Mental Health Services: Serving Military Personnel

Earl Howe Excerpts

Thursday 14th January 2016 Lords Chamber

[Baroness Tyler of Enfield]

To ask Her Majesty’s Government what assessment they have made of the support available to serving military personnel with mental health problems, and what plans they have to establish a 24-hour mental health helpline for serving soldiers.

[The Minister of State, Ministry of Defence (Earl Howe) (Con)]

My Lords, the Ministry of Defence is absolutely committed to looking after the mental health of our Armed Forces and provides a range of community-based healthcare in line with national best practice. Out-of-hours care already includes the free 24-hour mental health helpline run by the charity Combat Stress, which receives funding from the MoD, and the Big White Wall, which is a 24-hour online community. There are therefore no plans to provide an additional helpline.

[Baroness Tyler of Enfield (LD)]

I thank the Minister for his Answer. Will he say whether the Government consider it satisfactory that serving Armed Forces personnel are currently having, and under current plans will continue to have, to rely on support from the charitable sector for urgent mental health issues which occur outside of Monday to Friday normal office hours? With the very best will in the world, those charities will not have access to the in-house mental health records, know about their situations or the medication that they are taking.

[Earl Howe]

My Lords, there is no point in duplicating a service that already works very well. We work in close partnership with Combat Stress, which provides an extremely effective service, and, if necessary, signposts the individual to the right service according to need. There are helplines available for veterans as well, which we run on a 24-hour basis, but we do not see the need and there is no evidence that we should be looking at duplicating that service.

[Lord Craig of Radley (CB)]

My Lords, do the Government accept that, as a result of operations over the last decade and more, there are many more potential and actual mental health problems among serving personnel? The Minister suggests that this can be helped by charities, but what information is given to serving personnel that these charities are available? It seems to me that there is not enough information available to serving personnel on this issue.

[Earl Howe]

The noble and gallant Lord raises a very important issue. I do not believe that there is any shortage of information available. Personnel are given briefings and advice on whom to contact if they think they need help. These are reinforced by publicity material such as posters and leaflets in all unit primary care centres. Information is also available online on the MoD’s area of the GOV.UK website. Similar guidance can be found on the NHS Choices pages. I believe that there has been a significant improvement in the provision of this kind of information in recent years.

[Lord Campbell-Savours (Lab)]

My Lords—

--- Later in debate ---

[Lord Campbell-Savours]

My Lords, when many of our young men, who are little more than teenagers, are being hounded by public interest lawyers, the Iraq Historic Allegations Team and the Iraq fatalities investigation unit, is it fully appreciated that they may have been under intense pressure in combat—even in a state of panic and mental stress—when they have been involved in individual incidents? Is this not what happens when we send young men and women to war?

[Earl Howe]

My Lords, as someone who has returned to being a Defence Minister after a break of 20 years, there is no doubt in my mind that the Armed Forces have come a very long way in that time. They take the mental health of their personnel extremely seriously. As one would expect, the model adopted is one of best practice, prevention, early detection and the ready availability of evidence-based treatments. This applies not just during a deployment but pre-deployment and post-deployment as well.

[Lord Robathan]

My Lords, I am sure that the whole House would welcome the improved understanding of mental health issues in the Armed Forces, and, indeed, the improved provision for those who, sadly, develop mental health issues. But would my noble friend agree that most of the Armed Forces are not affected by mental health issues when they are serving and that there is a danger, by concentrating on this, that serving personnel are undermined because they feel that they are being pitied, rather than respected for the excellent work that they do?

[Earl Howe]

I hope that service personnel do not feel that way, and rather that they feel well supported, but my noble friend is right. It is notable that incidence of post-traumatic stress disorder, for example, is extremely low in the UK Armed Forces in numerical terms. One can attribute that, in very large measure, to the services and support that are now available to Armed Forces personnel, both in this country and on deployment.

[Lord West of Spithead (Lab)]

My Lords, my noble friend Lord Campbell-Savours is absolutely right: it is outrageous that we are chasing, many years later and in an open-ended way, the men and women who have tried to protect us. Can we not carry out an urgent investigation into firms of solicitors that I know use agents in Iraq—and no doubt will in the future in Afghanistan—effectively to ambulance chase to get cases? We are constantly seeing these cases, which cost immense amounts of money and cause mental anguish to our men and women, so they affect the issue we are talking about. We really need to get a grip on this.

[Earl Howe]

As the noble Lord rightly points out, there has been extensive coverage and publicity on this very issue in the press in recent weeks, and I share his concern. The fact of the matter is, though, that it is not the Government chasing our armed services personnel. Every time a complaint is raised, we have a duty to investigate the complaint. It is not a matter of hounding Armed Forces personnel but rather of trying to get to the bottom of the complaint as quickly as possible. Indeed, many of these complaints have been found to be without foundation, but I share his concern about the behaviour of certain law firms.

[Lord Touhig (Lab)]

I am sure that the Minister and many other Members of the House will be aware of the excellent work done by the organisation Combat Stress. In a well-researched report published recently, it revealed that there had been a fourfold increase in the number of veterans who had asked for help for mental health conditions over the last 20 years. Its research suggests that this will continue. The good news is that Combat Stress has treatments that work, but it needs additional funding to deliver them. Has the Minister’s department had discussions with Combat Stress about this need for additional funding and, if it has, what is the outcome?

[Earl Howe]

My Lords, yes, we do have regular discussions with Combat Stress, with which we work very closely in partnership, as I have already indicated. It is interesting that, while the number of military personnel assessed with a mental disorder has risen steadily in the past couple of years, the level of mental illness remains broadly comparable with that of the general population. Although it may sound strange to say it, I think the rise could indicate good news rather than bad news, in that the more we address stigma in mental illness, the more we encourage people who need help to come forward. I hope that is attributable to the better services that are available.

[Lord Deben (Con)]

Will my noble friend tell me when last we had a thoroughgoing investigation into what other forces do in this area? Is this not surely something about which we could learn a great deal from, and teach a great deal to, others who are concerned with what must be a universal problem among the major forces of NATO? A comparative piece of work might very well be valuable.

[Earl Howe]

My noble friend hits on an extremely important point, which is why, in 2003, the Ministry of Defence commissioned the King’s Centre for Military Health Research, which is part of King’s College London, to conduct a long-term research study following a cohort of more than 20,000 members of the Armed Forces. That study continues with the same cohort. In so doing, comparative information is emerging about the performance of other armed services around the world. We can take credit for the fact that the incidence of mental illness in our own armed services compares very favourably indeed with that of some other armed services around the world.

[Baroness Jolly (LD)]

My Lords, men and women seeking this sort of support require anonymity and are anxious about that, as, indeed, they are about quality. Therefore, will the Minister explain to the House whether anonymity is protected, how this service is regulated and when it was last quality tested?

[Earl Howe]

The noble Baroness is quite right that anonymity is important to many people and, of course, record-keeping is scrupulously observed in that sense. At the same time, some people feel that it is important to identify mental illness when it occurs. That is why peer support among a unit, for example, features very large, particularly when armed services personnel are on deployment. Anonymity in that sort of instance is difficult to achieve by the very nature of the support that we wish to see personnel give to their peers.