October 7, 2024 • 46 mins
In part 1 of the final episode of Invisible Injuries season 5, host Andy Fermo engages with Gillian Yates from Insight Solutions Group, a veteran rehabilitation provider specializing in psychosocial recovery. The conversation centers around the importance of vocational rehabilitation, particularly for veterans and first responders who face medical transitions that force them to leave their careers unexpectedly. Gillian shares her passion for supporting these individuals in regaining their independence, helping them find new purpose and direction post-service.
The episode explores the challenges of transitioning out of military life, particularly the feelings of loss—of identity, community, and purpose—that veterans and first responders often face. Gillian explains how psychosocial rehabilitation can address these challenges by helping individuals reconnect with their communities, build new skills, and find meaningful work. She highlights the role of social connection in recovery, drawing attention to research on the harmful effects of social isolation and loneliness on both physical and mental health.
Gillian also touches on her experience working with various military groups, including veterans of the Australian Army, Air Force, Navy, and Special Forces, to help them navigate the complexities of returning to civilian life. She emphasizes the need for personalised rehabilitation programs, tailored to the individual’s readiness to engage, and underscores the importance of supporting veterans in regaining control over their lives.
Key Takeaways | Insight
1. Vocational Rehab Importance | Veterans benefit from structured rehabilitation to regain independence.
2. Medical Transitions Are Difficult | Many veterans don’t choose to leave; their medical discharge is unexpected.
3. Grief and Identity Loss | Veterans struggle with losing their sense of identity, community, and purpose.
4. The Power of Social Connection | Reconnecting socially is vital for emotional and mental health recovery.
5. Loneliness vs. Social Isolation | Social isolation has a greater risk of mortality than loneliness.
6. Psychosocial Rehab Promotes Recovery | Rehabilitation encourages rebuilding life through structured activities.
7. Challenges Veterans Face | Barriers like unemployment, financial stress, and health issues complicate recovery.
8. Readiness for Rehab | Veterans must be ready to engage in rehab for it to be effective.
9. Veterans' Unique Needs | Veterans require personalized programs, considering their military experience.
10. Empowering Veterans | Successful rehab involves veterans taking control of their recovery journey.
Contact - Gillian Yates
Website: https://www.incitesolutions.com.au/
Help Lines Open Arms (VVCS) | Lifeline | RedSix app
"RESPECT, NO POLITICS, WE'RE VOLUNTEERS"
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Claire Fermo (00:04):
I welcome to invisible injuries podcast aimed
at bettering the wellbeing andmental health of veterans, first
responders and their immediatesupport experiencing post
traumatic stress by sharing thestories of the lived experiences
of our peers, the support staffand the clinicians. It's our aim
(00:25):
to make sure we can have ameaningful connection with our
audience and give them the ideasfor their own self care plan. If
you do like what you're hearing,subscribe to the channel and
share it with your friends.
Lastly, these stories may be atrigger for your post traumatic
stress. If your PTSD istriggered, we have links to
(00:46):
support in the description. Orif it's immediate, please call
lifeline on 1311, 14. Here'syour host. Andy fermo,
Andy Fermo (01:02):
Hello everyone, and welcome to another episode, and
the final episode of season fiveof the invisible injuries
podcast. I'm your host, Andyfermo, and today for our final
episode, it's been a long timein the making, pretty much all
year, because we've been sobusy. I'm so glad to have our
guest, Gillian Yates, or Jill,as she'd like to be called, From
(01:25):
insight Solutions Group, who isthe WA provider for work rehab,
a national vocational rehabprovider. So welcome to the
show, Jill.
Unknown (01:36):
Thanks, Andy, great to be here, and I'm also so glad
we're finally doing this.
Andy Fermo (01:41):
Yes, we've talked about it. We've been dared and
gone through and workshopped alot of different topics, because
vocational rehab is such as sucha big breadth of services that
you provide, and I'd like you tobe able to share what it is
that's really passionate for youthat we're going to be chatting
about in this first part of ofour chat. Yeah,
Unknown (02:00):
absolutely great to be here, and it's great to have a
platform to discuss, I guess,what we do as allied health
professionals working withveterans and first responders
and supporting their recoveryprocesses and journeys. I have a
background in occupationaltherapy, and I'm passionate
about helping people to regaintheir independence and build a
(02:23):
life that's worth living full ofI started this journey actually
fell into working with defensemembers at RAF Williamtown and
was involved in the sort of onbase rehab team, and realized
that military members were sucha wonderful cohort to work with
so motivated, engaged, and therewas something that really
(02:46):
resonated with me about them andtheir ability to show up and get
the job done. So I've followedthat military theme one way or
another throughout the course ofmy career, and worked with
either veterans or militarymembers. Basically, since
graduating as an OT, how longhave you been in the industry
(03:09):
for now? It's now 10 years. Yes,I had a small hiatus in I went
to London and worked with theNational Health Service there to
shake it up a little see Europedo the whole working holiday
thing, and it sent me straightback to Oz to work with our
military and veteran population.
Because, yeah, it's just such agreat population to work with.
Andy Fermo (03:33):
And what was it?
What was it that taught you togravitated you before like to
become an OT you know,
Unknown (03:38):
I think I always knew I wanted to work with people and
to help. As a child, I alwayshelped out wherever I could, and
got a lot of joy from being ableto contribute in that way. I
think I was always going to endup in a profession that involved
working with people, being ofservice, right? Yeah, I get I
(03:59):
guess so, yeah, and it's such aprivilege to be able to work
with people, I think it's it canbe difficult at times, but
there's a lot of reward thatcomes from it, and it's often
just the very, very smallthings. You don't see huge
changes every single day, butyou use and that's everything.
(04:22):
Isn't
Andy Fermo (04:22):
that case, though, isn't. And before we hit, hit
record for our audience there.
So, yeah, so Jill's got somesome really cool other stuff
that she does as we which willtouch on, which is the which was
your training, which I want tosteal your thunder by letting on
that. But when you're going infor the long haul, just say, if
you're in the fitness industry,and if you're hopping on the
scales every single day, you'renot going to see anything. But
(04:44):
if you go, Hey, let's take oneat the start, a snapshot, and
this snapshot at the middle, andthen the snapshot at the end of
a certain transformationalprogram, so to speak, that's
when you see those changes,right? So you might not see them
in your line of work everysingle day, but that increment.
A good change over time. Yeah,and I think it is a bit of a
long run thing, as opposed to,like something, like a fad that
(05:04):
just might come and go straightaway. Yeah, you actually can
have some long lasting changes.
Yeah,
Unknown (05:12):
absolutely. I think it's important to think about
that bigger picture and lay thefoundation and then bit brick by
brick, on a strong foundation,equating that to the work that I
do prior to supporting peopleback into higher level
activities, there's afoundational piece that needs to
happen. And in that space, wesaw that,
Andy Fermo (05:36):
Okay, excellent. And that's something there, which is
the topic that we're going to bereally getting right into in the
moment, but just so that for ouraudience, and being a charity
that supports veterans and firstresponders when you're going
into it, so that if we can set abit of a base in the foundation,
which we spoke about, for thepsychosocial if we try and paint
a scenario of what may havehappened, how people led to a
(06:00):
vocational rehab provider, willthat provide some clarity for
the psychosocial piece thatwe're about to go into? Yeah,
absolutely.
Unknown (06:09):
I suppose there's a few different types of work that I
do. The primary element andfocus, most recently for me, has
been working with veteransthrough dva funded programs to
support their rehabilitationpost service. And generally, our
(06:29):
veterans are referred by dva fora rehabilitation assessment and
for our recommendations onwhether they need a rehab
program or not. So typically,they've experienced a medical
transition from defense. Somehave voluntary, discharged or
retired, but typically, the mosttypical pathway we see is
(06:53):
actually a medical transition.
So oftentimes, those peopleweren't planning to leave the
military. They were looking foreither a career in the military
or a set period of time toachieve certain goals within
that line of service, and thenleave when they chose to leave.
For the individuals that we see,that's not the case. They
(07:14):
haven't chosen to leave. Somethings happen to them, and then
they've been thrust into asystem that ultimately expels
them out of the service. Sothere's a lot of grief there.
There's a lot of unknown aboutthe future. There's a lot of
identity questions that pop up.
Who am I now without theuniform? Who do I What group do
(07:38):
I belong to? Who are my mates,there's so much that sort of is
stripped away when somebodyleaves a brethren and the
community of the military. And Iknow that you've had this
experience personally, and somany of your comrades as well.
And so that's typically theperson that we see in that
(07:59):
veteran space. They've had thatprocess, and then we pick them
up, and they might be five yearsdown that road, they might have
just left the military, and wedo what's called a warm handover
with ADF, and we conduct a rehabassessment, so we look at the
whole picture. Where is thatperson at in terms of that
(08:20):
transition journey. And eachperson is different, if it's
very fresh and raw, often theyneed some time for the dust to
settle, and important, probablynot to overload them, and to
look at just establishing aroutine and connection with the
right supports for others, thosethat are years down the line,
(08:45):
it's about looking at theirneeds. Their needs are probably
different. Are they connectedwith their community? Are they
socially involved? Becausethat's a huge protective factor,
and are they ready to contributeagain? And that's a big one, is
be of service. Yeah, it is a bigone. So my role is all
(09:06):
encompassing. It's aboutconnecting people with the right
supports, often treatment andmedical and allied health
supports initially, and thenlooking at different programs,
groups, interest groups,hobbies, courses, to get people
out of the house and engaged insomething that might interest
them, something that mightstimulate them cognitively,
(09:28):
socially. And then the nextpiece is that sense of purpose,
the contribution, the service,the work. So I guess we yeah, we
lay the foundation, and then webuild from there,
Andy Fermo (09:43):
amazing. And then do you find that the same as well,
in a pathway that, before werecord a further first responder
setting that foundation there?
