We are failing to adequately care for service personnel and veterans
Serving personnel and veterans who need mental health care are not receiving the support promised in the Armed Forces Covenant. That needs to change, says Ruth Smeeth
We have a problem. It’s becoming received wisdom that people leave the armed forces broken and without the right support package in place. For the overwhelming majority of veterans, this simply isn’t true; they transition to civilian life as well-rounded, highly skilled individuals who contribute hugely to their community. But what is a concern is what’s in place for those people that do need support both during their service and after, how long they need to wait for help, how they can access continuing care pathways and who are supporting their families.
Unbelievably, at the crux of the matter is a clash between the Armed Forces Covenant and the NHS constitution. The covenant recognises that our veterans may have the right to special treatment if required (although no one has defined special treatment), but the NHS constitution states that those in the armed forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside. So we have a conflict – “special treatment” versus “not disadvantaged”.
Falling through the Gap
Regardless of the administrative battle, this means that veterans and their families have been falling through the gap, especially when we look at the issue of access to NHS mental health services. Last month, the Defence Select Committee published a report exploring Mental Health and the Armed Forces: Provision of Care. Our findings were stark and should unsettle every policymaker in parliament. If we truly believe that the men and women who volunteer to serve our country and keep us safe have a reasonable expectation that we will look after them both during and after their service, then we are failing.
For serving personnel, we found that two of the four MoD mental health centres were rated inadequate or needing improvement, and over half of all psychiatric posts are currently unfilled. The situation was little better for specialist veteran support, with veterans waiting up to 12 months for treatment after their initial assessment, allowing patients to deteriorate over that period to the point of acute distress for some. This situation was particularly dire in Northern Ireland. But we shouldn’t be surprised when across England, Scotland and Wales we are spending less than £10m per year on veterans’ mental health care. This alone is leading to a patient lottery, with excessive waiting lists and no single body in charge of an individual’s care pathway.
As shocking as these statistics are, and we must remember that behind every statistic is a family, I think the most shocking indictment on the current system is the fact that the MoD final ‘check-in’ with veterans is 12 months after discharge, when armed forces charities have been clear that Iraq and Afghanistan veterans typically don’t seek medical help for four years post discharge, for support related to their service.
So what do we need to do to ensure the Armed Forces Covenant is being applied in the way we intended? Well …
- Once assessed, veterans should be continually monitored during the wait for treatment to ensure that intervention is made to prevent cases from becoming acute.
- There needs to be a national, dedicated mental health centre, ideally co-located with the Defence and National Rehabilitation Centre which is currently being built at Stanford Hall in Leicestershire, which will oversee both acute cases but also coordinate long-term care pathways so veterans have the support they need at home.
- We also need to remember that the covenant applies to families too, and currently their specialised mental health provision is practically non-existent.
So there is work to be done and money to be spent but our armed forces personnel have been made promises which we now have to deliver.
Ruth Smeeth is Labour MP for Stoke-on-Trent North and a member of the Defence Select Committee More here