report on progress as part of enterprise-level risk management

Defence should address in-service risk factors for suicide and suicidality as part of the reporting processes related to enterprise risk management and the development of mental health and wellbeing strategy by:

1. identifying in-service risk factors to be reported (including, but not limited to, the risk factors for suicide and suicidality related to Australian Defence Force service identified in Chapter 1, Understanding suicide)
2. developing outcomes-based measures against these risk factors
3. developing risk controls and measures of control effectiveness.

Enterprise risk management must be informed by a contemporary assessment of hazards related to the health and wellbeing of Defence personnel and should inform delivery of the joint Mental Health and Wellbeing Strategy 2024‒2028.

Recommendation 40: Improve governance mechanisms from the unit level to the enterprise level

In order to identify and address barriers to effective governance from the unit level to the enterprise level, Defence should:

1. review all internal and external governance reporting mechanisms
2. identify root causes of non-compliance with required reporting
3. identify duplicative reporting information and processes
4. draw on process-improvement methodologies (for example, Lean Thinking) to reduce the administrative burden of reporting and governance compliance across Defence
5. improve governance, performance-reporting and data literacy at the unit, service and enterprise level via training and/or embedding coaching.

Recommendation 41: Build project-management capability so that reform initiatives are successful

To build sustained capability to implement lasting policy changes, Defence should:

1. engage independent expertise to undertake a project management maturity assessment of the areas in Defence that will be responsible for implementing the recommendations of this Royal Commission
2. upon completion of the maturity assessment, develop a blueprint and implementation plan to deliver the improvements to those areas of project management capability that require an uplift
3. monitor the implementation of the capability uplift through to completion via a Tier 1 Committee.

Recommendation 42: Ensure that future Inspectors-General of the Australian Defence Force will not have served in the ADF

The Australian Government should amend Part VIIIB Division 2, sections 110E to 110P of the Defence Act 1903 so that:

1. a person appointed as the Inspector-General of the ADF must not have served in the ADF
2. the Inspector-General should be supported by two Deputy Inspectors-General with appropriate skills and experience, for example, having served in the ADF or having experience and understanding of the justice system, including military justice
3. the Deputy Inspector-General positions are to be statutory appointments.

Recommendation 43: Allow the Inspector-General of the Australian Defence Force to make recruitment decisions for the staffing of their office

The Inspector-General of the Australian Defence Force (ADF) should have the responsibility and authority for the selection of staff in their office, including as to whether staff are drawn from the ADF, the Australian Public Service, or from other sources.

The Inspector-General should have the power to select and recruit freely from the ADF without being constrained by whom the Chief of the Defence Force, the service chiefs or the Director of Military Legal Capability select or recommend.

Recommendation 44: Ensure that staff of the office of the Inspector-General of the Australian Defence Force have the necessary skills, expertise and qualifications

The Inspector-General of the Australian Defence Force (ADF) should develop a workforce plan that includes:

1. a review of the skills, expertise and professional qualifications required to discharge effectively the Inspector-General's complete functions
2. an assessment of the current workforce in the office of the Inspector-General in which any competency gaps are identified
3. a strategic plan to attract and deliver the required capability profile to the office of the Inspector-General.

Recommendation 45: Improve transparency and accountability of the Inspector-General of the Australian Defence Force by increasing their reporting requirements

The Inspector-General of the Australian Defence Force (ADF) should improve the transparency and accountability of their office by:

1. updating and publishing comprehensive guidance or other standard operating procedures on its website, including quality-assurance measures, related to the discharge of the Inspector-General's functions in each directorate of the office of the Inspector-General
2. establishing and including in this guidance specific performance measures related to timeliness in the completion of assessments and inquiries and the consideration of redress of grievance complaints, and reporting annually on performance against these measures.

Recommendation 46: Ensure staff of the Inspector-General of the Australian Defence Force are trained in trauma-informed practice

The Inspector-General of the Australian Defence Force should ensure that all staff in the office of the Inspector-General (including consultants) who engage with members' next of kin and family members; are communicating with complainants, respondents or witnesses for the purpose of an inquiry; or who are charged with considering a redress-of-grievance complaint have completed the Compassionate Foundations course or equivalent training in trauma-informed practice before doing so, and complete refresher training every two years.

Recommendation 47: The Inspector-General to inquire into all deaths of serving members unless suicide can be excluded as the cause of death

The Inspector-General of the Australian Defence Force (ADF) should ensure that where suicide cannot be categorically excluded as the cause of death of an ADF member, a formal inquiry under written directions is conducted.

When undertaking such an inquiry, the Inspector-General should obtain input from a qualified mental health expert, such as a psychologist, when determining:

1. whether suicide may have been the cause of death
2. where suicide cannot be excluded, what the contributing factors may have been and whether there was a 'service nexus'
3. what recommendations should be made.

Recommendation 48: When a member dies by suicide, appoint a legal officer to represent the interests of the deceased and support the next of kin

When a serving member dies by suicide, or is suspected to have died by suicide, the Inspector-General of the Australian Defence Force should ensure that a legal officer from Defence Counsel Services has been appointed to represent the interests of the deceased upon written directions for a formal inquiry being issued.

The Inspector-General should ensure that interviews with the member's next of kin are conducted after the legal officer has been appointed and made contact with them.

Recommendation 49: Minimise disclosure restrictions of Inspector-General inquiry reports and ensure they are fair and understood by the next of kin

In relation to non-disclosure directions made pursuant to section 21 of the Inspector General of the Australian Defence Force Regulations 2016:

1. staff from the office of the Inspector-General must explain the scope of the directions to next of kin and family members before they are made
2. the directions should not apply to information that next of kin themselves provide to an inquiry, and which next of kin may know independently of anything contained in a draft, unredacted or redacted report
3. next of kin should be consulted directly about the persons that are to be included in the carve-outs to the directions permitting disclosure, and persons nominated by the next of kin should be included unless there is a good reason not to include them
4. restrictions on disclosure in respect of unredacted and redacted final reports should only extend to those parts of the reports that need to have disclosure restricted in the interests of the defence of the Commonwealth, or for reasons of fairness to a person who the Inspector-General considers may be affected by the inquiry
5. the Inspector-General should establish a mechanism by which next of kin may have the directions that are made reviewed by a legal officer of the office of the Inspector-General who was not involved in the relevant inquiry or in the decision to make the directions. The Inspector-General must have regard to the issues or concerns raised by the legal officer
6. there should be comprehensive guidance in relation to the making and terms of Section 21 directions included in the updated comprehensive guidance on the Inspector-General's website.