Unknown (09:52):
Yeah. Some other work that we do is working with WA
Police. We do work with DFAS,the Department of Fire and.
Emergency Services as well, andit's fairly similar work.
Oftentimes, what we see with WAPolice is we are referred
individuals who are stillworking within WA Police and
(10:13):
have been injured, physically,psychologically. It may be a
work related injury, it may be anon work related injury, and our
role is to support them backinto the routine of work. If
that injury is going to renderthen them unable to do their
role, whether that's operationalpolicing duties or non
(10:35):
operational duties, then theymay be facing a medical
retirement. So a similar processwith defense members. There's
that saying if you aren'tdeployable, you're not
employable. And there, there areroles within the military, and
similarly, within police, wherean individual doesn't have to be
(10:55):
physically ready to deploy orready for operational work,
yeah, but they, they're few andfar between, yeah, and if there
is a reason why they are unableto undertake those active
duties, oftentimes they'refacing some sort of medical
process that, or I guess,employer break based process
(11:17):
that ultimately renders themunfit for that line of work. So
again, you know, massive thingthat happens in somebody's life,
it's loss of role, purpose, acommunity, a direction, and so
again, we need to help withnavigating all of that as well.
Yes,
Andy Fermo (11:37):
my bad and navigators are very important,
right? So in both sort ofindustries there, and both
communities. Navigation piece isa big one, yeah, and I think
part of it's also that journey,which I'm hearing that
connection through that journey,and which can be many stops just
spoken about, which is huge. Sothat leads me to that you
(11:58):
mentioned that the socialaspect, and then that the
psychosocial that we're going totalk about. So yeah, let's hook
into this. Yeah,
Unknown (12:06):
I guess it's worth defining what psychosocial well
being, and it's essentially thefeeling that what we're doing
with our lives is giving usmeaning and purpose, and we're
going in the right directionwhere there's a disruption with
that, I guess we havepsychosocial dysfunction, and my
(12:27):
role as an occupationaltherapist and as a rehab
consultant, supporting peoplethrough recovery processes is to
help them navigate thatpsychosocial dysfunction and
rebuild their lives. So itsounds incredibly broad, fairly
wishy washy, but there is alittle bit of science to it as
(12:49):
well. PsychosocialRehabilitation promotes personal
recovery, successful communityintegration and improved quality
of life for people, we'relooking at helping individuals.
Recover and regain lost skills,always focusing on strengths of
what people can do, yes, andpromoting them to return to
(13:16):
health and wellness. I suppose,under the DVA model, they have a
definition of psychosocial rehabwhere they have said it's a
broad term used to describe aset of rehabilitation
interventions which may improvea client's quality of life, and
in so doing, support achievementof their overall rehabilitation
(13:36):
goals. In dva, PsychosocialRehabilitation is delivered as
one element within the continuumof support, which may include
treatment, vocationalrehabilitation and medical
management. So we often look atactivities to support this
(13:56):
process. It may be sporting andrecreational activities, maybe
clubs, groups, classes, maybeshort courses, being programs,
also life skills programs. Soparenting programs, anger
management programs, financialcourses, oftentimes we see the
(14:18):
barriers to psychosocial wellbeing social, so a lack of
connection with others, whichhas huge health ramifications,
and it's something that would bequite keen to go into. Next is
looking at social isolation andloneliness and some of the
research around that. Oh,
Andy Fermo (14:38):
that's a massive one, isn't it? When we talk
about socialization andconnectedness. For in this
opening part is that when youfrom lived experience and then
talking to so many other gueststhat have been is that when
you're disconnected in that sortof way, especially when it's
medically and it's not underyour own terms, I try and liken
it to when you see that warningthat comes in, and you try and.
(15:00):
Pull a USB from the computer,and there's a lot of the time.
Now, if you've got lots ofinformation passing through
there, and you disconnect it,it's going to be all jumbled up,
and it's not going to work aswell. So that's the way I try
and see that those bits. Now,you're like, how do I piece
those bits together again? Or,how can I do that? Or how can
someone guide me to do this? Ifthat's happened, we were talking
(15:21):
about the social isolation andsome of the statistics behind
that, you said that were quitealarming. Could you share some
of those bits in regards towhat's happening in that space?
Statistic wise?
Unknown (15:35):
Yes, absolutely. So last year 2023 there was a meta
analysis. So a look at a numberof studies. There were 90
studies that these researcherslooked at, and they published
this meta analysis in naturehuman behavior. They found that
(15:57):
people that are sociallyisolated have a 26% risk of
increased risk of death comparedwith those that aren't socially
isolated, which is huge. Theydid look at the difference
between social isolation andloneliness, and they found that
defining those two areas wasquite important in understanding
(16:22):
exactly what was going on andwhich was more detrimental than
the other. So social isolationis defined where somebody has a
lack of social connection due tobeing geographically isolated or
physically isolating themselves,that it might mean that they
live alone and they just havevery few connections with
(16:44):
people. It's very much anobjective state of being,
whereas loneliness is thesubjective experience of feeling
disconnected and in a state ofdistress because their
perceived, I guess, theirperception of their social
connection is not where theywant it to be.
Andy Fermo (17:05):
That's massive.
Yeah, that's a huge difference.
Unknown (17:09):
And what this research found was that it's social
isolation that is the biggestkiller, and loneliness is
detrimental to health as well.
But it's really that lack ofsocial connection, rather than
the perception of the lack ofsocial connection. And why this
(17:30):
is because, generally speaking,people that are isolated or
lonely tend to engage inunhelpful or unhealthy lifestyle
behaviors, which is detrimentalto their overall health and well
being. They might not leave thehouse as much, not exercise as
much. There's an increase intheir blood pressure. Generally,
(17:54):
there's an increased incidenceof cardiovascular issues,
increased incidence of beingoverweight or obese, and there's
just that sort of negativespiral that happens from there.
So if somebody's not feelingconfident about the way they
look or how they're feeling,they're going to be less likely
(18:14):
to put themselves out there toconnect with others. So at the
heart of this, what I draw fromthis is that social connection
is massively protective forpeople and their health, and we
know that, particularly withPTSD, people avoid and they
withdraw and hyper vigilantabout others and what could
(18:41):
happen, and so they might putthemselves in a position of
being socially isolated. Whattreatment will look to address
so psychiatry, psychologicaltherapy, is prepare them to be
in a place where they canconnect. What psychosocial rehab
will do is provide theopportunities or encourage the
(19:06):
opportunities for that socialconnection. So yeah, that the
social piece, for me, isfundamental, and knowing what's
happening in the community aboutwhat people are offering in the
community, for veterans, or notfor veterans, for anyone that
helps with connecting, and thatsense of belonging is just so
(19:29):
paramount, and
Andy Fermo (19:33):
it's massive. And just so when we talk of when you
mentioned before, so what was itthe 20 what? 26% more likely?
And when you say that could beat risk of death, are we talking
about suicide or elementssurrounding talking
Unknown (19:46):
about, yeah, all kinds of death. It might be cancer
related issues. It might becardiovascular related issues.
So generally, there's morecomorbid issues that happen with
that population. The lonely orcyber
Andy Fermo (20:01):
isolated. So it might not necessarily just be
that one mechanism of, say, asuicidal ideology, that might be
doing it, but that could be avery big precursor through
isolation. And obviously there'sother factors as well that can
come in on board, but that's amassive statistic from if you're
talking about 10,000 veterans,and if you're all socially
(20:23):
isolated, just say during covid,so to speak, that 26% increase
as a lot, right? Yeah. So
Unknown (20:30):
it's a big number, yeah, it's very much
statistically significant. Needto do something about it and
address that core issue of thelack of connection. What is also
interesting is that adult menhave the fewest friendships of
all other demographics, andtypically, we see a higher
(20:52):
incidence of men that enter themilitary and consequently leave
the military. Certainly, there'sa big female population now, but
still probably more dominated bymales, and that is always at the
back of my mind when workingwith male veterans, is who are
(21:15):
they connected with? There'salso a staggering statistic that
80% of the defense or veterancommunity have relationship
breakdowns compared with the 50%in the civilian space, wow.
Yeah. So it's mostly attributedto the fact that military
personnel have had to work awayso much and that just causes
(21:38):
fractures in relationships.
