(2 years, 10 months ago)
Grand CommitteeMy Lords, I am very happy to add my support to my noble friend Lord Dannatt’s Amendment 48 regarding mental health support. I came to today’s debate thinking that it struck me as a very modest but effective way of keeping the Ministry of Defence’s feet to the fire on an issue patently requiring action. However, having listened today, I begin to worry that it may not be enough.
I think it is now more generally accepted in society that in human beings mental health is every bit as prevalent as physical health. The fact that mental health can suffer as a result of traumatic experience is also widely accepted. Mental health should nowadays carry no stigma and should be proactively monitored in the same way that physical and dental health are. This is where I improvise and part company with my prepared thoughts, as I reflect on my own experience of the mismatch in the approach to mental as opposed to physical health.
In September 1973, as an 18 year-old, I attended Sandhurst. On day one, I was weighed. Sandhurst had an idea that an officer had to weigh 12 stone 8 pounds. If you weighed more than that, you were put in a queue for extra PT. If you weighed less, you were put in a queue for extra milk.
In virtually every week, if not every day, of my life in the Army in the following 43 years, something to do with my physical health was assessed or tested, with a basic fitness test every other day, a battle fitness test probably once a month, the Army physical training assessment, the Army physical fitness assessment, annual medicals, hearing tests, foot inspections and dental tests. This mismatch between checks on my physical and mental well-being is remarkable. I was never once in 43 years asked by anybody how I felt mentally. I know from my own children that sports physiotherapists are everywhere. People, including my son, think nothing of taking a couple of sessions with a therapist to make them feel a bit better—he knows he will get better, but he just feels a bit down.
If the Minister will forgive me, the appearance of the annual online platform and £2.7 million in funding does not seem a sufficient amount of effort. It smacks of tokenism to meet something that actually needs a cultural shift in the whole approach to mental health from the Armed Forces and the Ministry of Defence. Whatever happens to this amendment, which I fully support, I hope that this sense of a need for a cultural shift is taken back to the ministry and the Armed Forces.
My Lords, it is a privilege to follow the noble and gallant Lord, Lord Houghton. His sharing of his personal experience has honestly been of great benefit to the Committee on this group of amendments, although I am not sure I can match the impact it has probably had on your Lordships’ thinking. I should begin my first contribution to the Committee by offering my apologies for my absence from the first day; family commitments required that I was in Scotland.
The proposals before the Committee in this group have the same objective: they are aimed at safeguarding and improving the mental health and welfare of service personnel. I support Amendments 48 and 66A but have added my name to Amendment 60, and I thank the right reverend Prelate the Bishop of St Albans for tabling it. I agree with the arguments that he put forward and begin my remarks in support of his amendment by referring the Committee to his Oral Question in your Lordships’ House on 13 September, on the prevalence of gambling disorder in the Armed Forces. In my supplementary question then, I drew attention to the Army Headquarters Regional Command IPPD information sheet, Gambling—A Serious Risk to Military Personnel, which he has drawn from today. If the Committee will allow me, I wish to do the same for part of my argument.
In the preamble—this is the Army talking—it is stated that
“service personnel … are potentially more vulnerable and at greater risk to the harm that can result from gambling than the general public”.
As has been pointed out, it goes on to assert specifically that:
“Military veterans are 8 times more likely to become problem gamblers than the general population”.
This is not an historic document. Examination of it reveals in its last footnote a reference to 30 April 2019, which I understand to be its publication date, so it is a relatively modern view of the Army.
The Forces in Mind Trust study on veterans’ health and gambling, published on 23 September 2021, reinforces the Army’s official conclusion that there is that prevalence among veterans. It finds that veterans who responded to its survey were 10 times more likely than non-veteran respondents to experience gambling harm, and that veterans gambling were seven times more likely to be motivated by a need to escape or avoid distress. But this research is much more valuable than that, because it reveals some other very disturbing traits among veterans. Veteran participants were found to be at much greater risk of poor mental health outcomes, including depression, anxiety and post-traumatic stress disorder, and to have an alcohol and/or nicotine dependence. This research found that veterans with problem gambling had higher healthcare and benefit costs, as well as higher levels of debt than non-veterans. It is relevant to the right reverend Prelate’s amendment that the recommendations from the report include routine screening for gambling problems, including when leaving the Armed Forces.
I have to be completely honest about this: on the publication of the report, the researchers emphasised that their research must be considered with some caution, principally because
“The sample was recruited online, and veterans who have gambled may have been more likely to take part”.
I say that, however, with some further qualification because it is exactly the broader discussion about gambling and gambling harm that the Government themselves have been relying on for the oft-made assertion in your Lordships’ House that such harm is present in only a very small number of gamblers. It is all based on research and data gathered in much the same way. However, Professor Simon Dymond, the lead author of the report, said:
“Despite this, the significance of the findings is indisputable. This is the first UK study to explore the impact of gambling on UK ex-Service personnel, and our findings are consistent with the international body of work which finds that veterans are at greater risk of gambling harm.”
From my perspective, in addition to its consistency with the international body of work referred to, this research is fully consistent with the position adopted by the Army itself, which is expressed unqualified in the transition IPPD information sheet. Further, it is significant that the veterans who participated, whether self-selecting or not, were motivated to gamble by the need for an escape from, or avoidance of, distress.
However, this is perhaps the most concerning finding of the research. I quote the executive summary of the study:
“All veterans surveyed experienced some symptoms of depression, anxiety, risky alcohol use, nicotine dependence at higher levels, and increased indications of PTSD and complex PTSD … diagnoses compared to non-veterans.”
Consequently, I repeat what I said on 13 September in my supplementary question. In considering this, the “appropriate questions”, both for the Government and for us, that need to be answered are—