Recommendation 50: Amend the scope of the Inspector-General's role to inquire into suicide deaths of former Australian Defence Force members

The Inspector-General should be required and empowered to inquire into the death of a former Australian Defence Force (ADF) member where the death may have been by suicide, and where:

1. the death occurs:
   1. after 30 September 2024; and
   2. within two years of the former member ceasing to be an ADF member; and
2. the Inspector-General is notified or otherwise learns of the death within three months of the date of death.

Recommendation 51: The Inspector-General to regularly review inquiries into suicide deaths to determine common themes

The Inspector-General of the Australian Defence Force should conduct a review of all inquiries and reports into suicide or suspected suicide every three years to determine whether there are any common themes and contributing factors, and report the findings to the Chief of the Defence Force, the Minister for Defence and the Minister for Defence Personnel.

Recommendation 52: Conduct a merits review when a member's service is involuntarily terminated and they submit a redress of grievance complaint

When a member makes a redress of grievance complaint concerning a decision to terminate their service, the Inspector-General of the Australian Defence Force should:

1. (in addition to Recommendation 32) conduct a review in the nature of a merits review and determine, in their view, the correct or preferable decision
2. conclude their consideration of the complaint within 60 days of referral
3. give the member the opportunity to provide any further information or submissions prior to concluding their consideration of the complaint, in person, if practicable to do so, when the proposed outcome will not be favourable to the member.

Recommendation 53: Give members 21 days to make a complaint after being notified of a decision to terminate their service

Defence should amend Section 41(2) of the Defence Regulations 2016 to allow a member to make a complaint up to 21 days after they are notified of a decision to terminate their service.

Recommendation 54: Improve the frequency of military justice-related audits conducted by the Inspector-General of the Australian Defence Force

The Inspector-General of the Australian Defence Force (ADF) should:

1. conduct a routine military justice performance audit of every major ADF unit every three years, and of every ab initio training establishment every two years
2. conduct a longitudinal study of all audit reports every two years to determine trends, themes and issues of concern, and provide the outcomes of this analysis to the Chief of the Defence Force, the Minister for Defence and the Minister for Defence Personnel
3. audit at least three non-major units each year that are not part of the Directorate of Military Justice Performance Audit routine audit cycle.

Recommendation 55: Conduct an audit into Defence workplace health and safety risk management

The Defence Audit and Risk Committee should commission an audit into Defence workplace health and safety (WHS) risk management within the next 12 months. The audit should include, but not be limited to:

1. reviewing WHS hazard trends with a focus on psychosocial health and compliance with requirements of the Work Health and Safety Act 2011 (Cth)
2. reviewing the accuracy of existing WHS enterprise risk reporting, including the WHS dashboard
3. assessing WHS risk-assessment methodology, and the accuracy of categorisations of 'likelihood' and 'impact' of hazards within the 'WHS' enterprise risk category
4. assessing the suitability and effectiveness of WHS hazard controls, including their ability to be measured for impact.

The findings of the audit must be reflected in the delivery of the Defence WHS Strategy and WHS risk reporting going forward.

Recommendation 56: Improve guidance and understanding of Defence's 'if in doubt, notify' policy

Comcare and Defence should work together to improve guidance and understanding of the 'if in doubt, notify' policy in relation to determinations about when to report notifiable incidents to Comcare.

Recommendation 57: Comcare to regularly review Australian Defence Force determinations of 'service nexus' for suicide attempts and suspected deaths by suicide

Comcare should improve its quality assurance of Australian Defence Force (ADF) 'service nexus' determinations made by the ADF by:

1. undertaking a periodic review of service nexus determinations made by the ADF for incidents of suicide, suspected suicide, attempted suicide, and non-fatal self-harm by ADF members, where the ADF has concluded that the incident did not arise out of the conduct of the ADF's business or undertaking, under section 38(1) of the Work Health and Safety Act 2011 (Cth)
2. evaluating the results of these periodic reviews after three years to determine whether there is a continued need for them. The timeframe of three years will enable Comcare to test a sufficient sample size to inform a decision about whether to continue periodic reviews.

Defence should fund any additional resourcing required by Comcare to undertake these periodic reviews over the three-year period and conduct its evaluation at the end of that period.

Recommendation 58: Give Comcare access to the National Veterans' Data Asset

Comcare should have access to the National Veterans' Data Asset (Recommendation 107), to inform Comcare's regulatory approach to preventing psychosocial harm including latent harm.

Recommendation 59: Defence to participate in Comcare's Psychosocial Proactive Inspection Program

Defence should participate in Comcare's Psychosocial Proactive Inspection Program, once the evaluation has established that it is effective.

Either:

1. Defence should fund its participation in that program, or
2. a Commonwealth appropriation should be made to Comcare for the purpose of Defence's participation in the program.

Recommendation 60: Improve strategies for harm prevention and early intervention by sharing quality data with Comcare

To improve Comcare's ability to inform prevention and early intervention strategies for suicide and latent harm arising from Australian Defence Force service, Defence should:

1. share with Comcare on a quarterly basis through the Suicide and Self-Harm Working Group meeting:
   1. data on psychosocial harm (including data related to notifiable and non-notifiable incidents)
   2. Defence's analysis of this data to identify systemic issues related to psychosocial harm
2. share with Comcare through the Defence-Liaison Forum meeting what actions it has taken to document and implement controls to address systemic hazards, risks and issues relating to psychosocial harm.

Recommendation 61: Establish a brain injury program

Defence and the Department of Veterans' Affairs should establish a brain injury program that covers, at a minimum, relevant Army corps, special forces, Navy clearance divers, Air Force combat controllers, and serving and ex-serving members exposed to mefloquine and/or tafenoquine. The program should:

1. aim to better understand, and mitigate, the impact of repetitive low-level blast exposure on brain processes
2. assess and treat neurocognitive issues affecting serving and ex-serving members, whatever their cause.

To do this, it should:

3. monitor and assess environmental exposure to blast overpressure
4. record members' exposure to traumatic brain injury and minor traumatic brain injury, including in medical records
5. establish a neurocognitive program suitable for serving and ex-serving members experiencing a range of neurocognitive issues, whatever their cause. This could be adapted from the former Mending Military Minds program
6. provide referral pathways for further medical assessment, when required.

Recommendation 62: Establish a research translation centre for defence and veteran health care

The Australian Government should support the development of a research translation centre for Defence and veteran health care, or a similar body with an explicit research translation focus.

