Hansard

One in 10 UK armed forces personnel was seen by military healthcare services for a mental health related reason in 2020-21. Although that represents a fall in numbers from 2019-20, that might be attributable to a reduction in routine and training activity during lockdowns.

As “Veterans Mental Health and Wellbeing Action Plan” states, the Ministry of Defence reported 1,578 medical discharges across the UK in 2020. It is estimated that 34 per cent of those discharges were on mental health grounds. If that is taken as a proportion of the size of the veteran population in Scotland, that would equate to approximately 50 Scottish veterans per year declaring a mental health difficulty at the point of being discharged.

Veterans therefore need access to mental health support and treatment, just like the rest of us, although, as others have noted, stigma is a specific factor. We must also acknowledge that veterans are exposed to stressors and experiences that most of the general population do not face, and that any mental health support must be person centred.

As we have heard, the action plan is based on three key principles. It focuses on veterans having timely access to well-planned mental health and wellbeing services, no matter where they live. It is vital that those principles be adhered to, so that no one slips through the cracks and is unable to access the support that they need. Some of the issues that we see are similar to those that we have previously discussed for the general population, but some treatment will be specific to veterans. As a party, Greens would always advocate for peaceful resolution, rather than armed conflict. However, we recognise that person-centred care is important for those who have been involved in conflict to ensure that they can deal with their experiences.

As the motion notes, we must deliver holistic care that takes into account the entirety of an individual’s needs. That will include services such as housing and rehabilitation, where appropriate. That care should also take account of family situations, and of children in particular. It is hard not to refer to the situation in Ukraine while taking part in this debate. For those who have experienced armed conflict, the blanket coverage of the current war might be retraumatising. I encourage anyone who is experiencing deterioration in their mental health because of that to seek help.

I would also like us to consider how we can support the children of people who have been involved in war. I am sure we have all seen in the past few days children in the news who have been forced to flee Ukraine and who tell reporters that their fathers have stayed behind to fight. Information and pictures from war are much more available to young people than they were previously. I hope that we will be able to give the appropriate support to children of veterans and to anyone who comes to Scotland from a conflict zone. Where appropriate, that should be whole-family support.

There should also be an appropriate mix of treatment, including counselling and trauma support services, to provide support in the most appropriate format for individuals. As with health support for non-veterans, we must ensure that people are asked to explain their trauma or symptoms only as often as is necessary. Some current practices mean that people might have to repeat their story many times to various clinicians. It is important to ensure that we can share data effectively. Any veteran who is disabled as a result of their deployment should not have to repeat their story every time they need physical support. That should be the same for mental health support.

We must also consider unmet need. The action plan highlights many reasons why individuals might not declare difficulties on discharge, including issues of discrimination and stigma. Studies have shown that stigma is particularly problematic for people in the armed forces, where physical and psychological resilience in the face of adversity are promoted and valued.

PTSD can develop years after a traumatic experience. Delayed onset PTSD might make it difficult to determine the true extent of mental health problems among veterans. A study that was published last year by researchers from the University of Glasgow highlighted that

“The risk of suicide among UK military veterans remains unclear. Few recent studies have been undertaken, and most studies found no clear evidence of increased risk.“

It is clear that we need more research into, and a better understanding of, veterans’ mental health.

The action plan highlights many risk factors that can lead to veterans developing mental health problems, and rightly notes that LGBTQ veterans might be at greater risk of poor mental health due to the discrimination that they have historically faced in the armed forces. It also highlights older female veterans as a group who are at risk of suicide. It is vital that mental health services for veterans take the needs of at-risk groups into account and develop tailored support for people who might have experienced discrimination in the armed forces.

The action plan also notes:

“The intake of Black and Minority Ethnic service personnel increased by 110% between March 2019 and March 2020 in the UK. Mental health and wellbeing services should therefore be cognisant of this growing cultural diversity in the future design and development of services.”

As I said, we need person-centred services that seek to treat the individual and which do not view veterans as a homogeneous group of people with similar experiences. It is vital that that approach be supported by good data collection, not only on mental health outcomes for our armed forces personnel and veterans, but on the demographics of the armed forces.

I welcome the “Veterans Mental Health and Wellbeing Action Plan” and the Government’s commitment to support the mental health and wellbeing of veterans. Veterans have specific needs and need dedicated support that takes account of the unique stressors that they have faced. The action plan represents an important step towards delivering truly person-centred care for Scotland’s veterans.