Although most British military personnel do not experience mental health problems while they are in service or afterwards in civilian life, they may face particular risks and require particular treatments and mental health services.
The most obvious risk to mental health is combat itself, a violent and often disturbing experience that can lead to later mental health problems. Other factors may include the consequences of the heavy drinking culture often found amongst service personnel or the strain of making the transition from an institutional life in the services to the life of a civilian.
There are five million veterans (with eight million dependants) in the UK, along with around 180,000 serving personnel. Although only a minority of serving personnel and veterans experience mental health problems, they still form a large group of people.
Back to the top
There has been little research into mental health in the UK armed forces compared to the United States. However, various UK studies have indicated links between active service and mental health problems:
- 22% of a sample of Falklands War veterans showed symptoms of Post Traumatic Stress Disorder (PTSD) – a much higher percentage than in the general population.
- Troops deployed to the first Gulf War in 1991 were suffering higher than normal levels of psychological distress and fatigue many years after the conflict.
- A study of body handlers from the Gulf showed that 50% were experiencing PTSD symptoms.
- Psychological difficulties in a sample of British troops increased by 50% after return from duty in Northern Ireland during the conflict there.
- By June 2006, 1,897 British service personnel had been treated for mental health problems thought to be related to their deployment to Iraq.
Back to the top
Little is known about the mental health of the 18,000 service personnel that rejoin civilian life each year. However, research has shown that those experiencing mental health problems during service are more likely to leave the forces, at which point they lose access to the mental health services provided by the Ministry of Defence (MoD). Only half then seek help from the NHS. Most of those that do receive help are prescribed anti-depressants with very few being referred to specialist mental health services.
Veterans’ mental health problems may be made worse or caused by post-service factors, such as the difficulty in transferring to civilian life or marital problems. Ex-service personnel are also vulnerable to social exclusion and homelessness, both risk factors for mental ill health. Both Crisis (1994) and the Ex-Services Action Group (1997) found that about a quarter of homeless people had served in the armed forces - 25% and 22% respectively.
The Alcohol Recovery Project found that 9% of clients attending its London walk-in centres had a services background, demonstrating the risks posed by the drinking culture in the armed forces.
Back to the top
The mental health problems experienced by military personnel are the same as the general population, although experiences during service and the transition to civilian life mean that their mental ill health may be triggered by different factors. PTSD, depression, anxiety and substance abuse affect a significant minority of service personnel and veterans.
Which services support serving personnel and veterans?
People who are currently serving in the armed forces are entitled to different mental health services from those who have left the armed forces.
Back to the top
Currently serving personnel are entitled to services supplied by the Defence Medical Services (DMS), attached to the Ministry of Defence. Outpatient treatment is available from one of 15 regional Community Mental Health Teams run by the DMS. Personnel requiring inpatient care are referred to The Priory Group (a private mental health service provider), with whom the MoD has an arrangement, or to an NHS hospital.
Back to the top
Veterans are entitled only to NHS treatment which may not be designed with their particular needs in mind, although an NHS clinician can put a veteran forward for priority care if that veteran is also a war pensioner. The first point of contact for veterans is often their GP. However, research has shown that some veterans feel that GPs do not understand their needs.
In 2007, the MoD and the NHS began piloting six sites for veterans – Community Based Veterans Mental Health Services – that aim to provide a pathway into NHS care for former service personnel. Veterans who are concerned that their mental health has been affected by service (since 1982) and feel their needs are not understood by the NHS are also now entitled to a mental health assessment from the MoD under the Medical Assessment Programme at St Thomas’ Hospital in London.
The armed forces welfare support services are responsible for veterans’ transition to civilian mental health care. A Minister for Veterans is charged with ensuring that services for veterans are co-ordinated across government.
Reservists demobilised since January 2003, however, are entitled to continue receiving mental health care from DMS. This follows research published in 2006 which showed British reservists in Iraq are at greater risk of encountering mental health problems related to their service than their full-time counterparts.
The Service Personnel and Veterans Agency (SPVA), part of the MoD, acts as a single point of contact to provide advice for serving military personnel, ex-service personnel and their dependents. The SPVA is responsible for the War Pensions Scheme and Armed Forces Compensation Scheme. These schemes provide compensation to personnel for illness that arises as a result of service prior to 6 April 2005 and on/after 6 April 2005 respectively.
Outside the NHS, the charity Combat Stress provides specialist inpatient and outpatient mental health care for veterans while other organisations, such as Community Housing and Therapy, provide some services for ex-service personnel.
Back to the top
Written in 2007
|
|
|
|
|
|
|
|
|
|
|
|
|
|
