Ex-service Personnel (Psychological Welfare)
(Limited Text - Ministerial Extracts only)
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The Minister of State, Ministry of Defence (Mr Mark Francois)
I congratulate the hon. Member for Paisley and Renfrewshire North (Jim Sheridan) on securing this debate on the mental health of our former service personnel. I thank him for his courtesy in giving me some idea of the issues that he intended to raise.
This is a vital subject in which cross-Government working is having a real impact. Although the four UK Health Departments hold primary responsibility for the issue, I naturally take a very close interest in it given my veterans portfolio. I hope that in the previous debate on armed forces personnel I was able to persuade the House that in the three months in which I have been doing the job I have taken a very close interest particularly in the medical issues that affect personnel and veterans.
That said, I must regretfully disagree with the charges that the hon. Gentleman laid against this Government. We are investing in mental health at every juncture of a service career. From recruitment, to deployment, to discharge and transition into civilian life, the Ministry of Defence and the Department of Health have made funding available for extensive support to serving personnel and veterans who encounter mental health problems.
Let me also say that the Government very much welcome the role played by service charities. It is entirely appropriate that we should look to harness their niche capability and expertise to maximise the quality of support given to the service community. In many cases, this support is provided by a partnership with Government, and that should be celebrated rather than regretted.
As the former Defence Secretary, my right hon. Friend the Member for North Somerset (Dr Fox), announced on 6 October last year, the Government accepted all the recommendations in “Fighting Fit”, the report by the Under-Secretary of State, my hon. Friend the Member for South West Wiltshire (Dr Murrison), which now forms the backbone of the work being done across Government to improve mental health care for service personnel and veterans. I can report good progress in delivering those recommendations. The hon. Member for Paisley and Renfrewshire North specifically talked about veterans, but I will briefly set out the context of our overall strategy for mental health.
While serving, all personnel, including reservists, are encouraged to report distress or mental health concerns. We have introduced a process called trauma risk management, or TRiM—a peer group support system that is helping to identify those at risk and provide support to them.
Bob Stewart (Beckenham) (Con)
From what I have heard, there is extremely good counselling in the field after incidents have occurred. People zone in on those affected, immediately and without delay, and check them out as best they can.
Mr Francois
I am grateful to my hon. Friend for that important intervention.
TRiM was initially developed by the Royal Marines. It involves training non-specialists in military units to lead discussions about traumatic events and spot those who may need additional help. We make sure that we have mental health professionals forward deployed in theatre, exactly along the lines that my hon. Friend the Member for Beckenham (Bob Stewart) mentioned, to deal with such eventualities if and when they occur. We deploy uniformed mental health teams to provide care on the front line. Regular psychological health assessments are conducted to ensure that support in theatre is sufficient and, if needed, a UK-based team of a psychiatrist and mental health nurse can deploy to theatre at short notice if an incident warrants it.
At the end of an operational tour, units undergo decompression—an opportunity to unwind and talk about their experiences. At this point, personnel also receive a series of briefings designed to help them adapt to their return from deployment, and mental health is one of the specific issues raised.
Specific measures are also in place for those leaving the service. After a successful regional pilot, structured mental health assessments were rolled out nationally in July 2012 as part of routine and discharge medicals. We hope they will be useful in highlighting mental health problems at an early stage.
To ease transition from military to civilian life, personnel with identified mental health issues can access military departments of community mental health up to six months after discharge. There are 15 such departments across the United Kingdom, providing specialist mental health support to military personnel. In addition, GP registration forms in England, Scotland and Wales now enable those who have served to declare this when registering with a doctor’s practice, providing an opportunity to discuss their unique needs, if they so wish.
On the specific steps that we are taking for veterans, the Department of Health, working with South Staffordshire and Shropshire mental health trust, has put in place a national veterans mental health network. This brings together NHS clinicians, the Ministry of Defence, Combat Stress and others to assess the implementation of the recommendations made by the Under-Secretary. The network’s first full meeting was in Stafford on 29 October and a national conference will take place in March 2013. I also take this opportunity to place on the record our appreciation for the valuable work done by Combat Stress, and I am looking forward to a meeting with its chief executive, Mr Andrew Cameron, in the next few days.
Armed forces networks, whose role is to provide links between the forces and the wider community on health issues, are beginning to implement veterans mental health projects in each former strategic health authority area. I am delighted to report that there are now more than 50 extra veterans mental health professionals in the NHS across the various armed forces networks in England, which is 20 more than originally recommended by my hon. Friend. I do not, therefore, accept the point made by the hon. Member for Paisley and Renfrewshire North about lack of resources, although I accept that he made it in good faith.
In his report, my hon. Friend acknowledged the value of the medical assessment programme, which offers assessments to ex-service personnel suffering mental health problems. On 29 October, the MAP was relocated with the reserves mental health programme at Chilwell, Nottingham, to form the veteran and reserves mental health programme. This more central location in the middle of the country will, we believe, make for easier access and ensure that high standards of clinical oversight are maintained.
