Service users and their family members’ views of a veterans’ mental health service in the UK: a qualitative evaluation

Background: Op COURAGE is a National Health Service (NHS) specialist service that provides mental health and well-being support for people who have served in the UK Armed Forces, including reservists, and those approaching discharge who are experiencing mental ill health. They offer a holistic package of care, including help with transitioning to civilian life, psychological and pharmacological treatments, support with social vulnerabilities and referral to other services. Op COURAGE works collaboratively with other NHS services and charity partners. The NHS provides clinical aspects of care, and the charities including The Stoll Foundation and Walking With The Wounded support service users with housing, finances and employment. The Ripple Pond supports veterans’ family members. Researchers at University College London were commissioned by NHS England to independently evaluate the support delivered by the Op COURAGE service based in London.

Methods: We conducted a qualitative evaluation of the treatment and support offered by the London Op COURAGE service from the perspectives of veterans and their family members. We involved service users in the design of the research. Using rapid qualitative interviews, we explored their views about the service and suggestions for improvement. We analysed the qualitative data using a rapid form of framework analysis.

Results: We conducted nine interviews - six with veterans and three with their family members. We developed four domains: entering the service, journey of discovering support, specialist and personalised care, and developing the service. The majority of the challenges experienced were in reaching and entering the service, followed by understanding the treatment process and the varied support available. Our participants, during treatment, found the service and the staff to be sensitive to veterans’ and their carers’ needs. Our participants reported the need to improve visibility, outreach, service user involvement, clinic environment, referral processes and veterans' networks.

Conclusion: Our evaluation provided insight into the participants’ experiences and highlighted barriers and facilitators to engaging with this specialist veterans’ mental health service.