1. Defence and the Department of Veterans' Affairs (DVA) should work with relevant stakeholders, including researchers and health providers with expertise and experience in defence and veteran health care, to develop a model for the establishment of the research translation centre and priority initiatives for funding.
2. The model should be informed by the National Health and Medical Research Council criteria for accreditation of a research translation centre, and include the following aims:
   1. promoting and increasing research on Defence and veteran health care in Australia
   2. translating research into improvements to the health system and better outcomes for patients
   3. facilitating collaboration among and between researchers and clinicians
   4. supporting research-infused education and training.
3. Defence and DVA should jointly develop a business case for the research translation centre for consideration by the Australian Government.

Recommendation 63: Reduce stigma and remove structural and cultural barriers to help seeking

The Australian Defence Force (ADF) should identify and remove cultural and structural barriers to help seeking and make a greater concerted effort to reduce stigma. This should include:

1. the Australian Government should remove reference to the word 'malingering' at Section 38 of the Defence Force Discipline Act 1982 (Cth)
2. Defence should review all its policies and procedures and amend or remove those that are stigmatising
3. the ADF should develop a dedicated training program and a communications campaign to reduce stigma and promote help seeking.

Recommendation 64: Establish an enterprise-wide program to monitor and prevent physical and psychological injury

The Australian Defence Force should establish a comprehensive, enterprise-wide injury surveillance and prevention program. The program should encompass physical and psychosocial risks and hazards, and:

1. be adequately resourced, including by engaging staff with appropriate expertise in injury prevention, including physical and psychosocial injury and illness
2. identify the most common injury risks and hazards and implement strategies for preventing or minimising them
3. include functionality within the reporting system to identify root causes or contributing factors including location, time, and activity being undertaken at the time of injury
4. actively monitor where injuries and psychological risks and hazards occur and generate quarterly reports on injury rates and clusters with actionable recommendations for commanding officers.

Recommendation 65: Improve access to, timeliness and quality of mental health screening and use the data effectively

The Australian Defence Force should ensure that its mental health screening continuum effectively identifies members who require additional support and/or who are at heightened risk of suicide, and that these individuals receive support, by:

1. ensuring that members have access to screening and are offered referrals for further support at all known points of vulnerability, including: during ab initio training, when their military employment classification is downgraded, and accessing rehabilitation
2. ensuring that a sufficient and appropriately trained workforce is available to administer the mental health screening continuum and conduct the required follow-ups, including:
   1. ensuring screening is done in such a way that encourages disclosure, including face-to-face screening wherever possible
   2. ensuring members receive timely and appropriate referrals following screenings where required
   3. monitoring the uptake of referrals and following up with members who do not action these referrals
   4. monitoring members who are overdue for screenings and following up with them
3. introducing tools that screen for known risk factors for suicide and suicidality that are not currently screened for, including problematic anger, sleeping difficulties and military sexual trauma
4. using the data collected during screenings for longitudinal surveillance.

Recommendation 66: Where possible, support injured members to be rehabilitated at work, within their home unit

The Australian Defence Force (ADF) should support and resource rehabilitation services within the ADF to adopt a tailored approach, from members rehabilitating within their home unit, either with or without the support of a specialist rehabilitation service working in conjunction with the chain of command when required, to coordination of rehabilitation and recovery through a specialist rehabilitation unit only in exceptional circumstances and when necessary to optimise functioning and return to work.

Consistent with this approach:

1. Defence policies and procedures related to rehabilitation should adopt the principle of recovering at work, where safe to do so. This principle should be embedded in the Defence Health Manual, Military Personnel Manual, ADF Rehabilitation Program Procedures Manual, and other relevant policies and guidelines.
2. rehabilitation at home or in a designated rehabilitation unit should be reserved for exceptional circumstances, and even in these instances, home units must maintain connection with the member undergoing rehabilitation, whether that be at home or assigned to a designated rehabilitation unit
3. rehabilitation outcomes should be publicly reported on a regular basis.

Recommendation 67: Align Defence's clinical governance framework with the national model framework

Defence should work with relevant bodies, including the Australian Commission on Safety and Quality in Health Care and the Royal Australian College of General Practitioners, and in consultation with Bupa, the Department of Veterans' Affairs (DVA) and relevant civilian health services to review its clinical governance framework, with a view to aligning it with the National Model Clinical Governance Framework.

Defence should give particular attention to:

1. strengthening its quality improvement systems to actively manage and improve the safety and quality of its health care
2. ensuring that performance monitoring systems are in place to monitor clinical effectiveness
3. establishing partnerships across DVA, civilian healthcare services and specialist facilities for serving and ex-serving members, and leveraging these partnerships to respond optimally to the unique needs of each patient
4. ensuring that serving members are a partner in the design, delivery and evaluation of Australian Defence Force healthcare services.

Recommendation 68: Strike the right balance between upholding confidentiality and disclosing information when a member is in distress

Defence should ensure that members and commanding officers understand how the Privacy Act 1988 (Cth) operates and the importance of members' consenting to their health information being shared with those able to facilitate appropriate care and support, in the event members are distressed or experiencing mental health challenges.

To this end, Defence should:

1. continue its proactive approach to consent and provide regular training on the Privacy Act
2. regularly evaluate members' understanding of the importance of consent and how Defence will use their personal information
3. by the end of 2025 and regularly thereafter (no less frequently than every three years), review its privacy policy and amend it as appropriate to ensure that it is clear, particularly with respect to:
   1. what it means to provide consent, and why consent is important, particularly for ensuring that family members are equipped with relevant information to support a members' mental health and wellbeing
   2. how members' health information is reasonably necessary for, or directly related to, the functions and activities of the Australian Defence Force (ADF), including what 'suitability for service from a health perspective' means
   3. when a 'general permitted situation' (as defined in section 16A of the Privacy Act 1988 (Cth)) exists in the context of the ADF, particularly when a member is experiencing distress or mental health challenges that puts them at risk of suicidality
   4. when members' mental health information will be disclosed to their commander or manager to facilitate their wellbeing; when, in the context of the ADF, disclosure is necessary to lessen or prevent a serious threat to the life, health or safety of any individual or to public health or safety, and to whom the information can be disclosed.

If barriers remain following review and amendment of the Defence privacy policy, then consideration could be given to subsequent legislative change, as part of the process set out in Recommendation 74.

