Veterans' Mental Health
01 February 2011
We recognise the importance of appropriate and timely mental health support for people who have served in the armed forces.
To achieve this, the following points are critical to the commissioning and provision of services.
- Commissioners and providers of services need to provide a full range of appropriate and evidence-based interventions for a range of disorders, including depression, PTSD and treatment for alcohol and/or drug misuse.
- Veterans could be encouraged to seek help if there was a better understanding, among primary health care and social care professionals in particular, of the culture of the armed forces, the particular pressures that veterans may be under and the risk of veterans developing mental health problems. There is a strong case for veterans to be involved in awareness training for health and social care professionals who come into regular contact with veterans.
- Veterans themselves need to recognise that seeking help for a mental health issue is not a sign of weakness. Local mental health promotion initiatives could usefully include veterans as a specific target audience. There is an equally strong case for veterans to be involved in providing peer advice, advocacy and support to other veterans who may be at risk, or have an identified mental health need.
- Given the number of veterans who are either within the criminal justice system (especially in prison, where there are known to be very high levels of mental health problems) or experience homelessness or problems with housing, more research is needed into the factors that prevent some veterans from returning to civilian life successfully, so that these can be tackled as a matter of priority.
- Two cohorts appear to be at particularly high risk of developing mental health problems: younger veterans with a relatively short period of service (early service leavers), and reservists who have served in combat zones. Planners and commissioners of services need to take this into account when considering the needs of their local populations, and where resources (including specialist outreach services) need to be targeted.
- Some veterans, such as those leaving the armed forces after a relatively short period of time and younger veterans, receive abbreviated support from the Ministry of Defence in terms of preparing them for the transition from the services to civilian life. The Ministry of Defence should consider how this support can be enhanced so that it reflects existing and likely future need rather than just length of service;
- The 2003 review of support available for veterans (Dandeker 2003) made a number of policy suggestions relating to in-service initiatives, transitional arrangements between service life and civilian life, and post-service life, including enhanced mental health service support and more flexible provision of housing. A number of these have seen good progress over the past few years but the Ministry of Defence and Department of Health should carry out an audit on these suggestions, and commit to action where progress has been slow.
Read a briefing on veterans' mental health.
Overall, levels of mental health problems among veterans are not significantly different to that within the general population. However a significant number of veterans do experience high levels of mental health problems, ranging through anxiety, depression and post-traumatic stress disorder and sometimes involving alcohol and drug misuse. Many do not access services that might be able to help them..
For some veterans, mental health problems arise many years after they have left the services, but may be related to experiences they had in the services. Frequently, the culture of the armed forces results in veterans showing a reluctance to attribute their condition to their service.
The incidence of mental health issues arising from military service is a major issue; since 2005, for example, Combat Stress has reported an increase of seventy-two per cent in the number of former military personnel seeking help. Their current workload includes over 4,400 veterans.
The Government has recognised this issue, and, commissioned the 'Fighting Fit: a mental health plan for servicemen and veterans (PDF file)' report by Dr Andrew Murrison MP, which was published in October 2010 (link below). The report's four main conclusions included provision of a trialled online early intervention service, a veterans' information service, an increase in the number of mental health professionals conducting veterans' outreach work and an inquiry into current mental examinations for serving members of the armed forces. In response, the Secretary of State for Defence, Dr Liam Fox MP, announced that the Government would introduce a dedicated twenty-four hour support line for veterans, and the introduction of thirty dedicated mental health nurses to ensure that the right support is available specifically for veterans.