Armed forces veterans often have unique health needs. Clinical staff from London NHS Op COURAGE explain how their service works, some of the additional support available, and how GPs can refer into the service.
On leaving one of the armed services, many personnel transition well into civilian life, however a significant number experience difficulties. Veterans may grapple with a range of mental health issues, including post-traumatic stress disorder (PTSD), depression, anxiety, anger, and alcohol misuse.
Op COURAGE is a specialist NHS service that helps individuals navigate these mental health challenges and other issues they may encounter post-military service in line with the Armed Forces Covenant.
Duty of care
The Armed Forces Covenant is a promise by the government to the armed forces, including reservists, veterans, and their families, that they are not disadvantaged as a result of military service. This promise is now enshrined in law with the introduction of the Armed Forces Act 2021.
There is now a legal responsibility for statutory services to show ‘due regard’ to the armed forces community and prevent disadvantage as a result of military service.
The role of Op COURAGE
Op COURAGE helps address the unique needs of both veterans and military personnel transitioning back to civilian life. It offers an in-depth mental health assessment and subsequently explores what support may be available locally for the veteran. Where local support is not available or accessible in a reasonable timeframe, Op COURAGE bridges this gap and provides psychological interventions and care.
Op COURAGE also provides psychiatric management and case management, where veterans present with multiple needs. The service offers a holistic multidisciplinary approach that incorporates therapeutic interventions, peer support, practical resources, and family support to help veterans regain control of their mental health and overall wellbeing.
Therapeutic interventions
The primary focus of the service is to provide access to evidence-based psychological interventions to address a wide range of mental health difficulties that recognises some of the unique challenges facing veterans.
Veteran peer support
Veterans often find solace in connecting with peers who have shared experiences. Veteran peer support workers at Op COURAGE offer a safe space for veterans to discuss their feelings and challenges openly; they also assist with practical support, advocacy and help veterans to engage with local activities. These connections help reduce feelings of isolation.
Social integration and employment
Op COURAGE also helps to address social vulnerabilities (such as debt, or housing) that cause or exacerbate mental health difficulties with the expertise from veteran charitable partners Walking With the Wounded (WWTW) and STOLL, a provider of supported housing for vulnerable veterans.
The service also has links with other veteran organisations supporting veterans with employment and with Op NOVA, a service for veterans in contact with the justice system, and Op FORTITUDE, a service for veterans who are homeless or at risk of homelessness.
Support for family and significant others
Op COURAGE also extends support to veterans’ families. The service strives to include significant others in the development of each veteran’s care plan. By extending support to a veteran’s close support network, significant others can better understand veterans’ needs and be provided with the tools to offer effective support.
The service supports referrals to The Ripple Pond, a charity with extensive experience in supporting family members primarily through peer support, and works closely with Op COMMUNITY – a service for armed forces families that is available to the families of serving and reservist members of the armed forces as well as veterans’ families. Op COMMUNITY also offers advice and consultation to NHS staff, to improve their understanding of military life and culture.
Physical health support
Op RESTORE provides specialist care and support to veterans who have physical health issues as a result of their time in the armed forces. It uses a network of clinicians across England who have a military background and/or an understanding of the military.
Work with other services
It is important to note that we do not offer support in isolation, and our aim is not to duplicate mainstream NHS services. We work alongside other NHS services and with a wide network of statutory and non-statutory providers to support veterans to get the help they need. However, we have particular expertise in working with veterans and help navigate the complex NHS and third sector veteran landscape.
Accreditation
GP practices could consider becoming accredited to ensure the meeting of the needs of the armed forces community. GP practices can become accredited under the RCGP’s Veteran Friendly GP scheme. Research shows that becoming accredited benefits both veterans and practice staff, with veterans getting access to the right support for a better patient experience and improved outcomes.
What veterans have said about Op COURAGE
‘I was well looked after from as soon as I made that initial phone call right up to discharge. The sessions I received and training I gained has helped me to build the foundations I need to start to reclaim my life back.’
‘The service really helped with my anger… now I feel much more calm and don’t experience the same anger I felt before. It was so helpful for me and I am so grateful.’
How to make a referral
Op COURAGE accepts self and professional referrals. You can find full details of the Op COURAGE services and contact details for each part of the country on NHS England’s website here.
For those in the London and Greater London area we have an online referral form here. London Op COURAGE also provides training on veteran sensitive practice and encourages professionals to sign up as veteran champions on our website.
- This article was written by Jade Gibson, assistant psychologist, London NHS Op COURAGE, Dr Sue Ferrier, consultant clinical psychologist and joint head of London NHS Op COURAGE, Dr Deirdre MacManus, consultant Psychiatrist and joint head of London NHS Op COURAGE, and Dr Alyssa Joye, lead clinical psychologist, London NHS Op COURAGE