STEVE CANNANE, PRESENTER: Former commander of Australian Forces in Afghanistan, retired Major General John Cantwell has written about his own struggles with post-traumatic stress disorder in his book Exit Wounds.

He joined me earlier from Maroochydore in Queensland.

John Cantwell, thanks very much for joining us.

JOHN CANTWELL, MAJOR GENERAL (RET), FMR COMMANDER OF AUST FORCES IN AFGHANISTAN: Your welcome, thanks Steve.

STEVE CANNANE: From the story we've just seen, we got a sense of the kind of benefits that peer to peer counselling can provide for veterans. What are your thoughts on this kind wilderness therapy as Dogs Kearney calls it?

JOHN CANTWELL: I think it's fantastic. Any sort of activity that gets veterans into a situation where they feel comfortable, where they can trust those around them and open up and talk about issues that are troubling them has got to be a winner and this is a winner of a proposal.

STEVE CANNANE: You said "trust". How important is that because I know that when you sought help initially when you had post-traumatic stress, you came across people who didn't really understand your situation?

JOHN CANTWELL: Yeah, look trust is a vital part of it. It's really hard for someone who has been through a stressful situation, whether they're a veteran or even more broadly a police officer, ambulance officer et cetera, but let's talk about veterans. They do feel as if they're a distinct group and have had unique experiences and it's therefore part of their culture to share with their mates who have been through something similar. It's very hard therefore for them to open up to a physician, a psychologist or even a bureaucrat. They feel much more comfortable where there are certain understood elements to their story and then they can talk about their own place in it.

STEVE CANNANE: A paper recently delivered at the Australasian Military Medicine Conference provided evidence that this program is actually working according to the study of those who met the criteria for severe stress before they went on Trojans Trek, 78 per cent of them did not meet the same criteria two months afterwards. Do organisations like this need more funding, more resources?

JOHN CANTWELL: If those figures are accurate and I've got no reason to doubt it because it is a wonderful program, I know something about it and I know both the guys who are running it - it's tremendous to see those sort of outcomes. If we can take that model, that process, and apply it elsewhere, why wouldn't we? I know from my own experience that being able to talk about the issues was just such an important part of starting to heal. Once you start to talk things get better but if you bottle it up that's when real problems can arise.

STEVE CANNANE: I'm wondering what you think about the role that it plays for the mentors as well. These are men who've suffered post-traumatic stress themselves but this is giving them a purpose, isn't it? This is providing worthwhile work for them to be doing, to be putting back into the veteran community and to the younger generations.

JOHN CANTWELL: Look I think what they're doing is just tremendous. It's heroic. It's not easy to open up because they tell their own stories and that's hard so they're offering private insights, they're trusting those younger guys with their stories and that's why it is so powerful because they then feel able to respond and open up. I think it's just tremendous. I know both of the fellows concerned.

Dogs Kearney was one of my instructors when I was a young guy and Moose Dunlop is a man of great insight with a tremendous plan. I think what they're doing is absolutely fantastic and I just wish that they didn't have to now scrape around for funding, you know, do fundraisers and the like. Why don't we fund them? It's not expensive, surely, and it's something I think we could afford to do.

STEVE CANNANE: Over 25,000 Defence personnel have served in Afghanistan over the last 12 years. You're concerned that the end of the mission will bring on even more cases of post-traumatic stress. What are your concerns?

JOHN CANTWELL: My concern is that not only are there people who are already presenting with post-traumatic stress symptoms as a result of their service, whether it's in Afghanistan or whether it's the navy crews who are doing that difficult and very disturbing work rescuing or recovering the bodies of boat people arriving off our borders to the north-west of Australia, it doesn't matter who you are, these are profoundly important issues that affect the individuals and affects their families.

I know from my own experience that these can be really corrosive situations and it's so important that we, as a society, as Australian people, we should recognise these people and I think we do increasingly but we now need to take the next step and provide proper resourcing, proper funding, proper frameworks so that these people who have done so much for us can be looked after when they need some help.

STEVE CANNANE: Because the mission is finishing, does that mean the lid is coming off in a sense, that some of these men and women would have been going back and back and back and keeping lid on it but once that mission finishes then maybe that pressure cooker explodes? Is there something like that?

JOHN CANTWELL: Look I think there is something. There's two issues there. Repeat exposures, I think are now an accepted factor in the development of post-traumatic stress disorder so we've had lots of people being repeatedly exposed to things that have shocked, horrified and disturbed them, so that's a factor. The fact that they are no longer in operations and perhaps thinking about leaving the service, and they will eventually, there is a time factor as well. Not everybody presents straight up. Not everyone starts to show the symptoms or even be aware they have them but they do eventually come out and the time lag is simply unknown. It can be months, it can be many years and we just need to be ready to accept that at some point in the service and in the post-service lives of our veterans and other first responders in our community that they may well struggle and we need to be there to help them out.