More than 2,500 members of the armed forces community are now registered to use the Big White Wall, which the hon. Gentleman mentioned. It is a website that allows users to talk anonymously about mental health issues. Early indications suggest that it is proving a valuable means of interaction without the stigma sometimes attached to mental health. User surveys are reporting significant reductions in stress and anxiety, not least because individuals can raise issues anonymously, if they so choose.
Plans are also maturing for the veterans information service, a means of providing advice to veterans on accessing services and support for health issues related to their military service. When launched, all veterans who leave the armed forces will be contacted by letter or e-mail after 12 months, so that we can check how they are getting on.
On work in the nations and regions, I recently met Keith Brown MSP, the Scottish Minister for Transport and Veterans, to discuss the steps the Scottish Government are taking on veterans’ issues. In addition to maintaining support for specialist mental health services for the next three years, they will fund and seek to expand the Veterans First Point service, an advice centre designed to help veterans and their families during the transition to civilian life.
In Wales, the all Wales veterans health and wellbeing service is providing access to specialist outpatient care and signposting veterans and their families to other support that they may require. It offers access to therapists with expertise in veterans’ mental health to provide assessment, treatment and referral. Treatment options include commissioning the services of Combat Stress, which works in partnership with the service to provide nurse-led community support groups.
In Northern Ireland—I should place on the record that the hon. Member for Strangford (Jim Shannon) was present for part of this debate—a specialist aftercare service was established in 2007 to address the unique requirements of veterans of the Ulster Defence Regiment and the Royal Irish Regiment home service, and their dependants. Each year, that widely praised aftercare service deals with about 4,500 cases, providing welfare support and medical services, including mental health support.
Jim Sheridan
Is the Minister aware that a significant number of veterans are serving prison sentences or are on parole? The American system is different because it tracks the crimes of ex-service personnel. I am not suggesting for a minute that people should be able to commit crimes and get away with them, but is there something that we could do in Britain to copy the American system?
Mr Francois
I have looked into this matter and am advised that the proportion of veterans in prison is no higher than the proportion of the civilian population that is in prison. We need to do what we can through rehabilitation and other means to help those people, just as we would help others.
The Department of Health in England has extended its funding of the Combat Stress and Rethink 24-hour mental health helpline for service personnel, families and veterans. In addition, the Department of Health, in partnership with the Royal College of General Practitioners, has put in place training packages for GPs to raise awareness of the unique needs of armed forces families and veterans.
On a broader point, in line with the principles of the armed forces covenant—we launched the report on that today—the Government have reaffirmed that veterans in England should be given priority NHS treatment for conditions related to service, subject to the clinical needs of others. The Scottish and Welsh Governments accord the same priority to veterans. That is important, given that one in 10 adults in the United Kingdom is now a veteran, going right back through the second world war, Northern Ireland and other conflicts up to the present day. A high proportion of our population have served their country in uniform in one way or another.
The hon. Gentleman referred specifically to post-traumatic stress disorder. I was delighted to be able to visit King’s College London recently, not least because some time ago that was where I completed my master’s degree in war studies. To some extent, I was going back to my alma mater. While there, I met Professor Simon Wessely and his internationally renowned team in the King’s centre for military health research. Mental health issues, particularly PTSD, have been a key focus of his research, which the MOD continues to fund. I was reassured by Professor Wessely that comparatively low rates of PTSD are being recorded in the service community. The evidence indicates that the mental health of the armed forces remains robust, but naturally we will do our utmost to help the minority who develop PTSD or other mental illnesses.
In addition to the measures that are already in place, we have made provision for the training for primary health care staff to raise awareness of PTSD. Defence Medical Services has more than 200 mental health professionals who provide specialist support to service personnel and, as I have mentioned, additional personnel are available in the NHS to augment the existing capability. I have also mentioned the veterans and reserves mental health programme, which the MOD continues to fund. The Department of Health has agreed to fund the provision of acute PTSD services by Combat Stress with £3.5 million a year for five years. As I have said, I shall be meeting Andrew Cameron shortly to discuss how that money can best be deployed.
The hon. Gentleman asked about the Christmas Island veterans. I hope that he will forgive me, but I have concentrated my remarks on mental health. The fairest thing that I can say is that I will write to him about that issue. I hope, under the circumstances, that he regards that as acceptable.
I think that what I have said gives an indication of the importance the Government attach to the treatment of the mental health problems of our service personnel and veterans. Although we have long been aware of the implications of physical injury to our armed forces personnel, it is fair to say that for a long period there has been a stigma surrounding mental health. We are starting fully to recognise and deal with the impact on the lives of those who suffer from such issues. It is to the credit of the previous Government that work was done to begin to address these issues on their watch. The House can rest assured that the current Government will continue to do all that we practically can to look after service personnel and veterans who develop mental health issues. These people are important to our country and we must do our best for them.
Question put and agreed to.