The Ministry of Defence (MoD) recognises that psychological illness, including post-traumatic stress disorder (PTSD), can be a serious and disabling condition, but one which can be treated.
The Defence Mental Health Services has extensive experience in psychological treatment of mental health problems and psychological injury.
The main focus of the treatment of mental illness is on recovery and rehabilitation. Priority is placed on increasing awareness of stress-related disorders and diagnosing and treating them.
Measures are in place to increase awareness at all levels to prevent the development of PTSD and other stress-related disorders among servicemen and women.
Preventing mental health problems is difficult, but caring leadership, effective line management and robust, realistic training can help.
Most of the preventive measures focus on early detection and management of problems before they cause significant impairment.
In the field
Support is given to military personnel by trained mental health staff before and after servicemen and women are deployed.
This includes briefings on how to get help, ongoing assessment and treatment (if required).
If someone thinks they have a mental health condition, they can ask for help from any medical officer or their chain of command.
Units are supported by non-medical personnel who can signpost personnel to medical services. This includes chaplains and Trauma Risk Management (TRiM) practitioners, who are trained in assessing the risk of problems after traumatic events.
MoD mental health services provide community-based healthcare, offering assessment and treatment that follows NHS guidelines.
Personnel can be treated for mental health problems by their medical officer in their unit medical centre, or referred to specialist mental healthcare services.
Specialist mental health services are primarily delivered through 16 military Departments of Community Mental Health (DCMHs) located in large military centres across the UK, as well as centres overseas.
DCMHs are staffed by psychiatrists, mental health nurses, clinical psychologists and mental health social workers.
The aim is to treat personnel with mental health needs involving their unit medical centre and medical officer or GP, and, with the patient's permission, involve senior officers in managing their condition.
A wide range of psychiatric and psychological treatments is available, including medication, psychological therapies, social support and a change of environment, where appropriate.
Treatment for armed forces personnel approaching discharge
Armed forces personnel approaching discharge can now get treatment and support at NHS veterans' mental health services.
Available across England, these services provide a range of treatment and support in close liaison with Defence Medical Services (DMS).
This includes recognising the early signs of mental health problems and providing access to early treatment and support, as well as therapeutic treatment for complex mental health difficulties and psychological trauma.
These services work closely with a range of organisations to provide a complete package of care to help support a smooth transition to civilian life.
As part of this, patients will be provided with help, where appropriate, with employment, reduction in alcohol consumption, housing and social support.
To access these services, patients must meet the following criteria:
- be a resident in England
- have an identified or diagnosed mental health illness/disorder; and
- have a discharge date from the MOD or be found to be unfit for continued military service by their medical board; or
- have been identified by the DCMH as requiring follow on psychiatric care on discharge from the MOD; or
- a DMS GP has identified a need for mental health transition support for a patient who has had their pre-release medical; or
- the patient self-refers once they have had a pre-release medical
People meeting the criteria can self-refer or request referral via a health care professional or service charity.
Upon receipt of referral, patients will be offered an initial face-to-face assessment within two weeks and a first clinical appointment two weeks thereafter. Contact your local veterans' mental health services.
Many fear the consequences of seeking help for a mental health problem.
It may be reassuring to know that around 70% of those who present to DCMHs are returned to full fitness and can continue a productive career.
Of those that don't, many are satisfied with the outcome of leaving the armed forces. Only 3-4% end up being medical discharged.
Alcohol and substance misuse
Alcohol misuse is more common amongst armed forces personnel compared to the general population. Alcohol misuse isn't always easy to identify.
All personnel are required to attend an alcohol and drug awareness lecture every few years, where information is given on safe levels of alcohol consumption.
There are personnel policies about managing alcohol misuse, which provide guidance to the leadership on how to manage personnel whose alcohol misuse comes to their attention.
This includes guidance on managing those whose alcohol misuse does not respond to supportive measures. In some cases, this can lead to administrative discharge.
Support for alcohol misuse can be obtained from your medical officer and DCMHs, which might involve psychological interventions and medication. Support can also be obtained from Alcoholics Anonymous and SMART Recovery.
The MoD has a zero-tolerance policy for drug misuse. Units are randomly visited and personnel will be tested. Anyone found with evidence of illicit drug use risks an immediate administrative discharge.
Inpatient care, when necessary, is provided by the NHS, contracted by the MoD. This means that patients receive treatment much closer to their unit than when the armed forces operated its own psychiatric hospitals.
A close relationship is kept between local DCMHs and the NHS to make sure inpatient care is the best it can be.