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Fighting for veterans’ mental health care

As the next steps on the NHS Five Year Forward View announced 17,500 forces veterans and service personnel will benefit from £9million investment in new and improved NHS mental health services, NHS England’s Director of Health & Justice, Armed Forces and Sexual Assault Services Commissioning looks at what it will bring:

Improved NHS mental health services for veterans were launched at the weekend.

So it was timely that the King’s Centre for Military Health Research at King’s College recently hosted its second conference on this subject , entitled ‘Veterans’ Mental Health – The Wider Perspective’. 

I joined a debate that looked at whether or not mental health care for veterans should be part of mainstream mental health services.  I debated in favour of this, presenting my case in front of over 200 guests from across the third sector, military, NHS and academic world, while the opposing this view was provided by Sue Freeth, Chief Executive of Combat Stress.

This format was a first for the event and proved fruitful in the spirit of open conversation and the range of views generated from the wider room.

I challenged people to think about veterans as they would any patient, all of whom should rightly have access to high quality mental health care regardless of which service they access.

This does not by any length mean ignoring their armed forces’ experiences and dismissing their time in combat.  It does, however, mean that across the NHS, veterans should have a positive patient experience and access to consistent support and treatment that is in line with the health commitments of the Armed Forces Covenant.

The intention of the recently commissioned service, known as the NHS transition, intervention and liaison veterans’ mental health service, is that it acts as a front door to a range of mental health services across the NHS depending on the needs of the patient.

Varying levels of treatment and support can be provided, from recognising the early signs of mental health problems and providing access to early interventions, to providing therapeutic treatment for complex mental health difficulties and psychological trauma.

In order for this to work, the service is integrated with other mental health services across the NHS to ensure veterans receive treatment in a manner and setting that is considerate of the complexity and severity of their condition.  Furthermore, it will work closely with the wider NHS, statutory bodies, local authorities and the third sector to ensure holistic support is in place to help veterans enjoy a full life and achieve positive outcomes relating to not only mental health, but also employment, reduction in alcohol consumption, improved housing and social support.

Sitting as part of mainstream mental health services, it is essential that the appropriate quality standards and specialist training are in place within the service to drive up levels of clinical care for this patient cohort.  With the proportion of veterans experiencing mental health difficulties expected to come forward and seek help sooner, our ability to effectively reach out to them and provide timely care that is considerate of their needs and that of their families is essential.

We can always do more and there is always room to improve; and what better way to do this than through the commitments of The Five Year Forward View for Mental Health.

I feel privileged to be involved in its delivery and even more delighted that it recognises the importance of veterans’ mental health as a core element of mainstream mental health service provision.  A major driver for this will be working in partnership with local public, private and voluntary sector organisations, acknowledging the contributions of each to improving mental health wellbeing.

As part of this, however, we must also widen our scope, acknowledging that veterans may need a broader range of services than those typically considered; whether this is from Marie Curie, the Terrence Higgins Trust or The British Heart Foundation.

To me, this was a momentous day, which was signified by the presence of Prince Harry, who took the opportunity to address the common misconception that many veterans have PTSD, whereas actual rates are around 4% to 5%, which is broadly equivalent to the incidence among civilians.

More common issues include other mental health difficulties, such as anxiety, depression and problems related to alcohol.  This is reflected in the offering of the NHS transition, intervention and liaison veterans’ mental health service, which provides an enhanced range of tailored treatment, care and support options to ensure those who have served receive timely and consistent care.

I truly hope this front door to a range of NHS mental health services will encourage those who need help to seek it and in doing so continue to break down the associated stigma.

We are in a strong position to make advancements in this area and I encourage all to take responsibility in challenging those who care for patients to truly understand the needs of the individual. In doing so, we should consider whether a patient is a veteran and, if so, what can be done to make their experience of care better, their outcome a positive one and their family feel supported.

Kate Davies, CBE commenced in December 2012 as the Director of Health and Justice, Armed Forces and Sexual Assault Referral Centres (SARCs) for NHS England.

She is a national director of three areas of direct commissioning, working to support the commissioning of healthcare services across England for serving personnel, veterans and their families, Sexual Assault Referral Centres (SARCs) and healthcare services in prisons, secure children’s homes and training centres, as well as immigration removal centres. This national role is to assure high quality, consistent and sustained services with a strong focus on health inequalities and outcomes for patients and their families.

Kate has developed and led the national partnership agreements with the Ministry of Defence for Armed Forces commissioning, the Ministry of Justice for prisons and the children and young people secure estate and the Home Office for immigration removal centres. The cross departmental partnership agreements focus on core objectives and outcomes across government for key patient areas that can only be delivered in partnership with cross government agreements.
Veterans mental health has been a focus for the partnership agreement between the Ministry of Defence and NHS England who have secured commissioning for veterans’ mental health services across England (The Veterans’ Mental Health Transition, Intervention and Liaison Service and the Veterans’ Mental Health Complex Treatment Service).

From a health and justice perspective, the partnership agreement has supported the development of the national Liaison & Diversion Programme and Street Triage. Kate has developed and lead and increased provision for survivors of sexual violence including the partnership publication of a NHS Sexual Assault and Assault Strategy in 2018 (SAAS).
Previously, Kate was the Executive Lead for Prison, Detainee and SARCS Healthcare Commissioning for East Midlands, when she led the healthcare commissioning for prison and offender health.

Kate has also worked as the Strategic Director of the award-winning Nottinghamshire County Drug and Alcohol Action Team from December 1995 to May 2009, co-ordinating and delivering the Government’s National Drug Strategy. From 2003 to 2010, Kate was seconded to the University of Central Lancashire, International School for Communities Rights and Inclusion as Director of Black and Ethnic Minority Community Engagement, focussing on the health and social care of diverse groups who experience discrimination and/or disadvantage and directing the national community engagement programme.

Kate has been a Non-Executive Director on the National Treatment Agency Board in England between 2000 and 2013. She was also a member of the Government’s independent Board for the Prison Drug Treatment Strategy Patel Review, which implemented the Substance Treatment Service and Strategy and delivery across England and currently acts as an Ambassador for Diversity in Public Appointments for the Government Public Appointments Commission. Kate started her career in the Probation service and was a qualified Probation Officer from 1986 to 1995, before joining the NHS.

Kate was awarded an OBE in 2009, for services for disadvantaged communities. In 2018, she was awarded a CBE for her work to improve services for some of the most vulnerable groups and an Honorary Doctor of Staffordshire University in recognition of her commitment to health and social equality.

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  1. andy says:

    just a shame they pass the book around from one dept to another so there is no real focus to the person who needs help as it becomes more stressful so the person going or asking for help in the first place is no better off…face to face meetings are in my pov better than someone on the phone especially when the person on the phone only seems to know one word and thats suicide