Mental Health (Veterans)

Gemma Doyle Excerpts

Tuesday 6th December 2011 Westminster Hall

[Gemma Doyle (West Dunbartonshire) (Lab/Co-op)]

I, too, congratulate my right hon. Friend the Member for Salford and Eccles (Hazel Blears) on securing this debate on an important and topical issue. More importantly, I thank Neil for coming along today and allowing us to hear his story, which has both provided a context for our discussion and put a face on the issue that we are debating.

I welcome the opportunity to discuss these issues with the Under-Secretary of State for Defence, the right hon. Member for South Leicestershire (Mr Robathan). We have spent much time during the past year discussing the Armed Forces Bill and the armed forces covenant. The Bill has now received Royal Assent, so it is perhaps fitting that as we come to the end of the year, we are again discussing the welfare of our brave serving personnel and veterans and the impact on their families.

My right hon. Friend painted an honest and vivid picture of the problem of veterans’ mental health. It is easy to be preoccupied with the scenes from Afghanistan that we still see and not to pay as much attention to the issues facing service personnel and their families when they leave the forces or return from theatre. We know that they are skilled, highly trained and resilient people, but more than 180,000 personnel have served in Iraq, Afghanistan and elsewhere, as we have heard, and a significant number will have returned with mental ill health or will, sadly, go on to develop problems later in life. We should be prepared to deal with that and ensure that the right facilities and support are in place to diagnose and treat such conditions.

Significant progress has been made in recent years, particularly through mental health pilot schemes and work done since then, to improve support and treatment for personnel suffering from mental health problems, but no party has a monopoly on wisdom when it comes to improving services for our forces. We have all met constituents who have told us about their experiences. We have heard about some of those and about Members’ personal experiences of the issues.

I emphasise the importance of the current campaign by Combat Stress about the stigma attached to mental health, which my right hon. Friend mentioned. Combat Stress provides an invaluable service to veterans around the country. Its centres and outreach work allow veterans to get the help and support that they need in a specialised environment, along with other veterans going through similar experiences. Combat Stress’s “The Enemy Within” campaign seeks to tackle the stigma that, unfortunately, can be a barrier to people getting the support and help that they need.

However, the work of Combat Stress and of many other important organisations and charities such as the Royal British Legion should not give the Ministry of Defence or the Government an excuse to opt out of their responsibilities, or indeed ours. It is important that we do not view the services offered by the voluntary and charitable sector as a replacement for acting ourselves. Such organisations should complement, not replace, the services that the Government offer. The voluntary and charitable sector is facing a tough time at the moment. Forces charities are spared some of that pain by generous ongoing public support, but we should not assume that those services will always exist and will always have enough funding to run.

Government should decide what services they have a duty to provide and should fund them properly. The Government need not always be the vehicle to deliver those services, as we have heard, but they can fund experts such as Combat Stress to do so on their behalf. This Government should also consider how mental health services for veterans or anyone else who needs them can be guaranteed when their national health service reforms are removing accountability. Again, we have discussed that already.

Those in the forces are trained to be strong, resilient and able to push through any challenge that stands in their way. That does not lend itself easily to admitting that one needs help because of a mental health problem. My right hon. Friend highlighted the high proportion of veterans suffering from a mental health condition—a staggering 81%—who are embarrassed by or ashamed of their condition and do not feel able to come forward. We have also discussed the average length of time it takes people to present in search of support, which is about 13 years. I understand that there are examples of people who have waited up to 40 years to get help. We must do all that we can to change that situation. We cannot just let it continue.

Combat Stress has also provided detailed evidence involving cases of individuals who have faced marriage break-up, unemployment, social isolation or substance abuse, all because they were unable to deal with their mental health. My hon. Friend the Member for Clwyd South (Susan Elan Jones) mentioned homelessness as well. We should be concerned about the figures, and I agree that it is right that we should seek to quantify the problem. The figures show that, even though help and support exist, too many people still find the stigma far too great to overcome. Until we tackle that stigma, no matter what support is out there, there will be no real change. Combat Stress’s campaign focusing on the issue of stigma is vital.

We have spent much of this year’s parliamentary debates on the forces discussing legislating for the covenant, so it is welcome that we are now debating the substance of the issues covered by the covenant and what it should mean in practice. It is right that nobody who serves their country in the forces should be disadvantaged as a result of their service. In some ways, however, getting the Government to enshrine that in law was the easy bit. The Government must now take action to implement the covenant so that we can see what it means in practice. I would welcome information from the Minister about the planned implementation of the covenant and how the Government intend to ensure that Departments and public bodies audit and change their policies to give our forces, our veterans and their families a fair deal.

