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NHS England to ask military veterans how to improve mental health services

NHS England is today asking armed forces veterans to share their experience of mental health services and help improve future care across the country.

The launch of a national survey will help improve the care available for veterans as they move from military to civilian life.

The survey is a chance for veterans to share their experiences and views of existing mental health services and to understand the reasons why some people have not sought or received support and treatment.  In addition to seeking views from veterans, family members and carers, as well as staff and organisations that are providing treatment and support in this area are all able to take part.

The NHS currently provides 12 mental health services across England specifically for veterans. They enable specialist staff to care for ex-forces personnel with mental health needs, direct them to the most appropriate service and give them effective treatment.  With new contracts due in the next year, this is an opportunity to develop future services that take account of current experiences.

Dr Jonathan Leach, Chair of NHS England’s Armed Forces and their Families Clinical Reference Group, said: “On leaving the armed forces, most people successfully transition back into civilian life. But some individuals can experience very traumatic situations whilst serving in the military before facing the additional challenges of moving back into civilian life, all of which can take a severe toll.

“While mental health awareness is improving, we can do more to identify issues not just with Post-Traumatic Stress Disorder but with wider problems linked to anxiety and depression. We are asking for feedback from veterans, their families and NHS specialists so that the right care and support is available early and easily for those who need it.”

It is hoped that thinking about their experiences will help to start breaking down some of the stigma when it comes to talking about mental health issues.

One veteran to benefit from the care delivered by NHS staff at the Veterans First Service is Spencer Orchard. Spencer served in the British Army and saw action in the first Gulf War but his experiences lead to him showing the classic signs of Post-Traumatic Stress Disorder (PTSD).  After struggling with anger management problems and adjusting to civilian society, he came to the service run by the North Essex Partnership University NHS Foundation Trust.

After extensive treatment, Spencer is doing well.  He is pursuing a new career as a psychologist and is looking to help others who have gone through similar experiences. He is doing voluntary work at the local university and helping staff with a research project into PTSD.

Meanwhile Tony Stubbs, who served three years in the Army, was also struggling after his time in the military ended. He was referred to the Pennine Care NHS Foundation Trust’s Military Veterans’ Service. Tony said: “I’d be dead by now if the Military Veterans’ Service hadn’t helped me stop drinking and then helped me deal with my mental health problems. Now I’m well, back on speaking terms with most of my family, helping other veterans as a peer mentor, studying at college and looking to get a paid job.”

Tony is one of four veterans who recently trained as a Community Reporter as part of a pilot, commissioned by NHS England, to explore the barriers that Veterans experience in accessing mental health support.

For further details on the survey, please visit: https://www.engage.england.nhs.uk/survey/veterans-mental-health-services

25 comments

  1. Colin Rayfield says:

    Interesting to watch the conversation – where it’s obvious what the problem is by simply following the previous posts.

    One. Those who NEED help don’t ASK for it. But they should be compelled to be consulted, interviewed, and then everybody LISTENS – that’s the key word: LISTEN.

    Two. The NY and LA Police have lessons on setting up Behavioural Science Units, to address such issues.

    Three. The ‘macho’ culture – and ridicule – is what stops those who most need it, from seeking help. But they DON’T – for just those stated reasons. How can a ‘macho’ profession allow someone to show a ‘weakness’ – by asking for help?

    With all due respect – ViroBono appears to be not ‘familiar’ with the real suffering – but wants to TALK about it. Don’t talk – LISTEN.

    No, we aren’t. You say people are in denial, I say that there are barriers to seeking help, but that they aren’t the same thing. What I mean by this is that someone without insight doesn’t know they are unwell, or what their symptoms mean; someone who is in denial knows they are unwell, but doesn’t accept the reality in order to cope with distressing feelings. So I’m keen to know what you think these people are suffering from, and why you think they are in denial.
    ‪ViroBono‬, Feb 4, 2016 >

    I know Australians aren’t popular on this forum – what would WE know?

