Understanding the Wellness Journey: A Snakes & Ladders ApproachBy Deb Herring July 2, 2019
As we explore and focus on mental health within the Australian Defence Force (ADF), there still seems to be a stigma around mental health and wellness. Although we can access a plethora of information relating to anxiety, depression and Post Traumatic Stress Disorder (PTSD), the fear of vulnerability and ‘weakness’ will always create a barrier for serving members who feel their own pressure to be strong leaders and maintain a high level of resilience. This will continue to be a systemic problem as long as our military service requires physical and moral courage – it is the nature of the beast and the ADF cannot thrive with anything less.
In recent years, the ADF has invested a significant number of resources to provide therapeutic, clinical and reactive initiatives in an attempt to address mental health concerns amongst all ranks, which has been acknowledged and addressed in the ADF Mental Health and Wellbeing Plan (2012-2015). As serving members reluctantly admit that their personal struggles may be jeopardising their career and/or lifestyle, they are encouraged to access a range of supportive services to begin the pathway to recovery. For some, the journey to recovery can be a painful, uncomfortable and long process of self-discovery and self-disclosure, which often deters ‘war fighters’ who prefer to battle silently and alone.
UNDERSTANDING WELLNESS IN THE ADF
It appears that the ADF loosely categorises members into two distinct categories; those who are considered “OK” and those who are “not OK”. Those members who fall into the “OK” category are considered as “ready” for courses, deployments and promotions. On the other hand, those who are “not OK” are generally given time to recover until they are physically or mentally capable of returning to the fight. This can mean not being pannelled for course and, of course, being classified as undeployable. Unfortunately, this scenario can incentivise struggling personnel to wear a ‘mask’ in order to maintain their position and career success in the “OK” category.
So, this raises questions about the way we support personnel who are “OK”, yet may be tentatively hanging on to avoid falling into the “not OK” category;
- What resources are currently available to empower members who are struggling with mild mental health concerns, however are still within reach for intervention and do not require reactive mental health rehabilitation? (NB: The ADF Mental Health and Wellbeing Plan (2012-2015) identifies the need for intervention and education, however initiatives have not been accessible to all levels of the ADF).
- How can the ADF address mental health concerns “at arm’s-length” to help support members who struggle with vulnerability and self-disclosure?
- How does the ADF support personnel in the “OK” category throughout periods of life/work stress and adversity?
As an organisation, we focus on emotional agility from a leadership and resilience perspective. However, we do not focus on empowering members with appropriate tools and coping mechanisms to manage life/work stress before a visible decline in mental health. We are trained to be experts in military related information through doctrine and structured training systems, but have not implemented practical training programs for proactive mental wellness. It appears that while ADF personnel are trained to identify the symptoms and impact of stress and mental health disorders, they are rarely educated with the ‘tools’ to acknowledge and work through these challenges as part of daily life. It is in the best interests of the ADF to empower and inspire an emotionally intelligent and mentally agile workforce who continuously function in the “OK” category.
It seems obvious to note that the management of mental and emotional wellness differs from the management of physical fitness and wellness. There is no shame or perceived ‘weakness’ for personnel who commit to physical fitness training 3-5 days per week. This type of proactive intervention is often celebrated and promoted as a normal part of military service, where members are motivated to identify areas for physical improvement, then seek information and ‘tools’ to enhance their physical fitness and wellbeing. Why is mental and emotional wellness not part of the daily routine? Why is it socially acceptable to acknowledge areas of physical limitation but not emotional challenge? A healthy and empowered mindset will drive physical performance and increased capacity for success across the ADF.
There is no denying that a significant number of military personnel who experience psychologically diagnosed mental health conditions may not have benefited from appropriate preventative training. However, it seems likely that a significant proportion of personnel at all levels within the ADF would benefit from proactive intervention and wellness education which focuses on developing a ‘toolbox’ of self-managed coping skills. The wellness journey is extremely personal and there appears to be some frustration with the expectation that personnel should be willing to openly share their emotional vulnerability in a clinical setting. Unfortunately, personal barriers to seeking mental health rehabilitation is unlikely to change in the near future regardless of the amount of reactive mental health services, resources and treatments available to serving members. In the meantime, there needs to be a more proactive approach to supporting ADF personnel through arm’s-length education and early intervention along the wellness journey.
The wellness journey is illustrated in the following diagram:
FOUR WELLNESS ZONES
As illustrated in the above diagram, the wellness journey can be separated into four distinct zones;
- Optimal zone;
- Tentative zone;
- Danger zone, and;
- Crisis zone.
