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Mental Health Care Provision

Volume 518: debated on Monday 8 November 2010

4. What assessment he has made of the effect of the outcomes of the strategic defence and security review on mental health care provision for service personnel. (22164)

5. What assessment he has made of the effect of the outcomes of the strategic defence and security review on mental health care provision for service personnel. (22165)

The strategic defence and security review committed an additional £20 million per year for the provision of health care to service personnel, part of which will be used to deliver further enhanced mental health care services. It is planned that this will include an uplift to the numbers of specialist and supporting mental health personnel.

Although I welcome the Government’s commitment to increase mental health services for servicemen and veterans, does my right hon. Friend share my concern about the need to tackle the prevalence of dual diagnosis alcohol-related disorders given that it has an impact on those who are in the transition to civilian life, with some ending up in the criminal justice system?

Indeed, my hon. Friend makes an important point. A range of different groups suffer from mental health problems, both inside and outside the armed forces. There are those who come into the armed forces with a problem—either a mental health problem or a substance-abuse problem—those who develop one during their time in the armed forces and those who subsequently develop one. In a civilised society, it is very important that we ensure that all three groups are properly looked after. I would go so far as to say that it is the measure of how civilised a society we are that we look after the most vulnerable, and those with mental health problems must be in that group.

Will the Secretary of State take this opportunity to pay tribute to service charities such as Combat Stress? It can take quite some time before mental health problems become apparent. It is important to support our veterans in the long term and not just in the short term or in the immediate aftermath of their retirement from the service.

My hon. Friend makes an excellent point. Recent evidence suggests that post-traumatic stress disorder is likely to present at a peak at about three years, but may take as long as 14 years to present. It is therefore important that we recognise and see through our through-life responsibility to our armed forces. It cannot be right that our duty of care ends at the point of discharge from the armed forces themselves.

Has the Secretary of State considered the impact on former serving personnel of the proposals by the Government to remove the mobility component of the disability living allowance benefit for those residing in residential care accommodation, which includes, of course, many ex-service personnel?

On all the issues affecting the changes set out to welfare, there have been considerable cross-governmental discussions. I shall continue to have discussions with my colleagues because it is right, as I said, that we look after not only those who are serving but those who have served in a way that is indicative of the services that they have already given to this country.

The Government are reviewing tour lengths and the interval between tours. At the same time, they intend significantly to reduce the size of the deployable force. This means that operational commitments will increasingly fall on the same individuals with greater frequency. Does the Secretary of State share my concern that that will have serious consequences for the mental health and well-being of our troops?

Leaving aside the assumptions in the hon. Lady’s question, which are an argument in themselves, her key point is whether the incidence of post-traumatic stress disorder is related to tour length or tour frequency, or a combination of the two. Evidence increasingly tends to suggest that the key element is the length of the tour rather than the frequency, and that, of course, will instruct the Government’s thinking.

Does the Secretary of State accept that mental health issues sometimes come to light only as a result of self-referral and that the culture of all three services is against such self-referral? Is one way of dealing with that to ensure that, during training, people—and not just those who will be in the chain of command—accept and understand the possibility of mental health issues arising, and that they are willing to recognise that and, if necessary, to take steps to deal with it?

That is true for not only the armed forces but society in general. Only when we, as a society, remove some of the taboo of mental illness will we properly unlock the ability to deal with it successfully. My right hon. and learned Friend is correct that we need to look at people’s willingness to self refer, and that process is made easier if they can contact a helpline run by members or ex-members of the armed forces, in whom they are likely to be able to place greater faith.

The King’s college review of mental health services for the military says that one way in which the mental health of those serving in theatre can be impacted is if they feel that their families are not being supported. Given the review of allowances that has taken place, how will we ensure that our serving personnel are confident that their families have good support and appropriate allowances?

The hon. Lady is absolutely correct. One thing that I learned during the five years I worked alongside the armed forces and their families as a doctor was that if one wants to create unhappy service personnel, the surest route is to create unhappy service families. We must examine the situation as a whole, and we need to look at all elements of the military covenant—not just the financial elements that she mentions, but service education, access to health care for service families and other welfare issues, including accommodation.