Additionally, in the veteranspace, when somebody's gone
through that transition ofleaving the military and
becoming a civilian, that spaceis so tricky and is fraught with
difficulty, and relationshipsoften suffer because of it. So
the relationships can be thecollateral damage from the
(21:59):
occupation or leaving theservice as well, and without
those protective personalrelationships, without
friendships or otherconnections, that does leave one
to be very isolated. Well,
Andy Fermo (22:18):
I think, yeah, and you really come on and touched
on a really important point,Jill, because when you've got
there's a few things that youtalked about there, you've got
the transition, then you've gotthe relationship piece, and more
often than not, a lot of thosethings are happening
concurrently. So if you'rehaving to deal with lots of I'm
dealing with one I've got areally full plate. Then I'm
dealing with a relationshipbreakup, then I'm also dealing
(22:40):
with having to work through myown trauma. If I'm seeing
someone that's huge, that couldreally then make them withdraw
into that shell. And this iswhere that real, the importance
of that psychosocial connectionis, I think, as a bloke now,
that's, I'm in my 40s, right?
And just the thing is, as amale, it is harder to make new
friends because you're so usedto either whether you're army
(23:02):
mates as well, or a new cohortof people that you go up. I
might have trust issues orlearning to be able to we might
be walking alongside, but youhave you earned that actual
trust there to be able to go,Look, I'm gonna call you my mate
type. That's huge one, and toreintegrate it into like a
civilian setting is can be verydifficult if you're not okay.
(23:22):
I've lost my mates, and I lostthat purpose dealing with all
this other stuff that's goingon. But this is the importance
of that, the psychosocial piece,Yeah, isn't that? Now I'm just
going to go out and people knowwhat it is that we've had that
common thing, which is, might bemilitary, first responder, but
now we're doing an activity herethat then I can create some new
friends or have a new meaning.
Unknown (23:47):
Absolutely, yeah, I think that experience for men in
particularly, is quite profound.
Making new friends. Men have adifferent way of connecting with
one another than women. Womenmight be more emotionally
focused, whereas men tend to bemore task and solution focused
and doing and not a lot oftalking about feelings. It's
(24:09):
difficult to then createconnection by being that way.
It's certainly not impossible,and my role is about being
creative and exploring differentopportunities to get people
connected. Yeah,
Andy Fermo (24:27):
and then that's through activities, is a great
one, and which we're talkingabout, because then that way you
could be there and you could dosomething, and as a bloke, we
could be doing somethingsimultaneously. And you don't
need to talk about that examplethat you used with the with the
surfboards, and connected bywith the guys having it, like
the surfboards, the vehicle thatyou're coming in, in that safe
(24:47):
space to do something, um,another example would be, we
spoke about the rallying or cometry surfing and or there's some
forges in especially this iswhat I found. I. With,
especially guys in that aretransitioning out from that,
that Special Forces space isthat, and blokes in general
don't really want to be liketalking too touchy feely. But
(25:08):
thing is, okay, we're talkingabout mental health. What is it?
So there's this activity, apsychosocial activity, that's
based around, you bring this oldfile in, and then you go and
heat it up, and then you do someman bashing. And then by the end
of it, you have this, you breakthis thing down, and then you
remold it, very much like goinginto recruiting from being a
(25:28):
Syrian made into a soldier, intothis nice, beautiful knife, all
right? So that's really manly,right? So this is really cool.
Oh, I want to have a go at doingthat as well. But at the same
time is, the point is that therecould be a group of males in
that sort of same age group. Youdon't need to sing Kumbaya, but
you're there doing an activitythat has meaning and purpose.
(25:50):
And by doing something togetheraround fire, which is that
holistic point, really can help,yeah? Or doing something that's
going to be in the water and I'min nature,
Unknown (26:00):
yes, yes, yeah. The our veterans Forge is a great
organization to military exmilitary people run that two
blokes who had a desire to helppeople forge connections once
they left the military saw thatthere was a need and did
something about it, and yeah,it's wonderful being able to
(26:25):
draw on the resources that arethere in the community that
often very much grassrootsprograms, often being run by
veterans or people who've hadsome sort of experience with or
connection with the military,and that that transition, the
difficulty that brings, hastouched their lives in some way.
(26:47):
Yeah, so yeah, absolutely, it'snot about sharing feelings and
talking. It's again, about thedoing and creating, being
active, and with that comes theconnection. I
Andy Fermo (27:03):
am in this sort of state where it's been
disconnected, you can go intothe shell, which is that, that
social piece where I'm like, Idon't want to see anyone, I
don't want to do anything, andand that can be a real it can be
a real detriment over time,especially when speed prolonged,
isn't
Unknown (27:18):
it? Yeah, yeah.
Absolutely. That socialconnection is just key to all of
this. I think that's that can bea massive element of
psychosocial dysfunction,alongside other barriers, like
unemployment, that lack ofpurpose and meaning that we
spoke about earlier, a financialissue going on, or financial
(27:41):
stress and health issues andconcerns as well. So we look at
trying to address those barriersone by one through various
psychosocial interventions andactivities and like DBAs
definition said it's about thatcontent continuum of care. So
(28:04):
we're one cog in a big wheel. Wedon't necessarily provide the
medical and treatmentintervention, but we will help
people to connect with the rightsupports in that space.
Andy Fermo (28:21):
So when you do this assessment, which you mentioned
at the start, is finding outwhat it is that that particular
person needs, and thencustomizing the to what it is
that they need. So if they need,if they're if the priorities is
that they're looking to havesome some specialists come in
and some counseling, that mightbe the bit to be able to at
(28:41):
least get them down to to astate which then may think
about, okay, let's get yourfinances in order. And this
might be something, the pathwaythat we're going to go down
there one at a time, absolutely,
Unknown (28:54):
absolutely. And we also apply a little bit of scrutiny
around whether somebody's readyto engage in our service. Oh,
that's a big one. Yeah, it's notnecessarily a service that is
for everybody, because we needto in our swim lane and do what
we do best, focus on doing itwell and supporting the people
(29:17):
that are ready for the service.
So we wouldn't look at turningpeople away and leave them
unsupported. We would helpconnect people with the right
services, depending on wherethey're at. But if people are
looking to really engage andcommit to a rehabilitation
program, if they're ready, thenwe want to work with them so
(29:39):
that readiness looks like anability to meet
Andy Fermo (29:46):
us. Oh, okay, so to meet you halfway, halfway,
Unknown (29:51):
we're doing all the work. Then there's something
wrong. The individual needs tohelp themselves and needs to
learn how to put their ownoxygen mask on. And our job. Is
to help them to do that, orencourage them to do that. Yeah,
so there's very realconversations that happen there.
There can be challengingconversations as well, because
(30:12):
if we we're just lettingsomebody maintain the status
quo, we're not doing our jobsand we're not being of service
to people. We're looking toreally get people standing on
their own two feet with whateversupport they may need, but
ultimately feeling that they'veregained some control in their
(30:33):
lives and that sense of purpose.
Yeah,
Andy Fermo (30:35):
that sounds like it's also it's empowering for
them, so when they're ready toempower themselves again, yeah,
at that stage, and that, fromwhat I'm hearing Jill, is that
that part of that is thatwillingness to then meet
halfway, yes. So if someone'sthere, willing to work with you
to customize something thatworks for the for the individual
(30:56):
and their situation, theindividual has to then come and
say, hey, look, actually, I'mwilling to put in that work.
Yeah,
Unknown (31:03):
absolutely nothing ventured, nothing gained, and
everything worthwhile is hard aswell, and then you reap the
reward. So it does take work tobe able to build routine again,
to be able to get out of thehouse, put yourself out there,
make new connections, trysomething new in terms of a
(31:26):
hobby or an interest, and thenultimately, I guess, get back
into the workforce, or some sortof work that you know may not
necessarily be paid work, but ithelps with that sense of
purpose, contribution andmeaning, cool
Andy Fermo (31:47):
and so in regards to that, and when, you know, we've
talked to like, when someone'sready, but what would be some of
the roadblocks from yourexperience having worked over in
the last decade with you know,with the audience, Is that? What
are some of the roadblocks thatstops people that you found at
getting to that point wherethey're ready to meet someone
halfway?
Unknown (32:08):
Look, I think there can be massive medical barriers for
people. So if somebody is veryunwell, whether that's
physically or psychologically,they're not going to be in a
place where they're ready toengage in a rehab program fully,
so they probably need to spendsome time making sure their
treatment is optimized and theircondition is well managed, if
(32:32):
there's a lot of symptoms goingon for somebody that could get
in the way of their engagement.
So I'm talking about painsymptoms. I'm talking about very
significant avoidance symptomsas well. A lot of the time we do
see presentations of PTSD. Wesee a lot of depression,
anxiety, often those featuresare part of PTSD as well. We're
(32:55):
also seeing a hell of a lot ofmusculoskeletal injuries that
are very chronic. So that bringswith it a lot of pain, which
impacts sleep, lots of sleepdysfunction. And whilst we want
to try and support thoseconditions and help with the
management of those conditions,if they're not well controlled,
(33:17):
then that's probably where amedical or service is more
appropriate than our service. Soagain, looking at when whether
somebody's ready and whetherthey're suitable to engage in a
rehab program, it's not reallyworth the investment, because
all of this, like I said,initially, our services are
(33:38):
funded through DBA. So we'relooking at taxpayer funds.
There's an obligation to usethose wisely, so we're going to
get the most bang for buck whensomebody's ready.
