Veterans (Mental Health)

James Gray Excerpts

Wednesday 7th March 2012 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

Given the nature of this afternoon’s debate, I should like to pay tribute to the soldiers missing and believed killed in Afghanistan. Our thoughts and prayers are with their families at what must be an incredibly difficult time.

It is always a privilege to serve under your chairmanship, Mr Dobbin, and indeed to initiate a debate in this Chamber. I feel, however, an even greater sense of privilege due to the special nature of this debate. Like many Members on both sides of the House, I am a great supporter of our armed forces family. From serving personnel to veterans, those brave men and women have served our country with dedication, and they deserve admiration, respect and parliamentary attention.

I should like to discuss veterans’ mental health, which is one of the few subjects that quite rightly commands political unity on both sides. The work of successive Governments over recent years has given the issue great momentum, and early in the debate I should like to commend the previous Government on the work that they did on behalf of veterans. I also congratulate the Minister on the way that the current Government have championed this worthy issue.

My interest in the mental health of veterans comes from my frequent correspondence and discussions with one of my constituents who is the mother of a veteran. Her dedication to improving the provision and information provided to veterans is inspiring, and I hope that she will take heart from today’s debate.

In recent years, efforts to tackle the cruel stigma that is related to mental health issues more generally across society have begun to make a difference to many of those who suffer from what is often an invisible illness. Indeed, it has been estimated that one in four people in the country suffer from some form of mental health issue each year. The Mental Health Network, which is part of the NHS Confederation, has carried out excellent work, and over the past few years, it has been heartening to see the Ministry of Defence and the Department of Health working closely with the Royal British Legion, Combat Stress and others in the voluntary sector to provide a range of improved services for veterans who suffer from mental health problems.

Let me take the opportunity to praise the work of all charities up and down the country that work day in, day out with members of our armed forces family. In particular, I should like to champion the Royal British Legion and Combat Stress—two charities that play a vital role in delivering key services to veterans and serving armed forces personnel. Together, those charities offer vast experience, unquestionable compassion and unwavering dedication. With approximately 22,000 armed forces personnel leaving the service and returning to civilian life each year, we must appreciate the wide-ranging mental health issues that can be provoked by experiences in war-torn countries and dangerous conflicts around the world.

Over the past 10 years, British troops have been involved in a range of conflicts from Iraq and Afghanistan to Bosnia and Sierra Leone, and the bloody experiences of those wars cannot fail to leave a mark on those who confront them. When we think of the sacrifices made by armed forces personnel, it is right to consider not only the often terrifying physical risks undertaken, but the mental strains that are placed on our brave servicemen and women.

It has been estimated that more than 27% of veterans suffer from a common mental disorder. For those armed forces personnel who leave the service each year having experienced direct action in recent operations, the transition from service life to civilian life is often traumatic. For many, the future is uncertain, and owing to the stigma that surrounds mental health issues, many sufferers fail to seek help on leaving the services. If they do seek help, it is often at a dangerously late stage. A Mental Health Network briefing last year suggested that, on average, veterans do not come forward for mental health support until 14 years after their discharge. Sadly, homelessness and alcohol or substance abuse is more prevalent among veterans when compared with others of similar age or social background.

I have three main objectives in this debate: first, to commend the superb work that has been carried out on behalf of veterans who have suffered from mental health problems in recent years; secondly, to seek assurances about the continuation of parliamentary support for such work to be maintained on a more permanent basis; and thirdly, to ensure that our provision for veterans is coherently delivered in the best possible manner.

The previous Government’s “New Horizons” strategy document bound the NHS and the MOD to improve access and support for the early treatment and prevention of mental health illness among servicemen and veterans. The current Government, led admirably by the Prime Minister, launched the military covenant, which enshrines into law the Government’s duty to support the entire armed forces family. The covenant makes a new commitment to provide

“extra support for veteran mental health needs.”

Soon after taking office in 2010, the coalition Government asked my hon. Friend the Member for South West Wiltshire (Dr Murrison) to produce a report on veterans’ mental health. He should be congratulated on his truly outstanding work and recommendations, and I encourage any hon. Member who has not yet read the report to request a copy from the Library.