STEVE CANNANE: In Exit Wounds, you wrote about how you were haunted by the lives lost in Afghanistan. I'm wondering if it weighs heavily on you what' happening to these young men as they come back in society and as they're struggling like Mick and Sean in that story we just heard before, as they're struggling to adapt back into civilian life?

JOHN CANTWELL: I do worry about them. I worry about them a lot and they are just two examples of thousands of veterans either having these issues or are likely to have them. About 20 per cent of all those we've sent to the various wars that Australia has been in, and other traumatic things like rescuing or pulling from the water men and women and children who are trying to get to this country. Those things will leave a mark and it just is a sad fact that their service, their honourable, proud service to our nation is likely to leave a scar on them and it will affect them and it will affect their mates and affect their families.

STEVE CANNANE: Let's talk more about had families because we know from the Vietnam Veteran experience that the children of Vietnam Veterans are three times more likely to commit suicide than the rest of the population. Are these the forgotten people in these circumstance and do we need to do more about providing counselling to help them?

JOHN CANTWELL: I think we do need to do more about our families. They are certainly those who bear the brunt of the occasion al bad behaviour, if you like. The symptoms of PTSD, the mood swings, the anger, the sense of distance and isolation perhaps, you know, drinking too much, all of those symptoms.

The first ones who cop that are the family and particularly children who are so vulnerable and easily confused about these issues and, as you've just said, it can have knock-on effects. I speak to see many groups of veterans and families and all sorts of people in our community and I hear often people say, "My family was broken by my dad's service," say in Vietnam, "I never had a relationship with my dad."

Now, I'm pleased to hear that they now perhaps understand better why but that doesn't solve the problem for them or all the thousands and thousands of other families. We need to do better for our families. We need to help them understand the issues because in many cases they are confused. They don't understand what's happening and we need to have a network that reaches out to them. We have veterans' organisation that look after veterans. Fantastic. Who looks after the families? I think we can do better there.

STEVE CANNANE: When I was out bush talking to the returned soldiers, an issue that kept coming up all the time was their dealings with the Department of Veterans' Affairs. They were feeling frustrated, feeling like it was very difficult to deal with the bureaucracy and people at the other end of a phone who may not have understood the horrors that they've been through. Does that need to improve and are you hearing those kind of things to, those kind of complaints from veterans about the department?

JOHN CANTWELL: I do hear people say things about the Department of Veterans' Affairs that they're not happy, not satisfied. I think there's a couple of things need to be said.

Firstly, I think the Department of Veterans' Affairs is an organisation filled with great people who are trying to do the best for our veterans. They care about them. I know many of them. They're good people. They're working within the guidelines, regulations that they have to apply. Sometimes those guidelines don't get the outcomes for the veterans but that's not a reflection on the efforts made by the people in the organisation.

I would say this, the bureaucracy is sometimes a very difficult beast to deal with and it's often the case that someone who's trying to get some support, some assistance, some recognition of their emotional trauma find it very hard to deal with a bureaucracy. They're perhaps at their least able to do that because they are prone to anger, they're prone to frustration and if they're asked to fill out multiple forms and talk to someone who they know doesn't understand exactly their situation, you can understand why that produces frustrations.

I have to say in my dealings with the DVA I was looked after very well. That's because I had an advocate, someone who was independent, did this voluntarily. When I was emotionally troubled I was in no State to deal with DVA in terms of a big bureaucracy. My advocate did it and took all of that off my shoulders and there are organisations, the RSL provides advocacy, the Vietnam Veterans' counselling service has now transformed to the veterans' counselling service, they provide a great asset there in terms of counsellors and also advocates. Why don't we make that a formal process?

STEVE CANNANE: You mentioned earlier that you were concerned about the trauma that people in the Navy may have deal with in the operations to stop people smuggling in the waters in our north. What are you hearing about that? Are you hearing that the sailors are under great stress, getting involved in these interventions?

JOHN CANTWELL: There can be no doubt that they are under stress and strain and, yes, I do know of specific examples of sailors who have had to fish bodies out of the water, who have been unable to make a rescue because of terrible weather conditions and the like and that's got to work on your heart.

It will affect every one of us, would be affected by that and I've got no doubt that there are issues for those folks who are exposed to that type of activity which they're doing in accordance with Government policy. I had a chance to speak to the chief of Navy and all of his senior leadership group just a few days ago about this issue. I know that they're well aware of it.

STEVE CANNANE: Are they concerned about it?

JOHN CANTWELL: Of course they're concerned. They care about their people. All of the service chiefs care about their people and they will do whatever they can. I've asked the chief of Navy if he'd like me to talk to some of them. I'd be delighted to do that and he's I considering that.

But look it doesn't need just individuals, it needs an organisation to be responsive. And I am mostly satisfied that all of the services are now much more attuned to this and much more responsive and helpful of their people.

STEVE CANNANE: John Cantwell, we have to leave it there. Thanks very much for coming in this evening.

JOHN CANTWELL: You're welcome, Steve.