Recommendation 69: Improve suicide-prevention training so it is practical, tailored, informed by lived experience and delivered in person

The Australian Defence Force should revise and improve its suicide-prevention training so it:

1. focuses on practical rather than theory-based learning, and ensures members are familiar with what support is available
2. is scaled, to emphasise different levels of responsibility, from junior ranks to commanders. Specific training should be offered to senior leaders, which sets out how they can support those under their command
3. is informed by, and involves, members with lived experience of suicide, suicidality or mental health
4. delivers all suicide prevention training in-person by no later than 31 December 2025.

Recommendation 70: Revise protocols for responding to suicidal crisis to be in line with clinical best practice

By no later than 31 December 2025, Defence should revise its protocols for responding to suicidal crisis so they are applied consistently, in line with clinical best practice.

1. The protocols should, among other things, specify:
   1. the availability of, and arrangements for accessing, culturally appropriate crisis care facilities
   2. a minimum standard for aftercare
   3. how monitoring and follow-up support should occur following a suicide-related incident
   4. approaches to reintegration following a suicidal crisis.
2. The revised protocols should be developed in partnership with an external body with expertise in managing suicidal crisis and aftercare.
3. The revised protocols and their application across the three services should be subject to independent evaluation after five years.

Recommendation 71: Increase the Department of Veterans' Affairs fee schedule so it is aligned with that of the National Disability Insurance Scheme

The Australian Government should amend the Department of Veterans' Affairs (DVA) fee schedule to mitigate the challenges faced by veterans in accessing health care, ensuring that:

1. at a minimum, the revised fee schedule aligns with that of the National Disability Insurance Scheme
2. efforts to mitigate supply constraints are prioritised, such as non-fee-for-service components, additional loading, and/or incentive payments, including in areas with few health services for the populations being served.

DVA should reduce the time taken to pay healthcare providers, and track and publicly report on the time taken to provide these payments.

Recommendation 72: Expand and strengthen healthcare services for veterans

The Australian Government and state and territory governments should prioritise networks of care in the National Funding Agreement on Veterans' Wellbeing (Recommendation 88).

To enable this, the Department of Veterans' Affairs (DVA) should develop a plan to expand and strengthen specialised health care for veterans. It should set out how to bring together the different components of the health system to meet the health needs of veterans. DVA should complete the plan by September 2026 and submit it to the Veterans' Ministerial Council for endorsement as part of the funding agreement.

The plan must set out measures to improve the coverage of specialised veterans' care, including by:

1. providing support for primary and allied care providers whose services focus on veterans' health needs
2. expanding veteran-specific secondary and tertiary health services
3. developing additional partnership agreements between DVA and primary health networks.

It must also support the integration of veterans' health services at a local and national level, including by:

4. better informing veterans about available services
5. using existing health infrastructure, such as primary health networks
6. developing local exchanges to tighten relationships between medical and allied health care practitioners.

The plan should be guided by current and future needs and informed by data on Australia's veteran population showing the size of veteran communities in different areas, where specialised services currently exist or are lacking, and how and where veterans access health services.

Recommendation 73: Improve military cultural competency in health professions working with veterans

The Department of Veterans' Affairs (DVA) should complement the work outlined in Recommendation 72 by expanding its efforts to build cultural competency relating to veterans among health workers who operate in mainstream health settings. DVA should expand its training modules and enable health professionals working with veterans to complete them. It should promote this work, including through partnerships with professional bodies.

Recommendation 74: Clarify the application of the Privacy Act to veterans to determine whether amendments are necessary

The Department of Veterans' Affairs (DVA) should seek legal advice clarifying the application of the Privacy Act 1988 (Cth) (and any other relevant legislation) to veterans and their families in the context of sharing data and information related to health, wellbeing and safety.

DVA should use this advice to inform consideration of whether legislative amendments are required to optimise the management of the health and wellbeing of veterans. Consideration may be given to extending the scope of any changes to encompass serving members, if this is needed following the review of the Defence privacy policy proposed at Recommendation 68.

Recommendation 75: Conduct an independent review of Open Arms and publish the report

The Australian Government should commission an independent review of Open Arms, to commence in 2027, following the implementation of the new Model of Care and led by a qualified entity outside of the Defence portfolio.

The scope of the review should be wide-ranging and it should examine:

1. how Open Arms is discharging its functions, including its compliance with clinical standards and its management of at-risk clients
2. issues that could affect Open Arms' ability to discharge its functions, including workforce, culture and funding
3. what functions Open Arms should perform within the wider network of services accessible to serving and ex-serving members
4. the appropriateness of Open Arms' delivery model, and whether another model is preferable.

The Australian Government should make the review's report public.

Recommendation 76: Develop a postvention framework with experts and those with lived experience of suicide bereavement

The Australian Defence Force should develop a postvention framework that must be implemented following a serving member's death by suicide (or suspected suicide) for the purposes of supporting the member's family members and colleagues, as well as first responders. It should involve:

1. collaborating with and seeking input from peak postvention organisations and those with lived experience of suicide bereavement
2. developing communication materials and training modules for commanders and key decision-makers about trauma-informed postvention support for Defence personnel
3. the use of a systematic process for identifying and referring those at highest risk following a suicide death
4. consideration of the unique circumstances of each posting or cultural circumstances of the bereaved
5. greater surveillance and evaluation of the broader impact of suicide on personnel and their functioning for the purposes of improving interventions.

Recommendation 77: Develop a suite of postvention resources in collaboration with stakeholders

Defence and the Department of Veterans' Affairs should fund and facilitate the development of a postvention network of suicide-bereavement resources in collaboration with ex-service organisations, states and territories, lived experience peers, and civilian support organisations to augment current postvention offerings, which can be inclusively accessed by and are tailored for the military community and all those affected by veteran suicide.

Recommendation 78: Prevent, minimise and treat moral injury

Defence and the Department of Veterans' Affairs should work collaboratively to develop an agreed approach to minimising the negative impacts of moral injury, including the risk of suicide and suicidality for serving and ex-serving members. The approach should evolve in line with emerging research and best practice, and at a minimum include:

1. implementing education, training and support programs with the explicit objectives of preventing, minimising and treating moral injury
2. considering using the Moral Injury Outcome Scale or other tools, as the evidence base evolves, to support the early identification and treatment of moral injury
3. conducting or commissioning further research to better understand moral injury in the Australian military population.

Recommendation 79: Ensure that respect for and recognition of service are embedded throughout Defence and the Department of Veterans' Affairs

Respect and recognition should be a key element of separation and transition processes; they must also be the foundation for all interactions with members and former members of the Australian Defence Force during service and civilian life.

