The Veterans Mental Health Service. Innovation in practice Neil Carr OBE Chief Executive Rob Heath Lead Nurse (Veterans)

Important themes There is no critical mass Services should be accessible Patterns of morbidity in services should reflect these Don’t jump to assumptions One approach is the wrong approach Allow others who disagree to leave with dignity.

The service Dedicated veteran’s service Team breakdown Nurse Lead (CBT, EMDR) Veterans Specialist (CBT, EMDR) Consultant Psychiatrist Consultant Psychologist

The model RIO clinical system Instant and routine screening Four weeks Community deployable asset Support all veterans Families Peer support Teams (retain ownership Care Co- ordination) Self referral Free Phone Veterans App Veteran Education (Staff) Service Evaluation

The impact Increasing number of veterans identified Collaborative working with 3 rd sector Reduces gaps in service Innovation in practice Support to Defence Medical Services Promote best practice

So what’s the effect? Veteran two years post service Tours x2 Afghan, 1 x Iraq Multiple deaths Strong self image Episodes alcohol abuse Relationship difficulties Anger +++ Attempt hanging Police involvement Crisis Team / CMHT 3rd Sector GP Veterans Service Work issues final straw.

What happened? Automatic notification Discussion with CRS / CMHT Discussion with Service user Psycho education Stabilisation Medication via GP Alcohol reduction EMDR Work issues CMHT psychiatrist SUDS 9 to 0 Psycho metrics Discharge SPVA

So what happened? SU remains symptom free both OCD and PTSD Relationship stronger Self awareness Reduced impact on work Alcohol Anger

So what’s the impact? Increased awareness Not falling between services Peer support Responsive service All teams, all areas Increased satisfaction and improved clinical measures.