Mental health conditions among Australian defence force veterans: A systematic scoping review

OBJECTIVE: To review Australian research reporting on the mental health of Australian Defence Force veterans, identifying the most documented mental health conditions and populations within this group and summarising approaches to study design and measurement. METHODS: A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines on PsycINFO, CINAHL, Cochrane Trials and MEDLINE databases, supplemented by screening key Australian government reports. Eligible sources were quantitative studies published from 2000 onwards, which included currently serving and ex-serving Australian veterans, and reported rates, frequency or severity of mental health symptoms or psychological distress. RESULTS: Of 2771 records, 118 studies met inclusion criteria. The majority were cross-sectional (61.0%), followed by prospective cohort/longitudinal studies (16.9%) and retrospective cohorts (9.3%). Participants were predominantly male and of middle to older age (45 years and over). Women, Indigenous Australians and LGBTQ+ veterans were rarely reported separately. Vietnam-era and mixed-era cohorts were the most common sampling context. Post-traumatic stress disorder, depression, anxiety, alcohol use and psychological distress were the most frequently documented mental health conditions in veteran populations. Notable heterogeneity in mental health measures, cut-off scores and assessment periods were observed. CONCLUSION: Published research on the mental health of Australian veterans is methodologically and chronologically heterogenous. It is currently focused on men's experiences of post-traumatic stress disorder, depression, anxiety and alcohol use. Coordinated, inclusive and methodologically consistent research is required to inform future research and policy in the current context of veteran mental health reform.