Defence and armed forces – guidance

Mental health support for the UK armed forces

Mental health support and advice facilities for service personnel, reservists, veterans and service families.

The mental health and wellbeing of service personnel, whether regulars or reservists, their families and veterans is a priority for the government.

Serving personnel

The MOD and Defence Medical Services have worked hard to improve the mental health services available to those serving in the armed forces (including mobilised reservists). We have implemented many new interventions including deploying expert mental health professionals to the front line and ensuring that briefing on the support available, assessment and treatment (if required) is offered to every serviceman and woman both before and after deployment.

These improvements have seen stress management being embedded throughout the armed forces, with mental health awareness training, caring leadership and effective line management skills becoming a priority for all levels. We are making a concerted effort to reduce the stigma associated with mental health and further promote awareness of the medical care and support available.

If someone thinks they have a mental health condition or just wants someone to speak to, they can ask for help from any medical officer or their chain of command. All units are supported by non-medical personal that are able to signpost to the relevant service. This includes Trauma Risk Management (TRiM) Practitioners (individuals trained in assessing the risk of problems associated with traumatic events) and chaplains.

Personnel can then either be treated for mental health problems by their medical officer in their unit medical centre, or referred to specialist mental healthcare services.

Specialist mental health services are primarily delivered through 16 military Departments of Community Mental Health (DCMHs) located in large military centres across the UK, as well as centres overseas. UK DCMHs are staffed by psychiatrists, mental health nurses, clinical psychologists and mental health social workers.

A wide range of psychiatric and psychological treatments are available, including medication, psychological therapies, social support and a change of environment where appropriate.

For some personnel there may be a fear that presenting for help with a mental health problem may damage their opportunities to remain in the armed forces. More than 70% of those who do present to DCMHs are returned to full fitness and can continue a productive career. Of those that don’t, many are satisfied with the outcome of leaving the armed forces. Only 3 to 4% of personnel are medically discharged as a result of a mental health problem. It must be noted that to ensure a continuation of care, individuals are still able to access defence mental health services up to 6 months after discharge.

Reservists

Mobilised reservists receive care in the same way as regular personnel. Non-mobilised reservists remain under the care of NHS services, and can also access occupational health services via the Defence Medical Services, which addresses their fitness to serve.

The Veterans and Reserves Mental Health Programme , run in partnership with the NHS is staffed by both military and civilian clinicians with extensive military experience and knowledge.

The service offers free advice and is open to all current or former members of the UK volunteer and regular reserves who have been demobilised since 1 January 2003, following operational deployment overseas as a reservist and who believe that their deployment may have affected their mental health.

Service families and veterans

In the UK, the NHS is responsible for delivering healthcare for the families of those serving and veterans. Mental healthcare is a multi-agency delivery effort and the MOD and UK Department of Health are working with the NHS and service charities, including Combat Stress, to promote awareness of veterans’ and service family issues.

Veterans can also access services ran by the Veterans and Reserves Mental Health Programme (VRMHP) as above.

The MOD provide healthcare services to families who are registered with Defence Medical Services, including those who accompany their serving family member when posted to our major bases overseas.

Armed forces covenant and mental health

The Armed Forces Covenant states that the armed forces community should enjoy the same standard of, and access to, healthcare as that received by any other UK citizen in the area they live.

MOD has published information leaflets aimed at veterans, serving personnel and their families outlining how the Covenant can help them. If members of our armed forces community feel they have been disadvantaged accessing public services these leaflets will help to identify where to go to address the problem.

Getting advice or help urgently

Serving personnel

Help is out there for serving personnel:

  • your first point of call should be your chain of command, unit medical officer, welfare officer or chaplain if you are in the UK or overseas. They are there to help and offer the best advice. Contact numbers for medical out of hours support are available through your medical centre

  • in an emergency you should contact your local medical officer. If your local medical officer is unavailable and you are in England, Scotland or Wales contact your local NHS accident and emergency (A&E) unit. In Northern Ireland, Medical Reception Station Aldergrove operates 24/7 telephone manning with access to appropriate specialists

  • additionally, Combat Stress/Rethink offer a 24 hour freephone helpline if you have concerns about your mental health. The number to call is 0800 138 1619. They provide emotional support, a listening ear and signposting service

  • the MOD has contracted with the Big White Wall which provides safe, anonymous support to anyone struggling with a range of common mental health issues, or who feels burdened by everyday worries and concerns. It is free for all serving personnel, veterans, and their families and is available 24/7 at www.bigwhitewall.com, and via a smartphone app for iOS and Android.Members can talk to each other anonymously and share experiences, express themselves in images, and follow guided self-help courses on topics such as managing anxiety, stopping smoking, dealing with alcohol, and getting better sleep. There is also a range of clinical tests, guides and tips to improve wellbeing including articles on self-esteem, relationships and many more. Trained counsellors (called Wall Guides) are on hand at all times to moderate the service and provide support. Go to www.bigwhitewall.com for more information or to join today.

Reservists

There are specific mental health services for reservists:

  • if currently mobilised, then follow the advice provided above for serving personnel
  • if previously mobilised, talk to your NHS GP or the Veterans and Reserves’ Mental Health Programme. The freephone number to call is 0800 032 6258
  • Combat Stress/Rethink offer a 24 hour freephone helpline if you have concerns about your mental health: Freephone: 0800 138 1619. They provide emotional support, a listening ear and signposting service
  • Big White Wall provides safe, anonymous support to anyone struggling with a range of common mental health issues, or who feels burdened by everyday worries and concerns. It is free for all serving personnel (including mobilised and non-mobilised reservists), veterans, and their families and is available 24/7 at www.bigwhitewall.com, and via a smartphone app for iOS and Android.Members can talk to each other anonymously and share experiences, express themselves in images, and follow guided self-help courses on topics such as managing anxiety, stopping smoking, dealing with alcohol, and getting better sleep. There is also a range of clinical tests, guides and tips to improve wellbeing including articles on self-esteem, relationships and many more. Trained counsellors (called Wall Guides) are on hand at all times to moderate the service and provide support. Go to www.bigwhitewall.com for more information or to join today.

Veterans

Discharged servicemen and women are able to access Defence Mental Health Services up to 6 months after leaving the armed forces. It is important that once an individual knows their location after discharge that they register with a local GP as soon as possible, this will enable better continuation of care and alert services of their needs. More information on the service available veterans and an easy to use service locator tool can be found on NHS Choices.

Service families

If you have a concern about the mental health of a family member who is a serving regular, reservist or veteran:

  • use the appropriate contacts set out above
  • talk to your NHS GP
  • access support from Big White Wall