Jamie Hacker-Hughes

Military mental health: Could screening and online therapy reduce depression risk?

By Samantha Dalton - 20 November 2013

Access to online therapy and the routine screening of new military recruits could help reduce the numbers of service personnel who go on to develop depression, anxiety and post-traumatic stress disorder, a former leading military psychologist has claimed.

Professor Jamie Hacker Hughes is also calling for increased access to therapy for veterans and believes online therapy could be part of the solution. The former head of clinical psychology at the Ministry of Defence (MoD) is now director of the Institute for Veterans and Families Studies at Anglia Ruskin University,

The professor made the comments during a webinar on military mental health hosted by PsychologyOnline, a provider of online text-based cognitive behavioural therapy (CBT).

He insists: “I’ve always said we should screen as this would provide a baseline assessment of all new recruits, particularly younger people.  The current policy in the British military with regard to screening is that we don’t do it and have never done it, unlike most of our Allies. This policy hasn’t been reviewed with the benefit of current knowledge to date.”

However, Professor Hacker Hughes has welcomed a trial which is currently underway at Kings College London to update the psychological community’s knowledge of the benefits of post-deployment screening as well as welcoming the introduction of brief mental health assessments throughout service.

Research suggests around 20%* of men and women leave the armed forces with a “psychological wound”. Depression, anxiety and alcohol dependency are the most common disorders and about 4% of veterans will develop post-traumatic stress disorder (PTSD). Recent figures from the MoD reveal cases of this condition have doubled in the past six years. 

Evidence from a separate study† also found that mental health problems still have a perceived stigma and embarrassment. Seeking help in a face-to-face environment means that some ex-service personnel are often not accessing the support they need when they need it.

Although access to psychological therapy for serving personnel and veterans alike has improved considerably in recent years, Prof Hacker Hughes would like to see online therapies such as PsychologyOnline, which provides one-on-one access to a therapist via a secure online consulting room, integrated into the current system as part of the range of therapeutic options available to mental health professionals.

He adds: “I’ve been interested in online therapy for some time as I believe that it is ideally suited for use in the military where there can often be resistance to seeking face-to-face therapy.   It also has particular benefits for those on deployment.

“For example, troops stationed overseas in Afghanistan or elsewhere have regular access to the internet and could easily access a therapy session in private.”

Professor Hacker Hughes stressed, however, the need for military GPs and mental health professionals to be aware of who is taking up this particular therapy option so that communication between all professionals involved with an individual’s care continues as normal

PsychologyOnline has been adopted by Surrey Mental Health CCG Collaboration as part of a portfolio of therapy services to improve access to mental health therapy.  It is available “on prescription” via referral from a GP.

Doctors in the county say it is proving popular with men as therapy can be accessed from the comfort of home, in the evenings and weekends, with relative anonymity and confidentiality.

In clinical trials the text-based approach to CBT has proven to be particularly beneficial for those with severe depression as it allows the patient to reflect on their problems as they write them down for the therapist.  This often results in “light bulb” type realisations that can bring rapid resolution to entrenched problems.

PsychologyOnline could also be useful in the treatment of reservists and veterans who still currently experience “fragmented” and inconsistent access to therapy, according to Prof Hacker Hughes, although provision of services, and their coordination, is gradually improving.

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