Former naval officer Angela Cooke spent nearly a decade standing on the bridge of a warship overlooking the ocean.
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Medically discharged after deployments in Iraq and Bahrain due to trauma sustained during service in her late 20s, and later diagnosed with post-traumatic stress disorder (PTSD), the irony is not lost on Ms Cooke that she's found healing back on the waves.
"[Before surf therapy] I was sitting in the car park and I just remember thinking, 'I don't want to go surfing. I just want to die'," she said.
"But by the end of the first session I had this huge smile on my face. I got to my feet and I felt this real sense of freedom and accomplishment.
"I was hooked."
Historically, ex-serving Australian Defence Force (ADF) members have been more likely to die by suicide than the general Australian population, according to the Australian Institute of Health and Welfare (AIHW).
Compared with the Australian population, suicide rates between 1997 and 2020 were 27 per cent higher for ex-serving ADF males and 107 per cent - or 2.07 times - higher for ex-serving ADF females.
A 2020 review of 'qualitative and quantitative research evidence' of surf therapy, published in the Global Journal of Community Psychology Practice reported, for veterans, surf therapy provided respite from symptoms of PTSD, decreased stress levels, depressive symptoms and use of narcotics, and an increase in feelings of self efficacy.
Veterans Surf Project instructor Rusty Moran told ACM the immersive and social aspects of surf therapy were among the reasons it worked so well for veterans.
"Military people love adventure ... surfing recreates that camaraderie and the adventure of military life," he said.
"[But] you fall off the surfboard and you fall into the water, you don't get blown up or injured.
"Then, you know, back in the car park, they're all bragging about who got the best waves and then we go for coffee and they're still talking about their rides and then conversations go a bit deeper without them realizing it."
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The Veterans Surf Project, based at Gerroa on NSW's south coast, has previously received funding by the Department of Veterans Affairs to deliver surf therapy to veterans.
A spokesperson for the Department of Veterans Affairs (DVA) told ACM it administered "a range" of grants programs to help veterans and their families, although surf therapy was not currently endorsed as medical treatment.
"Any new or alternative treatment supported by DVA must be empirically validated to ensure it meets veterans' needs, provides safe and quality health care, and benefits veteran mental health and wellbeing. There is currently a lack of evidence to support surf therapy," a department spokesperson told ACM.
"Alternative therapies, such as surf therapy, can be a beneficial psychosocial support and funding for such therapies can be considered on a case-by-case basis where it may support an individual's psychosocial needs and assist in their recovery."
Surf therapy is the subject of Mr Moran's masters research at the University of Sydney.
He hopes to deliver further evidence of the effectiveness of the treatment to the government through his research and propel the DVA towards fully funding surf therapy across the country.
For Angela Cooke, its been 14 months since she hit the waves and it's now the predominant tool she uses to manage her mental health.
"Everyone talks about how you need to be present in the moment. The thing about PTSD is if you're thinking about the past, which is ultimately where you get stuck, or you're thinking about [the future] ... when you're in the surf it's very easy to just be there," she said.
"The ocean is a beast. Some days, if you're having a bad day, the waves are smashing you, you can have a cry or have a scream and it feels like the the turbulence of the waves matches how you feel on the inside, but you fight through it and then you get out the back and it's just this calm, serene, floating.
"It's total immersion."
Need help? There is support available.
- Suicide Call Back Service 1300 659 467
- Open Arms 1800 011 046
- Beyond Blue 1300 224 636
- Defence Member and Family Helpline 1800 624 608
- Lifeline 13 11 41