Meeting of the Parliament

Meeting date: Thursday, June 1, 2017

Official Report 887KB pdf

---

Veterans (Deprivation)

The next item of business is a members’ business debate on motion S5M-04061, in the name of Maurice Corry, on Combat Stress finds veterans in Scotland face higher levels of deprivation than those in the rest of the United Kingdom. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes the research paper, Multiple deprivation in help-seeking UK veterans, published by Combat Stress, which found that ex-servicemen and women receiving help from the charity in Scotland, including those in West Scotland, face higher levels of deprivation than those living in the rest of the UK; understands that the report surveyed of over 3,000 veterans registered with Combat Stress from across the UK and found that veterans in Scotland face greatest risk of deprivation, in both levels of income and employment; notes that the report also found that half of veterans in Scotland who are registered with Combat Stress live in the most deprived three areas of Scotland, and thanks Combat Stress for collecting the information which it considers illustrates the work that still needs to be done to support the veterans community in Scotland.

12:48  

Thank you, Presiding Officer—[Interruption.]

Just a minute, Mr Corry. I ask the public to leave quietly so that we can hear Mr Maurice Corry in what is a very important debate.

I thank those members who have supported my motion and allowed the debate to take place. I also welcome staff members from Combat Stress to the public gallery, and I thank them for all the work that they have done throughout the years to help our veterans and armed forces personnel.

Many of my colleagues will know that I am a veteran and that I therefore feel strongly about the subject of veterans’ mental health. I have campaigned enthusiastically for many years, first as a councillor on Argyll and Bute Council and now as an MSP for West Scotland, to ensure that veterans’ issues are not overlooked. I believe passionately that veterans should get the recognition that they deserve for serving our country. That is why I think that Combat Stress’s finding that veterans in Scotland face the greatest risk of deprivation in levels of income and employment is a great concern that needs to be addressed.

I recently visited Combat Stress’s Hollybush house centre in Ayrshire and was impressed by the service that it offers, which is absolutely vital to our forces and veterans and is now fully recognised by the national health service.

Combat Stress was started in 1919 and has built up an excellent service for our veterans and serving armed forces personnel. The fact that we can now have an open debate about the impact of mental health issues among veterans is a huge step forward, as it was previously something that many service personnel were reluctant to accept. By talking about poor mental health and trying to help those who unfortunately suffer from it, we are helping to get rid of the stigma that still surrounds mental health issues, which is a huge achievement.

It is also worth mentioning the great strides forward that the Ministry of Defence is taking in helping to fight issues around mental health within the ranks of the armed forces.

Combat Stress’s report “Multiple deprivation in help-seeking UK veterans”, a copy of which I have with me, provides an overview of the experience of deprivation in a national sample of veterans with mental health difficulties and gives us a better idea of how best to target specialised military support to veterans with mental health difficulties. The report is based on a survey of more than 3,000 veterans who are registered with Combat Stress, the leading UK mental health charity for veterans, which discovered that veterans living in Scotland have higher levels of deprivation in income and employment than veterans living in the rest of the UK. The finding that half of those Scottish veterans who are registered with Combat Stress live in the three most deprived areas of Scotland is shocking, and the matter needs to be addressed.

The fact that those veterans are dealing with a range of complex mental health issues—whether post-traumatic stress disorder, depression or anxiety—means that it is already a struggle for them to readjust to the civilian world. If we add in the facts that they have to cope with higher levels of deprivation in income and employment and that they are living in the most deprived areas of Scotland, we begin to see why it is vital that we do something to help them.

Given that many veterans who do not suffer from mental health issues struggle to deal with the transition from military to civilian life, we cannot begin to imagine how hard it is for this particular group of ex-servicemen and women to do so. It is up to the Scottish Government to work with agencies and charities to minimise the mental health challenges that veterans face.

The report highlights the inequalities that veterans in Scotland face in relation to employment, and I am sure that everyone in the chamber welcomes the work of Eric Fraser, the Scottish veterans commissioner, and the 19 recommendations that he has made.

I was glad to see that the new strategic working group on employment has convened and that it held its first meeting last month. I look forward to hearing the outcome of that and future meetings. It is a positive step in the right direction to ensure that veterans who settle in Scotland are not left disadvantaged by their military service and can play a full and productive role.

