Veteran or Forces Family? Where to Start

Op COURAGE is an NHS specialist mental health service for serving personnel due to leave the military, reservists, armed forces veterans and their families in England. It is run by trained professionals who are from, or have experience of working with, the armed forces community. It works with armed forces charities to help you get the right specialist care.

Who can use it. You must:

• live in England and have served in the UK armed forces for at least a full day
• be registered with a GP surgery in England, or be willing and eligible to register
• give your military service number

It does not matter how long ago you left or how long you served. You can also contact it if you are still serving but have a discharge date.

How it can help. The NHS lists support with moving to civilian life, early signs of mental health problems through to more advanced conditions and psychological trauma, substance misuse and addiction, getting into other NHS services such as talking therapies, links with charities for housing, money, relationships and work, and support for families.

How to get in touch. You can contact it yourself, or through a family member or friend, or ask a GP, another health professional or a charity to refer you. Contact the service for your area:

• North of England: 0300 373 3332
• The Midlands: 0300 323 0137
• The East of England: 0300 034 9991
• London: 020 3317 6818
• South East England: 0300 365 2000 (option 4)
• South West England: 0300 034 9986

Sources: NHS: mental health support for veterans, service leavers and reservists and GOV.UK: access Op COURAGE. Op COURAGE was previously known as TILS, CTS and HIS.

Combat Stress is a charity that helps veterans recover from trauma from military service, with specialist expertise in PTSD, complex PTSD and other trauma-related difficulties.

• Helpline: free on 0800 138 1619, 24 hours a day, 365 days a year. You can also text 07537 173683 or email [email protected]. It is free for veterans, family members and carers, and also supports serving personnel.
• Referring yourself: the easiest way is to call the helpline. The call usually takes 20 to 25 minutes and asks for things like your contact details, GP details, service number or military history, and why you are seeking support. About 24 hours later you get a short questionnaire, and an initial clinical meeting usually follows within about 10 to 20 working days.
• Professional referrals: GPs and other professionals can refer too. Combat Stress says people referred must have served in the UK armed forces, as a non-operational reservist, or in the Merchant Navy; have difficulties consistent with PTSD, complex PTSD or moral injury from their service; be likely to need support from several professions; and be registered with a UK GP and living in stable accommodation.
• How treatment is given: about 80% is online, with some in-person outpatient treatment at hubs in Edinburgh, Glasgow, Birmingham, Belfast and Leatherhead in Surrey.
• Combat Stress does not offer a standalone formal diagnosis service, and its helpline is not a crisis service.

Sources: Combat Stress: get help, Combat Stress: how to make a referral and Combat Stress: FAQs.

Trauma can affect the people closest to a veteran too. Op COURAGE supports armed forces families affected by mental health problems, including helping them reach local services, and a family member or friend can make contact on a veteran's behalf. Combat Stress provides treatment services for family and carers. Sources: NHS: Op COURAGE and Combat Stress: family support services.

A family member can also see a private practitioner in their own right. Family and systemic psychotherapists work with the whole family, and getting help for your child's mental health covers children and teenagers. If you are supporting someone, see helping someone find a practitioner.

• Reservists: the Ministry of Defence's Reserves Mental Health Programme gives mental health assessments and treatment advice. Referral is through your NHS GP or the DPHC GP for your parent unit.
• Togetherall: anonymous, round-the-clock online support with trained counsellors, open to serving personnel, reservists, veterans and their families.
• NHS Talking Therapies (England): you can refer yourself if you are 18 or over (16 or 17 in some areas). It can help with PTSD. NHS: find NHS talking therapies.

Source: NHS: mental health support for veterans, service leavers and reservists. If you live in Scotland, Wales or Northern Ireland, Op COURAGE is not for you, but Combat Stress works UK-wide and your GP can talk through local services.

You can also see a private practitioner, alongside or instead of these services, if you want to choose who you see or start at a time that suits you. Several professions work with trauma, and none is better for everyone. When you contact someone, ask:

• what training and experience they have in trauma, including PTSD and complex PTSD
• whether they have worked with veterans, serving personnel or forces families
• which approach they use, and how you will review progress together
• their fees, session length and whether they work online or in person

• Counsellors and psychotherapists, on accredited registers such as BACP, UKCP and NCPS.
• Practitioner psychologists, such as clinical and counselling psychologists, on the HCPC register.
• CBT therapists, often accredited by BABCP.
• Arts therapists (art, music and drama) and dance movement psychotherapists, if putting things into words feels hard.
• Family and systemic psychotherapists, if the whole family is affected.
• Occupational therapists, who can help with getting back to work, routines and daily activities.
• Psychiatrists, medical doctors who can assess, diagnose and prescribe.

Our trauma and PTSD guide explains the treatments the NHS describes. On Therapist Circle you can search by profession, issue and area, and send a free, private introduction. Each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself. See also how much therapy costs and free and low-cost therapy.