Andy Fermo (33:52):
Yeah, and then that's a big one as well,
because you ultimately the goalis to be able to empower people,
then to stand on their own twofeet after a few services, but
not saying that, if you fromwhat I'm hearing, is that if
there's someone at that stage,they're nearly ready, but maybe
not for the full shebang. Isthat guidance, which is still
under the umbrella to help guidethe individual to a service that
(34:16):
might it's like the pre coursework that you need to do is
okay, that's actually working onyourself. Yes, am I ready now to
then have a cup that's fullenough to be able to go, Hey,
I'm ready to absorb information.
I've got some energy here tooverflow now to invest my time
in something like arehabilitation program.
Unknown (34:36):
Definitely, I think what I've always really enjoyed
as well about doing this work isit is a well funded space. So
compared with our public healthservice, and certainly compared
with the National Health Servicein the UK, there are a lot of
resources and supports out therefor veterans, indeed, I think
(34:57):
more so than, say, our local WAPolice. Force the Yeah, the
Federally run programs under dvafor veterans are very good.
There's still a way to go with,with spot for the most part,
it's it's a generous system, andthere's funding there for
veterans to receive the care andthe treatment that they need,
(35:18):
most importantly, and then thosesecondary services, the Allied
Health sort of services as well.
And then
Andy Fermo (35:25):
some massive space, though, and you've mentioned it
a few times, is that navigation,isn't it, that if you don't know
where the stops could be, orwhat, if you don't know where
that those parts are, or thesegues from along that journey,
that's part of what you guys arealso as being of service there,
external to the actual like aspecific program is helping
(35:47):
people navigate what'savailable. Yeah, like there is
so much out there. Isn't thereso
Unknown (35:52):
much, it can be a real minefield for people, like
overload, right? Yes,definitely. When we're looking
at somebody that might havePTSD. We need to be mindful that
they potentially can't accessall of their brain all of the
time, and so there is that senseof overload. They often are
(36:12):
operating in that real fight orflight mode, and we need to do
some of that legwork for them inhelping them navigate the chaos.
I suppose what is worth speakingto is the organization where I
(36:36):
work in Site Solutions Group wasfounded by three women who were
previously working for theCommonwealth rehabilitation
services, which was a federallyrun department that would
actually support militarymembers as well as veterans with
all of these services, thatdepartment was then shut down,
(36:58):
and so A lot of those servicesended up becoming privatized,
and my three directors builttheir business insight solutions
group because they wanted tocontinue to work with this
population of people. So thereis a lot of wisdom there, and a
lot of experience with, youknow, the entire history of the
(37:20):
Department of Veterans Affairs,the Australian Defense Force as
well, and we are pretty adept athelping people navigate those
systems. I bring a slightlyunique set of experience as
well, having worked on with thetri services and some of the
subgroups within those services.
So I mentioned before RAF base,Williamtown, I was also at
(37:43):
singleton infantry base when Ireturned to wa I've I worked at
hms. Yes, thank you. GardenIsland, Campbell barracks as
well. Okay, so there's been thatArmy, Navy, Air Force exposure,
worked with Submariners, workedwith SAS Special Forces and
(38:03):
clearance divers as well. Andbringing that into an
organization that works withveterans is super helpful,
because we're able to understandwhere it all started for people,
what that military experiencewas like, what it's actually
like to be in a submarine andwork in those incredibly unique
(38:28):
environments. I think for you,it's probably second nature.
This is all normal stuff, butfor civilians, it's not normal.
It's incredibly unique. And alot of the health professionals
working with defense or exdefense members don't
necessarily understand what it'sreally like to be in those
(38:49):
environments. So I think that'sa helpful element that we can
offer.
Andy Fermo (38:55):
So having that lived experience in the space, even
from a provider that's actuallybeen there that's like, okay,
cool. I'm speaking with a cohortof people from this space. And
an example would be a single theguys at Singleton, yeah, that's
primarily a training facility,and so the needs of those
members would be a little bitdifferent as to someone that if
you come across all the way fromthe East Coast to the West
(39:18):
Coast, and let's use theSterling and sub mariners,
that's a different environment.
Again, it's primarilyoperational. They're even the
full time service, and theirconditions are a little bit
different, even though you mightbe in close proximity. I'm just
thinking about how those guyslive pretty much on top of each
other. You can't get away.
There's that aspect, you'regoing away for a long time,
(39:40):
that's one bit. Yeah, soisolation from from immediate
support group could be onething, and loved ones, you know,
and all those things. And thenif we're going over to somewhere
like the SAS, the camel barracksin Perth, I'm just thinking,
there's a lot of, there's a lotof compartmentalization with how
you're going to go about it. Sothen trying to find a way that
works for people. And theirsituation when they can't
(40:01):
divulge all their stuff thatthey're experiencing would be
okay. How can I talk? Or how canI connect with a with the
individual that's working inthat space? Yeah, to be able to
say, okay, but we're not, I'mnot asking you about your
operational details. Let's see,but let's talk about you as an
individual and what you'reexperiencing, and what we can
Unknown (40:19):
help is that, yeah, absolutely. I found that showing
that we can speak the language,because there is a real
difference in the languagebetween military and civi
Street, that that's everything.
We don't have to get intodetail. In fact, we don't want
to, and that's not our role.
It's just about having thatempathy around where it all
(40:41):
started for that person.
Andy Fermo (40:43):
That's a big one.
Isn't the empathy. You don'tactually have to be walking in
that shoe. It's justempathizing. It's just, let's
walk a lot inside with you andexplore in lifeline. They call
it being walking with someone orbeing with someone in their
pain, right? You don't actuallyhave to be the person that's
jumped into it, because you'reactually guiding them through.
Someone pulls you into it. Ifthey're drowning, and they pull
you in. They want to be twopeople drowning. You want to be
(41:06):
here's the lifeline boy typething. Yeah, and you can
empathize with they're goingthrough something. Yeah, we
don't need to rip open the
Unknown (41:15):
wound. No, no, that's right, absolutely. I like to use
the analogy of driving a car,and the individual I'm working
with, I really force them to bein the driver's seat. They're
driving the car, and I'm in thepassenger seat, maybe looking at
the roadmap. Maybe the roadmap's upside down, and we're
(41:35):
trying to navigate our wayahead. But the crux is, there's
somebody there in the passengerseat reading the roadmap, and
the individual is in thedriver's seat. They have
control. They don't have tonecessarily follow the
directions, because it's theirlife. And
Andy Fermo (41:55):
that is, it is very true. And on that yesterday, or
just recently, I was talking tosomeone, well, two people just
recently, and we're talkingabout this navigation and the
driver, because people in themotorsport industry that are
helping out with these programs,and a critical part of, say,
rally or motorsport racing, ishaving someone as the Navigator.
(42:17):
The driver might be driving at200 kilometers an hour, or
whatever it is, through thebush, let's say in a rally. And
the navigators like reading thismap. Okay, easy, left, easy,
right. We've got a big hairpinturn here. Now they're just
saying what's ahead? What'sahead in on that map? Yes, but
ultimately, what you're sayingis that drive is in control of
how they go around it, right? Soif we've got a hairpin turn
(42:39):
that's 180 degrees, I'm going tohave to do some things, knowing
that the navigators saidsomething's coming up. Yes, and
we've got to make that action.
But ultimately, that drivers inthere, the navigators just in
the seat, strapped in tight,right, holding on for dear life,
Unknown (42:56):
yes. And the what I see there is, there's a team, yes,
it's not doing it solo, it'sdoing it together and being
connected, and sometimes beingshown the way, or sometimes
being allowed to explore wherethat way is. And that's the
(43:16):
beauty of the role that I sitin, is I never know really where
we're going to go, but it'sabout trusting the process and,
yeah, and allowing eachindividual to really make their
own way. Yes, yeah,
Andy Fermo (43:35):
I think. And that's the thing, though, isn't it?
There's a saying in the militaryas well, you can be lost. Lost
is one thing and then, but thenthere's that other saying, we're
trying to flip that coin is, Icould be lost for a little bit,
but then they have a bit of acry. And they used to say, oh,
Nate, have a cry. Get it all outcry. Bring your mom. That's type
thing. And then, but when yousit down to it, you can go, I'm
(43:56):
actually just geographicallyembarrassed, alright, so not
lost. I'm geographicallyembarrassed, and I just need to
find a way go introspective andthen have you cry, or whatever
it is, and this is from amilitary perspective, so I don't
want to trigger anyone here orput anyone I'm not putting
anyone down and just thinkingactually I'm geographically
embarrassed. But what is it thatI need to do now to be able to
(44:18):
get out and from a navigationalpoint of view, that one of the
tools was called a resection.
Let's find some bearings aroundhere. Jill might be holding the
map upside down, so we're goingto look for some landmarks that
are here, and then we're goingto then triangulate to see where
we are, and then from there, andthen maybe find a way to go
through these destinations. It'snot the destiny, the destination
(44:40):
is the goal at the end, but thatjourney and the learning and the
growth comes from actuallydoing, isn't it? And
experiencing those things fromthe individual, actually
experiencing those things, andhaving a go, yeah? Being
introspective at what works bestfor them. That's what I'm
hearing.