    Well, what we are doing – started some time ago. We are also about to have a Royal Commission into our ‘DVA (Veterans Affairs) activities’ – and this where a lot of the mental issues BEGIN:
    – DENIALS,
    – DELAYS,
    – and DEFRAUDING Veterans of their entitlements.

    This can prompt SUICIDES from those most vulnerable – BECAUSE of rejections by the DVA – showing little respect for our servicemen.

    And recently it was extended – BY the veterans:

    Convoy cruises through Canberra to boost awareness of PTSD –
    http://www.abc.net.au/news/2016-06-21/convoy-cruises-canberra-increasing-ptsd-awareness/7529926

    A former Australian test cricketer, Tony Dell – and Vietnam Veteran – organised a PTSD Awareness Convoy from Brisbane to Melbourne. The participants were ‘first responders’ – cops, ambos, firies, and military Veterans – all of them subject to PTSD from their traumatic experiences – but many not ‘noticed’ by the public.

    At the same time the Victorian Police Commissioner called for a review of the mental health issues in the Vic Police – they have had 19 suicides over the previous 2 years; that’s 19 TOO MANY. Probably doesn’t compare with British or US Police casualties. But I applaud him for what he has initiated.

    I suggested that the funds will be hard to find – but perhaps if Vic Police were to link up with Defence – and Federal funds were found, then a SHARED facility (Defence / Police) could be utilised by all ‘first responders’ alongside Military Veterans – and they can become contributors to society once more, rather than ‘spat out’ of the system ‘due to mental health issues’.

    The convoy – ‘Stand Tall for PTS’ – has been raising funds on the road trip with vehicles from each organisation participating. I feel that contacting Tony Dell might be a worthwhile starting point, possibly LA and NY Police also.

    I will now retreat from this discussion. We all have to find a solution – there’s too many hurting out here.
    And watching current world mayhem unfold is difficult through teary eyes. (NOT very ‘blokey’ is it?).

  2. Mike Gleeson says:

    I was diagnosed with PTSD. I didn’t know I had it, people around me noticed the change. I lost my job, career and income , plus a lot of friends. My GP is useless. A&E sent me home. I had a relapse. I see a “nurse” every six weeks who tells me “It will get better”. Its not a cut finger.
    If people knew what it was they might be in a position to help.

  3. martin says:

    I have read through all of the comments below and wonder what in gods name is our country coming to, I hope the NHS can help you guys, as we all know you deserve that help.
    Good luck to you all and thank you to the staff od the NHS that are trying their best with such a poorly financially supported role.

  4. Christina Ball says:

    How are stakeholders in this survey being identified and contacted ? I am personally cognisant of mil vets with pensions who know absolutely nothing about this survey ?
    Not rocket science to contact at least military pensioners surely ?

  5. Susan Fryer says:

    I welcome this study because I lost my brother in 2013. He was in the RAF for well over 22 years and he retired in his mid 40’s. Refusing to end up working as a security guard in a supermarket, he did more training and joined a charity in Africa. He worked for this charity for 2 years fitting solar panels to buildings in villages in the middle of nowhere. During this time he used up all of his RAF final payout money. When he came back to the UK, unbeknown to me and my sister he was homeless for 2 years, drinking heavily and was diagnosed with HIV (which he must have caught when he was out in Africa). He was finally scooped up by a charity, put in a hostel then was found a flat. But he had difficulty adjusting and could not sleep in a bed. He walked the streets at night with heavy rucksacks on his back as if he was still in training. He was hyper vigilant all of the time, suffered anxiety attacks and was very depressed. We tried to get him assessed for PTS but discovered there was a 6 month waiting list to be seen. I was taking him to the HIV clinic but they would not start treatment until he stopped smoking and drinking. In short he was in his own personal hell and we (my sister and I) felt completely abandoned. In July 2013, he collapsed in a shopping centre in Horsham, smashing his head against the pavement. He died of his injuries, the next morning. The post mortem diagnosed that he had, had a bleed on the brain that had caused him to collapse. He had no alcohol in his blood at the time.
    My brother was the most intelligent, caring, talented person you could wish to meet and he deserved a longer, better life after coming out of the RAF.

