17. Special (but only while needed)
Resolution submitted by the RCN Salisbury and South Wiltshire branch
That this meeting of RCN Congress urges RCN Council to make renewed effort to campaign to ensure that ex-members of the armed forces, who suffer psychological problems relating to their service time, can access appropriately skilled and knowledgeable mental health services
Report on this debate
This resolution introduced by Derek Blackshaw, RCN Salisbury and South Wiltshire branch, inspired impassioned debate with personal accounts of the effect of service life, especially conflict, on the mental health of service personnel. Derek described how these effects; depression, alcoholism, post traumatic stress disorder, to name a few, often surface after the two year deadline of mental health evaluation in the services. Supporting this resolution Tom Murray of the Exeter branch spoke about the British Legion who support not only veterans of the first and second wars, but survivors of conflicts such as the Falklands, Bosnia, Kosovo, Northern Ireland and Afghanistan, offering financial, social and emotional support to many of the 10.5 million people eligible to access their charitable service. Tom said that there is a place for charities like the British legion, with their specialist knowledge and understanding of the issues involved, to support the Government and health services but that they should not be used as a substitute.
Tom Bolger, Stuart McKenzie and Brian Williamson all told of their privilege in working with ex service personnel but described their sadness that their contact was in forensic or prison environments when the effects of service life had left individuals unable to cope and conform with life in society.
Lisa Lester and Gail Brooks felt bitter that the RCN were again debating the issue because previous promises by Government had not been fulfilled and service personnel were still being failed.
The resolution was passed with a 99.25% vote.
| For | 396 | 99.25% |
|---|---|---|
| Against | 3 |
0.75% |
| Abstain | 2 |
| For | 123 |
97.6% |
|---|---|---|
| Against | 3 |
2.4% |
Background
Military personnel continue to present with the psychological consequences of engagement in warfare. There has always been a marked reluctance on the part of service personnel to access mainstream health and social care services, particularly in areas where they have served, such as Northern Ireland. This problem is often exacerbated by the difficulty in accessing mainstream health services; seven of the eight military hospitals in the UK have shut since the government review of the early 1990s, with the final unit scheduled for closure in 2009. However, acute services are currently being developed, such as the Birmingham New Hospitals project.
Yet, the treatment of mental health problems of military and ex-military personnel is mixed. The House of Commons Defence Committee recently concluded that mental health provision for serving personnel was ‘adequate’ but with room for improvement. However, many problems only come to light several years after people have left the Armed Forces, and there is currently no proper system for tracking ex-servicemen and women and making support available to them when necessary (Defence Select Committee, 2008).
In 2003 RCN Congress passed a resolution requesting RCN Council raise the profile of mental health services for armed forces personnel. In 2005, the RCN hosted a conference which aimed to persuade the government to ensure every mental health trust had a senior clinician in place, responsible for educating staff on the special needs of ex-service personnel. To date, there has been no discernable outcome on this issue.
In response to complaints from solders and families about the difficulty of accessing quality care upon returning from Iraq and Afghanistan, new rules have now been put in place to fast-track NHS treatment for military personnel returning from action. In November 2007, the Welsh Minister for Health and Social Services also announced that war veterans will get priority NHS treatment. The Welsh Assembly Government (2007) will be issuing guidance to clinicians to highlight the extension of priority treatment for war veterans. Clinicians will continue to decide on the priority for treatment, based on patients’ clinical needs ― war veterans will not automatically go to the top of waiting lists. The Scottish Government’s new blueprint for NHS Scotland, Better health, better care, (Scottish Government, 2007) also states a commitment to ‘work in partnership with Defence Medical Services Department and the charity Combat Stress to meet the mental health needs of serving and former armed services personnel’.
In December 2007 the government announced the establishment of a new service to provide care and rehabilitation for former service personnel in Northern Ireland, representing an investment of £2 million per annum. In addition, a new model of community mental health services is to be piloted, offering veterans access to clinicians with expertise in veterans’ mental health, and providing assessment and help for veterans to get suitable treatment. Six dedicated mental health units to help soldiers suffering post-traumatic stress disorder will also be set up across the UK.
If ex-service personnel are to gain access to the specialist mental health care services they require, then those services need to be adequately equipped and able to both recognise and treat the problems arising.
References and further reading
Welsh Assembly Government (2007) Extra support for war veterans in Wales, Cardiff: WA. Available from:
http://new.wales.gov.uk/news/ThirdAssembly/Health/2007/1820777/?lang=en
(Accessed 30 January 2008) (Internet).
House of Commons, Defence Committee (2008) Medical care for the armed forces: seventh report of session 2007-08, London: Stationery Office (HC327). Available from: www.publications.parliament.uk/pa/cm200708/cmselect/cmdfence/327/32702.htm (Accessed 25 February 2008) (Internet).