Unknown (44:57):
Yeah, yeah, absolutely.
I think having. A Go is key, andsometimes we have to encourage
somebody to fake it until theymake it, which I feel like
that's what I'm doing today on apodcast. It's just about trying,
and it's maybe about havingsomebody's hand to hold whilst
jumping into the deep end. We'regoing to be there no matter
(45:19):
what. Jill, I
Andy Fermo (45:22):
was guiding that today, so the powers out, blah,
blah, blah. And I'm like, I'vegot just a backup. I've got a
backup here. I've got the I gotthe power bank. We're going to
do the Okay, I want to do this.
And then I came here and she'sgot all of the notes, all the
stuff that we're talking about.
And it's just an amazing processthat's happening. So she's dived
(45:43):
into the deep end, and we'redoing it
Unknown (45:44):
right? So by example, yeah, you're my navigator
Andy Fermo (45:48):
for this part anyway, yeah,
Claire Fermo (45:55):
join us next time for the next episode of the
invisible injuries podcast.
Don't forget to subscribe formore great content. Follow us on
our socials, on Instagram, andyou can also visit our website,
www.invisibleinjuries.org.au.
Where you can access morecontent. Thank you for listening
(46:16):
to invisible injuries. You
I welcome to invisible injuries podcast aimed
at bettering the wellbeing andmental health of veterans, first
responders and their immediatesupport experiencing post
traumatic stress by sharing thestories of the lived experiences
of our peers, the support staffand the clinicians. It's our aim
(00:25):
to make sure we can have ameaningful connection with our
audience and give them the ideasfor their own self care plan. If
you do like what you're hearing,subscribe to the channel and
share it with your friends.
Lastly, these stories may be atrigger for your post traumatic
stress. If your PTSD istriggered, we have links to
(00:46):
support in the description. Orif it's immediate, please call
lifeline on 1311, 14. Here'syour host. Andy fermo,
Andy Fermo (01:02):
Hello everyone, and welcome to another episode, and
the final episode of season fiveof the invisible injuries
podcast. I'm your host, Andyfermo, and today for our final
episode, it's been a long timein the making, pretty much all
year, because we've been sobusy. I'm so glad to have our
guest, Gillian Yates, or Jill,as she'd like to be called, From
(01:25):
insight Solutions Group, who isthe WA provider for work rehab,
a national vocational rehabprovider. So welcome to the
show, Jill.
Unknown (01:36):
Thanks, Andy, great to be here, and I'm also so glad
we're finally doing this.
Andy Fermo (01:41):
Yes, we've talked about it. We've been dared and
gone through and workshopped alot of different topics, because
vocational rehab is such as sucha big breadth of services that
you provide, and I'd like you tobe able to share what it is
that's really passionate for youthat we're going to be chatting
about in this first part of ofour chat. Yeah,
Unknown (02:00):
absolutely great to be here, and it's great to have a
platform to discuss, I guess,what we do as allied health
professionals working withveterans and first responders
and supporting their recoveryprocesses and journeys. I have a
background in occupationaltherapy, and I'm passionate
about helping people to regaintheir independence and build a
(02:23):
life that's worth living full ofI started this journey actually
fell into working with defensemembers at RAF Williamtown and
was involved in the sort of onbase rehab team, and realized
that military members were sucha wonderful cohort to work with
so motivated, engaged, and therewas something that really
(02:46):
resonated with me about them andtheir ability to show up and get
the job done. So I've followedthat military theme one way or
another throughout the course ofmy career, and worked with
either veterans or militarymembers. Basically, since
graduating as an OT, how longhave you been in the industry
(03:09):
for now? It's now 10 years. Yes,I had a small hiatus in I went
to London and worked with theNational Health Service there to
shake it up a little see Europedo the whole working holiday
thing, and it sent me straightback to Oz to work with our
military and veteran population.
Because, yeah, it's just such agreat population to work with.
Andy Fermo (03:33):
And what was it?
What was it that taught you togravitated you before like to
become an OT you know,
Unknown (03:38):
I think I always knew I wanted to work with people and
to help. As a child, I alwayshelped out wherever I could, and
got a lot of joy from being ableto contribute in that way. I
think I was always going to endup in a profession that involved
working with people, being ofservice, right? Yeah, I get I
(03:59):
guess so, yeah, and it's such aprivilege to be able to work
with people, I think it's it canbe difficult at times, but
there's a lot of reward thatcomes from it, and it's often
just the very, very smallthings. You don't see huge
changes every single day, butyou use and that's everything.
(04:22):
Isn't
Andy Fermo (04:22):
that case, though, isn't. And before we hit, hit
record for our audience there.
So, yeah, so Jill's got somesome really cool other stuff
that she does as we which willtouch on, which is the which was
your training, which I want tosteal your thunder by letting on
that. But when you're going infor the long haul, just say, if
you're in the fitness industry,and if you're hopping on the
scales every single day, you'renot going to see anything. But
(04:44):
if you go, Hey, let's take oneat the start, a snapshot, and
this snapshot at the middle, andthen the snapshot at the end of
a certain transformationalprogram, so to speak, that's
when you see those changes,right? So you might not see them
in your line of work everysingle day, but that increment.
A good change over time. Yeah,and I think it is a bit of a
long run thing, as opposed to,like something, like a fad that
(05:04):
just might come and go straightaway. Yeah, you actually can
have some long lasting changes.
Yeah,
Unknown (05:12):
absolutely. I think it's important to think about
that bigger picture and lay thefoundation and then bit brick by
brick, on a strong foundation,equating that to the work that I
do prior to supporting peopleback into higher level
activities, there's afoundational piece that needs to
happen. And in that space, wesaw that,
Andy Fermo (05:36):
Okay, excellent. And that's something there, which is
the topic that we're going to bereally getting right into in the
moment, but just so that for ouraudience, and being a charity
that supports veterans and firstresponders when you're going
into it, so that if we can set abit of a base in the foundation,
which we spoke about, for thepsychosocial if we try and paint
a scenario of what may havehappened, how people led to a
(06:00):
vocational rehab provider, willthat provide some clarity for
the psychosocial piece thatwe're about to go into? Yeah,
absolutely.
Unknown (06:09):
I suppose there's a few different types of work that I
do. The primary element andfocus, most recently for me, has
been working with veteransthrough dva funded programs to
support their rehabilitationpost service. And generally, our
(06:29):
veterans are referred by dva fora rehabilitation assessment and
for our recommendations onwhether they need a rehab
program or not. So typically,they've experienced a medical
transition from defense. Somehave voluntary, discharged or
retired, but typically, the mosttypical pathway we see is
(06:53):
actually a medical transition.
So oftentimes, those peopleweren't planning to leave the
military. They were looking foreither a career in the military
or a set period of time toachieve certain goals within
that line of service, and thenleave when they chose to leave.
For the individuals that we see,that's not the case. They
(07:14):
haven't chosen to leave. Somethings happen to them, and then
they've been thrust into asystem that ultimately expels
them out of the service. Sothere's a lot of grief there.
There's a lot of unknown aboutthe future. There's a lot of
identity questions that pop up.
Who am I now without theuniform? Who do I What group do
(07:38):
I belong to? Who are my mates,there's so much that sort of is
stripped away when somebodyleaves a brethren and the
community of the military. And Iknow that you've had this
experience personally, and somany of your comrades as well.
And so that's typically theperson that we see in that
(07:59):
veteran space. They've had thatprocess, and then we pick them
up, and they might be five yearsdown that road, they might have
just left the military, and wedo what's called a warm handover
with ADF, and we conduct a rehabassessment, so we look at the
whole picture. Where is thatperson at in terms of that
(08:20):
transition journey. And eachperson is different, if it's
very fresh and raw, often theyneed some time for the dust to
settle, and important, probablynot to overload them, and to
look at just establishing aroutine and connection with the
right supports for others, thosethat are years down the line,
(08:45):
it's about looking at theirneeds. Their needs are probably
different. Are they connectedwith their community? Are they
socially involved? Becausethat's a huge protective factor,
and are they ready to contributeagain? And that's a big one, is
be of service. Yeah, it is a bigone. So my role is all
(09:06):
encompassing. It's aboutconnecting people with the right
supports, often treatment andmedical and allied health
supports initially, and thenlooking at different programs,
groups, interest groups,hobbies, courses, to get people
out of the house and engaged insomething that might interest
them, something that mightstimulate them cognitively,
(09:28):
socially. And then the nextpiece is that sense of purpose,
the contribution, the service,the work. So I guess we yeah, we
lay the foundation, and then webuild from there,
Andy Fermo (09:43):
amazing. And then do you find that the same as well,
in a pathway that, before werecord a further first responder
setting that foundation there?
Unknown (09:52):
Yeah. Some other work that we do is working with WA
Police. We do work with DFAS,the Department of Fire and.
Emergency Services as well, andit's fairly similar work.