A further issue that is raised in Combat Stress’s report is that it takes the average veteran 11 years to seek help after leaving the military. That brings me back to my previous point that, simply by discussing the issue of mental health among veterans, we are making headway on it. It could be that a veteran does not recognise or want to admit that they are suffering from mental health issues, and they might not seek help for many years. Alternatively, it could be that symptoms of poor mental health do not set in until other events trigger them at a later date. Either way, our debate and the work that Combat Stress carried out to produce its report send a clear message to veterans who think that they could be suffering from poor mental health that it is okay to admit that they need help and that such help is out there.

The report sets out that those who waited the longest to seek help were the ones living in the most deprived areas. That demonstrates that it is crucial for the Scottish Government to support mental health organisations and encourage veterans to use the resources that are available to them and get help early.

It is also important to note that a high proportion of those who experienced multiple deprivation were early service leavers. That group also has the highest unemployment rates. They need to be continually supported to get the best out of them as they transition into the civilian world.

Maurice Corry has mentioned the responsibilities of the Scottish Government a number of times. Does he recognise any impact on deprivation among veterans from the UK Government’s welfare changes to housing benefit, disability benefits and, indeed, war pensions? Does he recognise any impact from those changes on veterans in Scotland?

I understand where the cabinet secretary is coming from but, as we go forward, many charities, organisations and local authorities are, in my experience, willing and able to deliver the help and support that those people need. In particular, Combat Stress is supplying that help admirably in relation to mental health issues.

I repeat my thanks to those who have helped to ensure that we have been able to hold this important debate in the chamber today. I also thank Combat Stress for its research, for bringing us its report, and—most important—for its support for the many veterans who deal with mental health conditions daily.

12:56  

I thank Maurice Corry for securing this important debate. One of the first chats that we had after we were elected was about veterans’ mental health, and we quickly realised that we had a common interest. The issue is not only vital but brings politicians together—even those with such diverse backgrounds and political views as me and Maurice Corry.

As many members know, I worked in mental health for 20 years and I now co-convene the cross-party group on mental health. One of the first meetings that we held was on veterans’ mental health, and it was great to hear from Combat Stress at that meeting about its valuable work to support veterans.

Although I welcome the report for highlighting the important issue of multiple deprivation, I cannot fully support the motion. The report analysed a sample of only 332 veterans who were seeking help from Combat Stress in Scotland. That is 332 out of a total veteran population of more than 400,000, so any findings can be generalisable only to the group that is seeking support from Combat Stress and are not necessarily representative of the Scottish veteran community as a whole.

On page 81, the report states:

“Each country reported the relative measure of deprivation independently, thus the measure cannot be used as a relative measure between the four countries.”

It adds that

“conclusions cannot be drawn about causality of associations”.

Veterans in Scotland were overrepresented in the study, with English veterans underrepresented compared with the general population make-up of the UK as a whole. Therefore, we need to be cautious about drawing comparisons with other parts of the UK on the basis of the report’s findings.

The Scottish group was different in other ways, too. The following factors might have had more of an impact on the levels of deprivation that they suffer than geography alone: they were more likely to have served in the army than in the other forces; they were more likely to be single males; they were more likely to be early service leavers, as Maurice Corry mentioned; and they had taken longer to seek help.

I will pick up on the particular issue of early service leavers. The research that Dr Beverly Bergman presented at the cross-party group showed that the high risk of mental illness among the earliest leavers may reflect pre-service vulnerabilities that were not detected at the point of recruitment. Those vulnerabilities become apparent during early training and lead to early discharge.

Of course, poverty in childhood is a risk factor for later mental illness. Early last year, ForcesWatch and Quakers in Scotland petitioned Holyrood to stop the high number of recruitment drives by the armed forces in schools in deprived areas. Their argument is that many veterans would have gone into the forces young and were from the most deprived areas originally, which factors contribute to their lagging position when they leave the services.

We all agree that veterans deserve the best support and care that society can offer across Scotland and the UK as a whole. The Scottish Government has a strong track record on supporting veterans, and I am sure that, in summing up, the cabinet secretary will list its many initiatives.

The UK Government, on the other hand, has presided over a rise in insecure employment, welfare cuts and ideologically driven austerity, which have contributed to a rise in homelessness and food bank use across the UK. Children, families, pensioners and veterans have all been pushed into poverty and crisis because of UK Government policies—let us not forget that.

