£2million to support veterans mental health

Discussion in 'Professionally Qualified, RAMC and QARANC' started by Bedpan2zero, Apr 13, 2010.

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  1. http://www.dh.gov.uk/en/MediaCentre/Pressreleasesarchive/DH_115239

    2m of new funding to help improve mental health services and access to the best possible NHS services in England for Armed Forces veterans was announced by Health Minister Mike O’Brien today.

    The investment forms part of the Department of Health’s ongoing commitment to provide high quality, tailored, health and social care to Armed Forces veterans and those preparing to make the transition from military to civilian life, working closely with voluntary sector partners. The £2 million will fund:

    Up to 15 Community Psychiatric Nurses (or Veterans Therapists) to work in Mental Health Trusts alongside specialist Combat Stress teams to forge better links between the two and enabling more veterans to be treated closer to their homes and families Combat Stress to join forces with The Mental Health Helplines Partnership – so that their helpline can be accessed 24 hours a day by veterans needing advice and support Improved education and training for GPs to help them identify veterans suffering from mental health problems, providing them with the information and skills to ensure that veterans get the best possible treatment Working with Combat Stress and the Royal British Legion to ensure veterans themselves are aware of the range of support available to them, building upon our existing efforts to promote services available from the NHS and from the service charities and organisations.Health Minister Mike O'Brien said:

    'The brave men and women who have given so much for their country deserve the very best health care. That is why we are already working closely with service charities and the Ministry of Defence to ensure that veterans' health needs are better met. The NHS’s high quality mental health services are the best place to ensure veterans get the treatment they need.

    'This new funding will mean even further improvements for veterans and will ensure they can access mental health services more easily, whenever they need them.'

    Wing Commander David Hill, Chief Executive of Combat Stress said:

    'We know from over 90 year’s experience that Veterans want to be treated alongside their peers and by organisations that understand Service-related psychological injury. Today’s announcement is a very welcome further step to ensuring that Veterans have improved access to a choice of appropriate services, with the long term aim of reducing the average 14 year timelag that it takes for Veterans to seek help for psychological illness after leaving the Armed Forces.'

    Today’s announcement builds on a package of measures set out in January this year together with the MOD, to improve support for the increased number of Armed Forces personnel who have received serious injuries such as loss of limb or brain injuries whilst on active service. This included new arrangements to ensure that the transition into NHS care for seriously injured personnel and for all veterans is as smooth as possible and that they receive an early and comprehensive assessment of their current as well as ongoing needs.

    That package also set out that all veterans will be entitled, where clinically appropriate, to the same level of prosthesis from the NHS as they would have got from Defence Medical Services.

    Last week we announced that we are making up to £10m of funding over five years available for research into the affects of acute trauma and physical or psychological rehabilitation.
  2. Ventress

    Ventress LE Moderator

    Shame they cant get the care of the great unwashed right. In my county the only place of safety for a person requiring help is a police cell for 10-20hrs depending when they are picked up to seen by a crisis team. Squalid.
  3. A whole 15 CPNs (or Veterans Therapists, meaning that they may not be nurses at all but CBT practitioners as part of IAPTS)? One for every ten PCTs? Wow! That's going to solve a lot isn't it? I think a large portion of this money may already have been announced anyway as part of the IAPTS (Improved Access to Psychological Therapies) monies were earmarked for veterans psychological provision.

    Will be interesting to see the detail of this.
  4. £2 million? Peanuts. If this announcement is as shallow as previous improvements this government has made, the actual good that may result in practice is likely to be negligible. Pre- election sound bites, I reckon. Nothing more.
  5. Too little, too late.

    Hang on there must be an election soon.....
  6. Check out www.thelongboathome.co.uk. We are an association of over 600 psychotherapists and counsellors who are offer reduced rates for services personnel -their partners and adult dependents & ex-services personnel, plus their partners and adult dependents (and that can include parents).

    The idea is to build a private and confidential network of care across the UK. We are not there yet but I expect that within a year we will have enough volunteers to provide a strong national service. I would like to emphasise that this is not just about PTSD it's much more than that. Some of the top therapists in the UK have joined - many have military links and Yes, we can offer CBT but our members can do much more.

    I would really like your feedback on the offering - Best wishes Martin Pollecoff - Chief Purser - The Long Boat Home
  7. My personal preference, based on work with and for service (and ex-service) charities, would be for a veterans' case worker qualification and organisation (charity run with government funding) with some legislative tinkering to various entitlements e.g. housing and health care waiting lists, for veterans. The case workers would be responsible for picking up vulnerable service leavers and those who get into trouble down the line and then acting as advocates with regards to housing, benefits, healthcare access, etc. as well as general support and mentorship. Successfully reintergrated ex-service personnel would be ideal for this role. It should be a full time job/career that also allows for training and development. I don't feel that it should require a health care or therapist background.

