Military Training: Mental Health Resilience

Caroline Ansell Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Caroline Ansell (Eastbourne) (Con)]

I beg to move,

That this House has considered opportunities for mental health resilience in military training.

All of us in this place realise the debt we owe to our armed forces personnel and to their families for the sacrifices they make to keep us safe. It has to be acknowledged that unless we, too, have seen active service, faced danger and death, witnessed carnage and experienced loss we cannot fully appreciate or understand the impact and the price that some pay.

I had second-hand experience of such sacrifice when working in a boarding school. I was in loco parentis to 25 teenage girls whose fathers were serving in Bosnia. I saw something of the impact of protracted periods of lives lived apart and of relationships stretched. I saw something of the fear and anxiety of children for their father, and the loneliness and challenge for the parent left behind. Boarding school often provided the continuity that families need and, for the overwhelming majority, service life is one of purpose, identity and fulfilment, with men and women going on to lead successful lives thereafter. For the estimated one in five who bear the unseen scars, however, every opportunity to build resilience or mental toughness needs to be recognised.

The Ministry of Defence recognises mental illness, including post-traumatic stress disorder, as a serious disabling condition, but—importantly—as one that can be treated. My question today is, can it be prevented? In the US Battlemind programme, mental resilience training has been dubbed “armour for your mind”. Can we put mental health resilience on the same footing as physical fitness or, indeed, physical armour?

[David Simpson (Upper Bann) (DUP)]

This is an important debate and I am sure that the hon. Lady agrees with the importance of having full implementation of the military covenant throughout the whole of the United Kingdom. I am sure she shares my frustration that in Northern Ireland we cannot achieve that. The points she is making are very important.

[Caroline Ansell]

I absolutely subscribe to the hon. Gentleman’s passionate support for the military covenant. I will say more about that later.

The new and growing recognition for mental health and veterans’ care on returning home is very welcome, and I pay tribute to the work of charities, of hon. and gallant and hon. Members and of the Government for their unswerving commitment to the military covenant. We are living amid a sea change in our understanding and recognition of mental health issues as we strive for parity of esteem between physical and mental health in our NHS. Times are changing.

Our commemorations of the centenary of the first world war remind us of a different time, when mental health issues bore a stigma and the social view was that wounds that could not be seen could not really be there. Veterans did not seek help and many could not even speak of their experience. Henry Allingham, God rest his soul, was an Eastbourne resident and a supercentenarian. He only started to share his story at the age of 105, but between his 110th and 111th birthdays he is reported to have made more than 60 public appearances. I met him the once.

“It’s good to talk”—the time-honoured role of the padre reflects that and initiatives such as the armed forces’ mental health first aid programme recognise it. After operational deployment, decompression is another hugely valuable opportunity to safeguard resilience. Furthermore, the stress and resilience training centre within the Defence Academy at Shrivenham runs a course called “START Taking Control”. Perhaps the Minister will elaborate on whether such training, which was designed for postgraduate and leadership roles, might soon be extended to initial training.

[Mrs Flick Drummond (Portsmouth South) (Con)]

My hon. Friend is making an excellent speech on a subject that is incredibly important, in particular to someone who has a close relative serving in the armed forces. Alcohol misuse is one of the most frequently reported mental health problems for deployed UK troops. It is the only mental disorder to have increased in prevalence. Comparison of alcohol misuse in the same age and gender group shows that armed forces personnel are more likely to misuse alcohol than the rest of the population. Does she agree that the dangers of alcohol misuse must be incorporated into any training to improve the resilience of personnel?

[Caroline Ansell]

I acknowledge the great wisdom of what my hon. Friend says. It has been recognised for some time that alcohol abuse has too long been part of a work-hard, play-hard culture. Alcohol has also evidently been used to some extent to cope with the inevitable strains of conflict and combat. It is worth noting that young soldiers between the ages of 18 and 24 are three times more likely than their civilian counterparts to be consuming harmful levels of alcohol. The problem is a serious cultural issue that we must consider, in particular in connection with mental health.

Along with the many good things that the Government are doing to support mental health—I have touched on only some of those—I urge us not to overlook the most effective support system of all, which is the family. The UK Government implemented an operational mental health needs evaluation for those serving in the field during operations in Iraq and Afghanistan. Despite obvious operational difficulties in ensuring a full rate of participation, evaluation of a statistically significant 15% of all serving personnel in Iraq and 16% in Afghanistan greatly aided our understanding of the mental health challenges faced by our servicemen and women. The fact that 99% of those asked to participate did so suggests to me that the military has been successful in breaking down barriers to the point that armed forces personnel want to share their experiences, albeit anonymously.

The results of the survey, as broken down in The British Journal of Psychiatry, also showed the prevalence of the most common mental health disorders, with an incidence rate of about 20%. That, too, is significant. The results were used to match the correlations between family stress and the development of mental health disorders, further underlining how vital it is for us to support military families.

The past 15 years have been a time of strain for many armed forces personnel, given the extended interventions in Iraq and Afghanistan. We know that the mental scars of conflict can emerge many years after people are relieved of active duty. Many trigger points can be completely unrelated events that take place in the home, far from the field of battle. Problems at home such as financial trouble, relationship breakdown or even child-related stress can all trigger mental health issues. It is therefore imperative that we equip our soldiers and, crucially, their families with all the mental resilience skills necessary to hurdle the challenges of military life and beyond. Family is the best support system, as soldiers themselves testify. How we promote and protect the military family will be defining for mental health outcomes.

Mental health is likely to be a ticking time bomb. According to Combat Stress, the veterans’ mental health charity, 13 years is the average length of time between service discharge and a veteran seeking help. Next month marks the 13th anniversary of the US-led invasion of Iraq, so the demand for mental health services for veterans is likely to increase in the short term. Combat Stress has already seen a 28% increase on 2013-14 in the number of veterans seeking assistance in 2014-15.

I am pleased that we are making it easier for our armed forces personnel to get the support that they need and to come forward in the first place, although a report this week suggests that a significant number of them—perhaps up to 40%—are still not seeking such support. Is there a case for more training, particularly in initial training? The received wisdom is still that prevention is better than cure. Do we need to offer more specific training and dedicate time to building mental resilience, just as we push physical speed, strength and stamina? Does that need to be universally rolled out and not hostage to self-awareness, self-selection or self-referral?

I am a patron to the Military Preparation College. As I shake those graduates’ hands and see them walking off into the sunset, I need to know that we are doing everything in our power to mitigate what is certain occupational hazard, looking overseas for best practice, looking at initial training and training at every stage of military service and beyond. We are looking to change culture by lifting up mental health awareness and we will need to have that as a focus for the foreseeable future.