80. Dr Alex Lim - On veterans’ mental health: the good, the bad and the promising

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My guest today is Dr Alexander YC Lim, who is an Adjunct Associate Professor of Medicine with the Queensland Brain Institute. He is a Psychiatrist in private practice, and now almost exclusively looks after members of the Australian Defence Force, the Australian Federal Police, and the veteran community more broadly.

In 2019, Dr Lim set up Australia’s first integrated ketamine program for veterans, known as the ReVive Ketamine Program. Starting in February 2023, this program will become the subject of an ethics-approved clinical study into the long-term effectiveness and safety of ketamine for treatment-resistant depression and treatment-resistant PTSD.

Dr Lim joined me today to discuss some of the mental health challenges faced by our veteran community and to shed light on some emerging treatments that could aid them on their path to wellness.

Some of the topics we covered are:

• Dr Lim’s entry into psychiatry and veteran mental health
• The current state of veteran mental health support
• Difference between civilian and military/emergency services stressors
• Understanding the impact of stress, trauma, and PTSD
• Post-Traumatic Stress Disorder as a multi-system dysfunction
• Total and Permanent Impairment and associated challenges
• Moral injury and what causes it
• How stress affects our physiology, decision-making ability, and ethical frameworks
• The need to indoctrinate appropriate ethical frameworks as early as possible
• Importance of developing trust between the patient and their clinician
• Treating suicidality
• Drop-out rates in traditional psychotherapy treatment
• Why medications are not the ‘silver bullet’ for mental health concerns
• Synaptic Disconnection Syndrome and the effect of PTSD on the structure of the brain
• The issue of treatment-resistant illness and the promise of ketamine
• Preliminary findings and prospects of ketamine for treatment-resistant illness
• How to access the ketamine program for those with treatment-resistant illness

As mentioned in the introduction, you can find Australian Defence Force personnel suicide statistics here.