Defence and the Department of Veterans' Affairs should:

1. examine their processes to identify ways in which respect in interactions with serving and ex-serving members can be increased
2. create a survey to benchmark the levels of respect shown to current and ex-serving members prior to 30 June 2025
3. conduct this survey every two years to identify areas for improvement, and introduce improvements no later than the following year
4. support the Joint Transition Authority to review its policy on recognition and farewells on a regular basis (at least every three years) to identify areas for improvement, and introduce these improvements by the following year.

Recommendation 80: The Department of Veterans' Affairs to take responsibility for supporting members to transition out of the Australian Defence Force

Defence should continue to be responsible for supporting members to prepare for and complete separation from the Australian Defence Force (ADF). The new executive agency to be established in the Department of Veterans' Affairs (DVA) (Recommendation 87) should take responsibility for supporting members to transition into civilian life.

Through the new agency, DVA should:

1. establish a meaningful relationship with serving members as soon as they begin a pathway towards transition
2. conduct a transition readiness review prior to separation, which includes the member, their commanding officer and DVA support person
3. lead transition screening and expand it to assess members' psychosocial readiness for transition, including purpose and connection, help-seeking, beliefs about civilians, and regimentation and adaptability
4. with the consent of the member, share transition screening results (wholly or partially) with the member's commanding officer and key transition support people within Defence and DVA (with Defence and DVA implementing a proactive process to obtain members' consent to share this information)
5. proactively reach out to ex-serving members in the 12 months after they leave the ADF to understand their experience of transition, how they are adjusting to civilian life, and connect them with supports delivered by Australian Government agencies, states and territories, and ex-service organisations.

Recommendation 81: The Department of Veterans' Affairs to fund a program to support members' wellbeing during transition to civilian life

The Department of Veterans' Affairs (DVA) should fund and commission a cultural transition program to support members to build and maintain wellbeing during the transition from military to civilian life. The purpose of the program should be to empower members to develop the skills to adjust and integrate into civilian culture successfully and sustain social connections.

The program should:

1. be designed by an expert panel independent from DVA, including people with lived experience of service and transition (both serving and ex-serving Australian Defence Force members) and expertise in cultural adjustment and trauma-informed approaches
2. be delivered in two parts, the first prior to separation and the second within six months of separation
3. be evaluated three years after the commencement of the program to assess its outcomes and effectiveness, with adjustments made accordingly.

Recommendation 82: Establish a consistent, locally responsive policy on ex-serving members' access to bases

Defence should establish a consistent policy on access to military bases that includes the objective of supporting ex-serving members and their families to maintain social connections following separation from the Australian Defence Force. The policy should allow for local decision-making that balances the benefits of maintaining social connection with former colleagues in the 12 months following separation, with the need to maintain base security.

Recommendation 83: Increase opportunities for members to gain civilian qualifications from Defence training and education

Defence should expand the objective of its education and training policies and programs from a sole focus on Defence capability requirements to include member lifetime wellbeing. Specifically, Defence should:

1. commencing 1 July 2025, issue all civilian accreditations for Defence training at the point of completion of the requisite training, rather than at the point of transition from service
2. remove arbitrary limits on the number of civilian qualifications that may be awarded to a member in recognition of Defence training they have completed
3. 'fill the gap' between Defence and civilian training (where an equivalent civilian qualification exists), either by expanding the content of the Defence training course or by funding bridging training for members prior to separation.

Recommendation 84: Issue separating members with a reference that states their skills, experience and capabilities

To support ex-serving members to promote their skills and experience in the civilian job market, the Australian Defence Force should issue a reference to each member at separation. The reference should reflect the individual skills and experience of the member and include a personalised statement on the capabilities they demonstrated in their most recent role/s. Contact details of the member's commanding officer approximate to, or at, the point of transition should be provided wherever possible.

Recommendation 85: Develop employment pathways for ex-serving members in public sector agencies

The Australian Public Service Commission and its state and territory equivalents should work with public sector agencies to develop and prioritise employment pathways for ex-serving members. They should prioritise agencies in portfolios where military capabilities and lived experience of service are especially relevant, including health, justice, corrections, police, veterans' affairs and defence.

Recommendation 86: Ongoing funding for Veterans' and Families' Hubs

The Australian Government should develop a recurrent funding model for Veterans' and Families' Hubs to support their financial sustainability and ongoing operations. In particular, the funding model should ensure that the operating costs of hubs can be met (that is, separate from the costs associated with the services delivered by various providers). The funding model should be developed in consultation with lead organisations of Veterans' and Families' Hubs, as bespoke arrangements are likely to be needed.

Funding agreements should include standardised, de-identified data collection and reporting requirements to inform ongoing service delivery improvements and help to identify service gaps. Data should be shared with state and territory governments.

Recommendation 87: Establish a new agency to focus on veteran wellbeing

The Australian Government should establish a new executive agency focused on veteran wellbeing. The new agency should have distinctive branding, but be administratively nested within the Department of Veterans' Affairs (DVA) to ensure seamless information sharing and referrals.

The new veteran wellbeing agency should have the following functions:

1. Transition – to play a key role in supporting veterans to transition from military to civilian life (Recommendation 80), build relationships and encourage veterans to access early interventions and supports
2. System navigation and connection to wellbeing supports at the individual level – to help veterans to navigate the wellbeing ecosystem by providing clear information online about available services, and by working in partnership with Veterans' and Families' Hubs and expanding engagement with veterans through state and territory shopfronts
3. Improve referral pathways and service integration at the systems level by:
   1. managing relationships between Veterans' and Families' Hubs, ex-service organisations (ESOs), DVA, Australian and state and territory government agencies and non-government service providers
   2. ensuring referral pathways are in place and services are integrated to the greatest extent possible
   3. advising DVA and state and territory governments on service gaps
4. Co-designing wellbeing supports – to work with veterans and ESOs to co-design new prevention and early intervention wellbeing programs and services at the local level, supported by a dedicated funding stream under the redesigned grants program for ESOs.

The new veteran wellbeing agency should have an ongoing operating budget, and the following capabilities and features:

5. staff who have lived experience of military service
6. offices established in area/s where large numbers of veterans live
7. customer service expertise, including in digital-led solutions
8. a trauma-informed communications and service-delivery approach
9. led by a CEO who reports to the Secretary of DVA
10. adhering to a service charter and associated key performance indicators, supported by regular and transparent reporting requirements.

