Contents
1.0Purpose of Report3
2.0Recommendations3
3.0Background4
4.0Conclusions4
5.0Members and Witnesses6
Appendix 1 Scoping Document
THE MENTAL WELL BEING OF MILITARY PERSONNEL AND MILITARY VETERANS
1.0Purpose of Report
1.1 This is the report of the Mental Well Being of Military Personnel and Military Veterans Topic Group. In particular the Topic Group looked at how well the mental health needs of military personnel returning to Hertfordshire from conflict zones or military veterans who have experienced conflict in the past were being met.
1.2 The Topic Group addressed the following questions:
- Who are the people we are talking about and what will their needs be now and in the future?
- How well do we understand these people’s needs?
- How well are their needs being met currently?
- What plans are there for any required improvements in services or information?
1.3The Scoping document can be seen at Appendix 1. The papers issued to members can be found at:
2.0 Recommendations
2.1To be advised by Hertfordshire Partnership Foundation Trust, Mental Health Services, of the number of veterans seen each year by the team, when figures become available. (4.1)
2.2To investigate the possibility of HCC providing free accommodation for organisations like Combat Stress to provide activities such as therapeutic sessions. (4.5)
2.3To extend the scrutiny by a further day in Autumn 2011 to enable members to input to the work programme that the Joint Commissioning Team (JCT) wishes to establish to meet the needs of service personnel and veterans living in Hertfordshire. Members will also receive details of alcohol treatment services available in the county. NB the Crime and Disorder Scrutiny for 2011/12 is focussing on alcohol misuse. (4.7)
3.0 Background
3.1 As British military involvement in overseas operations in theatres such as Afghanistan and Iraq has increased over the last decade nationally there has been an increase in the number of military personnel and veterans experiencing mental health problems.
3.2 In Hertfordshire the consequences of additional military personnel and veterans experiencing mental health problems is limited because there is only one base, Northwood, within the county boundary. It is home to the Permanent Joint Headquarters of the armed forces, and it is a NATO base. As such the majority ofits service personnel based there do not see active service but are involved in the planning of operations. The army base at Bassingbourne is just across the county border and a number of the military personnel based there do live in the county or are registered with a Hertfordshire GP which means NHS Hertfordshire is responsible for their health care.
3.2Although mental illness is a major issue a far greater number of military personnel leaving the armed forces, 13%, have alcohol related problems.
3.3The definition of a veteran is a person who has served at least one day in the military.
4.0Conclusions
4.1 Members heard of the work of the Hertfordshire Partnership Foundation Trust Enhanced Primary Mental Health Services Teamwhich specialises in delivering Cognitive Behavioural Therapy (CBT) as a therapeutic intervention. In particular they heard of the work the team do to support adults experiencing mild to moderate anxiety and depression. They were pleased to hear of the training staff receive around the needs of veterans. Members noted that currently the service does not know how many of the 12,000 people referred to them each year are veterans or serving forces personnel. The topic group asked to be advised of the number of veterans and serving forces personnel seen each year by the team, when figures become available. (Recommendation 2.1)
4.2Members were advised of the services provided by the military to support service personnel returning from conflict, and personnel as they leave the forces. They welcomed the huge change in the level of support provided post conflict and the partnership working with NHS Hertfordshire to deliver high quality services.
4.3Members heard of the difficulties faced by veterans when the structured environment and support mechanisms the services provide such as food, clothes and accommodation are removed. They heard that at times veterans can be a group that are difficult to engage with. Evidence presented to members by the charity Combat Stress showed that the average elapsed time between leaving the forces and first contact with the charity is 13 years. Members also noted that average age of those accessing services had dropped from around 70 in 2000 to 44 in 2011, perhaps indicative of the scale of operations the military have been involved in the last 10 years. However, in general terms, the support networks now in place are much greater than they were even 5 years ago. Members endorsed the approach being taken to advertise the support networks available and encourage veterans to access them as and when required.
4.4Members discussed the disproportionate number of ex service personnel in prison. They heard of support in place for them upon release. Members commented that one measure of the effectiveness of all the support mechanisms both during and post service could be a reduction in the number of ex service personnel serving prison sentences.