  6. Robert says:

    For me I think it is a lack of training in the NHS in regards to recognizing military related PTSD. Time and time again I went to see doctors about Depression, Nightmares, Flashbacks, suicidal thoughts for over 27 years. I served in Northern Ireland from 1987 to 1989. If it had not been for Combat Stress I do not believe I would be alive now. The NHS let me down badly over those years by not correctly diagnosing my condition and just writing it off as depression and a whole raft of other causes. When you see a civilian shrink they have no real concept of what we went through because it is beyond their training, this needs to be addressed.

  7. Tony says:

    My breakdown happened six years after leaving the army. My GP was very quick to diagnose PTSD, in the initial ten minute appointment. I was then put on a list for the mental health team to get in touch.

    Fortunately my new employer was very good and sent me to occupational health who then referred me for counselling to get me back on my feet. Over a number of months the counsellor worked with me every week and was clear that I didn’t have PTSD.

    He diagnosed depression, anxiety and stress. Some probably due to my personality & character, some influence from my time serving and some my more immediate problems. As we talked it through it became clear I’d been on a gentle decline in mental health for several years. I was off work for four months and took about a year to get fully back to being ‘right in my head’.

    So the GP, who I’m guessing is not an expert in absolutely everything medical, was very quick to pigeon hole me and pass me on. The mental health team took seven months to get in touch – by which time I was well on the mend.

    So I had my new employer to thank for sorting me out.

    As a side note – when I passed my course to be a member of a bomb disposal team in Northern Ireland one of the briefings told us that stress was a normal reaction to unexpected events. In our business we could expect explosions so therefore couldn’t be stressed by them!

  8. M Moss says:

    I was discharged in 2012 and still receive support after extensive support and treatment. I was lucky having an established GP who DCMH was able to write to and suggest continuation of care. However the length of time before referral and initial consultation could leave people at risk of harm.
    Veterans have an especially strong appetite for self destruction and should not be left ‘hanging!’
    Anybody discharging with a history of accessing mental health support should have a note placed in their GP file. If they have no GP then that is another problem!

  9. L Moore says:

    I have had some excellent help from DCMH once I was diagnosed but that treatment is coming to an end. I hope to have easy access to my local NHS team. Someone who I can build rapport with, not just meet sporadically.
    I feel that when a person is in the early post therapy stages, they should be allowed to keep in the loop rather than being left to their own devices or you could very quickly be back to square one!!

  10. Tapiwa Masenda says:

    Mental health awareness is lacking in the armed forces, perhaps it because of the culture that soldiers are meant to be strong. More awareness should be raised whilst still serving as many soldiers have these symptoms but are not aware of them.
    My whole time in the army i was being told to use TRIM which i think is useful if used properly but in my experience it was not effective. It was difficult to seek for help as you would be labelled as the weak link.
    On the other hand i have met some ex servicemen and women seeking help in the NHS and noone seems to understand them.

  11. Peter says:

    Firstly, the army does need to be criticized. They can keep denying Deepcut until they are blue in the face, all recruits around that time knew what was happening around the ATRs. Abuse and bullying from the training staff was common knowledge, even whilst I was at ATR Winchester. Whilst the army won’t look at historic complaints, with the recent historic investigations a light will be shon on these stories soon.
    Like a number of former servicemen, I liked a drink.Unfortunately I got convicted for a DR10, which is my own fault. This was no barrier to me being mobilised to do a tour in Iraq but oddly did serve as a barrier when requesting to join the TA. How bizarre is that? Nor was the fact I had been signed off for stress a month before my tour a hinderance. If I am good enough to do a high intensity tour, can you please explain why I am not fit for the TA?
    With regards to the health service, again no secret that military ‘health’ clinics are compromised as they answer to local military command. Please don’t pretend that doesn’t go on. It does. I have countless strong anecdotal evidence that soldiers get signed fit due to local pressures. Local medical centre’s are seen as bent organisations.
    GPs aren’t much better. When I tried to speak to a GP, he told me how stressed he was due to his work-load. A complete joke.
    Only time army has been interested was when I put a claim in. 18 months later when they could be bothered to send someone out, I asked for advice and none was given, presumably to try and make my claim a lot weaker.
    I feel the NHS is more legitimate than the Army and is trying to help, but GP is useless, I have no faith in him whatsoever. Just not educated enough, at least you appear to be trying here.
    Today I am successful, a good career, home owner and family, but make no mistake this is DESPITE the Army, not BECAUSE of it.