13:00  

I thank the Presiding Officer and Maurice Corry for allowing me to speak in this very important debate. I am proud to declare that I, like Maurice Corry, have been a soldier, and that my son is currently a soldier.

I point out in the light of Maree Todd’s final comment that, in the past 12 years or so, a lot of things have been happening differently for serving soldiers. We have had more soldiers on the front line than ever before. Since the second world war, the armed forces have served in more than 100 conflicts, but never for such prolonged periods or on so many tours as in recent years.

I am sure that we all recognise that stress disorders affect service personnel in different ways: some know that they have a problem, and some do not; some can cope, and some cannot; some know where to turn, and some have no idea. Nothing is simple.

I found the Combat Stress report interesting and provocative, and I thank the charity for publishing it. It does not surprise me, as an ex-soldier, to read that the majority of service personnel who suffer from combat stress come from the Army. It is easy to see that the horrors of getting up close and personal will be traumatic, and that the vital but somewhat indirect support that the Royal Air Force and the Navy provide does not take its personnel as close to the front line. Let me be clear: I do not demean the vital roles that those forces play, but the way in which they serve is different.

Some of the information in the report is surprising, but it is also very helpful as it highlights some very important flags that we need to identify in relation to our veterans. It is immensely sad to read that it takes, on average, more than 11 years for people who suffer from combat stress to seek help. I am not sure that the report identifies why that is, but we need to find out, and to encourage veterans to come forward much earlier.

I find it interesting that those who seek help are just as likely to be married as they are to be single. However, it seems that soldiers who were single when they were exposed to combat are more likely to be affected by stress. To me, it is clear that sharing the pain of one’s experiences makes it easier to bear. I would like to see more work being done to identify whether those who are married or in a relationship present earlier than those who are not.

I find it disappointing that some servicepeople still find it difficult to identify combat stress-related disorders, and that early leavers are more likely to suffer. That highlights the need for more education while people are serving, and for longer-term support when they leave, especially if they do so before their time is up. The support that the services give to serving soldiers over the long period for which they serve perhaps bears that out.

All those points give us a strong guide as to what we must do. Every five years, we should monitor those who have been identified from the flags as being most likely to suffer from combat stress and ensure that they are offered appropriate treatment. We also need to offer a national treatment plan to deal with the issues—which came across loud and clear in the report.

The report also highlights the fact that veterans who live in urban areas of Scotland and are unemployed appear to be at the greatest risk of deprivation, which in turn means that they are more likely to suffer from mental health difficulties. We must ensure that our most vulnerable veterans do not fall between the cracks. I believe that an enhanced support package should be considered by the Scottish Government and local government under the armed forces covenant.

In conclusion, I commend the excellent Combat Stress report. We have much to do to support our veterans. We need to tackle the problems that are faced by veterans in urban areas in Scotland, which seem to make them more vulnerable to stress-related problems. We have been given some key pointers in the report, and we need to watch the people who are vulnerable. I call on the Scottish Government and the UK Government to deliver for those who have served us, often in the most difficult circumstances.

13:05  

I congratulate Maurice Corry on securing this debate on an issue that is of central importance to the work that we should be doing here and across the UK. For a very short time, I had the privilege of being a Government minister, and in that time the greatest privilege of all was to be the minister who had responsibility for veterans. I was struck then by the power of the voices of those who spoke up for people who had suffered in combat, and whose rights were generally ignored. They were a group and a force to be reckoned with. It is because of their courage in campaigning for the rights of veterans that people across the parties recognise that the issue is something that we can agree on.

It is the job of Government, wherever that Government lies, to understand the particular experience of veterans and our obligations to people who have defended our country or who have supported peacekeeping across the world. We may want to debate which Government is responsible for particular difficulties, but I know that, at heart, we all want to rise to the challenge that has been put before us by veterans, by Combat Stress and by others, and to recognise that we have a particular responsibility to understand their needs and to provide services in a way that best suits the veterans.

We also acknowledge the particularly important matter of mental health issues. In a world in which we are becoming more progressive, we need to understand the impact of mental health issues on people who have been in combat, and to recognise that although general provision may be suitable, there may also be a need for particular provision, that is supported by people who understand—more than I ever could—the consequences of veterans’ experience. We need general understanding and specific provision.