Oftentimes, what we see with WAPolice is we are referred
individuals who are stillworking within WA Police and
(10:13):
have been injured, physically,psychologically. It may be a
work related injury, it may be anon work related injury, and our
role is to support them backinto the routine of work. If
that injury is going to renderthen them unable to do their
role, whether that's operationalpolicing duties or non
(10:35):
operational duties, then theymay be facing a medical
retirement. So a similar processwith defense members. There's
that saying if you aren'tdeployable, you're not
employable. And there, there areroles within the military, and
similarly, within police, wherean individual doesn't have to be
(10:55):
physically ready to deploy orready for operational work,
yeah, but they, they're few andfar between, yeah, and if there
is a reason why they are unableto undertake those active
duties, oftentimes they'refacing some sort of medical
process that, or I guess,employer break based process
(11:17):
that ultimately renders themunfit for that line of work. So
again, you know, massive thingthat happens in somebody's life,
it's loss of role, purpose, acommunity, a direction, and so
again, we need to help withnavigating all of that as well.
Yes,
Andy Fermo (11:37):
my bad and navigators are very important,
right? So in both sort ofindustries there, and both
communities. Navigation piece isa big one, yeah, and I think
part of it's also that journey,which I'm hearing that
connection through that journey,and which can be many stops just
spoken about, which is huge. Sothat leads me to that you
(11:58):
mentioned that the socialaspect, and then that the
psychosocial that we're going totalk about. So yeah, let's hook
into this. Yeah,
Unknown (12:06):
I guess it's worth defining what psychosocial well
being, and it's essentially thefeeling that what we're doing
with our lives is giving usmeaning and purpose, and we're
going in the right directionwhere there's a disruption with
that, I guess we havepsychosocial dysfunction, and my
(12:27):
role as an occupationaltherapist and as a rehab
consultant, supporting peoplethrough recovery processes is to
help them navigate thatpsychosocial dysfunction and
rebuild their lives. So itsounds incredibly broad, fairly
wishy washy, but there is alittle bit of science to it as
(12:49):
well. PsychosocialRehabilitation promotes personal
recovery, successful communityintegration and improved quality
of life for people, we'relooking at helping individuals.
Recover and regain lost skills,always focusing on strengths of
what people can do, yes, andpromoting them to return to
(13:16):
health and wellness. I suppose,under the DVA model, they have a
definition of psychosocial rehabwhere they have said it's a
broad term used to describe aset of rehabilitation
interventions which may improvea client's quality of life, and
in so doing, support achievementof their overall rehabilitation
(13:36):
goals. In dva, PsychosocialRehabilitation is delivered as
one element within the continuumof support, which may include
treatment, vocationalrehabilitation and medical
management. So we often look atactivities to support this
(13:56):
process. It may be sporting andrecreational activities, maybe
clubs, groups, classes, maybeshort courses, being programs,
also life skills programs. Soparenting programs, anger
management programs, financialcourses, oftentimes we see the
(14:18):
barriers to psychosocial wellbeing social, so a lack of
connection with others, whichhas huge health ramifications,
and it's something that would bequite keen to go into. Next is
looking at social isolation andloneliness and some of the
research around that. Oh,
Andy Fermo (14:38):
that's a massive one, isn't it? When we talk
about socialization andconnectedness. For in this
opening part is that when youfrom lived experience and then
talking to so many other gueststhat have been is that when
you're disconnected in that sortof way, especially when it's
medically and it's not underyour own terms, I try and liken
it to when you see that warningthat comes in, and you try and.
(15:00):
Pull a USB from the computer,and there's a lot of the time.
Now, if you've got lots ofinformation passing through
there, and you disconnect it,it's going to be all jumbled up,
and it's not going to work aswell. So that's the way I try
and see that those bits. Now,you're like, how do I piece
those bits together again? Or,how can I do that? Or how can
someone guide me to do this? Ifthat's happened, we were talking
(15:21):
about the social isolation andsome of the statistics behind
that, you said that were quitealarming. Could you share some
of those bits in regards towhat's happening in that space?
Statistic wise?
Unknown (15:35):
Yes, absolutely. So last year 2023 there was a meta
analysis. So a look at a numberof studies. There were 90
studies that these researcherslooked at, and they published
this meta analysis in naturehuman behavior. They found that
(15:57):
people that are sociallyisolated have a 26% risk of
increased risk of death comparedwith those that aren't socially
isolated, which is huge. Theydid look at the difference
between social isolation andloneliness, and they found that
defining those two areas wasquite important in understanding
(16:22):
exactly what was going on andwhich was more detrimental than
the other. So social isolationis defined where somebody has a
lack of social connection due tobeing geographically isolated or
physically isolating themselves,that it might mean that they
live alone and they just havevery few connections with
(16:44):
people. It's very much anobjective state of being,
whereas loneliness is thesubjective experience of feeling
disconnected and in a state ofdistress because their
perceived, I guess, theirperception of their social
connection is not where theywant it to be.
Andy Fermo (17:05):
That's massive.
Yeah, that's a huge difference.
Unknown (17:09):
And what this research found was that it's social
isolation that is the biggestkiller, and loneliness is
detrimental to health as well.
But it's really that lack ofsocial connection, rather than
the perception of the lack ofsocial connection. And why this
(17:30):
is because, generally speaking,people that are isolated or
lonely tend to engage inunhelpful or unhealthy lifestyle
behaviors, which is detrimentalto their overall health and well
being. They might not leave thehouse as much, not exercise as
much. There's an increase intheir blood pressure. Generally,
(17:54):
there's an increased incidenceof cardiovascular issues,
increased incidence of beingoverweight or obese, and there's
just that sort of negativespiral that happens from there.
So if somebody's not feelingconfident about the way they
look or how they're feeling,they're going to be less likely
(18:14):
to put themselves out there toconnect with others. So at the
heart of this, what I draw fromthis is that social connection
is massively protective forpeople and their health, and we
know that, particularly withPTSD, people avoid and they
withdraw and hyper vigilantabout others and what could
(18:41):
happen, and so they might putthemselves in a position of
being socially isolated. Whattreatment will look to address
so psychiatry, psychologicaltherapy, is prepare them to be
in a place where they canconnect. What psychosocial rehab
will do is provide theopportunities or encourage the
(19:06):
opportunities for that socialconnection. So yeah, that the
social piece, for me, isfundamental, and knowing what's
happening in the community aboutwhat people are offering in the
community, for veterans, or notfor veterans, for anyone that
helps with connecting, and thatsense of belonging is just so
(19:29):
paramount, and
Andy Fermo (19:33):
it's massive. And just so when we talk of when you
mentioned before, so what was itthe 20 what? 26% more likely?
And when you say that could beat risk of death, are we talking
about suicide or elementssurrounding talking
Unknown (19:46):
about, yeah, all kinds of death. It might be cancer
related issues. It might becardiovascular related issues.
So generally, there's morecomorbid issues that happen with
that population. The lonely orcyber
Andy Fermo (20:01):
isolated. So it might not necessarily just be
that one mechanism of, say, asuicidal ideology, that might be
doing it, but that could be avery big precursor through
isolation. And obviously there'sother factors as well that can
come in on board, but that's amassive statistic from if you're
talking about 10,000 veterans,and if you're all socially
(20:23):
isolated, just say during covid,so to speak, that 26% increase
as a lot, right? Yeah. So
Unknown (20:30):
it's a big number, yeah, it's very much
statistically significant. Needto do something about it and
address that core issue of thelack of connection. What is also
interesting is that adult menhave the fewest friendships of
all other demographics, andtypically, we see a higher
(20:52):
incidence of men that enter themilitary and consequently leave
the military. Certainly, there'sa big female population now, but
still probably more dominated bymales, and that is always at the
back of my mind when workingwith male veterans, is who are
(21:15):
they connected with? There'salso a staggering statistic that
80% of the defense or veterancommunity have relationship
breakdowns compared with the 50%in the civilian space, wow.
Yeah. So it's mostly attributedto the fact that military
personnel have had to work awayso much and that just causes
(21:38):
fractures in relationships.
Additionally, in the veteranspace, when somebody's gone
through that transition ofleaving the military and
becoming a civilian, that spaceis so tricky and is fraught with
difficulty, and relationshipsoften suffer because of it. So
the relationships can be thecollateral damage from the
(21:59):
occupation or leaving theservice as well, and without
those protective personalrelationships, without
friendships or otherconnections, that does leave one
to be very isolated. Well,
Andy Fermo (22:18):
I think, yeah, and you really come on and touched
on a really important point,Jill, because when you've got
there's a few things that youtalked about there, you've got
the transition, then you've gotthe relationship piece, and more
often than not, a lot of thosethings are happening
concurrently. So if you'rehaving to deal with lots of I'm
dealing with one I've got areally full plate. Then I'm
dealing with a relationshipbreakup, then I'm also dealing
(22:40):
with having to work through myown trauma. If I'm seeing
someone that's huge, that couldreally then make them withdraw
into that shell. And this iswhere that real, the importance
of that psychosocial connectionis, I think, as a bloke now,
that's, I'm in my 40s, right?
And just the thing is, as amale, it is harder to make new
friends because you're so usedto either whether you're army
(23:02):
mates as well, or a new cohortof people that you go up. I
might have trust issues orlearning to be able to we might
be walking alongside, but youhave you earned that actual
trust there to be able to go,Look, I'm gonna call you my mate
type. That's huge one, and toreintegrate it into like a
civilian setting is can be verydifficult if you're not okay.