Recommendation 88: Develop a national funding agreement on veterans' wellbeing

A national funding agreement on veterans' wellbeing should be developed, with immediate focus on the following priorities:

1. improving outcomes for veterans who are experiencing homelessness, including a long-term investment framework that supports capital and operational expenditure for veteran-specific housing and the provision of wraparound services
2. supporting veterans who are incarcerated, both during and after their incarceration
3. facilitating school enrolments for children of serving members, without requiring a confirmed address
4. developing networks of health care for veterans (see Recommendation 72)
5. obtaining individual consent from veterans who separate involuntarily for medical or other reasons (and other cohorts at higher risk of suicide and suicidality) to provide their personal data to state and territory governments to ensure they can receive tailored support and referrals to veteran-specific services, including Veterans' and Families' Hubs.

Recommendation 89: Establish a national peak body for ex-service organisations

The Australian Government, in consultation with ex-service organisations (ESOs), should establish a national peak body for ESOs following a co-design process.

The role, functions, membership, governance and funding model of the peak body should be informed by the outcomes of the business case, and agreed between the Department of Veterans' Affairs and the ESO sector. The funding model should not exclude participation of any eligible ESOs, particularly those who operate on a not-for-profit basis.

Recommendation 90: Remove the service differential for permanent impairment compensation and expand mental health support to all reserve personnel

The Australian Government should:

1. remove the service differential as it relates to permanent impairment compensation
2. extend non-liability health care for mental health conditions to all reserve personnel.

Recommendation 91: Implement combined benefits processing for all initial liability and permanent impairment claims

The Department of Veterans' Affairs (DVA) should implement combined benefits processing for all initial liability and permanent impairment claims under the Military Rehabilitation and Compensation Act 2004 (Cth) (the new single Act) for veterans' entitlements, noting that some limited exceptions will apply.

The Australian Government should ensure that DVA has sufficient additional funding to implement this new approach to claims processing.

Recommendation 92: Review claims to the Department of Veterans' Affairs associated with physical and sexual abuse

The Department of Veterans' Affairs (DVA) should commission an independent review of claims made between 2015 and 2024 that are associated with physical and sexual abuse during service. The review should:

1. determine if there is any material difference in the acceptance or correctness rates for these claims compared to other claim types and, if so, identify why and any required changes to veterans' entitlements legislation, DVA policy, and/or training and support provided to delegates
2. recommend any necessary improvements that will ensure delegates deliver services in a trauma-informed way and understand the dynamics of military sexual violence and other forms of abuse during service
3. examine the supports in place for victims who have submitted a claim of this kind and recommend any necessary improvements to align with best practice.

Recommendation 93: Fund the Transition Medical Assessment Pilot Program on an ongoing and national basis

The Australian Government should provide funding to the Department of Veterans' Affairs and Defence to support:

1. expanding the Transition Medical Assessment Pilot Program to North Queensland in 2025–26
2. rolling out the program nationally to serve all Australian Defence Force members who are medically separating with complex needs from 2026–27 onwards.

Recommendation 94: Improve timeliness and reporting on information-sharing between Defence and the Department of Veterans' Affairs for claims processing

To ensure timely information-sharing between the Department of Veterans' Affairs (DVA) and Defence for the purpose of claims processing:

1. DVA and Defence should establish a key performance indicator for the timeliness of information provided by Defence through the Single Access Mechanism, and report on performance in annual reports
2. Defence should report annually on the progress of records digitisation until all records are fully digitised.

Recommendation 95: Support the expanded application of 'presumptive liability'

The Department of Veterans' Affairs (DVA) should:

1. establish a dedicated ongoing workstream to support the expanded use of presumptive liability as part of its research and evaluation model, informed by the views of the expert committee on veteran health research (Recommendation 117)
2. follow developments in civilian workers' compensation schemes, and consider where they are relevant to Australian Defence Force (ADF) contexts. As an immediate priority, DVA should consider whether a presumption related to liability for post-traumatic stress disorder should apply to certain roles within the ADF.

Recommendation 96: Ongoing funding for Provisional Access to Medical Treatment

The Australian Government should fund Provisional Access to Medical Treatment beyond June 2026 on an ongoing basis.

Recommendation 97: Consider giving the Veteran Payment to more veterans with physical health conditions

The Department of Veterans' Affairs (DVA), in conjunction with the Repatriation Commission, should examine whether there are specific cohorts of veterans with physical health conditions who are at higher risk of suicide and may therefore benefit from receiving the Veteran Payment.

If such cohorts are identified, DVA should seek the appropriate authority from the Australian Government to extend the Veteran Payment to those cohorts.

Recommendation 98: Strengthen Department of Veterans' Affairs performance targets for claims processing timeframes, and improve transparency

Department of Veterans' Affairs (DVA) performance targets for the timeliness of liability and permanent impairment claims under the Military Rehabilitation and Compensation Act 2004 (Cth) (the new single Act) should be reset so that:

1. by 1 July 2026, at least 65% of claims are determined within 90 days
2. by 1 July 2028, at least 80% of claims are determined within 90 days.

Starting in 2024–25, DVA should include in its annual reports:

3. data-driven measures of DVA's compliance with its customer service standards
4. the percentage of claims for which DVA requested an independent medical examination
5. the number of additional conditions and sequelae covered by presumptive liability compared with the previous year, as well as the number and percentage of initial liability determinations that were made pursuant to presumptive liability provisions.

Recommendation 102: Implement and improve upon the Defence Strategy for Preventing and Responding to Family and Domestic Violence

In addition to, and as part of the implementation of the Defence Strategy for Preventing and Responding to Family and Domestic Violence 2023–2028, Defence should:

1. recognise the nexus between family violence and suicide, including the inclusion of family violence indicators within approaches to suicide prevention, and consideration of suicide risk within responses to family violence
2. implement all recommendations made by Defence Families of Australia (DFA) in its issues paper on Australian Defence Force families and domestic violence and work collaboratively in an enduring fashion with the DFA to deliver ongoing reforms to prevent family and domestic violence and support victims of family and domestic violence
3. establish and communicate a set of minimum standards to guide its approach to family and domestic violence that are publicly available and:
   1. clearly articulate victim safety (including that of children) as the primary consideration in decision-making
   2. define how Defence will ensure that any protection orders that may be in place can be upheld in the workplace, including how it will ensure that postings and workplace arrangements prioritise the safety of the victim
   3. include clear expectations regarding disclosure by Defence members who are the respondent on a protection order relating to family violence
4. take steps to ensure that Defence property, equipment and resources are not used to perpetrate family and domestic violence, including that Defence housing stability is not used as a means to exercise coercive control or to create barriers to safe separation
5. ensure that there are no impediments to Defence personnel accessing emergency services responses while on base, in relation to family and domestic violence. All materials regarding family and domestic violence should include emergency services response information and be regularly reviewed for currency.