    Despite the fact that there's probably a job in it for me, I'm a little wary of the rush to roll out more and more PTSD treatment based veterans' services. Even amongst this high-risk group, PTSD remains a comparatively rare condition if diagnosed properly by a competent and knowledgable practitioner. Most veterans I've had contact with have a mix of symptomotology around depression, anxiety, personality problems and (depressingly commonly) alcohol misuse. I think it's a big ask for one agency to put this often complex series of life problems right using EMDR or TFCBT. Helping the guys sort out the chaos in their lives and providing a sympathetic ear are, I feel, much more important. Even if they need PTS focussed interventions they're not going to work on someone who is homeless and permanantly drunk.

    Also, I would re-write the definition of 'veteran' and provide an easy way for case workers to check on eligibility. I'm getting sick of listening to horrific war stories from guys who, it turns out, managed two weeks of basic training at RAF Swinderby.
  8. Neuroleptic - That Case Worker Idea is a good one and it should happen- but don't wait for that job.

    Right now, there is not very much support for Veterans or their families or even for the families of serving soldiers.

    www.thelongboathome.co.uk is simply one way of helping to plug that gap.

    As for the issue of PTSD, it's still not the main problem for Veterans or their families. True it's debilitating. You do not want PTSD but it is treatable.
    The problem is that its very dramatic for journalists and politicians to talk about and its very interesting to read about and relatively if you are a charity to raise funds for PTSD treatment, it's a heart-breaker. but its not the main reason for which veterans or their families seek out therapy.

    In my experience - the issues that are reported back to me - are 1/ problems with drink. 2/ problems creating and sustaining relationships 3/ Problems with losses, 4/ problems adapting to civilian life and all these issues include feelings of depression and anxiety and sometimes great anger.

    Some of our members are trauma specialists - most are general practitioners - that is not why we set us the service and I make that perfectly clear on the site.

    You guys deserve all the help you can ask for - you do not need to have PTSD to get help.

    Best wishes Shrink.
  9. This is an excellent idea and assessment of the real problems affecting service leavers. WTF can't the RBL pull it's bloody finger out and start sticking its weight and resources into sorting this mess out?
  10. Tastytoggle,

    How long do you have? The answers are complex and some of them are politically sensitive (in the widest sense of that phrase in that some of them are "off message" for service charities and veterans' interests as well as creating problems for the government). I freely admit that this is my interpretation of the situation and others might disagree.

    We have a distorted view of the traumatising effects of war. Not so much that it doesn't actually cause problems (it most certainly does), but that it is felt that the "problem" is PTSD and other mental health problems closely related to it. Therefore we are going to throw resources, money and time into treating PTSD. In fact, the burden of problems caused by involvement in conflict is much wider and largely, in my opinion non-clinical. What I most frequently see is a lack of 'fit' between the expectations of the veteran and what society is prepared and able to offer him or her. There are in effect two very different beasts looking at each other in mutual incomprehension.This can lead to alcohol problems, involvement in crime, domestic violence, occupational insecurity and a slide down the social scale. Some of these individuals do have PTSD, but many don't. The shift from a very specific type of institutional environment to a radically different way of life is often the main problem. It is a convenient label to stick on the veterans with problems rather than a useful guide to helpful action. I feel that my suggestion of case workers who are trained to identify and assist the vulnerable veteran/service leaver (backed with appropriate resources) is the way to go.

    Why is this? My opinion again, but I blame the Amercians. Well, to be fair, the political and social culture at the end of the Vietnam War that led to the 'discovery' of PTSD (before any one gets upset, I'm not denying the existence of PTSD specifically or psychological war trauma in general. They certainly exist as clinical entities.). PTSD became the problem and has entered the popular consciousness as the main outcome of psychological trauma in war. We can hear it on the radio, see it on TV and in films both factual and dramatic (and some we're not sure about...), read about it in newspapers, magazines and on ARRSE.

    This is where it gets a bit dangerous for me. It is easy to appear very nasty and cynical, as well as become the victim of a witch hunt. If you're a veteran who is finding adjustment to civilian life difficult, you went through some unpleasant stuff whilst serving, is it hard to see why people , and those they seek help from, might frame their problems in terms of PTSD? In fact, the more helpful thing to do might be to concentrate on that adjustment through help and mentoring with employment, education, housing, (appropriate) access to health care, etc.