4.5Members asked Combat Stress whether there was any help they could provide. They were advised that if it were possible for HCC to provide free accommodation for activities such as therapeutic sessions it would help them greatly. (Recommendation 2.2)
4.6Members heard from Viewpoint. They were pleased to hear of its work with Combat Stress and how Viewpoint is seeking to work with veterans since commencing a programme of support in 2009. This programme seeks to raise the voice of veterans, act as a signpost and provide appropriate support. It is early days but the intention is to develop the service further.
4.7 Members welcomed the news that the JCT have organised a stakeholder event on the 21 June 2011, with a view to establishing a military veteran’s network. They heard the event will be an opportunity for key stakeholders in Hertfordshire to review the current Department of Health guidance and policy, share information about the current picture and identify how stakeholders can work together to improve the health and well being of military personnel, their families and veterans.Members agreed that there should be a second meeting of the topic group, in Autumn 2011. This will allow them to give input to a work programme the JCT want to establish to ensure the needs of service personnel and veterans living in Hertfordshire can be identified and addressed at a much earlier stage, and to make health and social care ensure that there are appropriate services in place locally which are accessible. (Recommendation 2.3)
5.0 Members and Witnesses
Members of the Topic Group
Allison Ashley
Roger Beeching (Vice Chairman)
Jan Maddern (Chairman)
Eddie Roach
Colin Woodward
Witnesses
Michael AntellGP Practice Manager Nato Headquarters, Northwood
Major Malcolm BellwoodOperations Manager, Combat Stress
Leslie BillyOperational Manager, Viewpoint
Steve MaluskySenior Commissioning Manager, Adult Mental Health Services, JCT
Sian TimmsMilitary Social Worker
Dr Nick WhiteConsultant Clinical Psychologist, EPMH, HPFT
Officers
Tom HawkyardHead of Scrutiny
Laura Shewfelt Democratic Services Officer
Also in attendance
Sarah McIntyreTrainee Solicitor
SCRUTINY REMIT:
Effectiveness of Primary Care in addressing the needs of military personnel
and military veterans
OBJECTIVE:To identify how well the mental health needs of specialist groups are being met and in particular of military personnel returning to Hertfordshire from conflict zones such as Afghanistanor military veterans who have experienced conflict in the past.
QUESTIONS TO BE ADDRESSED :
- Who are the people we are talking about, and what will their needs be now and in the future?
- How well do we understand these people’s needs?
- How well are these people’s needs being met currently?
- What plans are there for any required improvements in services or information?
OUTCOME :
Clarity about, and changes needed, in services
CONSTRAINTS :
a)There is a wholescale transformation underway of all Mental Health services in Hertfordshire. This is taking place in challenging financial circumstances. During such large scale change it can prove difficult to focus on the needs of specific hard to reach groups or on areas of particular unmet need.
b)It is possible that initially there may not be sufficient information for an informed decision to be made about this topic. If so, then following initial examination, it may be worth planning a further examination once extra information has been gathered.
EVIDENCE & WITNESSES:
Joint Commissioners / Health and Wellbeing / Public Health Officers
Hertfordshire Partnership Foundation Trust / Clinical Professionals
Viewpoint
Armed Forces Charities (SSAFFA, Combat Stress etc)
METHOD:One day DATE: 16 June 2011
MEMBERSHIP: Jan Maddern (Chairman), Eddie Roach, John Usher, Roger Beeching, Alison Ashley
SUPPORT :
Scrutiny Officer: Tom Hawkyard
Lead Officers: Steve Malusky
Democratic Services Officer: Laura Shewfelt
HCC Priorities for Action : -how this item helps deliver the Priorities
- Support economic well being
- Maximise independent living
- Ensure a positive childhood
- Secure a good education for all
- Reduce carbon emissions
- Ensure safe neighbourhoods
b) A significant number of offenders have mental health problems which may also be combined with substance use problems. Addressing these issues will help reduce the likelihood of offending
- Be a leading council
CfP’S OBJECTIVES :
- Provides a critical friend challenge to executive policy makers and decision makers
- Enables the voice and concerns of the public to be heard
- Is carried out by independent governors who lead and own the scrutiny role
- Drives improvement in public services
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