Surgeon General visits mental health unit

Parklands Hospital in Basingstoke is one of seven mental health units across the UK giving dedicated mental health in-patient care to military personnel. Each year there are around 250 in-patient admissions to these units.

This year the Basingstoke unit has cared for 80 personnel from across the Navy, Army and RAF, making it by far the busiest of the seven specialist medical centres.

The unit, which opened in January, serves MOD personnel serving in the area, including the major bases of Aldershot, Tidworth, Portsmouth and Brize Norton.

During his visit on Monday 23 November 2009, the Surgeon General said:

"Overall servicemen are healthier than the general population. The mental health profile is similar to that of the general public and although alcohol problems are higher, particularly in the Army, the main mental health problems that the military have, they share with the general population; depression, anxiety and relationship issues."

Countering widespread media claims that post traumatic stress disorder (PTSD) is a problem in the military, especially for those who have served on operations, Lt Gen Lillywhite said:

"PTSD is a very small proportion of the problem. Only four per cent of those that deploy will suffer from PTSD.

"My view is that we do not have a time bomb waiting to go off or that PTSD is a major concern.

"We're already addressing the issues of mental illness from the beginning of a recruit's career and we're educating people at every stage in their training. People are being told to accept that it [mental illness] is a normal part of life, that it can be treated and it's not a problem.

"Young soldiers are now more ready to engage with psychological issues. Whether this is a societal change or something we are doing, we don't know. But it doesn't matter. The important thing is they are seeking help."

The specialist six-bed unit at Basingstoke is part of Hawthorns 2, an acute ward already based at the hospital.

MOD patients have a separate area with their own bedroom and a lounge, toilet, garden and gym but they can integrate with the rest of the unit for dining and therapy.

Personnel referred by the MOD have the same individual, tailor-made treatment as any other patient would receive.

Less than one per cent of the military patients in the unit have been treated for post traumatic stress disorder.

Most have been admitted with anxiety problems or depression and have spent on average three weeks in the unit before returning to their units.

Staff from the NHS take part in joint planning and training with the MOD to build up expertise in treating patients and improving the service.

In-patient care at one of the specialist mental health units is just one aspect of mental healthcare in the forces.

All personnel - including reservists - are encouraged to talk to medical officers, chaplains or their chain of command if they are distressed or believe they might be suffering from a mental health condition.

The introduction of Trauma Risk Management (TRiM) has made it easier to identify such individuals and give them the support they need, whether in-theatre or in the UK. TRiM is a unit-led and peer-group-administered approach that aims to reduce the sense of stigma surrounding mental health. TRiM relies upon non-medically trained staff to spot those who might have been affected by traumatic events and pass them on for professional care. See Related News >>>

In Afghanistan (as in Iraq until the recent withdrawal of British troops), uniformed mental health nurses are deployed to provide care and treatment. Consultant psychiatrists visit operational theatres every three months or so to provide clinical and administrative support.

An on-call consultant psychiatrist is always available to provide specialist support by phone, and a UK-based team of a psychiatrist and a mental health nurse is at high readiness to deploy to operational theatres to support local teams if needed.

At the end of their operational tours most units undergo a 'decompression' period at bases in Cyprus, during which they begin to unwind mentally and physically and have time to talk with colleagues and superiors about their recent experiences. As well as enjoying recreational facilities, they are given presentations and information to alert them to the possible after-effects of operational deployment.

If personnel need to leave the operational environment for mental health treatment before the end of their tour, their care continues either as an out- or in-patient in the UK.

Community-based mental healthcare is provided mainly through 15 military Departments of Community Mental Health located across the UK, and there are similar centres at major bases overseas. They provide out-patient mental healthcare in a military setting and are staffed by teams which include psychiatrists and mental health nurses. They also have access to clinical psychologists and mental health social workers.