Preliminary discussion of the wider context has taken place and some ideas have been developed. Last year, officials from the MoD Gulf veterans' illnesses unit and medical policy (veterans) and DH officials began a series of meetings to scope areas for potential co-operation with the aim of delivering better care for veterans. Five groups have been considered:

a)     serving service personnel;
b)     personnel on the point of discharge on medical (mental health) grounds;
c)      veterans in receipt of a relevant attributable pension; and
d)     ex-service personnel not invalided but whose mental ill health is nonetheless potentially attributable to their service experience
e)     ex-service personnel not invalided and whose mental ill health is not causally related to service.

Agreement was reached for selecting areas of joint work that:

-  focuses on the most severe/vulnerable cases
-  builds on or strengthens existing, established activity
-  has a sound evidence base
-  makes significant impact
-  can be delivered, or at least initiated, within a year

1.      Self-help (mental health) information to support service personnel in transition between the service and civilian worlds (to cover information relating to the management of psycho-social aspects of health care, access to services, etc). A bid for vote 2 funds has been submitted to DH for costs of publication and staff time has been identified for this project. MoD will endeavour to find a project worker for six months.

2.      Initial meetings have been held between MoD and Professor Louis Appleby to discuss factors associated with suicide by ex-service personnel with a mental illness with the aim of identifying risk factors and to develop a strategy to reduce the rate of death.

3.      Of particular relevance to the Armed Forces is the major new DH/NHS focus on young men – looking to reduce stigma, increase awareness and developing innovative and assertive outreach tactics to help them access care in an appropriate and timely fashion (part of work on the National Suicide Prevention Strategy). Preliminary discussion has been held between Keith Foster and Dr Braidwood.

4.      Meetings have been held with officials responsible for NIMH(E)'s prison in-reach programme to promote an ex-service personnel focus sean.duggan@doh.gsi.gov.uk.

5.      Discussion has also taken place of scope to revive work initially started with the DH Emergency Planning Unit to develop best practice guidance on the psycho-social aspects of major incident management. No decision has yet been taken about how and whether to take this forward. In the event it is, a partnership with MoD colleagues in respect of service personnel will be essential.

Anne Richardson
Head of mental health programme