Study finds medical help for ex-Services 'fragmented'

Former military personnel who suffer with their mental health should not be refused treatment because of their alcohol, say new recommendations from experts.

Current support for ex-Services is often fragmented and disjointed and fails to acknowledge that alcohol and mental health issues are connected, resulting in people being denied treatment, a study found.

The research by Lancaster University and Liverpool John Moores University, calls for integrated treatment ‘as standard’ for those with both Alcohol Use Disorder (AUD) and Common Mental Disorder (CMD).

More than 30,000 former military personnel have both an AUD and a CMD with those with a CMD twice as likely to report an AUD as the general population but many are excluded from mental health services until they have stopped drinking.

More effective treatments

The researchers conducted a series of studies, including a review into the effectiveness of interventions, interviews with former Services personnel, an analysis of data from an NHS Military Veterans’ Mental Health Service, and focus groups and an online survey with service providers.

They found that integrated interventions which target both AUD and CMD were more effective than usual care for improving alcohol use and for treating CMD.

The interviews also highlight that aspects of military culture, such as norms around masculinity and the normalisation of heavy alcohol delay help seeking. Former Service personnel highlighted that mental health services often required individuals to be abstinent before accessing support, which led to delays in receiving care and encouraged people to hide their alcohol use.

“They said to me, whatever you do, don’t tell them you’re drinking.  Otherwise, they won’t treat you so I basically lied all though my therapy.”

Best practice 'uncommon'

Many participants described care as most effective when providers demonstrated both an understanding of military culture and a trauma-informed approach. Feeling that providers “spoke the same language” helped build trust and fostered an instant connection.

Focus groups with service providers largely echoed these findings, describing the mental health and alcohol care system as fragmented and disjointed. Integrated and coordinated treatment of both disorders, ideally within a single service or through collaboration, was widely regarded as the most effective but not a common practice.

The research project, funded with £148,000 by the Forces in Mind Trust, was led by Dr Laura Goodwin from Lancaster University and Dr Patsy Irizar from Liverpool John Moores University with colleagues from Lancaster, King’s College London and the University of Cardiff.

Dr Irizar said: “Many former service personnel with co-occurring alcohol and mental health problems delay seeking help, which can cause problems to worsen. The recommendations from our research suggest a need for increased visibility of services, so veterans know where to access support, and for national campaigns which aim to reduce stigma and encourage help seeking.”

Michelle Alston, Chief Executive, Forces in Mind Trust, said: “Whilst most Services personnel transition successfully to civilian life there are some who have served that struggle with alcohol and mental health issues together. This report sends a very clear message about how we should be helping this group. They are supported best when both issues can be treated together and we hope this report encourages more services to adopt an integrated model.”

See the full report for Forces In Mind here.