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.