CDF Speech: Mental Health at the Front Line and from the Centre

Ko te Ope Kātua o Aotearoa e!
He toki nā Tū
He toki nā Rongo e,
Mate atu he toa
Ara mai rā he toa!
Ngā rau e toru o te patu kotahi e!
Tihei Mauri Ora

Good afternoon. And thank you for this opportunity to speak with you today.

Wow, right? …I mean, a Health and Safety conference with a topic on ‘mental health’ on the agenda…

It’s fair to say that in New Zealand our approach to health and safety is undergoing a revolution… as evidenced by the Health and Safety at Work Act of 2015.

At its centre, I think we are coming to look beyond just our narrow interests as employers or leaders or managers… to also recognise the needs and expectations of workers themselves.

The funny thing is, it turns out that keeping our people safe and healthy, and being concerned as to their welfare, is good for our organisations: It lifts engagement, it lifts commitment, and it lifts morale, because it demonstrates to our people that we value them… And we know healthy and engaged people perform better too!

So one of the many things I am proud of from my time as Chief of Defence Force, is the increasing focus we have placed on mental health in our Defence Force.

I am convinced we are seeing a fundamental change in attitudes — yes, its gradual — but we are nonetheless witnessing a real shift in the way we think about and promote mental health across our organisation.

Which is really why I am here today: to share some of our experiences — what we’ve found on the way; and to mention the resources we’ve created, which you’ll be welcome to borrow…

Firstly though, perhaps a very quick introduction to the New Zealand Defence Force.

Our Defence Force is by New Zealand standards a large organisation, comprising approximately 14,000 in total: around 9,000 fulltime uniformed staff, our Regular Force; we have 3,000 civilians, and additionally we have 2,000 Reserve Forces.

We operate from nine camps and bases, spread across New Zealand and at any given time will have hundreds of service people deployed across the globe.

The New Zealand Defence Force’s primary purpose is to provide an armed force ready and able to perform in combat, should Government direct us to undertake such a role.

Obviously sometimes the nature of our work places unique demands on our people, in comparison to most other occupations… as you can imagine, sometimes the delivery of our outputs means deliberately placing our people in harm’s way.

You may be surprised to learn that operational deployments have been found to be an overall positive growth experience for most… our people view them as an opportunity to apply professional skills, in meaningful roles, that they have been well trained for.

However, when our people are exposed to unpleasant or life threatening experiences, these of course have the potential to have a negative impact on their wellbeing — and this affect can be immediate or delayed.

It is therefore essential that we minimise the potential for harm.

At the same time, our people will experience all the same non-operational stressors and vulnerabilities to physical and mental health as do people in our broader community.

Life has become increasingly complex and whether or not we are wearing a uniform, we all experience the same challenges with relationships, raising families, and navigating life’s other common hurdles — loneliness, financial struggles, or harmful addictions.

So we know, for example, that 1 in 5 New Zealanders will experience mental illness or addiction in any one year; and 1 in 6 will report a diagnosis of anxiety or depression in their lifetime.

Inside the Defence Force, we also know that when our people are not tracking ok, sometimes it is hard for them to ask for help.

Ironically the very things that make us successful as a fighting force, also make us vulnerable: We encourage our people to be strong, self reliant and in control; the same attributes that can make it harder to ask for help.

So this is something we are working on — we are reinforcing that seeking help is a sign of strength, rather than weakness. And that early help- seeking will speed recovery. More on that shortly.

We’ve taken a very deliberate approach to leading mental health from the centre.

While we recognise and promote that everyone has a responsibility for their own wellbeing, leadership is nonetheless the foundation for building and maintaining mental health and wellbeing across the Defence Force.

In 2015, we established a dedicated mental health strategy and an associated action plan. This strategy outlined our Model for Mental Health.

We use Sir Mason Duries’s Te Whare Tapa Wha model of Maori health (Physical, Emotional, Spiritual and Family / Whanau Health) to reinforce the importance of each cornerstone to overall health.

Our model reinforces the need for an integrated approach that reflects how our environment, culture, social support networks, leadership and families shape mental health.

So from our strategy, we were able to identify a range of initiatives spanning four themes:

1. Lead

Lead focuses on the important role leaders play in creating the right culture.

So we’ve focused a lot on building and maintaining leadership excellence through our internal suite of leadership development programmes.

We’ve also built additional resources for our leaders that focus specifically on building and maintaining positive mental health.

Our Leaders Guide was released in 2016. In response to interest from a range of agencies, I am pleased to share with you today a non-military version of this resource.

Another leadership issue, is the importance of having a safe, inclusive and respectful work environment.

Responding to this, in 2016 we launched our Operation RESPECT programme to reinforce expected codes of behaviour across NZDF based on respect.

We wanted to remind people that discrimination, harassment and bullying behaviours are not OK in the New Zealand Defence Force.

2. Understand

Here our focus has been on enriching the picture we have about the current mental health status of our people, including the most common risk and protective factors, and our priorities for focus.

