25 August 2016

Forthcoming Report on Post Traumatic Stress Injury

On Friday 9 September Australia21 (www.Australia21.org.au), in collaboration with FearLess, will be launching an essay volume designed to raise awareness of Post Traumatic Stress, and to form the basis of a future roundtable designed to improve our understanding of this widespread problem and help set the agenda for further work on it.
Below is the text of the Foreword I wrote for this forthcoming report.
Australia21 is an independent public policy think tank. Inspired by the Canadian Institute of Advance Research (CIAR), it was founded in 2001 to develop new frameworks of understanding about complex problems that are important to Australia’s future. For fifteen years we have been bringing together multidisciplinary groups of leading thinkers, researchers and policymakers to consider issues about our future, ranging from climate and the landscape, our society and our economy to Australia’s place in the world.
Typically the issues we deal with are those which social scientists call “wicked problems”. They are difficult to define clearly: different stakeholders have different versions if what the problem is, and there is usually an element of truth in each of those versions. They have many interdependencies and are often multi-causal. They hardly ever sit conveniently within the responsibilities of one organisation, and the organisations that need to be parties to the solution often have conflicting responsibilities and goals, which necessitates trade-offs between conflicting goals.
Our modus operandi is to work in collaboration rather than competition with those who have insights into the issues we tackle. It is rarely the case that any of the stakeholders lack state of the art awareness, or access to it, of the parts of the issue that fall within their responsibilities. Australia21 finds that its best value add comes from bringing together in the one room as broad a range of stakeholders and relevant subject matter experts as possible, to compare notes, in a systematic way, on what we think we know about the issue, and even more importantly, what we do not know, but need to know, in order manage the issue more effectively.
In the case of Post-Traumatic Stress Disorder (PTSD), or as I would prefer to call it Post-Traumatic Stress Injury (PTSI), we have an issue which affects not only the current wellbeing of an enormous number of Australians and permanent residents, but through that, their capacity to realise their full potential over the course of their lives. Often identified in the public mind as a problem arising from traumatic experiences in the course of military service, we find that PTSI in fact arises in a variety of segments of society. Sometimes it is the result of situations that people will inevitably encounter in certain occupations: among first responder organisations (police, fire-fighters, ambulance and other paramedics) trauma surgeons and nurses, for example. For others it is the consequence of sexual assault including sexual abuse of children, or other forms of social dysfunction: domestic violence, or drug or alcohol-fuelled violence within the community within which a person is trapped, or the circumstances which have forced people to flee their countries of origin and seek refuge in Australia.
Estimates put the numbers of Australians who live with PTSI (those directly affected plus their immediate families) as high as 3-4 million. This is an enormous proportion of our population living lives that range from tragic and/or dangerous, to “lives of quiet despair”, to lives that are simply not as productive and enjoyable as they could and should be. Clearly this comes at a very large cost: the economic and social costs of people being unable to rise to their full potential, and the costs in terms of overall societal wellbeing.
It also entails societal risk, where PTSI sufferers reach the point where they cannot perform their duties safely and effectively and become a risk to themselves and to members of the wider society.
Clearly the aims in dealing with such a major and important problem must be find ways to manage the risks that are inherent in certain occupations, to identify individuals’ emerging problems in sufficient time to allow a full recovery, and to address organisation cultural issues that make people reluctant to acknowledge that they are struggling. In order to achieve that, we need to put solid flesh on the bones of these aspirations.
Our aim in bringing together this collection of essays to gather together in one place a set of short readable essays by some of the most expert people in the country, covering every aspect of the problem: the nature and extent of the problem of trauma-associated stress in Australia; hazards in specific groups; societal and economic costs, and what is done and needs to be done. This collection will be used as the basis for a roundtable in which we ask as many as practicable of the contributors to view the subject as a whole and make their expert contribution to considering where we go from here.
If by so doing we can contribute to the identification of gaps in our knowledge and our procedures, we will consider that as time well spent.