In 2008 the Department of Health issued guidance that all veterans should be given priority access to NHS care, which includes IAPT services. This is contained in the Veterans Covenant.

A condition of this rapid access to NHS services is that their health difficulty needs to be a product of, or related to, their years of active service in the military. A veteran is defined as anyone that has served 24hrs or more in the three armed services, as well as Reservists and Cadet Adult Instructors.

In London in 2019/20 there were nearly 1,300 IAPT referrals from veterans (0.5% of the total number of referrals), of which nearly 1,000 entered treatment (77%) and 510 finished treatment (44%).

There is an IAPT positive practice guide for working with veterans. Guidance can also be found in Healthcare for the armed forces community: a forward view

IAPT examples

We have found few specific examples of IAPT services targeting veterans; these are set out below.

County Durham

County Durham IAPT service set up a specific rapid access service for veterans in response to the Department of Health guidance, and signed up to the Veterans Covenant. The primary focus of the service is to increase access and meet unmet demand for IAPT services among the veteran population of County Durham (the veteran population is not huge).

The service works with local veterans charities (such as the Military – Finchale Group) to deliver clinics in veterans hubs across the borough – often delivering treatment in Territorial Army centres or Finchale Group sites. Several staff within the IAPT service have dedicated time to working with this population group, depending on levels of demand. There has been a reduction in veterans referrals since the pandemic.

There is often stigma within this population group in accessing mental health services. There is a fairly consistent profile amongst the veterans population, who often have adjustment difficulties and a level of PTSD due to time served in the military. The services offered are tailored to these needs, but also include softer skills, such as social skills.

Greenwich

Have a veterans service. Information leaflets about the service are available in English and Nepali.

Other sources of support for veterans

A  new service has recently been launched for Veterans and Mental Health called Op Courage, which is a collaboration between NHS England and the Office for Veterans Affairs. Op Courage is also known as the Veterans Mental Health and Wellbeing Service, and aims to provide a clear single route for accessing specialist care. Veterans can self-refer or ask to be referred to it by their GP. Op Courage is the new name for the following services:

• Veterans’ Mental Health Transition, Intervention and Liaison Service (TILS), which provides mental health support to those due to leave the Armed Forces, and can refer on to additional sources of support.
• Veterans’ Mental Health Complex Treatment Service (CTS) provides treatment for those with significant mental health difficulties that are military related and have not improved with previous treatment.
• the Veterans’ Mental Health High Intensity Service (HIS)

Combat Stress – a charity for veterans’ mental health, providing specialist treatment and support for anxiety, depression and post-traumatic stress disorder (PTSD). National helpline: 0800 138 1619.

British Legion

Veterans who have had mental health issues post-Service are also able to get support through the Veterans and Reserves Mental Health Programme (VRMHP) based in Nottinghamshire. Helpline: 0800 0326258 Email: aphcsedcmhchl-vrmhp@mod.uk

The free Veterans Mental Health App (search Apple or android store for this title) includes help and guidance on key mental help conditions and also features videos of veterans telling their own stories about their mental health problems and journeys to recovery.

Veterans UK provide free support for all armed forces and civilian personnel as well as providing veterans support. Helpline: 0808 1914 2 18 Email: veterans-uk@mod.uk

Top tips for veterans, for getting the right care and support:

• Register with a GP: It is important to register with a GP, rather than wait until you need treatment. Visit the NHS website to find out details of GP practices in your local area.
• Tell your GP that you’ve served in the UK Armed Forces: Ask for the term ‘military veteran’ to be recorded in your patient record in the GP computer system. This will help your GP to better understand any military related health conditions that you may have and ensure that you are referred, where appropriate, to dedicated health and wellbeing services for veterans.
• Give your GP the paperwork that your military medical centre gave you, including any medical records. If you’ve recently left the forces, it is important to do this to help ensure your military health record transfers to your NHS health record. This will give your GP information on your health and ensure that any ongoing care and treatment is continued.