In relation to housing, employment and other services, the question that should be asked by those who deliver them is whether there is a particular impact on veterans or a particular need for which we should cater in developing the services—in particular, for those who do not want to seek help. I know that there has been progress in that regard. We all need to reflect on the evidence in the report and elsewhere, and to rise to its challenge.

There is an understandable desire to look at where the report does not properly reflect the differences across the UK but, to me, the loudest message that the report sends is that there are veterans in our country who are suffering. Irrespective of where the levers of power are, we need to use them to support and address that. Perhaps I say this because I am very far away from power, but the job of Government is to look at the evidence, listen to the voices and address the concerns, where it has the ability to do so.

I will finish with this point. Dr David Webster produced a report this week on benefit sanctions. People including nurses, social workers and social care workers will tell us what is happening in the real world in relation to provision of services and to the impact of disability sanctions. When we talk about the veterans who are suffering in a wide range of ways—as are others—we should not silo our policies on disability or our budget decisions for local government away from their impact on the people who will suffer as a consequence of them. We will be strengthened in our resolve to support veterans if we look to the evidence and if we develop and fund policies that will actually make a difference to them.

I congratulate Combat Stress and all the veterans who have voiced the needs and experience of people who have served this country. Our job now is to make sure that, wherever we have influence, we develop policy that meets the needs that they have identified.

13:09  

I, too, congratulate Maurice Corry on securing the debate. Maree Todd’s valid points notwithstanding, I think that themes that have been highlighted in the report and the debate are extremely important, and we should continue to debate them in the times ahead.

I also want to acknowledge the fact that, since devolution, veterans issues have had a much higher profile in Scotland, and the fact that the current Scottish Government introduced the first minister for veterans, set up the veterans fund and appointed the country’s first veterans commissioner. Those initiatives have brought a much greater focus to the serious and difficult issues that face the veterans community in Scotland.

I speak as the MSP for Moray, which I believe must have if not the highest, then one of the highest concentrations of veterans living in any particular part of Scotland. I know many of them personally as friends and neighbours, and I know many of the issues that they have had to cope with in everyday life in the years since they left the services.

I am also aware of the valuable contribution that is made by Combat Stress and many other organisations that are out there doing their best to offer practical support, advice and so on. I congratulate Combat Stress on its report. It is true that there are areas that require much further research, and I hope that the minister will respond to that when he closes the debate. However, we have to be concerned by a survey of 3,000 veterans that shows that veterans living in Scotland are more likely to live in areas of multiple deprivation, with all the issues that that brings.

I want to highlight a couple of issues. As Maurice Corry and others have indicated, the report says that a fifth of veterans who access care at Combat Stress are early service leavers, and that early service leavers are most at risk of mental illness and three times more likely to commit suicide. That is quite an alarming conclusion that we must take seriously and delve into further. The report also highlights the need to ensure that support is available at appropriate times for early leavers. Page 11 of the report says that

“there is still a significant overall delay between leaving Armed Forces and seeking help.”

That makes it extremely important that services are available and that veterans who are leaving the forces know that the services are available.

I like the idea of the one-stop shops that are being created. I know that many organisations are doing good work across the country, but the veterans first point service that has been set up, with eight centres across Scotland offering one-stop shops, is an important way forward.

I will be parochial and talk about the issues in Moray for a second. There is a veterans first point centre in Inverness, and one in Aberdeen that serves Grampian. However, despite the fact that the organisation says that the main focus for veteran interface actually occurs in Elgin, which is in Moray, we do not have a veterans first point centre in Moray, which has—as I said—a particularly high concentration of veterans in its community. That is perhaps something that the service is considering at the moment and will continue to consider. It has a drop-in location at the Moray resource centre in Elgin, and the Ministry of Defence has just seconded a nurse to work there with the national health service and other organisations.

It is important to ensure that support is available, but it is also important to ensure that veterans know where to access that support: there is no point in its being available if they do not know where to go. I hope that the good work that has been done can be built on.

