Beyond ‘are you okay?’
TRIGGER WARNING: The following story contains information relating to mental health and suicidal ideation. If you require any urgent support or assistance around this topic, please reach out to Open Arms via 1800 011 046 or call 000.
Following the Royal Commission into Defence and Veteran Suicide, the Ballarat RSL Sub-Branch is taking direct action. After two veteran suicides in the community, the Sub-Branch has partnered with Lifeline to deliver mental health training, equipping volunteers and first responders with the tools to support those in crisis.
As the Federal Government’s response to the Royal Commission into Defence and Veteran Suicide hit the headlines late in 2024, Ballarat RSL Sub-Branch President Frank Nuccio knew that sadly, it was too late for some.
“It’s the biggest problem we’re facing at the moment,” Frank said. “We’re seeing examples of this mental health struggle every day.”
Last November, in the space of a week, two veterans in the Ballarat area lost their lives to suicide. That one was in their 70s and one was in their 20s shows the insidious nature of suicidality. At any age, or at any stage post service, it can take hold of somebody.
“I got thinking about it,” Frank remembered. “And you say, ‘That’s sad and what can we do’, but we need to be proactive rather than just talking about it.”
It’s that tragic backdrop, coupled with the horrifying reality laid bare in the Royal Commission, that spurred Frank into action.
“What was front of mind, when I was looking at it all, was that we have ‘R U OK Day’ and we only have that once a year. We say to our mates, ‘Are you OK?’ and they say, ‘I’m fine’. But how do we get beyond that when we know there are issues, yet they just keep saying, ‘I’m fine’?”
He acknowledges that pride can be a brick wall when trying to get through to veterans with issues. “How do you break down the barriers to continue the conversation?”
Taking action
After a 2024 Veterans Expo with the Ballarat and District Suicide Awareness Network where Frank spoke with Lifeline, he conceived the idea of a seminar on mental health education for 2025.
Lifeline would be the facilitator of the session, the Ballarat RSL Sub-Branch would host and, with the Ballarat Veterans Assistance Centre (BVAC), bring the community together. Importantly, the Sub-Branch also wanted the session open to first responders such as police, fire, and SES, so it had broader community reach.
The landmark session occurred over two days in February this year.
Frank was in the front row eagerly taking notes across the two days, as was co-organiser Andrew Hamilton, the Secretary of BVAC. Representatives from the Buninyong and Ballan RSL Sub-Branches attended, along with those from the Vietnam Veterans Association and Legacy in Ballarat.
Gordon Hunt, Secretary of the Vietnam Veterans Association in Ballarat, said that, sadly, suicide is a constant in the Vietnam veterans’ community, so the seminar has been helpful in developing tools for those conversations.
“They’re giving us strategies to deal with it, and methods to use those strategies. It’s most important, because people will shut down very quickly if you don’t say the right thing. And once they shut down, you won’t get them back.”
The power of peer support
Gordon believes the education and the peer support experienced at the seminar have left him better equipped to help.
“I’m going to walk away from here more confident that we can save this person. It’s a good course and a good group. Everyone counts; we’ve got to keep these people alive.”
Andrew said that the messages from Lifeline have been enlightening. “I’ve learned that words matter. I’d never heard of the term ‘suicidal behaviour’ and what that entails before today. I’ve also learned we’ve got to be kind to ourselves as volunteers.”
The seminar further illuminated to Andrew the need for funding to ensure this type of education becomes more widespread.
“It places a lot of strain on the volunteers, so the more this can be funded and the more organisations that can come in, the more people we can keep alive.”
“The opposition has flagged potential cuts to Department of Veterans’ Affairs funding after the Federal election; if that happens, more veterans will die.”
Frank Nuccio
Fully subscribed and with an eagerness to help, Frank could call the seminar a success, but he knows that the mental health challenge does not come with a simple fix. “The course has just given me insights as to how to talk to people,” he said.
From there it’s the RSL’s role to use that knowledge as a key pillar of veterans’ lives and connect those in need with the help they require.
Opportunities for connection
Frank is already working on further activities for later in the year when the education process can be used. One is a campsite session, where veterans can come together and talk while exploring the things that make them happy.
“Everyone has a thing that helps their mental health, whether it be riding a motorbike, playing guitar, or going fishing. What’s your thing? It’s not to tell people to take up this hobby or that one, but it’s to show how having something to fall back on helps when you’re struggling.”
It is all part of the evolving needs for both younger and older veterans that RSLs like Ballarat are coming to terms with, an environment vastly different from that of 1916 when the RSL’s focus was on the physical health and rehabilitation of veterans.
While mental health challenges can strike at any age, the Royal Commission has made it clear: this is the most significant challenge for younger generations of returning veterans.
As Frank said, “The role of the RSL is to help veterans and their families, and mental health is where the issue is.”
PTSD and suicide risk
Post-traumatic stress disorder (PTSD) is a well-known risk factor for suicide, but rarely exists in isolation.
“PTSD co-occurs with many other things – depression, anxiety, moral injury… it’s often associated with alcohol or drug use as a coping mechanism, and with relationship breakdowns. All those factors can increase the risk, in addition to PTSD itself.”
The evolving understanding of PTSD as a whole-body condition has shifted treatment approaches. New and emerging therapies may provide better outcomes, but access to these treatments remains inconsistent.
Understanding suicide and suicidality
The Royal Commission into Defence and Veteran Suicide highlighted the complex and deeply personal nature of suicidality among veterans.
Dr Peggy Brown AO, one of the three Commissioners of the Royal Commission, explains that suicidality is not confined to those who have served in war zones.
“Many of the people from whom we received submissions had experiences across Defence and in their post-service lives that were very much related to their suicidality… that was nothing to do with being in a theatre of war,” she said.
The pathway to suicide is rarely linear. Many veterans experience suicidal thoughts without ever making an attempt, while others may escalate from thoughts to action if the right interventions aren’t in place.
“Some people experience suicidality – feeling like life is not worth living – but may not necessarily have suicidal thoughts. Others progress to having thoughts of suicide, then a plan, or taking an action.”
Policy gaps to be addressed
The Royal Commission has identified key areas for policy change to better support mental health and suicide prevention.
“Governments need to ensure that veterans have access to services that meet their needs, when and where they need them.”
This includes:
- Better transition support to prevent identity loss and social isolation
- Earlier intervention for mental health struggles, before suicidality escalates
- Stronger aftercare policies following a crisis or suicide attempt
As the Government considers its next steps, one thing is clear – early action saves lives.
Managing mental health: A lifelong mission
Mental health is not a ‘set-and-forget’ process – it requires ongoing attention.
For veterans, challenges can emerge during service, transition, or even years after discharge. Early intervention, awareness and support can make all the difference.
“One in three veterans experience high levels of psychological distress,” said Dr John Cooper, Consultant Psychiatrist at Phoenix Australia.
The most common conditions among veterans include:
- Anxiety disorders (generalised anxiety, panic attacks, social anxiety)
- Post-traumatic stress disorder (PTSD)
- Depression and substance use disorders.
While symptoms often develop during service, they can also arise due to transition stress, relationship breakdowns or workplace challenges.
“There are many reasons a mental health disorder may develop,” Dr Cooper explains.
“The sooner a person gets help, the better the outcomes.”
A tiered approach to mental health
Dr Cooper outlines three key levels of support:
- Prevention and awareness: prioritising sleep, exercise, social connections and stress management
- Early intervention: seeking support from a GP or counsellor when early symptoms appear
- Specialist treatment: for diagnosed disorders such as PTSD or depression, requiring therapy, medication or both.
This story was originally published in the April 2025 edition of Mufti.
