Suicidality, care access, and knowledge deficits lead priorities on blast overpressure/mTBI in an Australian special operations forces survey and their implications for evolving U.S. Warfighter brain health initiatives.

INTRODUCTION

Blast overpressure (BOP) and mild traumatic brain injury (mTBI) create persistent health, readiness, and care-navigation challenges in Special Operations Forces (SOF). We conducted a stakeholder-informed needs assessment to identify priorities within an Australian SOF-affiliated community and to consider, without assuming direct generalizability, how those priorities may inform allied brain-health implementation.

METHODS

An anonymous web-based convenience survey was distributed through established Australian SOF-affiliated networks (187 submitted records). The purpose-built instrument collected demographic, service, BOP-exposure, symptom-category, community-issue, audience, tool, and educational-format information. Analyses were descriptive; ranked items were summarized with weighted priority scores.

RESULTS

Among respondents to the nationality item, 96.2% were Australian; 97.3% of all respondents were male, and 56.6% of service-status respondents were Veterans with SOF backgrounds. Median self-reported career BOP exposure was 13.5 years. Perceived medical-knowledge deficits, difficulty obtaining timely information, and limited access to specialized care were leading community issues. Suicidality, depressed mood and isolation, chronic brain changes, and attention/executive dysfunction received the highest weighted symptom-priority scores. Exposure-history estimation, event tracking, and self-administered baseline or symptom-monitoring tools were prioritized. Brief videos, linked reading materials, and testimonials were favored formats.

DISCUSSION: These findings provide directional, Australian-specific guidance for co-design and implementation testing under Recommendation 61 of the Royal Commission into Defence and Veteran Suicide. Their convergence with a separately conducted U.S. SOF-affiliated survey identifies candidate allied implementation themes, but the Australian sample should not be treated as representative of Australian SOF as a whole or directly generalizable to U.S. military populations.