  12. David Minshull says:

    During the period I have been dealing with veterans on the streets I have listened to many issues related to service, which has left veterans in a point of dissatisfaction with the process in place and ways they have been left to cope with the aftermaths of PTSD, Mental Health, Alcoholism and Drugs after been left homeless due to relationship breakups, financial burdens and medical issues and not settling into society.
    It would be more beneficial if finances was made more available to bring all the services for veterans under one roof to deal with the issues of veterans rather than the gaps between appointments and many issues of travelling for rough sleepers and homeless veterans.
    Many veterans who become rough sleepers/homeless settle in different areas than where they came from as they don’t really belong to any area after travelling so much in the military, the system of homelessness and registering causes many other outbursts of PTSD, Anger, Anxiety of feelings of desertion and depression.

  13. P Jones says:

    As a nurse & having listened to one or two Veterans, who have been in the depths of depression, I find that It is suggested that they make contact with mental health services such as Combat stress. Now, I may be a little cynical, but, this is just never going to happen! These people are still of a mind that nothing can be done, or that they will sort it themselves,& therefore don’t call the right services. Those near to them, knowing they need help, should be able to refer them for help & support. Our veterans deserve better than to be told, we’re here but only if you call us. Some have insight, others don’t, they are the one’s in need of an advocate.

  14. Bob says:

    You get brushed off,

  15. Pauline eilson says:

    I hope this truly does lead to veterans receiveing the help they require. Reading through the comments I feel that a number of people are asking for help. I understand that you are advising they contact their Doctors however this is harder than you realize. My son has been MD due to an injury and PTSD. His appointment with an Army Psychiatrist finish in March and although we have been to our GP the waiting time on the NHS is 6 to 8 weeks. The same can be said for the treatment of his injury. It is a disgrace and I hope that you can do more than give advice. Some actual action would be good. The so called covenant is proving to be words rather than action.

  16. paul percival says:

    Ex Royal MARINES COMMANDO, whilst still in got sent to Naval Hospital. for assessment 2 x two weeks and they said personality disorder carry on 27 years later after three and a half years homeless three years in alcohol rehabs and seven detoxs i was diagnosed with severe PTSD at COMBAT STRESS that was 7 years ago and am no better now even after 26 weeks treatment . I have been discharged by THE COMMUNITY MENTAL HEALTH TEAM funding has run out WAR PENSIONS have stoped my funding saying treatment cant go on forever , so no more support and living in CORNWALL its really bad and the experts are so uninformed about PTSD. I lost my family. health ,job as i was discharged my home children and i blame the forces for not realising how ill i was . I was acting bizzarrely , drinking to much , aggressive, just thought i was crazy , life is ruined and my wife who was my carer died last march suddenly so feel somewhat alone now . Mostly house bound tv hiding away its safer ! There are not enough specialists who understand PTSD even GPs FACT.

  17. fiona cooper says:

    In 2014 I was diagnosed with Emotional Intensity Borderline Personality Disorder – I did a STEPPS course the same year – I am a veteran who did 6 years as a medic, I didn’t go to war but was at RAF Gutersloh, receiving troops to send to war amongst other duties.
    I also had an accident during my service time which has left me with a permanent hidden disability that is progressive . Because my disability was pre 2006, it is classed as income and affects my benefit entitlement as I am currently unable to work due to combination of health issues. I am left In poverty and due to strains on Mental Health budgets, I am without support – there is no support group and on going therapy – I have to start right back at the beginning each time – have not been able to get help with my eating disorder and self harming as these are separate issues and mine are not bad enough to warrant assessment – however they are all part of my BPD and support would address this.

