With 40,000 clients, Open Arms helps some of the country's most vulnerable people and their loved ones.
The government-run counselling service works with veterans and their families grappling with trauma from serving in the military and the challenges of transitioning back to civilian life.
However, on Thursday, senior leaders from the Department of Veterans' Affairs (DVA) said Open Arms' clients were potentially being put at risk.
Appearing before the Royal Commission into Defence and Veteran Suicide, representatives from the DVA and Open Arms acknowledged there was an "unacceptable" situation where key policy documents were potentially years out of date and many were still left as drafts.
The commission's counsel assisting, Gabriella Rubagotti, suggested it was an "absurdity" that several key policy documents — including those covering client care, clinical assessment and data storage — never made it past the draft stage, and had not been reviewed for more than two years, as required by the DVA.
DVA's Leanne Cameron — the agency's first assistant secretary for Mental Health & Wellbeing Services — agreed and said major reform was already underway.
"One of the challenges, for me in taking on this role, has been to ensure that we do have the right settings in place in relation to evaluation, quality and safety," Ms Cameron said.
"That is something that I am undertaking but it is very much a work in progress."
Ms Cameron agreed the out-of-date policy documents could potentially affect client care.
Counsel assisting: Would you agree too that, in those circumstances, out-of-date policy can adversely affect or impact a client because the staff may not necessarily know how to implement the relevant policy?
Leanne Cameron: It certainly has the potential to do that.
Counsel assisting: Given the services that Open Arms provides to the most vulnerable in the veteran community, as you've indicated, do you agree that out-of-date policy making is capable of giving rise to a systemic risk of adverse mental health outcomes?
Leanne Cameron: It has the potential for that.
Counsel assisting: And would you even say even to suicidality and attempted suicide and suicide?
Leanne Cameron: Suicidality is so multi-factorial that it has the potential to do that, yes.
Counsel assisting: In those circumstances, do you think this raises a real issue as to Open Arms' acknowledged accountability to the veteran community?
Leanne Cameron: Yes.
Ms Cameron, and Open Arms national manager Leonie Nowland, said issues such as out-of-date policies were primarily back-end issues and any risks poised "would not be as great" due to high-quality frontline care.
"We engage and employ very experienced clinicians, who are very passionate and committed to the veteran community and their families," Ms Nowland said.
"We do take clinical responsibility very seriously, at the same time as we are looking at the back-office things, such as the systems, as it were, that may not promote opportunities for best practice."
Thursday was the last day of the commission's public hearings in Darwin.
Its next hearings will be held in Wagga Wagga next month, with the commission due to hand down its final report by June 2024.
