Armed forces and mental health

Armed forces and mental health

Armed forces and mental health. Most British military personnel do not experience mental health problems while they are in service, or afterwards in civilian life.

However they face unique risks in service and, if they do experience mental health problems, they may require particular treatments and particular mental health services.

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. Post Traumatic Stress Disorder (PTSD), depression, anxiety and substance abuse affect a significant minority of service personnel and veterans.

What are the risks for people in service?

A number of UK studies have found links between active service and mental health problems in armed service personnel involved in recent conflicts. A very recent study of 10,000 serving personnel (83% regulars; 27% reservists) found lower than expected levels of PTSD. Common mental disorders and alcohol misuse were the most frequently reported mental health problems among UK armed forces personnel. In particular, levels of alcohol misuse overall were substantially higher than in the general population.

The main findings were:

4% reported probable post-traumatic stress disorder
19.7% reported other common mental disorders
13% reported alcohol misuse
regulars deployed to Iraq or Afghanistan were significantly more likely to report alcohol misuse than those not deployed
reservists were more likely to report probable post-traumatic stress disorder than those not deployed
regular personnel in combat roles were more likely than were those in support roles to report probable post-traumatic stress disorder
experience of mental health problems was not linked with number of deployments.
Fear NT, Jones M, Murphy D et al (2010). What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. The Lancet (2010) 375 (9728): 1783–1797.

What are the risks for veterans?

There are an estimated 5 million veterans in the UK, and a further 20,000 personnel leave the forces each year. When staff leave HM Forces, their healthcare transfers from the military to the NHS. Only around 0.1% of regular service personnel are discharged annually for mental health reasons. However some veterans develop mental health problems after leaving service, many of whom will be experiencing PSTD.

Until recently, little was known about these veterans. What is known is that only half of those experiencing mental health problems sought help from the NHS, and those that did were rarely 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 making the transition to civilian life, marital problems, and loss of family and social support networks. Younger veterans are at high risk of suicide in the first two years after leaving service. Ex-service personnel are also vulnerable to social exclusion and homelessness, both of which are risk factors for mental ill health. Alcohol misuse is also high.

What services are available?

A number of special mental health projects have been set up by the Ministry of Defence with the NHS, in recognition of the difficulties veterans face accessing help.

The Medical Assessment Programme (MAP), based at Guy’s and St Thomas’ in London, offers help and treatment to any veteran of any conflict, no matter how long ago, and their carers.

There is also a Reserves’ Mental Health Programme (RMHP) open to anyone who has seen active service as a volunteer or reservist since 1 January 2003 and is now demobilised, and has mental health problems that might be linked to service on operations.

You can contact the Medical Assessment Programme (MAP) on 0800 169 5401.

You can contact the Reserves’ Mental Health Programme on 0800 032 6258.

The MoD and NHS are also running six Veterans Mental Health pilot projects across the UK. The aim of these projects is to increase knowledge and understanding of veterans’ mental health needs among mainstream NHS staff , to improve access to mainstream NHS services.

The projects provide treatment and referrals to community mental health services, social services and specialist assessment and treatment elsewhere, including the residential centres run by the voluntary sector veterans’ support organisation Combat Stress.

Each project has a community veterans mental health therapist and the projects also have links with local veterans’ organisations to reach out to people who may need help.

Some local NHS Talking Treatments services are developing skills in working with veterans. Ask your GP about a referral for talking treatments, but be sure to check that they are confident and skilled to work with you.

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 for armed forced personnel who experience illness as a result of service.

Outside the NHS, the charity Combat Stress provides specialist residential and community outreach mental health care for veterans. You can contact them on 01372 587 000 or email Contact us for more information

Information for Referrers In the NHS or private/corporate Occupational Health.
How to make a referral
This is an open access service, so any professional or worker from within the NHS or Ministry of Defence can refer clients to The Spiritual Healing Centre. Clients can also self refer, but in our experience, many find it difficult taking that first step into treatment. Therefore, a referral from an agency, in agreement with the client, is preferable.

A more detailed referral allows for a better assessment, so we prefer referrals to include as much background information as possible. We are happy to discuss any potential referrals and provide consultation if you are unsure about how to best meet the needs of a veteran or indeed any other patient who you feel may benefit from our range of therapies.

How to contact us
The Spiritual Healing Centre UK

Information for Referrers
What does the service offer?
We provide a comprehensive mental health assessment and assertive treatment-advocacy service. When necessary this may include one or more extended assessment sessions with myself, during which I will be extensively data gathering from the veteran, family or agencies involved. Assessments are holistic, covering full personal, service and mental health history; mental health difficulties; and other problems/needs e.g. physical health, money, employment or housing. In order to ensure care is tailored to the individual our assessment reports will make diagnoses; establish a ‘formulation’ which is a shared understanding of how different problems link together and why they are happening and suggest referrals when necessary. We will undertake liaison and follow-up with any service we make a referral to and with the service user to try to make sure needs are met.
We offer psychiatric management, specialist psychological therapy, including individual trauma focused therapy for PTSD and case management. I am experienced and skilled in understanding military and Prison service related problems, I also manage individuals whose presentation falls between the gaps of existing services. I also offer information and one-to-one help to partners and family members.
I work closely with a large network of veteran support agencies to assist clients in accessing the right treatment and support, including welfare support.
I routinely assess clients who present with:
• Difficulties arising from past traumatic experiences (military or otherwise)
• Low mood and problems with anxiety
• Personality difficulties
• Anger and aggressive behaviour
• Behaviour which has brought them into contact with the Criminal Justice System
• A history of difficulty engaging with NHS services • Alcohol and/or drug misuse
In addition, we can offer consultation, training and supervision to other professionals on issues relating to veteran mental health.
Who is this service for?
Our service is open to all people currently experience some kind of truama or mental stress in particular ex-service members of the UK. We can also see reservists when they are not mobilised.
When should I refer to you?
Our service aims to cater for a spectrum of clients from those who have never accessed support services before, to those who fall between the gaps in mainstream services or require specialist assessment and treatment.
What happens after referral?
Clients will be contacted and asked to attend a remote therapy service for a one or two assessment session as a starting point. Once an assessment has been completed, the therapist will discuss possible options for treatment and/or support and will produce a thorough assessment report.
Recommended treatment may be accessed through our service section,

We offer highly specialised treatment for Post-traumatic Stress Disorder; military and/ or trauma informed therapy for complicated issues that do not neatly fit treatment criteria in existing services; group symptom management and other treatment options based on a NON RELIGIOUS NON RITUALISTIC approach that is in harmony with all religious belief systems, cultures and traditions and can treat a non religious person just as equally as well as a religious person.

How can this service help
your clients?
We were set up with an aim to help the NHS in supporting vulnerable people in our society in particular those who have served within a public sector role like the military. Our ethos enforced and endorsed the government’s strategy to improve health services for veterans in England. Some ex-service members of the armed forces experience difficulties because of pre-existing problems, upsetting military experiences, or a tough transition to civilian life. Frequently, veterans have reported problems accessing or engaging with NHS services. The Spiritual Healing Centre UK Service in this regard has extensive experience of working with ex-service personnel and are sensitive to the many issues they may face,
which can aid both engagement and the uptake of therapies.

We can offer availability to new NHS authorities in England and Wales, as well as Scotland and NI, to take on a significant workload and to help ease work load pressure on mental health services in your local area, in a professional and regulatory in check manner, working towards and in line with the government strategy guidelines for improving health services for veterans and mental health in the UK in general.

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