  18. Michael Robinson says:

    The conduct of both Social Services and the NHS regarding my care after several tours of duty in the armed forces has been appalling. i have had stroke, heart attack, i am now partially blind, i have PTSD, a diagnosis of schizophrenia etc etc etc.

    I have been sectioned by my mother in collusion with the psychiatric services who later state they have lost both my GP and Psychiatric medical records. It has been one thing after another.

    I have now relocated away from the borough of Rochdale where negligence and misconduct within the NHS seem rife.

    In the main, there has been no, no empathy or understanding of veterans concerns. It seems a parameter of life in the UK that has little investment possibly because it is not a vote winner and may be termed a sinkhole for funds just to establish better counseling for ex forces. We are a different breed in many ways that undertake a unique role yet, we are often placed among casualties of society we just cannot sympathize with such as drug abusers and alcoholics.

    And if you fall foul of the law because of being affected, the health services seem to take a very negative view of you. This now means that many ex forces rather than gain treatment, are now languishing in UK jails. I hope the NHS try to understand and adopt better principles and practice concerning ex forces.

  19. John Bailey says:

    I would like to be kept informed of this survey, the only help I was given when l needed it, was from the Warrior Programme regarding my mental health.

    No help from the military or even an appointment to NHS mental health Services, medical discharged, 50% disabled, no resentalment, that was of any good, after floating between jobs, help came from the Poppie Factory Supported Employment Scheme, and the Warrior Programme for my mental health.

    NHS need funding properly to deal with a growing problem. The military do not have the funding hospitals or staff anymore. I hope and pray that more things happen and funding to look after our heroes.

  20. Michael O'Brien says:

    Finally…. volunteered to be confined because it became to much for me….. 3 days then we were out, was good for the body but bad for the soul, put me in the acute so I would leave fast.

    At a later date I asked, and was assessed, for suicidal tendencies, by hell, they almost got it terrible wrong. And if I had terminated myself, I bet my record would have been quietly kicked under the carpet.

  21. Dawn Robinson says:

    I am interested in the outcome of the survey as my son suffered extremely bad with PTSD and 28 days after medical discharge from the army he had a horrific accident due to PTSD and is now in a wheelchair with brain injury after coming out of a moving vehicle.
    I would like to know if more help is to be offered to sufferers of PTSD as it is such a life changing illness.

  22. Tricia Stewart says:

    We are based in the west country where there are a number of military bases and the navel dockyard in Plymouth. We are currently commissioned to provide Primary Care based psychological therapy to general practitioners patients across a wide band of Devon. This includes many ex-servicemen and women presenting with combat related mental health issues. We are aiming to develop a service specifically for these patients and would be very interested in hearing the outcome of the survey to inform our developments.

  23. Shaun Rusling says:

    I served in the first Gulf War Op granby, former SNCO working in Resus 32 FD Hosp Wadi al Batin, I became ill after 3 separate courses of Anthrax and Plague all given over 3 x week time frame, in conjunction with known and unknown adjuvants and in conjunction with Hep B and A Immungloblin, on top of that I was ordered to take anti-malarials and Naps tablets (PB) and all other routine live and dead vaccines Yellow Fever (Polio). Majority of Gulf Veterans are suffering CFS and IBS plus Bladder, Sweats, Lo Grade Fevers, Loss of sexual function, and Interest in Life, subtle autonomic function and very serious Endocrine disruption, hormonal imbalance’s showing similar signs as PTSD.

  24. Geoff Apperley says:

    As both a member of NHS and ex-serviceman supporting veterans with welfare issues this intitiative is to be welcomed! It is about time we really put Veterans First as provmised in the trumpeted Covenant. I hope this survey will help identify and break down the barriers that Veterans experience in accessing mental health support.