In October 2016 we launched our NZDF Health and Wellbeing Survey.

Look, I’ll be honest, undertaking surveys that gather information about the mental health of your workforce won’t be without reputational risk. What do your instincts tell you the media would make of these results?

• Nearly two thirds of our people reported that one or more life stressors had been a problem over the previous four weeks. The areas with the strongest relationship to psychological distress were problems with sleep, loneliness, exposure to prior stressful experiences, job satisfaction, and finances.
• 23% of our people screened as having an elevated level of psychological distress that if sustained over time, may lead to physical and/or mental health related concerns emerging. Levels were higher for our groups who had never deployed, and rates were comparable between our military and civilian staff.
• 10% of our people showed more concerning symptoms of a stress disorder. Levels were higher amongst our junior staff, and those of people who had been exposed to trauma — both through deployment or other life experiences.
• And, around four-and-a-half percent of survey respondents had an elevated risk of self-harm.

While we are trying to be a fast follower of many of our counterpart militaries doing this kind of research, I suggest we are one of the few organisations who has undertaken this research in New Zealand.

I am proud that we have done so. However, we’ve also had to respect the sensitivity of this kind of information and treat it with the trust with which it has been shared.

We released a summary of our results to our people in December 2016, but I’ll be frank, it was not nearly as granular as the results I just shared with you. But it was a communique that promised our people that we would use the information to help prioritise areas of effort for enhancing health across our force.

3. Prepare

Which brings me to ‘Prepare’, our focus on enhancing education and training, including a focus on building resilience, reducing stigma, and promoting awareness.

We recognised the importance of making a focus on prevention a priority and this led to the development of a range of accessible tools and resources. We have:

– Rolled out Resilience training for new recruits and leadership groups.

– Launched our defence health website to build awareness and provide access to tools and resources that promote positive health across the four domains of health within the defence community — our website is accessible to defence families and veterans, as well as our Defence workforce.

– We have had ongoing development of life skills programmes including sleep, finances, and relationship management, as part of an Integrated Wellness Programme. Other initiatives in the Integrated Wellness Programme include a stronger focus on induction and transition support.

– In addition, training and access to information is provided throughout an individual’s career to encourage the early recognition and management of potential mental health issues.

– Periodic health checks are undertaken throughout an individual’s career and all personnel undergo post deployment screening and follow-up on their return from deployments.

– We’ve produced a range of additional tools and resources embedded into our training.

Buddy Support’ can be invaluable. Mates can help out in pointing out the changes they’ve noticed in our behaviour.

So we produced our Mental Health Pocketbook as a tool for having these discussions. It has a list of signs to look out for that might indicate someone isn’t ok — for example, changes in behaviour, as well as tips and helpful resources.

We’ve developed a non-military version of this for our wider defence community, which I have bought copies along today to share with you.

– We have also just released a new resource for the Defence Community — Staying At The Top of Your Game, in conjunction with a pilot for a Health Assessment Programme spanning physical and psychosocial health.

The aim of this programme is to help individuals to identify and leverage strengths, and to recognise and manage any potential health risks.

4. Care

Our last area of focus has been on ensuring that we provide accessible and comprehensive care for those who may need it.

Our comprehensive model of care for the total workforce (including civilians and Reserve Forces), and support for the broader defence community, is delivered across the continuum of care through the coordination of internal and external agencies.

But let me mention one initiative that may be of interest Our 0800 NZDF4U confidential telephone and counselling service. It is for our defence community, this includes all uniformed members, civilians, veterans and their families.

With these foundations now in place, key areas of focus over the next two years include:

• the ongoing development of accessible tools, resources and programmes;
• continued development and standardisation of coordinated best practice mental health support services provided by our internal and external health providers; and a
• continued focus on leadership development and stigma reduction.

So what do I think the big takeaways are for you?

1. Mental health, like physical health, exists on a continuum and can deteriorate or improve depending on life circumstances.
2. None of us are immune to risk to our mental health as a consequence of our life experiences, however there are things we can do to manage and reduce this risk.
3. In most situations mental health concerns have the potential to be temporary and reversible, particularly when identified and managed early. And…
4. Mental health conditions affect our entire community; for each individual the circumstances of their situation will also be unique and deeply personal. Sometimes these may be linked to the work environment but oftentimes they will not.

As organisations it is important that we support our people from the centre — through policies, tools and resources — and from the front line.

We need to be addressing the stigma that lingers about mental health.

I believe we can do this by talking more openly about mental health, and treating it in the same way as we do any other health issues.

As leaders we can help by creating an expectation of recovery, and reinforcing the need for rest and time for recovery.

In some cases there will be a need for specialist support, as we would do for a physical health injury.

Sometimes our people will need a helping hand to recognise when they are not tracking ok, and when it’s time to call for reinforcements, which is where good leadership and buddy support comes in.

We all have important roles as leaders, in maintaining and supporting the health and wellbeing of our people. Viva la revolution.

[Thank you.]