(23:22):
I've lost my mates, and I lostthat purpose dealing with all
this other stuff that's goingon. But this is the importance
of that, the psychosocial piece,Yeah, isn't that? Now I'm just
going to go out and people knowwhat it is that we've had that
common thing, which is, might bemilitary, first responder, but
now we're doing an activity herethat then I can create some new
friends or have a new meaning.
Unknown (23:47):
Absolutely, yeah, I think that experience for men in
particularly, is quite profound.
Making new friends. Men have adifferent way of connecting with
one another than women. Womenmight be more emotionally
focused, whereas men tend to bemore task and solution focused
and doing and not a lot oftalking about feelings. It's
(24:09):
difficult to then createconnection by being that way.
It's certainly not impossible,and my role is about being
creative and exploring differentopportunities to get people
connected. Yeah,
Andy Fermo (24:27):
and then that's through activities, is a great
one, and which we're talkingabout, because then that way you
could be there and you could dosomething, and as a bloke, we
could be doing somethingsimultaneously. And you don't
need to talk about that examplethat you used with the with the
surfboards, and connected bywith the guys having it, like
the surfboards, the vehicle thatyou're coming in, in that safe
(24:47):
space to do something, um,another example would be, we
spoke about the rallying or cometry surfing and or there's some
forges in especially this iswhat I found. I. With,
especially guys in that aretransitioning out from that,
that Special Forces space isthat, and blokes in general
don't really want to be liketalking too touchy feely. But
(25:08):
thing is, okay, we're talkingabout mental health. What is it?
So there's this activity, apsychosocial activity, that's
based around, you bring this oldfile in, and then you go and
heat it up, and then you do someman bashing. And then by the end
of it, you have this, you breakthis thing down, and then you
remold it, very much like goinginto recruiting from being a
(25:28):
Syrian made into a soldier, intothis nice, beautiful knife, all
right? So that's really manly,right? So this is really cool.
Oh, I want to have a go at doingthat as well. But at the same
time is, the point is that therecould be a group of males in
that sort of same age group. Youdon't need to sing Kumbaya, but
you're there doing an activitythat has meaning and purpose.
(25:50):
And by doing something togetheraround fire, which is that
holistic point, really can help,yeah? Or doing something that's
going to be in the water and I'min nature,
Unknown (26:00):
yes, yes, yeah. The our veterans Forge is a great
organization to military exmilitary people run that two
blokes who had a desire to helppeople forge connections once
they left the military saw thatthere was a need and did
something about it, and yeah,it's wonderful being able to
(26:25):
draw on the resources that arethere in the community that
often very much grassrootsprograms, often being run by
veterans or people who've hadsome sort of experience with or
connection with the military,and that that transition, the
difficulty that brings, hastouched their lives in some way.
(26:47):
Yeah, so yeah, absolutely, it'snot about sharing feelings and
talking. It's again, about thedoing and creating, being
active, and with that comes theconnection. I
Andy Fermo (27:03):
am in this sort of state where it's been
disconnected, you can go intothe shell, which is that, that
social piece where I'm like, Idon't want to see anyone, I
don't want to do anything, andand that can be a real it can be
a real detriment over time,especially when speed prolonged,
isn't
Unknown (27:18):
it? Yeah, yeah.
Absolutely. That socialconnection is just key to all of
this. I think that's that can bea massive element of
psychosocial dysfunction,alongside other barriers, like
unemployment, that lack ofpurpose and meaning that we
spoke about earlier, a financialissue going on, or financial
(27:41):
stress and health issues andconcerns as well. So we look at
trying to address those barriersone by one through various
psychosocial interventions andactivities and like DBAs
definition said it's about thatcontent continuum of care. So
(28:04):
we're one cog in a big wheel. Wedon't necessarily provide the
medical and treatmentintervention, but we will help
people to connect with the rightsupports in that space.
Andy Fermo (28:21):
So when you do this assessment, which you mentioned
at the start, is finding outwhat it is that that particular
person needs, and thencustomizing the to what it is
that they need. So if they need,if they're if the priorities is
that they're looking to havesome some specialists come in
and some counseling, that mightbe the bit to be able to at
(28:41):
least get them down to to astate which then may think
about, okay, let's get yourfinances in order. And this
might be something, the pathwaythat we're going to go down
there one at a time, absolutely,
Unknown (28:54):
absolutely. And we also apply a little bit of scrutiny
around whether somebody's readyto engage in our service. Oh,
that's a big one. Yeah, it's notnecessarily a service that is
for everybody, because we needto in our swim lane and do what
we do best, focus on doing itwell and supporting the people
(29:17):
that are ready for the service.
So we wouldn't look at turningpeople away and leave them
unsupported. We would helpconnect people with the right
services, depending on wherethey're at. But if people are
looking to really engage andcommit to a rehabilitation
program, if they're ready, thenwe want to work with them so
(29:39):
that readiness looks like anability to meet
Andy Fermo (29:46):
us. Oh, okay, so to meet you halfway, halfway,
Unknown (29:51):
we're doing all the work. Then there's something
wrong. The individual needs tohelp themselves and needs to
learn how to put their ownoxygen mask on. And our job. Is
to help them to do that, orencourage them to do that. Yeah,
so there's very realconversations that happen there.
There can be challengingconversations as well, because
(30:12):
if we we're just lettingsomebody maintain the status
quo, we're not doing our jobsand we're not being of service
to people. We're looking toreally get people standing on
their own two feet with whateversupport they may need, but
ultimately feeling that they'veregained some control in their
(30:33):
lives and that sense of purpose.
Yeah,
Andy Fermo (30:35):
that sounds like it's also it's empowering for
them, so when they're ready toempower themselves again, yeah,
at that stage, and that, fromwhat I'm hearing Jill, is that
that part of that is thatwillingness to then meet
halfway, yes. So if someone'sthere, willing to work with you
to customize something thatworks for the for the individual
(30:56):
and their situation, theindividual has to then come and
say, hey, look, actually, I'mwilling to put in that work.
Yeah,
Unknown (31:03):
absolutely nothing ventured, nothing gained, and
everything worthwhile is hard aswell, and then you reap the
reward. So it does take work tobe able to build routine again,
to be able to get out of thehouse, put yourself out there,
make new connections, trysomething new in terms of a
(31:26):
hobby or an interest, and thenultimately, I guess, get back
into the workforce, or some sortof work that you know may not
necessarily be paid work, but ithelps with that sense of
purpose, contribution andmeaning, cool
Andy Fermo (31:47):
and so in regards to that, and when, you know, we've
talked to like, when someone'sready, but what would be some of
the roadblocks from yourexperience having worked over in
the last decade with you know,with the audience, Is that? What
are some of the roadblocks thatstops people that you found at
getting to that point wherethey're ready to meet someone
halfway?
Unknown (32:08):
Look, I think there can be massive medical barriers for
people. So if somebody is veryunwell, whether that's
physically or psychologically,they're not going to be in a
place where they're ready toengage in a rehab program fully,
so they probably need to spendsome time making sure their
treatment is optimized and theircondition is well managed, if
(32:32):
there's a lot of symptoms goingon for somebody that could get
in the way of their engagement.
So I'm talking about painsymptoms. I'm talking about very
significant avoidance symptomsas well. A lot of the time we do
see presentations of PTSD. Wesee a lot of depression,
anxiety, often those featuresare part of PTSD as well. We're
(32:55):
also seeing a hell of a lot ofmusculoskeletal injuries that
are very chronic. So that bringswith it a lot of pain, which
impacts sleep, lots of sleepdysfunction. And whilst we want
to try and support thoseconditions and help with the
management of those conditions,if they're not well controlled,
(33:17):
then that's probably where amedical or service is more
appropriate than our service. Soagain, looking at when whether
somebody's ready and whetherthey're suitable to engage in a
rehab program, it's not reallyworth the investment, because
all of this, like I said,initially, our services are
(33:38):
funded through DBA. So we'relooking at taxpayer funds.
There's an obligation to usethose wisely, so we're going to
get the most bang for buck whensomebody's ready.
Andy Fermo (33:52):
Yeah, and then that's a big one as well,
because you ultimately the goalis to be able to empower people,
then to stand on their own twofeet after a few services, but
not saying that, if you fromwhat I'm hearing, is that if
there's someone at that stage,they're nearly ready, but maybe
not for the full shebang. Isthat guidance, which is still
under the umbrella to help guidethe individual to a service that
(34:16):
might it's like the pre coursework that you need to do is
okay, that's actually working onyourself. Yes, am I ready now to
then have a cup that's fullenough to be able to go, Hey,
I'm ready to absorb information.
I've got some energy here tooverflow now to invest my time
in something like arehabilitation program.
Unknown (34:36):
Definitely, I think what I've always really enjoyed
as well about doing this work isit is a well funded space. So
compared with our public healthservice, and certainly compared
with the National Health Servicein the UK, there are a lot of
resources and supports out therefor veterans, indeed, I think
(34:57):
more so than, say, our local WAPolice. Force the Yeah, the
Federally run programs under dvafor veterans are very good.
There's still a way to go with,with spot for the most part,
it's it's a generous system, andthere's funding there for
veterans to receive the care andthe treatment that they need,
(35:18):
most importantly, and then thosesecondary services, the Allied
Health sort of services as well.