The cabinet secretary should reflect on his earlier intervention and further examine the ways in which the UK Government’s welfare reforms and other policies exacerbate poverty in general in Scotland because, according to the report, they will have a disproportionate effect on veterans. We have to understand what that impact will be. I hope that the cabinet secretary will commission work on some of the themes that have emerged in the report, as well as on the impact of his policies and the UK Government’s welfare reform policies.

13:13  

I thank my colleague Maurice Corry for bringing this important debate to Parliament. It is, indeed, worrying to think that many of our service personnel, who have served their country and put their lives on the line to keep us safe, find life difficult on coming out of the forces.

The report, published by the veterans mental health charity Combat Stress, presented some particularly distressing findings. One of the most concerning was the fact that it takes, on average, 11 years for people who are in need of support to ask for help. I wonder why it takes so long. Another notable statistic was that nearly one in five of the people who sought help were early service leavers. Those people obviously need closer observation and more support in the early years after coming out of the forces.

The report was based on a sample of more than 3,000 veterans, all of whom were active clients of Combat Stress. Combat Stress is the largest provider of community and residential evidence-based mental health interventions in the UK, after the NHS. It is also the leading specialist clinical service provider for veterans, with some of its services being commissioned by the NHS.

The majority of subjects in the sample for the report were male—which is hardly surprising—with an average age of 48. Of the sample, 48 per cent were in a relationship and 52 per cent were single. The majority of the folk in the survey had served in the army: 87 per cent in the army, only 7 per cent in the navy and 6 per cent in the air force. That split is not surprising, because army personnel are much more likely to be in the front line and in close contact with the horrors of war. What was a surprise to me was the very low number—only 4 per cent—who were in receipt of pensions.

Perhaps the most significant finding was that veterans who live in Scotland appear to be at the greatest risk of deprivation, compared with those anywhere else in the UK. Combat Stress’s chief executive, Sue Freeth, stated that the report’s findings

“highlight the significant challenges that Scottish veterans face.”

That is in contrast with the findings for veterans living in Northern Ireland, where, on average, there is less risk of deprivation. I wonder what they are doing differently in Northern Ireland.

Further, 63 per cent of those in Scotland who left their service early were in the three most deprived areas, but, of those who left after 15 years or more, only 32 per cent fell into the most deprived categories—a trend that is not echoed in the rest of the UK.

The report is distressing in many ways, but I hope that it leads to the beginning of a more caring and supportive regime for members of the armed forces as they leave and return to civilian life. Given that we now know that many of those vulnerable ex-servicemen and women spiral into homelessness, debt and mental stress in their first few years as civilians, we must put in place mechanisms of support and monitoring over a period of time, to help them to adjust to life away from the forces. That is surely the least that we can do for them, as they were prepared to make the ultimate sacrifice for us, to maintain our freedoms and our safety.

I therefore call on the Scottish Government to work with the UK Government to devise a strategy of support to address the obvious difficulties that arise upon veterans leaving the forces. A civilised society can do nothing less.

13:17  

I congratulate Maurice Corry on bringing the debate to the chamber. I acknowledge and commend both him and Edward Mountain for their lengthy service in the armed forces.

The Scottish Government has worked tirelessly in support of our armed forces and veterans community, as has been acknowledged across the chamber many times. We have a commitment to ensuring that the armed forces, veterans and their families receive the best possible levels of support. We set that out in the “Renewing Our Commitments” document in 2016, and much progress has been made—from support on housing to ensuring that, from 1 April this year, veterans who receive social care in Scotland will receive the full value of their war pensions, thanks to £5 million of funding.

Here in Scotland, we are lucky to have so many excellent charities and organisations that provide a range of support to veterans and their families. As we have heard, Combat Stress plays a major role in supporting veterans who suffer from mental ill health. It offers a full range of specialist mental health assessment, treatment, education, advice and support to help recovery and to improve quality of life for veterans across Scotland. The Scottish Government has funded the charity to the tune of around £1.24 million per year, as well as £200,000 in the past year for community outreach work. The three years of funding up to 2018 will consist of £3.6 million in partnership with NHS Scotland for veterans resident in Scotland at Combat Stress’s Hollybush house facility in Ayr, which has been mentioned. It is worth remembering that those who use the service make up a small percentage of those who have served in the UK armed forces.

We have also made available £1.1 million through the Scottish Veterans Fund since its creation in 2008, and that supports 144 projects.