    I'm uncomfortable writing that, even though I hope people realise that I'm well intentioned. I know there are other professionals in military mental health and veterans charities who have similar views. Nobody wants to stand up and say "hey chaps, we've got this all wrong. Yes, some people actually do have PTSD. But a lot of service leavers/veterans have different problems. Trying a one size fits all approach based on PTSD interventions isn't just a waste of resources. If we use it on the wrong people, we could actually make them worse not better." They are reluctant to do that because they know that if the press and certain other interests in the 'support our boys' industry get hold of it, it would be perceived as an attack on veterans rather than a valid debate on how best to help them. A lot of hysteria surrounds anything that remotely appears critical of individuals who have served nowadays. So people tend to smile, nod and go with the safe bet.

    Oddly enough, the government has put a lot of cash into veterans therapy services. More is always welcome, but in real terms the mental health needs of veterans are getting more per head spent on them than at any time in history. Even post-WW2, its worth reflecting that only 1968 passed without any UK service personnel being killed in action somewhere in the world. Here I truly am going to be cynical. EMDR and TFCBT are a set course of treatment sessions that are easily quantifiable in terms of cost and are time limited. Ex-Corporal Bloggs, who has been diagnosed with PTSD, goes to the veterans clinic and has a course of therapy. Disppointingly, he does not improve. Everyone sadly shrugs their shoulders and mutters "oh well, we tried". He doesn't miraculously improve because he has a whole raft of other social, legal, financial and alcohol problems that cause him far more trouble and that he is understandably a bit put out with. But, and here is the truly cynical bit, if you really wished to help Bloggs you would have to turn on the money tap and keep it running for a long time. The government may be doing more than we often assume, but they're going to be very reluctant to start signing blank cheques. I don't wish to diss the therapists who deliver EMDR/TFCBT (after all I am one myself), but very often we're not treating the problem, just one aspect of it. Also, in these terms, we're cheap and cheerful.

    Lastly, because it's getting late and my vision is starting to blur, one more point. We tend to think of PTSD as something that could happen to anyone if the trauma is great enough. Again there is some truth in that, but the situation is more complicated. There is a heap of evidence to suggest that some people are more vulnerable to PTSD than others (as is the case for most mental health problems in fact). But again, it's not a comfortable thought. If i develop PTSD, does that mean I'm "weak" or flawed in some way? As a recruiter, might I be bringing into the armed forces people who are actually more prone than average to PTSD? It's a nasty can of worms that a lot of people don't like to think about. On the other hand, could case workers use that evidence to spot the "at risk" service leaver and avoid any sort of deterioration/build up of problems?

    Well, that's about 3% of the reasons why I feel we are getting this wrong, to the detriment of veterans, their families and the wider community.
  11. Its 15 better than none and is going to solve a lot more than nothing being done.

    It may be late but its happening and for those who are in need of these services, surely its a good thing!

    It may be peanuts but its £2 million better than nothing.

    You moan that nothings being done and then moan that when the ball gets rolling that its not enough! Its just the start and its better than nothing.

    As nursing/medical professionals sat behind your PCs whether they be at home, on a ward or in your DCMH type consultation rooms it may seem pretty poor but regardless of what you think for those who need help and their families its very welcome and its there for them.

    I just hope that its not a case of certain personnel in the military thinking that the NHS are being drafted in to help as the military are seen as not to be coping with it, so lets slag it off!

    I am of course on standby to hear the subject matter experts tell me that no help is better than a little help.
  12. Some help is always better than no help, if the help addresses the right problem. I am not convinced this initiative does that. See my post above.
  13. I see what you are saying, but if it encourages veterans to come forward then it will be worth it.
  14. Lets hope it works, you medical/nurse types need to be a bit more upbeat about this kind of thing, there are veterans from the Falklands, NI, Bosnia, Iraq, Afghan etc.. who need and want help who will have read this thread thanks to Bedpan posting it, who will no doubt not use this service because military psychie 'experts' have cast it aside as useless!

    To many ex and serving soldiers mental illness is something they are ashamed of, which is why they dont come forward and they continue to live in their own personal hell, I shouldnt need to tell you 'qualified mental health professionals' this but from reading your comments above I feel I need to, you should be advertising the help available not slagging it off before it even starts.
  15. This is great news for the PCT's. I can just see those bosses rubbing their hands together digging out an old plan of action that has never seen the light of day. The NHS is a bottomless pit and no matter how much you throw at it, it will always have its hand out asking for more. Well there is another 2 million gone to bonuses for Directors in all departments.

    This is crap news. We need Military Hospitals with military personnel running them.