And then
Andy Fermo (35:25):
some massive space, though, and you've mentioned it
a few times, is that navigation,isn't it, that if you don't know
where the stops could be, orwhat, if you don't know where
that those parts are, or thesegues from along that journey,
that's part of what you guys arealso as being of service there,
external to the actual like aspecific program is helping
(35:47):
people navigate what'savailable. Yeah, like there is
so much out there. Isn't thereso
Unknown (35:52):
much, it can be a real minefield for people, like
overload, right? Yes,definitely. When we're looking
at somebody that might havePTSD. We need to be mindful that
they potentially can't accessall of their brain all of the
time, and so there is that senseof overload. They often are
(36:12):
operating in that real fight orflight mode, and we need to do
some of that legwork for them inhelping them navigate the chaos.
I suppose what is worth speakingto is the organization where I
(36:36):
work in Site Solutions Group wasfounded by three women who were
previously working for theCommonwealth rehabilitation
services, which was a federallyrun department that would
actually support militarymembers as well as veterans with
all of these services, thatdepartment was then shut down,
(36:58):
and so A lot of those servicesended up becoming privatized,
and my three directors builttheir business insight solutions
group because they wanted tocontinue to work with this
population of people. So thereis a lot of wisdom there, and a
lot of experience with, youknow, the entire history of the
(37:20):
Department of Veterans Affairs,the Australian Defense Force as
well, and we are pretty adept athelping people navigate those
systems. I bring a slightlyunique set of experience as
well, having worked on with thetri services and some of the
subgroups within those services.
So I mentioned before RAF base,Williamtown, I was also at
(37:43):
singleton infantry base when Ireturned to wa I've I worked at
hms. Yes, thank you. GardenIsland, Campbell barracks as
well. Okay, so there's been thatArmy, Navy, Air Force exposure,
worked with Submariners, workedwith SAS Special Forces and
(38:03):
clearance divers as well. Andbringing that into an
organization that works withveterans is super helpful,
because we're able to understandwhere it all started for people,
what that military experiencewas like, what it's actually
like to be in a submarine andwork in those incredibly unique
(38:28):
environments. I think for you,it's probably second nature.
This is all normal stuff, butfor civilians, it's not normal.
It's incredibly unique. And alot of the health professionals
working with defense or exdefense members don't
necessarily understand what it'sreally like to be in those
(38:49):
environments. So I think that'sa helpful element that we can
offer.
Andy Fermo (38:55):
So having that lived experience in the space, even
from a provider that's actuallybeen there that's like, okay,
cool. I'm speaking with a cohortof people from this space. And
an example would be a single theguys at Singleton, yeah, that's
primarily a training facility,and so the needs of those
members would be a little bitdifferent as to someone that if
you come across all the way fromthe East Coast to the West
(39:18):
Coast, and let's use theSterling and sub mariners,
that's a different environment.
Again, it's primarilyoperational. They're even the
full time service, and theirconditions are a little bit
different, even though you mightbe in close proximity. I'm just
thinking about how those guyslive pretty much on top of each
other. You can't get away.
There's that aspect, you'regoing away for a long time,
(39:40):
that's one bit. Yeah, soisolation from from immediate
support group could be onething, and loved ones, you know,
and all those things. And thenif we're going over to somewhere
like the SAS, the camel barracksin Perth, I'm just thinking,
there's a lot of, there's a lotof compartmentalization with how
you're going to go about it. Sothen trying to find a way that
works for people. And theirsituation when they can't
(40:01):
divulge all their stuff thatthey're experiencing would be
okay. How can I talk? Or how canI connect with a with the
individual that's working inthat space? Yeah, to be able to
say, okay, but we're not, I'mnot asking you about your
operational details. Let's see,but let's talk about you as an
individual and what you'reexperiencing, and what we can
Unknown (40:19):
help is that, yeah, absolutely. I found that showing
that we can speak the language,because there is a real
difference in the languagebetween military and civi
Street, that that's everything.
We don't have to get intodetail. In fact, we don't want
to, and that's not our role.
It's just about having thatempathy around where it all
(40:41):
started for that person.
Andy Fermo (40:43):
That's a big one.
Isn't the empathy. You don'tactually have to be walking in
that shoe. It's justempathizing. It's just, let's
walk a lot inside with you andexplore in lifeline. They call
it being walking with someone orbeing with someone in their
pain, right? You don't actuallyhave to be the person that's
jumped into it, because you'reactually guiding them through.
Someone pulls you into it. Ifthey're drowning, and they pull
you in. They want to be twopeople drowning. You want to be
(41:06):
here's the lifeline boy typething. Yeah, and you can
empathize with they're goingthrough something. Yeah, we
don't need to rip open the
Unknown (41:15):
wound. No, no, that's right, absolutely. I like to use
the analogy of driving a car,and the individual I'm working
with, I really force them to bein the driver's seat. They're
driving the car, and I'm in thepassenger seat, maybe looking at
the roadmap. Maybe the roadmap's upside down, and we're
(41:35):
trying to navigate our wayahead. But the crux is, there's
somebody there in the passengerseat reading the roadmap, and
the individual is in thedriver's seat. They have
control. They don't have tonecessarily follow the
directions, because it's theirlife. And
Andy Fermo (41:55):
that is, it is very true. And on that yesterday, or
just recently, I was talking tosomeone, well, two people just
recently, and we're talkingabout this navigation and the
driver, because people in themotorsport industry that are
helping out with these programs,and a critical part of, say,
rally or motorsport racing, ishaving someone as the Navigator.
(42:17):
The driver might be driving at200 kilometers an hour, or
whatever it is, through thebush, let's say in a rally. And
the navigators like reading thismap. Okay, easy, left, easy,
right. We've got a big hairpinturn here. Now they're just
saying what's ahead? What'sahead in on that map? Yes, but
ultimately, what you're sayingis that drive is in control of
how they go around it, right? Soif we've got a hairpin turn
(42:39):
that's 180 degrees, I'm going tohave to do some things, knowing
that the navigators saidsomething's coming up. Yes, and
we've got to make that action.
But ultimately, that drivers inthere, the navigators just in
the seat, strapped in tight,right, holding on for dear life,
Unknown (42:56):
yes. And the what I see there is, there's a team, yes,
it's not doing it solo, it'sdoing it together and being
connected, and sometimes beingshown the way, or sometimes
being allowed to explore wherethat way is. And that's the
(43:16):
beauty of the role that I sitin, is I never know really where
we're going to go, but it'sabout trusting the process and,
yeah, and allowing eachindividual to really make their
own way. Yes, yeah,
Andy Fermo (43:35):
I think. And that's the thing, though, isn't it?
There's a saying in the militaryas well, you can be lost. Lost
is one thing and then, but thenthere's that other saying, we're
trying to flip that coin is, Icould be lost for a little bit,
but then they have a bit of acry. And they used to say, oh,
Nate, have a cry. Get it all outcry. Bring your mom. That's type
thing. And then, but when yousit down to it, you can go, I'm
(43:56):
actually just geographicallyembarrassed, alright, so not
lost. I'm geographicallyembarrassed, and I just need to
find a way go introspective andthen have you cry, or whatever
it is, and this is from amilitary perspective, so I don't
want to trigger anyone here orput anyone I'm not putting
anyone down and just thinkingactually I'm geographically
embarrassed. But what is it thatI need to do now to be able to
(44:18):
get out and from a navigationalpoint of view, that one of the
tools was called a resection.
Let's find some bearings aroundhere. Jill might be holding the
map upside down, so we're goingto look for some landmarks that
are here, and then we're goingto then triangulate to see where
we are, and then from there, andthen maybe find a way to go
through these destinations. It'snot the destiny, the destination
(44:40):
is the goal at the end, but thatjourney and the learning and the
growth comes from actuallydoing, isn't it? And
experiencing those things fromthe individual, actually
experiencing those things, andhaving a go, yeah? Being
introspective at what works bestfor them. That's what I'm
hearing.
Unknown (44:57):
Yeah, yeah, absolutely.
I think having. A Go is key, andsometimes we have to encourage
somebody to fake it until theymake it, which I feel like
that's what I'm doing today on apodcast. It's just about trying,
and it's maybe about havingsomebody's hand to hold whilst
jumping into the deep end. We'regoing to be there no matter
(45:19):
what. Jill, I
Andy Fermo (45:22):
was guiding that today, so the powers out, blah,
blah, blah. And I'm like, I'vegot just a backup. I've got a
backup here. I've got the I gotthe power bank. We're going to
do the Okay, I want to do this.
And then I came here and she'sgot all of the notes, all the
stuff that we're talking about.
And it's just an amazing processthat's happening. So she's dived
(45:43):
into the deep end, and we'redoing it
Unknown (45:44):
right? So by example, yeah, you're my navigator
Andy Fermo (45:48):
for this part anyway, yeah,
Claire Fermo (45:55):
join us next time for the next episode of the
invisible injuries podcast.
Don't forget to subscribe formore great content. Follow us on
our socials, on Instagram, andyou can also visit our website,
www.invisibleinjuries.org.au.
Where you can access morecontent. Thank you for listening
(46:16):
to invisible injuries. You
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