The Australian Defence Force is enlisting young recruits with significant psychological issues, leading to “catastrophic” consequences, including substance abuse and attempted suicide, a retiring veteran psychiatrist has warned.

Dr Mary Frost, who is retiring from veteran related work in 2023, has alleged that defence selection processes do not always adequately screen out individuals with psychological vulnerabilities.

Frost has worked as a treating private psychiatrist since the mid-1990s. Part of her work involves assessing recent recruits referred by the ADF after psychological risks become apparent.

She said they often came to her after no more than 20 weeks of training, showing obvious signs of a traumatic background, “sometimes suicidal, and desperately wanting out”.

“These are individuals that I would think would be easily identified with improved psychological screening at the time of recruitment,” Frost said.

“These are selection mistakes, and they should never have been allowed in.”

Last June the chief of the ADF, Gen Angus Campbell , told the royal commission into defence and veteran suicide the ADF had begun considering candidates with a marginally higher psychological risk indicator for certain roles, to help fill gaps left by an increasing rate of soldiers discharging.

“Given current economic circumstances and the low employment rate – that’s the general low unemployment rate in the country – the ADF’s risk appetite in recruiting has increased,” he told the commission.

They attempt to join defence as a last resort, without any life skills to survive the rigours of training, and army life Dr Mary Frost

The commission heard that in the 12 months to May 2022, the army lost 13% of its workforce while the navy and RAAF lost 9.3% and 8.7% respectively.

According to an overview of stakeholder roundtable discussions held in late 2021 and published by the commission the commissioners heard concerns about screening and the financial incentives driving recruiters.

“Roundtable participants suggested that those incentives might lead recruiters to miss or overlook vulnerabilities that should preclude recruitment”, including “where an applicant might under-report or not disclose past or present mental health conditions,” the overview reported.

The overview does not provide any more detail or identify the nature of any financial incentives for recruiters and defence did not respond to questions from Guardian Australia about the overview of these concerns heard at the roundtables.

“All candidates for the Australian defence force (ADF) undergo cognitive ability testing and an interview with a psychologist as part of the psychological screening process, in addition to a separate medical assessment of their mental health,” a defence spokesperson told the Guardian Australia.

“Whilst there are some mental health histories that will almost always preclude entry to the ADF, where there is evidence that a candidate has received treatment and subsequently shown effective functioning in their life, a psychologist may determine that they are suitable to join the ADF,” the spokesperson said.

“The outcome of the psychological screening process is an assessment of the likelihood that the candidate will be able to adapt to initial military and employment training, and to military service beyond training.”

Defence says it applies a continuous improvement process to ensure its recruitment practices align with best-practice.

Frost, who has treated hundreds of veterans and serving members from all three branches of the military, said she often dealt with women and men as young as 17 who “lie about significant psychological vulnerabilities”.

“This includes kids with significant substance-abuse histories in their early years, and some that have been substance abusing since preteen years before moving to ice.

“They attempt to join defence as a last resort, without any life skills to survive the rigours of training, and army life.

“These are young men who have drifted through life with little direction and discipline and have a sense of being lost, some of whom have had very little contact with functional adults, who then really struggle with authority figures and the rank structure.

“This can lead to sometimes catastrophic psychological consequences, including suicide.

“When they struggle to cope, they face a predictable psychological decline – often turning to drinking heavily and become suicidal.”

Frost said many of the young men she dealt with were drawn to the army because it promised to fill needs they had never had met – for an income, housing and a sense of belonging.

She said the extreme situations they might face by joining the military put them in danger of greater harm than those recruited from more stable and supported backgrounds.

“The neurobiological research suggests that people with a trauma background are far more vulnerable to PTSD if they are deployed in combat situations,” Frost said.

“When I deal with clients it takes only one or two questions about family history to understand why individuals become far more profoundly affected by traumatic exposure.”

In August, the former governor general and defence chief, Sir Peter Cosgrove, said new recruits needed to be more tightly screened to ensure they were not predisposed to mental health problems.

“I think we have to have a more modern, more pervasive monitoring of people’s mental wellbeing,” he told the Daily Telegraph.

Glenn Kolomeitz, a defence prosecutor and former army officer who served in Timor and Afghanistan and was on staff at the army’s recruit training centre, said the Department of Veterans’ Affairs often rejected compensation claims from veterans alleging they had suffered PTSD, or associated conditions such as anxiety and depression, because applicants were deemed to have had mental health conditions before entering service.

“In many cases I have represented … [the Department of Veterans’ Affairs] will deny the claim on the basis of issues being pre-existing – not related to their service in the army.”

Kolomeitz said he viewed this as effectively an admission that defence was allowing psychologically vulnerable people to join up.

“It begs the question as to why some people with these psychological vulnerabilities were allowed to join the ADF in the first place.

“It’s disgraceful, and they certainly have a duty of care to ensure that the soldiers they recruit have what it takes to withstand army life.”

Former platoon Sgt Anthony Meixner, who runs the veteran mental health service Swiss8, was previously a section commander at the school of infantry.

He said he saw first-hand the product of “physically and mentally unsuitable candidates” being pushed through recruitment.

“The defence force recruiting process and the subsequent backlash has been a running joke … for over 15 years,” he said.

“It is common knowledge that staff at [defence force recruiting] will allow unsuitable candidates to proceed to achieve quotas.”

Meixner said more pressure was placed on recruiters because the ADF had struggled to retain recruits over many years.

“Generals don’t want to acknowledge that defence retention is like a sieve, so they have to keep pouring more people in.

“Defence is competing with many other industries for … stable, well educated well-adjusted humans.

“They should fix the retention issue by improving the culture and the workload in defence.”

Prof Nicole Sadler, who served in the army for 23 years as a psychologist, agrees that people need to be screened effectively for their mental health, but acknowledges there are challenges.

“The general factors that should be considered include a history of significant adverse childhood events and mental health problems, as this increases risk of other issues later in their life,” she said.

“But getting that type of information can be difficult. You are often relying on the person to give an accurate personal history and they are actively seeking to make a good impression, like in any job interview.”

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