Any reserve serviceman or woman injured when on operational deployment is entitled to and will receive the same level of medical treatment and support as their regular colleagues. This may include treatment at a military Department of Community Mental Health (DCMH) or admission to the Priory Group. They will continue to receive treatment until they are deemed to have reached a steady state of fitness. They are then demobilised, and taken through a transition from military to NHS care, if they have continuing healthcare needs.
Once demobilised, it is a long established tradition that reserve forces’ medical care becomes the responsibility of their own local NHS primary care trust and the majority of veterans’ physical and mental health needs are met by these provisions. However, we recognise that many health professionals may have limited experience of dealing with individuals with mental health symptoms arising from their service experience, and some reservists may be concerned that there will be only limited understanding by GPs of the context of their illness. In these specific circumstances, MOD recognises that it has an expertise to offer, and in November 2006 it launched the Reserves Mental Health Programme (RMHP).
The RMHP is open to any current or former member of the UK volunteer and regular reserves who has been demobilised since 1 January 2003 following an overseas operational deployment as a reservist, and who believes that the deployment may have adversely affected their mental health. Under the programme, we liaise with the individual’s GP and offer a mental health assessment at the Reserves Training and Mobilisation Centre (RTMC) in Chilwell, Nottinghamshire. If diagnosed to have a combat-related mental health condition, we then offer out-patient treatment via one of the 15 DCMHs. If more acute cases present, the Defence Medical Services will assist in arranging for access to NHS in-patient treatment.
In conjunction with the Department of Health, we recently launched the first of a number of community mental health pilots. Each site will have a trained community veterans’ mental health therapist. Veterans will be able to access this service directly or through their GP, ex-service organisations, the Veterans’ Welfare Service, or Social Service departments. The pilot at the Staffordshire and Shropshire Foundation Healthcare Trust is now open. This will be followed by pilots in Camden and Islington, Cardiff, Middlesbrough, St. Austell and Scotland. If these pilots prove successful the model will be rolled out more widely across the UK.
As an interim measure, and to assist those veterans not in the catchment areas of one of the new community mental health pilots, we have expanded of our Medical Assessment Programme (MAP) based at St. Thomas’ Hospital, London, to include assessment of veterans with mental health symptoms with operational service from 1982 (including veterans of the Falklands campaign).
Veterans who have recently deployed to Iraq (Operation Telic) and Afghanistan (Operation Herrick) may also attend for a full medical assessment if their Service Medical Officer or General Practitioner thinks it would help. The MAP was established in 1993 for veterans of the 1990-91 Gulf conflict and we encourage veterans worried about their health to attend. The clinician in charge also provides support and advice to GPs and other civilian health professionals requiring advice on the military aspects of treatment.