Nurses Support Veteran’s Mental Health

Analysis: How Nurses are supporting veterans’ mental health

31 MAY, 2023 BY ELLA DEVEREUX– Nursing Times

By the time they do reach out to a health professional, some have developed trauma-related or stress-related mental health problems resulting from military service, such as depression, anxiety and post-traumatic stress disorder (PTSD).

As such, specialist help from clinicians is often needed to come up with a treatment plan that fits the veteran’s individual needs.

For over a century, nurses at Combat Stress, the UK’s leading charity for veterans’ mental health, have provided specialist mental health and substance use support to former servicemen and women with mental health problems.

The charity was founded in 1919 and has since supported veterans from every service and conflict.

Many nurses working at the charity have a military background themselves, or have close family ties with the armed forces, giving them a unique insight into the needs of the community they serve.

They told Nursing Times about the key role they play in supporting veterans’ mental health, and why they believe nurses across all settings should have a better understanding of the needs of servicemen and women.

Alan Meechan, a community psychiatric nurse (CPN) at Combat Stress, told Nursing Times he “felt lost” after he left the Royal Air Force (RAF) in 2006.

Mr. Meechan served in the RAF as a technician for four years but became long-term sick due to poor mental health and eventually had to leave the service completely.

He said: “It just didn’t work out due to my mental health. I was feeling a bit lost I suppose but I always felt I was quite caring and compassionate to others, and that’s when I just decided to go ahead with mental health nursing.”

Mr. Meechan joined Combat Stress in 2015 at one of its treatment centers in west Scotland, which is where he said everything “all fell into place”. He has since moved into the community and is currently completing a cognitive behavioral therapy (CBT) qualification.

Mr Meechan explained that his time in the RAF meant he was able to empathise with the community he looks after. “I can really get a sense of that loss of role, and loss of status,” he said. “In terms of trauma I can relate to that too.”

Emotions are something the charity “really encourages veterans to feel” and discuss, Mr Meechan said. “It’s just [about] creating a safe environment where it’s OK to talk about your emotions, because it’s not something that’s encouraged in the military at all,” he said.

The Ministry of Defence has estimated that there are two million UK armed forces veterans residing in Great Britain, meaning that nurses in all health and social care settings could come across veterans at some point in their career.

Mr. Meechan explained that there were still “a lot of stigmas” around the military, which could lead to “shame, guilt and disgust” felt by veterans. He urged nurses across all settings to “show compassion, empathy and just listen”.

Mr. Meechan said: “You could be the first person who they’ve opened up to and that just makes all the difference. All the treatment and everything else will fall into place, but they just need a safe space to talk without judgment.”

Head of nursing at Combat Stress, Heather Steers, echoed this, telling Nursing Times that nurses were “often the first people a veteran will have contact with”.

She highlighted how important it was that nurses were aware of the Armed Forces Covenant, which is enshrined in the NHS Constitution.

The 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 addition, veterans should receive priority treatment where it relates to a condition that results from their service in the armed forces, subject to clinical need.

Ms. Steers urged nurses to ensure that all veterans had their armed forces status on their NHS patient record. “Knowing that person is a veteran in the first place is helpful and understanding that they may have some specific needs that perhaps are more highly represented in the veteran group than in the general population,” she said.

Ms. Steers joined Combat Stress almost a decade ago, having previously worked across a variety of mental health nursing roles in the NHS.

Ms Steers has close ties to the armed forces, as growing up her father served in the Royal Navy and her grandfather served in the RAF. In addition, she explained that her husband still serves in the RAF.

“I wanted to do something that really meant something to me as a person,” she said, adding: “This role allowed me to combine my mental health knowledge and experience, but also my life as an immediate family member of those serving and who have served.”

Ms. Steers helped to create the head of nursing role at Combat Stress, a post she has held for the last three years.

Part of the work Ms. Steers has undertaken in the role is coming up with a “nursing strategy” within the charity.

She said: “Nurses have been at Combat Stress since 1919, and yet people don’t seem to know what they do.”

Ms. Steers added: “I’m always fighting for the nurses. There are some professionals who may look upon nursing as being more of a support or wraparound approach, but actually, we’re very skilled clinicians in our own right and it’s making sure that that is preserved and respected.”

Nurses at Combat Stress work with their allocated service users to achieve psychological stability. This may consist of one-on-one psychoeducational work, managing PTSD symptoms, goal setting, harm reduction, and general health and wellbeing support.

Across the UK, veterans are supported at treatment centres, in the community and, in recent years, online and by phone.

Mark, who did not want to give his full name, explained that the charity had adopted a hybrid working model due to the pandemic, but that “many of the veterans prefer it”.

Mark, who works as a CPN at Combat Stress, highlighted that using public transport or being in a busy city centre could trigger some veterans or cause them anxiety.

“To do it from the comfort of their own home suits them, and if it suits them then that’s a good thing,” he said.