Trigger warning: This article contains references to self-harm and suicide

Concerns over the mental health of servicing personnel and their transition from active duty to civilian life have long been a policy concern for successive governments (Lloyd George’s promise of ‘homes fit for heroes’), and thoughts of their wellbeing have remained in the public consciousness especially as Remembrance Sunday comes around.

Mental health armed forces research

Statistical evidence documenting the mental health of military personnel reflects a well-funded and organised system of support – even though imperfect.

One study found lower than expected instances of PTSD, mental health problems, and alcohol misuse in UK armed forces personnel. However, the study did link instances of those three issues to deployment in Iraq and Afghanistan, and therefore the prevalence of PTSD was unsurprisingly above the civilian population.

On the other hand, research published by the British Medical Journal recorded that serving military personnel are twice as likely to suffer from common mental disorders and pointed to a wide range of research that linked PTSD with suicidal ideation.

And in terms of homelessness, in 2014 The Royal British Legion estimated that the proportion of those sleeping rough who had served in the armed forces was between 3-6% (armed forces veterans were estimated in 2017 to make up 5% of household aged 16 years or older). In comparison, another study projected that the proportion of homeless people who were veterans in London dropped from 3-2% between 2017 and 2019.

Anecdotal evidence also suggests that there seem to be gaps within the safety net that has been designed to support those leaving the armed forces – as veterans have been reported to on average take 11 years to seek help for mental health issues, and many have voiced their problems in accessing the required mental health support.

Struggling to cope with the return to civilian life

Veteran Mark Foster struggled with physical injury, homelessness, alcohol dependency, and undiagnosed PTSD following the death of a close friend in Afghanistan.

Mark said: “I started to drink heavily and to have seizures and panic attacks, but I was too scared to ask for help. When I did finally go forward and speak out, I was branded a waste of space.”

He explained that he could not cope with civilian life, and with the trauma that he had experienced on duty, so he isolated himself from the outside world and his family and friends. And, as his destructive and aggressive behaviour towards those closest to him continued, he started to self-harm.

“I was that desperate and frustrated with my situation, that one day I… threatened to kill myself – that was when the Police came and I they referred me to a veterans’ charity who immediately understood my situation and knew how to help. They made all the difference and put me on the road to recovery."

"I needed their support earlier, right from the first signs of trouble – that understanding of the military is key to treating ex-military like me.”

The Veteran’ Mental Health High Intensity Service (HIS)

To help people like Mark, HIS will provide clinical care and treatment for veterans who are experiencing a mental health crisis and who urgently need help, doing this by working with local mental health services that are already treating the veteran – and will provide:

  • Crisis care services for veterans
  • 24/7 support during in-patient stay
  • Assistance in signposting to the best-suited services
  • Additional support for family members and carers.

David Rowley, head of operations at Leeds and York Partnership NHS Trust, said that: “We’ve developed this through a strong collaboration between the NHS, support charities and, most importantly, veterans who have experienced services first-hand. It is their stories that have shaped what we offer - notably around supporting their journey through treatment which can include their families.”

Samantha Hannar-Hughes, clinical team manager for the North of England Veterans’ Mental Health High Intensity Service, emphasised the importance of this new services and said that: “We know that veterans can struggle to engage with health services, particularly mental health, and sometimes it can take years for them to seek help. This means they can present in crisis to local services that might not have experience of dealing with veterans with complex mental health problems.”

This service will be rolled out across the country, but in the North of England, HIS is being provided through local NHS trusts and well-known veterans' support charities, one being Combat Stress. Dr Felix Davies, Director of Operations at Combat Stress, said: “Combat Stress will be building on the positive relationships we already have in place with the Trust and other providers in the north of England, as we deliver elements of both the High Intensity Service and Complex Treatment Service for veterans in this region.”