My right hon. Friend highlighted the need to recognise how many veterans suffer from mental health issues. My hon. Friend the Member for North Durham (Mr Jones), the previous veterans’ Minister, announced plans when he was in post for a veterans’ ID card. The card would have enabled veterans to be identified easily and to get priority NHS treatment.

As we have discussed, it is difficult to quantify the level of need. Without a tracking system for veterans, we will never be able to do so. My right hon. Friend has asked in written questions how many ex-service people are being treated for mental health problems on the NHS, but there is no record, so the Minister replying was simply unable to give an answer because the data do not exist. Being unable to quantify the problem makes the Government unable to quantify the true cost of treating mental illness among former members of the armed forces. Therefore, the true impact is unknown at the moment. A veterans’ card would enable the Government to track veterans and offer the right support to those who need it.

In the Armed Forces Bill Committee, on which the Minister and I both served, the Minister reiterated his opposition to introducing an ID card, but the Government agreed earlier this year to launch a veterans’ privilege card allowing veterans to access commercial discounts. That is welcome, but I urge the Minister to look beyond discount schemes and extend those proposals, and to use the card as a way to ensure that veterans can access the support that they require when they need it.

[Mr Gray]

I am puzzled as to why the deeply bureaucratic and complicated system of issuing 5 million people with a piece of paper would help those suffering from mental stress many years after service to come forward and ask for the help that they need. I am not certain as to why that is a solution to the problem under discussion.

[Gemma Doyle]

The proposals were not overly complicated. The initial proposal was to start issuing a veterans’ card to people who are leaving the services now, not necessarily to go back and identify the 5 million people, because, as the Minister has told me, he cannot identify them. If we do not start to make some changes, we will never be able to quantify the problems. When we are able to know who the people are, the right support and services can be offered to them and contact can be maintained where it is wanted to ensure that the services are being delivered. Then, when an individual presents with a mental health problem, they can clearly be identified as a veteran and we will be able to see the problem much more clearly.

[Sir Paul Beresford]

The point made by the right hon. Member for Salford and Eccles was that many of these people will not present themselves and do not understand the problems, and that asking them will not get the result that the hon. Member for West Dunbartonshire (Gemma Doyle) seeks. That is why I have insisted— I think this point was raised earlier—that the decommissioning that is done in the States, and to some degree here, might be the answer, without the paper.

[Gemma Doyle]

No one measure will sort out this problem—there needs to be a range of measures. I think that, taken together, the hon. Gentleman’s suggestion and mine would help to address the problem. I do not think that we will be able to quantify the issues unless the data and the systems are in place.

The hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile) has already mentioned that it is important that we do not overlook the particular impact of deployment on the mental health of our reservists. Professor Simon Wessely of the King’s Centre for Military Health Research states that reservists who have served in Iraq or Afghanistan are three times as likely to suffer mental health problems as members of the regular forces. The Government’s Future Force 2020 plan suggests that the role of reservists is to increase substantially as a result of the reductions in the number of regular service personnel, so the Government must have the support in place to ensure that reservists are prepared to take on those extra responsibilities and that extra role, as well as guarantee that they have access to the correct mental health care and support when they return from deployments or are no longer mobilised.

As in the rest of the forces, there has been progress in recent years. The reservist mental health programme extended mental health support for reservists, but, with their role set to increase, the provision of support will have to be pointed in the right direction to cope with the increased number of reservists who are to be deployed. I would therefore appreciate an assurance from the Minister that the mental health care of reservists will be given due attention.

In conclusion, I again congratulate my right hon. Friend the Member for Salford and Eccles on securing this debate. We have heard of experiences from around the country, and they have illustrated the need for attention not to be diverted from the issue. The hon. Member for North Wiltshire (Mr Gray) asked what measures we can and should take to improve the situation. Combat Stress is asking for five things. I do not think that I can improve on them and would welcome the Minister’s comments on them. This debate has given us the opportunity to recognise the role that the NHS, the Ministry of Defence and Combat Stress play in supporting the mental health and welfare of our veterans. I pay particular tribute to Combat Stress, which, along with many other service organisations and charities, plays an outstanding role in support of the whole armed forces family, for which we should thank it.