As Richard Lochhead mentioned, we appointed the first Scottish veterans commissioner; we did that in 2014. We also established a network of armed forces and veterans champions in our local authorities and other public bodies.

In 2016, as I mentioned, we published “Renewing Our Commitments”, which sets out our desire for Scotland to be the destination of choice for those leaving the armed forces, wherever they come from across the UK. We have made great strides in promoting that message. There is no question but that a small but important number of veterans struggle to make the transition to civilian life but, overall, our veterans and their families are, unquestionably, true assets to their communities, to their employers and to this country.

Combat Stress’s report, which was based on responses from just over 3,000 Scottish veterans, explores the experiences only of veterans who were engaging with the organisation. As has been pointed out, a huge number of veterans make Scotland their home. Furthermore, the report is clear—it is important to bear this in mind—that each country reported a relative measure of deprivation independently, so no direct comparison could be made between the different countries. However, the simple point is that those who require assistance, particularly because of deprivation, must be treated on their own merits, regardless of how matters are dealt with elsewhere.

I certainly accept that more can be done. There is no question but that veterans are struggling to make ends meet, just like other members of society are struggling, as Johann Lamont mentioned. I met some of those veterans earlier this week when I visited the Coming Home Centre in Govan. Maurice Corry attended that event, too. The message I hear is that it is the UK Government’s decisions that are driving people into hardship, poverty and deprivation. About £1 billion will be cut from welfare spend in Scotland by 2020-21, with a £0.2 billion cut due to changes coming into force this year alone.

We will continue to strive to protect the most vulnerable and those on low incomes by mitigating the worst impacts of the UK Government’s cuts. For example, we have made sure that no one has had to pay the bedroom tax. We are taking action on reducing poverty. Our fairer Scotland action plan sets out 50 concrete actions that, over this session of Parliament, will help to tackle the inequality that is experienced by veterans and others. We have invested more than £350 million to mitigate UK Government welfare reform and to support low-income families. We have also established a £1 million a year fair food fund.

I recognise the important point that was made about the time that it takes veterans to come forward. I have made suggestions—I think that it was two years ago—to the MOD that it could help simply by making sure that a person’s records go to a designated general practitioner when they leave the armed forces. That would prevent anyone from falling between the cracks after they leave.

Sometimes, as we all know, veterans do not take up the other assistance that is available, because they do not want to do that—that is their right—or they do not take health support, because they have not had to do that in a civilian setting for a number of years. If medical records are sent to a GP who is designated by the service leaver, the GP knows who they are dealing with, their background and their experiences in the armed forces. They will also make sure that there is, at the very least, a first check with that veteran. That seems to be a straightforward and sensible way to deal with the situation. It would not be the only way to deal with the situation, and other measures would have to be taken, too.

It is true—I have seen this over the years for which I have been the minister with responsibility for veterans—that the MOD and senior people in the armed forces started off with the view that if those who had been recruited from areas of deprivation were deprived when they arrived in the armed forces and that was the condition in which they left, that was their lookout. Over recent years, that view has changed and I have seen a much more enlightened approach. If it is the case that the armed forces in Scotland and elsewhere have recruited disproportionately from areas of deprivation, there is an on-going responsibility—not just for the armed forces, but for the state—to look after those people, not least because of the service that they have given to the country.

There are things that we can do. I am more than happy to look at commissioning the work that Richard Lochhead suggested. It is entirely up to the cross-party group in the Scottish Parliament on mental health to decide what it wants to do. It might want to look at the impact of welfare changes on the deprivation that veterans suffer here in Scotland, although we will look further into that matter in any case.

I hope that my response has helped to reassure members of the Scottish Government’s whole-hearted and on-going support for our armed forces veterans community. We should be supporting the veterans, as I think that Peter Chapman said, not least because they were prepared to make the ultimate sacrifice in defence of the freedoms that we all enjoy. If we have any conscience, we should recognise that service and sacrifice, and ensure that we do everything that we can to help those veterans when they come out of the armed forces. Veterans organisations regularly make the point to me that the vast majority of people who come out of the armed forces manage to return to civilian life with virtually no issues, but that there are others who do not, and they deserve our full support. It is important to recognise that.

Again, I commend Maurice Corry for bringing this debate to the chamber.

13:25 Meeting suspended.  

14:30 On resuming—