My hon. Friend’s “Fighting Fit” report received favourable backing from the Government, and rightly so because it includes a raft of measures to ensure better provision for veterans and their families. Among 13 action points and four principal recommendations, the report specifically calls for

“An uplift in the number of mental health professionals conducting veterans outreach work… A Veterans Information Service (VIS) to be deployed 12 months after a person leaves the Armed Forces… trial of an online early intervention service for serving personnel and veterans.”

As part of the Government’s initial response, a dedicated 24-hour mental health support line for veterans was launched in March 2011, operated by the charity Rethink on behalf of Combat Stress and funded by the Department of Health. In addition, the number of mental health professionals was doubled from 15 to 30.

With the “Fighting Fit” report, the Government’s military covenant and the previous Government’s valuable work, much effort has been made to deal with this issue. The objective now, however, is to ensure that that wide-ranging support, financial assistance, e-learning provision and information literature continues and is focused in the most effective way possible.

I have a number of questions for the Minister to which I hope he will respond, although I accept that some information might require communication with his colleagues in the Ministry of Defence. First, will funding for the dedicated 24-hour support telephone line continue after the one-year trial, which I believe is soon coming to an end? I believe that having someone on the end of a telephone at any hour of any day who is willing to listen, able to support and trained to understand must be of tremendous reassurance and assistance to affected veterans. The continuation of funding for that telephone service would indicate a clear commitment to veterans, and I urge the Minister to push for that support to continue.

With an eye on the future, I ask the Minister to outline the time scales involved in implementing the new veterans service to which the Government have made a commitment. A key issue as we discuss the future of such support is the difficulty of keeping in touch with veterans. As discussed earlier, many leave the service and move on to temporary accommodation or work. It is impossible to provide meaningful support if we do not know where veterans now live or work. Will the Government do more to track and store information about veterans, and will that information be shared with key partners?

[Mr James Gray (North Wiltshire) (Con)]

I congratulate my hon. Friend on securing the debate. Does he agree that there is a particular problem with regard to the Territorial Army and reserve forces? Many of them are spread out across the nation, and we do not know where they are. At least, regulars have the regimental family around them, even after they become veterans. People from the TA are often out in the wide world without anyone to provide such support.

[Julian Sturdy]

I agree. It is also worth noting that reservists tend to suffer more from mental illness, if they have experienced conflict, than regular soldiers, so it is probably even more important that we understand where the reservists are and can monitor that and target help towards them.

--- Later in debate ---

[Guy Opperman]

It is interesting, is it not, that today is 7 March and on 7 March 1982, exactly 30 years ago, about three and a half weeks prior to the Argentine invasion of the Falklands, which happened on 2 April 1982, the British ambassador in Argentina wrote a cable from Buenos Aires to the then British Prime Minister, saying that matters were escalating. It is very well known, and it was reported in the Franks report that assessed the Falklands war, that “contingency plans” needed to be made. That was not enough and a war began, then escalated. I certainly will not go down the route taken by the hon. Member for Newport West (Paul Flynn) by digressing further. However, the point is that the treatment of the veterans of the Falklands war was not as good as the treatment of veterans now, partly because there were difficulties at that time in understanding what post-traumatic stress disorder was.

From a health standpoint, PTSD is not confined to victims of conflict. There are also plenty of victims of PTSD who were involved in normal, day-to-day accidents and disasters, whether it is industrial health accidents or factory accidents; people can have PTSD arising from those things. We need to change the way that PTSD and other aspects of the mental health of veterans are visualised, because it needs to be recognised that PTSD and other mental health conditions are just as much a disease or condition as breaking an arm or suffering from cancer, and it is just as difficult to solve or treat.

I move on. I endorse entirely what was said about the current situation, and I will abbreviate my comments to making an assessment of the current situation. Various studies have shown that a very large proportion of our veterans are suffering from PSTD. At present, approximately 24,000 veterans are in jail, on parole or serving community punishment orders. That is the astonishing number that emerges if we assess how many veterans are going through our criminal justice system. It manifestly shows that, for whatever reason, we have not done enough.

