Navigating Complexity and Recovery: Reflections from Dr Julie Simes-Phillipps at 12 Months On

At this year’s 12 Months On Conference, the Pro Patria Centre was honoured to welcome Dr Julie Simes-Phillipps, a psychiatrist whose career spans decades in both the military and public health systems. With candour and wisdom, Dr Simes-Phillipps offered a refreshingly pragmatic take on supporting veterans and first responders through trauma, recovery, and the realities of modern mental health care.

Dr Simes-Phillipps began by reflecting on how times have changed in service life: “I’m old enough to remember when, when I first joined in the 80s, we were still having diaries issued and ration packs. So things have come a long way.” Now, as head of a new PTSD ward at Deakin Hospital in Canberra, she is pioneering services specifically for first responders and veterans, work she describes as “absolutely fantastic.”

She provided a snapshot of the ward’s demographic, noting that, “Probably 80% of the cohorts that have been coming through have been male,” and that about half have a military background while the remainder are police, ambulance officers, and other first responders. “There’s a lot of benefit in cohorting,” she explained, but also acknowledged that, “sometimes that needs a little bit of intense management on the ward. Because even though we’re all here as part of the veteran community, there’s a lot of first responders out there, and they don’t have the equivalence of DVA supporting them. So sometimes there’s friction points that have got to be managed around.”

Dr Simes-Phillipps stressed the importance of cultural competence: “That tribalism is really important. You know, I’m ex-green, so, you know, sometimes we’ve all got to suspend our own attitudes about passes and people, public servants and all that sort of stuff. So, you know, again, I think cultural competency is really important in the space of looking after first responders.”

When it comes to the label of PTSD itself, Dr Simes-Phillipps brought a nuanced perspective. “It’s an acronym that we all use, but understanding that there're so many different types of and pathways that lead people to have a diagnosis of PTSD.” She also noted the evolving definition of ‘veteran’: “Especially now with the definition of veteran being someone who served for 24 hours… back in the 80s, someone who was a veteran, was someone who’d served overseas and had active war-like service. And I think for a lot of people, you know, it’s quite hard getting your head around that and understanding what a veteran means. And I think it’s been absolutely fantastic that a lot of that stigma has gone away.”

Dr Simes-Phillipps is unafraid to question established gold standards: “Any of us who work with people who are a bit broken understand that a lot of our gold standards that treat standards, that treatments don’t do jack-shit. And part of the reason we come together in a group like this is trying to understand what are the solutions out there. Because some of our people are pretty broken.”

She champions a focus on functional recovery rather than just ticking boxes on self-reporting measures. “Some of these reporting scales are self-licking ice cream. If you hit anyone at a particular shit storm time of their day, they’re going to look absolutely dreadful. So really try and aim things around functional recovery.”

Her care model is equally pragmatic: “I sort of look at 14-21 days, because that’s about what most people can’t spare too much time outside of their lives… we do all have had those cohort of patients who… spend a lot of years really moving around the country, trying out different wards and different experiences, which is fine, if that’s helping them recover.”

Dr Simes-Phillipps also emphasises the importance of simplicity, collaboration, and respect. “I am definitely a keep it simple sort of person… keep it simple, keep it streamlined, and keep it sustainable, as what I try and operate under.” She is clear: “You’ve got to be collaborative with your patients, especially veteran patients. Don’t patronise them. Don’t do shit to them.”

She warns against getting lost in diagnosis: “You’ve really got to, I think, unpack the person in front of you...there are… a few hundred thousand ways you can get a diagnosis of PTSD… Don’t get caught up in diagnoses.”

Above all, Dr Simes-Phillipps highlights the importance of functional recovery and real-world outcomes: “People’s lives don’t happen in your reviews or your office or your ward. They happen out in their own life. So I think early on… you want to be collaborative with your patient, what are we trying to recover? What? What are we targeting? You know, it might be that you’re able to drop your kids off from school and pick them up. Whatever it is. So simple. Keep it simple.”

As we look to the future, her message is one of hope, realism, and community: “Find your happy space, guys. This is a marathon… look after yourselves. Find however you do that. I think coming together in groups like this, absolutely beautiful, because you can… it’s very hard… you’re very siloed… so find your happy space outside of work and with your own people and with whatever gets your dopamine pottering along.”

Dr Simes-Phillipps’s insights remind us that true recovery is found not just in treatment protocols, but in humanity, collaboration, and creating meaning beyond the walls of the clinic.

Pro Patria Centre, 12 Months On Conference Team