Byline: Madeleine Brindley
THE typical veteran referred to the community veterans mental health service is in his 40s and has served in Northern Ireland. He may also have seen active service in the Falklands or in Bosnia and Kosovo.
He's had several broken relationships and has fathered a few children. He may have been homeless for a while, has problems holding down a job. He has debts and is struggling with some form of substance misuse or dependence - most likely alcohol - and common mental health problems.
This brief description is typical of the background of the people referred to the Cardiff-based service over the last two years since the city was chosen as one of six locations for a pilot project. It is also typical of what the veterans' therapists will see in each of Wales' seven local health board areas as the all-Wales service is developed.
But it by no means describes every one of the 200-plus referrals the service has seen since 2008 - a small number of the veterans have been women. And while some will be suffering from mental health problems, which directly relate to their experiences of active service and conflict, many will be seeking help for common problems, including anxiety and depression.
Neil Kitchiner, who is the community veterans' mental health therapist, and based at the University Hospital of Wales, in Cardiff, said he is treating people whose problems stem from a car accident more than 20 years ago or who have been involved in incidents during military exercises; others have experienced problems while trying to adjust to civilian life.
"There's a high incidence of substance misuse, particularly alcohol, and with that comes psycho-social problems. We've also seen anxiety and depression, more serious mental illnesses and post traumatic stress disorder," he said.
The Ministry of Defence set up and funded the pilot project in 2008 amid concerns about the provision of services for veterans.
Historically veterans, people who have served at least one day in the military, have received priority treatment in the NHS - in 1948 a covenant decreed men and women with physical or psychological injuries through service for their country would be given priority treatment. But, until now, there have been no dedicated or specialist services for veterans within the NHS.
Health Minister Edwina Hart announced in March that she was investing almost pounds 500,000 to extend the community veterans mental health service across Wales. "I am determined to improve the care for people who have experienced health problems as a result of their military service," she said. "We owe them a debt of gratitude and have a duty of care to them."
Mr Kitchiner said: "If you talk to veterans they like the fact that they have a dedicated service where they know they will see someone with a knowledge of the military culture and they won't have to sit in a waiting room full of civilians with 'lesser' problems.
"I think it's difficult for military personnel to access mental health services while they are still serving because of the stigma. Many will say they'd be letting their mates down or that people would think less of them or that it will affect their promotion hopes. They will also have their gun taken off them and a man without a gun in the Army isn't very useful.
"Once out on civvy street, with the loss of the military support and camaraderie, there's a feeling that no-one understands veterans. GPs don't ask if you've ever served - it would be useful if they did because that would give them a different perspective to think about. …