Let us also bear in mind that American studies have shown that approximately 30% of the US troops who were in Vietnam suffered from PSTD, or about one in three. That is an absolutely staggering number. Therefore, although we might look at the respective troops coming home from Afghanistan, and at those who fought in Iraq and other conflict zones, and think that they are all right, three out of 10 soldiers will genuinely suffer PTSD. They may suffer it in year one after their return. Year 14 is the average length of time that it takes, but it can take as long as 25 or 30 years, and throughout all of that time, their individual families are suffering and going through particular difficulties.

I applaud the “Fighting Fit” report and the work that is being done. However, I regret to say that that is not enough. Personally, I do not consider that it is enough. I accept entirely that we are in straitened times and that, with every budget, we have to consider the way in which things are dealt with. Nevertheless, I very much hope the Minister will give the sort of assurances that charities and individual soldiers’ organisations seek about their future, and that there are commitments on an ongoing basis to the matters outlined in “Fighting Fit”, so that those charities and organisations have the reassurance that genuine efforts will be made to ensure that their funding is sustained; that mental health systems are structured properly; that the recommendations of the inquiry into medical examinations while soldiers are still serving are properly implemented; and, given that we are introducing all these ideas from “Fighting Fit”, that there will be proper assessment of those ideas after they are introduced. I agree that organisations such as the Big White Wall are not necessarily being utilised in the way that was envisaged; they are being utilised, but not necessarily in the way that was envisaged.

I would very much like to see an overarching body for veterans. I would like a veterans agency to be considered by the Government, and the Government to consider whether there is a possibility of bringing together certain parts of the NHS, the Ministry of Defence and social services and housing elements, which make up so much of all the difficulties that our servicemen suffer, and dovetailing that with the health services that are provided in prisons.

We can look at the way that people are dealt with in terms of health services in prisons. I have extensive experience of going to see clients who are former servicemen and who have received a custodial sentence or who are held on remand. There was absolutely no doubt that they were hopelessly unable to deal with the difficulties of a custodial sentence, or the difficulties of being detained, at that particular time, in circumstances that they would normally have been perfectly able to deal with.

[Mr Gray]

I have agreed with much of what my hon. Friend has had to say, but I have some difficulties with the notion of the establishment of a new agency to carry out the functions that existing Government bodies are required to carry out at the moment. If there were a veterans agency, would there not be a risk that people at the Department of Health or the Ministry of Defence would shrug their shoulders and say, “Someone else is doing this for us, leave it to them”, and that the services received by veterans would be significantly worse than they are at the moment?

[Guy Opperman]

I accept there is always a risk that, if we create some new body, we will be in a position whereby everybody passes the buck and says, “Well, they’re sorting it out”. However, I am clear that every single MP could come to this House and say, “I have individual examples of people in my constituency, or stories that I have heard of former servicemen.” Those servicemen are continuing to slip through the net—they are unaware of the individual aspects of the services that are available to them—and the Government are not necessarily acting as an overarching body to ensure that they are aware of those services.

Let me give some examples. There is very good evidence from the “Fighting Fit” report and other studies that follow it up that there should be a leavers pack for soldiers and, for example, an ability for veterans to be monitored after they have been discharged. All those services are good, but they stop after a certain period and the Government do not go back to those individuals to ask, “Are you actually all right? Are you in a position to cope with the vicissitudes of your life and your existence on an ongoing basis?” That is the sort of thing that I would like done. I concede that it may be possible to do such things in the present Departments, but there must be more joined-up thinking, because the problem is ongoing, and there are examples.

I am conscious that other Members wish to get into the debate, so I will abbreviate my comments. I want to talk about the work of Veterans in Action, a classic charity, which is run by individual veterans. For a number of years, they have been providing in-depth support, which they have found is, sadly, lacking in the system. They tell me that there is no generic way to collect veterans’ information and that it is collected very much on a local, case-by-case basis. Similarly, they say it is extremely difficult to get organisations to work together. They also tell me that the Big White Wall is not being used as it was intended to be and that people are using the Combat Stress helpline as a first point of contact.

A great many smaller, third sector organisations and charities set up by veterans are having similar problems. With no national directory or local directories of such organisations, it is immensely difficult for individual veterans who are constantly moving around—who have problems with housing and with all the dislocation that goes with that—to harness the efforts of such organisations. Therefore, just as successive Governments have done amazing work looking after individual veterans’ health in conflict zones, we should do more to look after their mental health after they have left those conflict zones.