Recommendation 103: Improve the support, communication and services provided to Defence families

In recognition of the critical role that Defence families play in Defence capability, and the stressors that service life places on the member and their family unit, Defence should:

1. increase and enhance the suite of family support programs and initiatives available to Defence families, informed by co-design with members, families and Advocates. This should include:
   1. systematically analysing data from the Defence Member and Family Helpline to better understand issues and trends, and create opportunities to better assist members and their families
   2. removing barriers to families directly accessing information and services provided by Defence Member and Family Support (DMFS)
   3. providing an evidence-based suite of information and resources to support families, especially at times of peak stress including postings, return from deployment and member transition
   4. facilitating greater access to or provision of family therapy, and services that support partners and children of Defence members
   5. an enhanced DMFS communications strategy
2. ensure that systems are in place to communicate directly with families on an ‘opt out’ basis to provide information on available services and supports, assisted by a refreshed DMFS communications strategy and greater efforts to publicise the supports available
3. develop and implement a framework to evaluate outcomes, including the efficiency and effectiveness of all current and future DMFS initiatives, with this material to be made public to demonstrate transparency and accountability for the performance of DMFS
4. work with the Australian, state and territory governments to investigate and improve arrangements for facilitating employment opportunities for partners of Defence members as well as opportunities for remote working, or preferential employment of this cohort in appropriate roles
5. work with the Australian Government, following the completion of the Defence Childcare Review and the Productivity Commission Review into Early Childhood Education and Care, to identify and realise opportunities to improve the provision of child care services to Defence members.

Recommendation 104: Improve the profile, resourcing and impact of the Defence Family Advocate

To achieve the best possible representation of serving and ex-serving members and their families, the Australian Government should:

1. improve the profile, resourcing and impact of the Defence Family Advocate, by:
   1. providing the Defence Family Advocate with appropriate staffing, budget and remuneration, with a salary and employment conditions at an equivalent rate to comparable executive positions, supported by full-time staff with the same employment conditions as their counterparts in Defence and the public service
   2. formalising the relationship between the Defence Family Advocate and the Veteran Family Advocate Commissioner
   3. working with the new Defence Family Advocate to implement the recommendations made in the ‘Our Community’ and the PricewaterhouseCoopers reviews to refine and improve the governance and outcomes of the Defence Family Advocate
2. appropriately staff and resource the Veteran Family Advocate Commissioner and their office to improve outcomes and ensure that veteran families are represented in policy design, decision-making and advocacy
3. investigate whether shared administrative support for both office holders may further assist collaboration and support the efficiency of their operations.

Recommendation 105: Improve coordination with coroners and the National Coronial Information System

The Australian Government Attorney-General’s Department should work with its state and territory counterparts to establish mechanisms that improve coordination between coroners, the Department of Veterans’ Affairs (DVA), the Australian Bureau of Statistics and the National Coronial Information System and work towards:

1. aligning coronial practices related to making determinations of intentional self-harm to improve the consistency and timeliness of national suicide reporting
2. implementing communication strategies between Defence, the Inspector-General of the Australian Defence Force, DVA and coroners to support the streamlined provision of information and reduce the risk of stress on families
3. sharing good-practice support regarding trauma-informed care.

Recommendation 106: Establish a suicide database of serving and ex-serving members

Defence should design and develop a new suicide database that is appropriate for the purpose of suicide monitoring and reporting of all relevant data of permanent, reserve and ex-serving members. The design and development of the database should:

1. leverage data collected throughout the service journey from recruitment to discharge and beyond
2. capture a broader range of risk and protective factors, including but not limited to recording incidents of unacceptable behaviour and injuries, which is necessary to improve understanding of suicide, suicidality and self-harm
3. be informed by best-practice approaches from other countries, including the United States.

Recommendation 107: Establish the National Veterans’ Data Asset

To improve understanding of deaths by suicide and provide better support to veterans and their families, the Australian Government should:

1. provide appropriation funding to the Australian Institute of Health and Welfare and the National Suicide Prevention Office (or any subsequent body assuming its functions) to establish and maintain a National Veterans’ Data Asset that brings together data from Defence, the Department of Veterans’ Affairs, and states and territories, to enable timely monitoring and surveillance of suicide and suicidality of serving and ex-serving Australian Defence Force (ADF) members
2. provide appropriation funding to the Australian Institute of Health and Welfare and the National Suicide Prevention Office to:
   1. use the National Veterans’ Data Asset to produce discrete annual public reports and other research to monitor and improve understanding of suicidality and deaths by suicide, and the associated risk factors for serving and ex-serving ADF members and their families
   2. commission an independent program of evaluation of the implementation and functioning of the National Veterans’ Data Asset, including an interim evaluation and a post-implementation evaluation.

The Australian Government and state and territory governments, through their relevant agencies, should use the National Veterans’ Data Asset for the purposes of:

3. furthering their understanding of suicide, suicidality, and health and wellbeing among serving and ex-serving members and their families; and
4. preventing deaths by suicide and improving postvention for serving and ex-serving members and their families.

Recommendation 108: Ensure that all relevant jurisdictions and entities regularly provide data to the National Veterans’ Data Asset

So that all jurisdictions provide data regularly to the National Veterans’ Data Asset:

1. the Australian Government, and state and territory governments, through their relevant agencies, should provide relevant data at quarterly intervals to the National Veterans’ Data Asset (Recommendation 107)
2. Defence and the Department of Veterans’ Affairs should prioritise data governance arrangements in order to provide data for the National Veterans’ Data Asset to support its development and ongoing use.

Recommendation 109: Defence to report annually on its progress towards data maturity

Defence should report on its progress to improve data maturity, each year, to the Minister for Defence, using the 2021 Defence Enterprise Data Maturity Assessment as a baseline. Reports should be supported by surveys of Defence staff every three years in addition to the data capability maturity assessment tool.

Recommendation 110: Review Defence’s data assets and address issues with their quality, management, integration and use

The Defence Chief Data Integration Officer (CDIO) and Defence Data and Analytics Board should establish a program of review of Defence’s data assets. As part of this program:

1. the reviews should be conducted by Defence’s Data Division and focus on the quality, awareness, management, access, integration and use of the dataset
2. the CDIO should designate actions required of data custodians to address any issues identified by each review and be provided with follow-up reports from Enterprise Data Custodians on the progress of actions following completion of Data Division reviews.

