(3 years ago)
Grand CommitteeMy Lords, in moving Amendment 48 I will speak also to Amendment 66A, both of which stand in my name and those of other noble and noble and gallant Lords.
I will address Amendment 66A first. Noble Lords will recall that a very similar amendment was tabled and debated during the passage of the recent overseas operations Bill in the previous Session of Parliament. Then and now, the amendment seeks to require the Ministry of Defence to identify a new duty of care to create a new standard for policy, services and training in relation to legal, pastoral and mental health support provided to service personnel, and to include a duty of care update in the Armed Forces covenant annual report.
Noble Lords will recall that our House divided twice on this issue, but the measure was overturned in the other place. In the interests of not losing the whole overseas operations Bill, the amendment was not pressed a final time. In concluding our previous debate on this subject, the Minister stated that perhaps the Armed Forces Bill was
“a more appropriate mechanism for any discussion of the wider duty of care owed to our people.”—[Official Report, 13/4/21; col. 1257.]
It is perhaps therefore no surprise that I am returning to this topic now, although I do not want to take undue time by rehearsing all the arguments made in our previous debate, the majority of which still stand.
That said, I am very aware that the Ministry of Defence has been working hard on duty of care related issues in recent months and I am sure that many serving personnel will already be benefiting from that work. However, the Minister for Defence Personnel and Veterans in the other place, during a debate on the duty of care amendment in the context of the overseas operations Bill, said that he wished to ensure that our care provided was at a gold standard. So I would be very grateful if the noble Baroness the Minister could update your Lordships on progress towards reaching this gold standard.
The initial impetus for Amendment 48 came in the aftermath of Operation Pitting as the final withdrawal from Afghanistan took place—but Op Pitting was only the most recent episode in a long series of operational settings that have put pressure on the mental health of our servicepeople. As with the duty of care issue, I am aware that the Ministry of Defence has been working hard on mental health matters. Nevertheless, I ask whether the Government’s recent mental health MoT announcement will include specialist support for personnel who have been affected by the withdrawal from Afghanistan. Indeed, could the Minister comment on what specialist mental health support has been offered to personnel involved in Operation Pitting?
Among the welcome recent initiatives, in October the Government announced the new annual mental fitness brief for UK Armed Forces. This is to be welcomed. The press release said it would be:
“Available on Defence’s internal learning platform”.
Can the Minister confirm whether face-to-face support will also be offered as part of this?
Very sadly, the tragic end of the mental health spectrum is the death by suicide of both serving and veteran members of the Armed Forces. In October the Armed Forces Minister said that the Office for Veterans’ Affairs had looked at how the frequency of suicide within the veteran community could best be measured and had identified a robust methodology. Can the noble Baroness explain this new methodology today? What frequency rate has been identified?
Furthermore, I was informed by the previous Veterans Minister that a new study was being undertaken to identify the rate of suicides among serving and veteran members of the Armed Forces. Previously, studies have been based on data from the first Gulf War and the Balkans, but the intensity of recent campaigns more than justified a new study. Can the noble Baroness say whether that new study has been completed? If so, what did it reveal? I am not alone in believing that recent operations have led to a tragic upturn in the suicide rate.
While commending the recent improvements in mental health provision, I believe that more can be done. I look forward to hearing the noble Baroness’s response later. I beg to move.
My Lords, I have added my name to Amendment 48. As we heard from the noble Lord, Lord Dannatt, it aims to improve mental health services and to provide additional support for serving personnel, particularly those affected by the United Kingdom’s withdrawal and the Taliban takeover in Afghanistan this year. I also support the other two amendments in this group, Amendments 60 and 66A.
At Second Reading I highlighted Operation Courage, a partnership between the NHS and Combat Stress and other mental health charities, whether Armed Forces-specific charities or local or specific mental health charities. In principle, Op Courage is a really good example of how mental health services for current serving personnel or veterans should be able to provide a strong, signposted short cut to mental health services when and where they are needed.
Combat Stress reports that during August it saw a doubling of calls to its 24/7 helpline. This was on top of already struggling to afford to offer its specialist treatment to around 1,600 veterans with complex mental health needs annually. It estimates that there are at least double that number out there who Combat Stress cannot afford to support.
As a charity, Combat Stress is currently 75% dependent on voluntary donations and the generosity of the public. I think we all know that donations to charities have significantly reduced during the pandemic. I have no doubt that with extra resources it and the other specialist mental health charities can deliver the services needed, because they understand the specific pressures facing serving personnel and the traumas that too many have to learn to live with, both during and after their terms of service.
Leo Docherty MP wrote to all MPs and Peers on 24 September, setting out the support available for service personnel and veterans, their families and the bereaved, should they need it. It was a helpful and informative letter, but it did not refer to when the further £2.7 million will be made available for Op Courage. Does the Minister have that detail available? Is it for spending in a particular period, or does it extend over more than one financial year?
The letter from Leo Docherty did not mention one welcome intervention in recent years: the training of mental health first-aiders in our Armed Forces. The mental health first-aid charity MHFA England says:
“In 2015/16, 3.2% of UK armed forces personnel were assessed with a mental health disorder—over 6,000 people. Many more go undiagnosed and untreated.”
When I have talked to service personnel who have become mental health first-aiders since their return from deployment in Afghanistan, I have heard of how the training that they received enabled them to recognise the warning signs this summer in those they currently serve with, as well as past comrades. One soldier told me that, in August, the community of personnel was able to come together on social media to support and encourage those reliving tough memories or, worse, flare-ups of PTSD. Because of their mental health first-aid training, they were able to help these colleagues to access phone lines—for example, to Combat Stress and other organisations.
How many Armed Forces mental health first-aiders are now in place? Will the extra funding announced in September include training for more mental health first-aiders in the future? Also, can the Minister explain how Op Smart, which was designed to develop mental resilience across personnel in the Armed Forces, sits with Op Courage? Op Smart is much to be welcomed, and is critical to personnel becoming not just self-aware but aware when colleagues may be facing problems. How is Op Smart, and specifically the mental health first-aider programme, funded? The last part of Amendment 48 talks about collecting data. It would be very beneficial to see data on all these issues, including, as the noble Lord, Lord Dannatt, said, on suicide. Can we find such data now? If not, will it be collected and, as the amendment says, included in the annual covenant report?
I return to the extra £2.7 million of funding. Many current and former service personnel who served in Afghanistan and elsewhere, and are currently reliving their traumas, need to access NHS mental health services, including crisis care, right now. Unsurprisingly, these services are facing extraordinary pressure already. The NHS Providers activity trackers show that, for October 2021, referrals remain 10% higher than pre-pandemic levels, with many people having to wait significantly longer than the 18-week target time for their first contact.
In July, NHS England proposed setting new mental health access service standards, working in conjunction with Mind, the mental health charity, and Rethink Mental Illness. The new urgent care proposals would mean that community mental health crisis teams could reach patients within 24 hours of referral. The other key target for mental health liaison teams linked with A&E departments would also be rolled out across the rest of England. Detail on the actual level of funding to deliver this new target is still awaited. For this Bill, I am particularly interested in how all this will fit in with Op Courage. Perhaps the Minister can help me; if she does not have that information at her fingertips, could she write to me afterwards?
This amendment seeks urgent, extra, specific support for Op Courage—and, I hope, for Op Smart too—to ensure that all those people who are serving, or have served, their country do not fall through the net when they need mental health services.