When Steve Ager first enlisted in the Australian Regular Army as an eager 19-year-old in 1980 he didn’t know his 27-year military career would end with him being classified as totally and permanently incapacitated — TPI, as it’s known in Defence — due to post-traumatic stress disorder. But he did know anyone who talked openly about health was dubbed weak.

“Pretty well the day you start your recruit training, there’s the person that will continue with training no matter what, and there’s the person that will attempt to access medical treatment at the slightest hint of something hard,” he told Crikey. “If you go to the regimental aid post [medical aid], you’ll get a reputation for yourself as being a softie and trying to get out of things.”

The unrelenting demand for toughness, an attitude that permeates the military, has a name. “The warrior culture is alive and well,” Ager said. “‘Have a cup of cement and harden up’ is a common catch cry.”

For Ager, this meant hiding his symptoms of post-traumatic stress disorder from the military for 20 years — partly out of ignorance, partly out of fear.

“I just thought everyone in the Army who has been in a long time felt like this: the flashbacks, the nightmares, the difficult sleeping, the anxiety, the depression,” he explained. But Ager says there was always an understanding that if you admitted to suffering from mental health issues, there’d be repercussions. “You know if you declare it, you’ll get the sack.”

He says he first developed symptoms of PTSD in 1986 but didn’t tell anyone about it until 2006, when he chose to leave the Army. “I didn’t declare it until my final medical to get out of the Army, because I was part of the system and the system said shut up and get on with it,” he said.

Military service and training in Australia can be just as psychologically damaging as overseas deployments, says Ager. In 1986 during an army training accident, a tank rolled over and killed Ager’s best friend, with Ager left responsible to climb into the tank with his mate’s body and deal with the live ammunition.

During a deployment to the Malay Peninsula in 1986, one of Ager’s soldiers self-mutilated in front of him. Several years later two young soldiers in Ager’s squadron were killed in a motorcycle accident — he was charged with informing the families, pack up their rooms and return their belongings to their families.

“I talk freely about it now, but it’s taken me years to arrive at that point of time. It cost me a family.”

The violation of human rights he witnessed during his posting to East Timor in 2000 affected him deeply. Ager reels off a list of horrors: the murder of three UN civilians in Atumbua, the death of Private Leonard Manning (a New Zealand soldier whose body was mutilated), orphans, horrific wounds, being sent to find a dead body, investigation of women being r-ped, children being s-xually abused.

“I talk freely about it now, but it’s taken me years to arrive at that point of time,” he said. “It cost me a family.”

It was by chance Ager was diagnosed with PTSD. His second wife, Naomi, was suffering from her own mental health issues after a navy career and deployments to East Timor and the Solomons (Ager’s first marriage broke up mainly because of his undiagnosed PTSD issues, he says). Ager drove Naomi to a grief counsellor weekly, who quickly identified his PTSD symptoms and suggested he come for counselling as well.

He did, but he didn’t tell his military bosses. He kept his mental health issues quiet until his final medical exam in the Defence Force, when he broke down. The civilian doctors that examined him declared him “Class 3” (temporarily unfit, the same level as a broken leg). Three years later the Department of Veteran Affairs certified him as TPI due to PTSD from military service.

Ager has left the Defence Force, but he says most of his friends are still military people — “I find it hard to relate to those who haven’t served” — and just three weeks ago he received a call from one who admitted he was suicidal. The friend was a soldier who left the army last year after a long and successful career, including several overseas deployments.

Suicide and reckless behaviour is a reoccurring issue with veterans. says Ager. “They’re driving cars down the wrong side of the road, they’re being public nuisances, they’re poisoning themselves, hanging themselves in their sheds where their families can see them, drinking or drugging themselves to deal with it. This warrior culture they are indoctrinated with means they don’t seek help.”

And if Defence personnel or veterans don’t seek help — or have a family member who does — there’s not much the Veteran Affairs or Defence departments can do. “They [DVA] don’t push or monitor you. You don’t have a standalone case manager,” said Ager. “You can go to see the Veterans and Veterans Family Counselling Service or ring to get mental health help and once you’re in that network you can fall in to different programs. But if you don’t wish to take them up on the offer, they are just happy to have you out there until you’re about to put a rope around your neck.”

The upper echelons of Defence and DVA have declared destigmatising military mental health issues a priority. Ager is understandably sceptical.

“If I slipped through the cracks, there has got to be literally thousands of others that the same things have happened to,” he said.

* Free, confidential counselling and support is available from the Veterans and Veterans Families Counselling Service for Australian veterans, peacekeepers and their family members. VVCS can be contacted 24 hours a day on 1800 011 046. For non-military help or information visit beyondblue.org.au, call Lifeline on 131 114 or visit this page for a detailed list of support services.

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