Recommendation 111: Achieve a ‘gold standard’ rating for Defence datasets related to suicidality and suicide

The Defence Chief Data Integration Officer should direct data custodians to improve the data quality of datasets related to suicide, self-harm and suicidality so they achieve a ‘gold standard’ rating. This will ensure the data is reliable and supports accurate decision-making. The remediation should focus on addressing issues of duplicated, missing, incomplete and non-standardised data, and ensuring datasets can be integrated.

Recommendation 112: Include data on suicide and suicidality in the enterprise-wide Defence data catalogue

Defence should prioritise the inclusion of datasets related to suicide and suicidality in its enterprise-wide data catalogue. Defence should also make its data catalogue publicly available and include the quality rating of each dataset.

Recommendation 113: Ensure commanding officers access and use quality data for continuous improvement of wellbeing metrics

To better support Defence commanders and personnel, Defence should:

1. use data from the following sources to provide Australian Defence Force commanders with data for their units and teams, as well as relevant comparison points:
   1. the new Defence suicide database (Recommendation 106)
   2. the National Veterans’ Data Asset (Recommendation 107)
   3. internal surveys
   4. unacceptable behaviour reporting and injury reporting.
2. ensure the data is provided in a timely manner, in an accessible format and with necessary context, and provide training that supports commanders to use the data to inform decision-making.

Commanders should use this data for continuous improvement and to better understand the wellbeing of the members under their command.

Recommendation 114: Defence and the Department of Veterans’ Affairs to prioritise research into veteran health and wellbeing, and publish their workplans

Defence and the Department of Veterans’ Affairs should publish research workplans showing research priorities on issues affecting the health and wellbeing of current and ex-serving members. These workplans should be updated annually and include information on planned research and the progress of research that is underway.

Recommendation 115: Defence and the Department of Veterans’ Affairs to publish their research into veteran health and wellbeing

Defence and the Department of Veterans’ Affairs should conduct and, as a matter of course, publish research that includes information on the health and wellbeing of serving and ex-serving members.

Prior to publication, research outputs should be subject to review from independent researchers, including from the new expert committee on veteran health research (see Recommendation 117).

Recommendation 116: Improve the quality, evaluation, translation and sharing of research findings

Defence and the Department of Veterans’ Affairs (DVA) should create evaluation and research teams in a central area of their respective departments to improve the quality and coordination of research and evaluation practices. These central research and evaluation teams should be given the following responsibilities:

1. take the lead on improving the research and evaluation culture
2. manage the evaluation of programs and policies within their respective departments, and ensure evaluations are appropriate and effective
3. develop and maintain the evaluation schedule of all mental health and suicide prevention programs
4. develop and maintain a central library of program evaluations and relevant research, ensuring that evaluation findings are used and incorporated into future programs and policies
5. monitor the integration of research outputs into policy, programs and practices, thus ensuring that research outputs are translated effectively
6. use data and research to provide timely, targeted and effective advice to improve suicide prevention, intervention and postvention support
7. implement the continuing joint Defence and DVA research agenda
8. in the case of the Defence evaluation and research team, develop a revised survey research program with surveys that:
   1. collect information that can be used to evaluate Defence programs and policies effectively
   2. capture data on the health and wellbeing of Australian Defence Force members
   3. capture data not otherwise included in Defence administrative datasets and the National Veterans’ Data Asset.

Recommendation 117: Establish an expert committee on veteran research

Defence and the Department of Veterans’ Affairs (DVA) should establish an expert committee on veteran research, comprising experts from government, academia and the private sector who have skills and experience in military and veterans’ affairs, health care, rehabilitation and family support.

The committee should:

1. be informed by international examples of success from Five Eyes partners and other nations
2. include representatives with lived experience of service life, suicidality and mental health
3. fulfil the functions described in Chapter 29, Use of data and research by Defence and DVA, and provide advice to Defence and DVA on research and evaluation matters relevant to improving the wellbeing of serving and ex-serving members.

Recommendation 118: Use the Census to collect information on ex-serving members as a population

To ensure there is ongoing collection of reliable statistics and information on ex-serving Australian Defence Force (ADF) members in the Australian community, the Australian Government should:

1. direct the Australian Bureau of Statistics (ABS) to continue the existing Census question on ADF service in 2026 and in future censuses
2. direct the ABS to include an additional question on year of separation for ex-serving members in the 2026 Census and in future censuses, with the ABS undertaking any testing required to include this question on the 2026 Census.

Recommendation 119: Improve understanding of veteran health by adding questions to Australian Bureau of Statistics surveys

The Australian Government should fund the Australian Bureau of Statistics to:

1. include additional questions on Australian Defence Force (ADF) service in any future iterations of the National Health Study, the National Study of Mental Health and Wellbeing, the General Social Survey and the Personal Safety Survey, prompting respondents to state whether they are a current or ex-serving ADF member and if so, whether they served in the permanent forces or solely in the reserve forces
2. increase the sample of serving and ex-serving members in any future iterations of these surveys to allow for robust reporting on serving and ex-serving members.

Recommendation 120: Increase funding for research into veteran health and wellbeing

The Australian Government should provide increased funding for research into the health and wellbeing of serving and ex-serving Australian Defence Force members by:

1. providing $10 million through the National Health and Medical Research Council to support a Special Initiative research grant program focused on veteran health and wellbeing
2. considering opportunities to fund veteran health and wellbeing research through the Medical Research Future Fund and Million Minds Mental Health Research Mission.

Recommendation 121: Enable research into the health and wellbeing of Defence families

The Australian Government should enable research on the health and wellbeing of families of current and ex-serving members through:

1. expanded National Health and Medical Research Council funding for veteran health and wellbeing research
2. Defence and the Department of Veterans’ Affairs leading research in conjunction with lived experience individuals (see Recommendation 117)
3. the Australian Institute of Health and Welfare, the Australian Bureau of Statistics and the Australian Institute of Family Studies being funded to collaborate and leverage existing datasets and the National Veterans’ Data Asset (see Recommendation 107), to develop a better understanding of veteran families through research on wellbeing and risk and protective factors.

Recommendation 122: Establish a new statutory entity to oversee system reform across the whole Defence ecosystem

The Australian Government should establish a new statutory entity with the purpose of providing independent oversight and evidence-based advice in order to drive system reform to improve suicide prevention and wellbeing outcomes for serving and ex-serving Australian Defence Force members.