In relation to the current informal ADF wellness categorisation, the Optimal and Tentative zones fall into the “OK” category and the Danger and Crisis zones fall into the “not OK” category. The critical point along the wellness journey is the “SLIP/GRIP POINT” which lies between the Tentative and Danger zone. This is also the point where the snake begins and flows into the Crisis zone.
DEPTH OF RESILIENCE
As the term suggests, the depth of resilience weakens across the four stages of wellness with the deepest level of resilience at the Optimal zone and the lowest level of resilience in the Crisis zone. The reduction of resilience creates additional turmoil as routine activities become more difficult and challenging to overcome, thus reinforcing negative feelings relating to “weakness” and helplessness. By educating serving members with appropriate tools to empower and promote self-managed recovery, the depth of resilience and emotional agility is likely to increase.
When we focus on the wellness journey, there appears to be a period of time spent in the Tentative zone where members experience one of two outcomes; 1) proactively manage their self-care and “grip” onto the ‘ladder’ of recovery to the Optimal zone or 2) continue to struggle with mental health concerns and “slip” down the ‘snake’ into the Danger zone. The ADF should be focused on providing the tools to help members “grip” to the ladder of recovery in the Tentative Zone. The SLIP/GRIP POINT should be used to bounce members back into the Optimal Zone before sliding down the snake into significant mental health concerns.
The snake represents the possible decline in mental health, which begins at the Danger zone and continues into the Crisis zone. The SLIP/GRIP POINT is the turning point for personnel who have been silently fighting mental health concerns for some time and have not been able to grip the ladder to rehabilitation and recovery. Personnel may find it difficult to avoid sliding down the snake once past the ‘slip’ point.
The ladder represents the climb to rehabilitation and recovery. ADF personnel in the Crisis zone face the largest challenge of climbing the ladder to the Optimal zone, which only adds to their distress and anxiety. Personnel can grip the ladder from any zone and start climbing to the Optimal zone.
PROACTIVE INTERVENTION (WITHIN REACH)
Proactive intervention applies to appropriate and structured education that empowers serving members with a set of practical ‘wellness tools’ to overcome various topics relating to life stress, as follows;
- Preventing burnout
- Managing stress
- Healthy relationships (professional and personal)
- Effective goal setting
- Managing anxiety
- Embracing change
- Financial literacy
- Fear of failure
Training packages should be designed to empower and engage ADF personnel to continue functioning within the Optimal zone and have the skills and knowledge to overcome life stress and avoid the Danger and Crisis zones. Proactive intervention presents the most economical solution for the ADF.
REACTIVE REHABILITATION (EXTENDED REACH)
Reactive rehabilitation is the highest cost to Defence in terms of financial investment, loss of capability (disengaged personnel and/or restricted service) and timeframe for recovery. With a stigma still surrounding mental health services, ADF personnel will continue to avoid treatment until entering the Crisis zone.
The aim of proactive intervention allows personnel to access practical tools and information to overcome life and/or work stress without self-disclosure or vulnerability. Education is not a sign of weakness!
The success of the ADF relies upon an emotionally agile workforce where personnel are encouraged to acknowledge their mental health and life/work stress concerns early and access appropriate training at arm’s-length. The proactive intervention model focuses on emotional agility.
SELF-MANAGEMENT OF OTHER LIFE CHALLENGES
Our self-management of mental health concerns is often vastly different to the way we manage other aspects of our lives. For example, how effectively do we manage any of the following lifestyle factors?
- Marital problems
- Vehicle maintenance
- Physical injury
- Raising children
- Household chores
- Physical fitness
In most instances, interventions for the above scenarios are often self-managed and proactive, whereby we acknowledge the requirement to seek information or solutions to resolve problems based on our understanding that small problems can become big problems without appropriate and proactive intervention.
In conclusion, the ADF should be focusing on educating personnel at ALL levels regardless of where they fit into any of the four wellness zones. We cannot continue to sit on our hands and wait as capable and functioning soldiers ‘suddenly’ fall to their knees. We also cannot continue to put pressure on personnel to self-disclose when they have not been trained to show vulnerability - the mental health message is almost contradictory to the ADF mission statement. So, how does the ADF implement programs to reduce the cost to Defence, Defence personnel and their families? How can we launch training systems that provide effective tools for self-managed wellness across all levels of the ADF (not just leaders)? And how can we encourage personnel to learn about self-managed intervention when they are most agile and capable of learning, but unlikely to feel the need for wellness tools when functioning in the Optimal or Tentative zones? In reality, we do not train to become experts in close combat at a crisis point when we need it the most, so our view of wellness should be equally as proactive. We need to arm ourselves with better systems for emotional agility and stop playing an expensive game of ‘snakes and ladders’ within the ADF.