Written by Professor Neil Greenberg, Lead for Military and Veterans Health at the Royal College of Psychiatrists.

As the crisis in Afghanistan unfolded last year, many veterans who served there may have asked themselves if the sacrifices they and others made were worth it. For some, it may have brought back distressing memories of the atrocities they saw while on active duty or indeed forced them to recall, potentially re-evaluate, the decisions that were taken under the most difficult of circumstances.

Members of the armed forces are regularly exposed to events and challenging conditions because of their job. Most veterans won't experience longer-term mental health difficulties because of their military experiences, but a significant minority will. Those who do often don't seek help despite there being a lot of support available. Their condition may also affect those close to them, particularly their spouses and children, which is why delivering high-quality veterans mental health care is crucial to helping them recover and live full lives as civilians.

Operation Courage: supporting veterans’ mental health in the wake of war

Substance Use Disorder and Post Traumatic Stress Disorder (PTSD) are mental illnesses more commonly experienced by members of the armed forces than those who’ve never served. Data from the King’s Centre for Military Health Research (KCMHR) shows that nearly 1 in 5 military veterans whose last deployment was in a combat role may be suffering from PTSD. Around 1 in 10 of those who served are likely to experience alcohol use disorder.

While the rate of suicide among those serving isn’t higher than civilians, there is no up-to-date or robust evidence on which to assess the rates of suicide among veterans. This must change if we’re to fully understand the potentially devasting consequences of a mental illness on our veterans.

There have been increases in the number of serving and ex-personnel seeking help for their mental illness. A recent KCMHR study found that a third of those with a mental health problem had seen a mental health specialist, and half had consulted a GP or a Medical Officer. Those who don't seek help often believe that their mental illness isn't serious enough to warrant support and want to deal with the problem themselves. Some service personnel, and veterans, also question the quality of mental health services available for them.

Over the last few years, much work and investment have dramatically improved NHS veterans' mental health services. The NHS provides dedicated mental health services for veterans, which can be accessed through Operation Courage in England, with similar services available across the UK. There's also a myriad of military charities who deliver a range of care and support for military veterans and their families.

Two important resources for improving accessibility

However, there are two important pieces of work that will not only further improve services for veterans but also aim to help those who are reluctant to access mental healthcare to come forward for the help they need.

Firstly, the Royal College of Psychiatrists’ Centre for Quality Improvement launched a quality network for veterans’ mental health services in 2020. It’s introducing new, specific quality standards for these organisations and will help improve outcomes by improving the quality of service provision and by supporting consistency across services.

Secondly, the KCMHR veterans’ mental health conference is supported by the Royal College of Psychiatrists and takes place in March. It attracts delegates from a wide range of charities, academic institutions, the NHS, and government with the intention of providing them with up to date and emerging evidence and policy information as well as being a great place to network and share experience and relevant information. The event tends to sell out quickly; tickets and information about this year's conference are available online now.