Transition, intervention and liaison mental health service for armed forces personnel approaching discharge and veterans.
On 1 April 2017, NHS England launched the transition, intervention and liaison (TIL) mental health service for armed forces personnel approaching discharge and veterans.
The following providers have been appointed to deliver this service under a three year contract:
Avon and Wiltshire Mental Health Partnership NHS Trust (covering Buckinghamshire, Oxfordshire, Berkshire, Hampshire, Isle of Wight and the South West of England)
Camden and Islington NHS Foundation Trust (covering South East of England and London)
Coventry and Warwickshire Partnership NHS Trust (covering the Midlands and East of England)
Northumberland, Tyne and Wear NHS Foundation Trust (covering the North of England).
Available across England, the service will seek to provide increased access and treatment to appropriate and timely mental health services for armed forces personnel approaching discharge and veterans with mental health difficulties. There are three elements to the service:
1. Transition: service for those in transition, leaving the armed forces The service will work with the Ministry of Defence (MOD) to offer mental health support for armed forces personnel approaching discharge.
2. Intervention: service for veterans with complex presentation Service personnel approaching discharge and veterans will have an assessment within two weeks of a receipt of referral. If their needs are identified as more complex, they will be offered an appointment two weeks thereafter at the TIL veterans’ mental health service. This will be with a clinician who has an expert understanding of armed forces life and culture. They may also be supported by a care coordinator who will liaise with other services and organisations to ensure a coordinated approach to their care.
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3. Liaison: general service for veterans Patients who do not have complex presentations, yet would benefit from NHS care, will be referred into local mainstream NHS mental health services where they will receive treatment and support.
The service will support delivery of The Five Year Forward View for Mental Health through partnership working with local public, private and voluntary sector organisations, recognising the contributions of each to improving mental health wellbeing.
Patient centred care
A key influencer of the service specification has been the findings of the national engagement on NHS veterans’ mental health services, which took place in early 2016. The engagement aimed to capture views and experiences of these services and to understand the reasons why some people have not sought support and treatment. Findings have helped to inform a service that builds on the success of previous provision.
From the outset, veterans and their families, service charities, commissioners and organisations providing treatment and support in this area have been involved in the commissioning of the service. This has included scoping and shaping the engagement and co-developing supporting materials and activity, as well as involvement in the engagement and procurement process.
This has influenced the development and provision of an enhanced mental health service that is sensitive to the needs of patients and their families. In line with key findings from the engagement, the new service will offer the following:
A national service that seeks to provide increased access to local care and treatment across England in a more uniformed manner.
Veterans, and for the first time armed forces personnel approaching discharge, can self-refer or request referral via a health care professional or service charity, with an initial face to face assessment offered within two weeks of a receipt of referral and where appropriate a first clinical appointment offered two weeks thereafter.
Veterans can access the service regardless of when they leave the armed forces.
A single point of contact for patients that accepts and makes referrals so that the appropriate care and support is accessed in a timely and responsive manner.
An enhanced range of treatment and support from recognising the early signs of mental health problems and providing access to early interventions, to providing therapeutic treatment for complex mental health difficulties and
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psychological trauma.
Patient advice and care provided in a range of locations and settings and via a range of methods, such as face to face and Skype, to support improved access.
A Care Programme Approach, with patients involved in the development of tailored care packages to help them enjoy a full life and achieve positive outcomes relating to mental health, employment and reduction in alcohol consumption, as well as improved housing and social support.
Where appropriate, families and carers will be involved in planning and assessing care with patients and will be supported to access care and treatment for themselves if required.
All patients being seen in the service will have access to an out of hours point of contact in the event of an emergency.
Collaborative working with the wider NHS, Defence Medical Services (DMS), statutory bodies, local authorities and the third sector to ensure holistic support is in place for patients and their families. This will include working with existing veterans’ mental health services commissioned by NHS clinical commissioning groups so that patients can access and receive the highest quality of care.
A single point of contact over extended working hours for health and social care professionals that provides evidenced based professional advice on the treatment of and support for veterans with acute mental health difficulties and guides service providers on the most appropriate initial treatments, including referral pathways.
Access criteria
To access the service as a veteran, patients must:
be a resident in England
have served in the UK armed forces for a full day
be registered with a GP practice in England or be willing to register with a GP
be able to provide their military service number or another form of acceptable proof of eligibility.
To access the service as a member of the armed forces approaching discharge, patients must:
be a resident in England
have an identified or diagnosed mental health illness / disorder; AND
have a discharge date from the MOD or be found to be unfit for continued military service by their medical board; OR
have been identified by the Departments of Community Mental Health as requiring follow on psychiatric care on discharge from the MOD; OR
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have had their pre-release medical and been identified by their DMS GP as requiring mental health transition support; OR
have had a pre-release medical before they self-refer.
Those people meeting the criteria can self-refer or request referral via a health care professional or service charity.
Further information
Information on the service can be found on the NHS Choices and NHS England websites.
If you have any queries, please email england.south-armedforces@nhs.net
