How veterans in Northern Ireland can access support from Combat Stress

The Northern Ireland Veterans Support Office (NIVSO) team recently visited the office of  Combat Stress in Belfast.

The aim of the visit was for the NIVSO team to gain an-depth knowledge of Combat Stress services and to find out how to encourage veterans to seek much needed support.

On the day, various Combat Stress experts were on hand. Here we look at the contribution of Consultant Forensic Psychiatrist, Dr Adrian East.

Dr Adrian East, Consultant Forensic Psychiatrist

Unravelling the Journey of Healing: A Psychiatrist’s Role in Combat Stress Referrals 

When it comes to addressing mental health challenges among veterans, the involvement of a skilled psychiatrist is crucial for those who require high level support.

Veteran, Reservist, and Consultant Psychiatrist at Combat Stress, Dr Adrian East, sheds light on his role and the unique approach taken to support veterans. 

We take a broad variety of referrals, I get involved when somebody identifies that we need a psychiatric opinion. And that can be either from a diagnostic point of view or because somebody’s medication needs looking at. 

I tend to see people very early in the journey and a lot of what I do is get somebody well enough, so then they can do the work with Lauren. That’s what Combat Stress does that no one else, frankly, can do. And when you look back in a year’s time, that’s what made the difference. A lot of my job is getting you well enough, that might mean some appropriate medication, it might mean doing some supportive work to get you up to that level and that’s very much where I see my role.

An average appointment with Adrian can last around 30 minutes, and he will always see clients in person.

He explained, “People are surprised it’s not as long as they think it’s going to be. I’m very much: you’ve done a bit of work already, gone over your background, I’m not going to kick you through all that.” 

Acknowledging that sometimes healing involves navigating through difficult emotions, Adrian focuses on empowering individuals to address the underlying issues effectively.

We do keep it fairly informal, but I am quite direct in terms of: this is the question I need you to answer today, and try and keep that on track. Otherwise we could end up spending three hours together and not actually achieving anything, so we do try and keep it focused.

Reflecting on the veteran’s improvement throughout the journey, Adrian highlights the progress made, often unnoticed by individuals deeply entrenched in their experiences:

What I find is that every session, people leave better than the session before. They usually can’t see that because they’re living it day in day out, and I’m at the beginning of the journey, but I can see the trajectory. And I like to reflect on that and get people to think back: remember when you first came to see me? And you couldn’t sit down, you couldn’t even come in the room? 

Addressing the prevailing notion that it’s “ok to not be ok,” Adrian offers a different perspective.

Instead, he emphasises that recognising and accepting the existence of a problem and taking active steps to address it is better in the long term:

There’s a phrase you will hear out there, it’s ok to not be ok – that’s not true. If you’re not ok you need to do something about it. I think it boils down to recognising there’s a problem, accepting there’s a problem and then doing something about the problem. If the problem is because your wife has left you, then that’s what you need to address. If the problem is you have lost your job, that’s the problem you need to address. So it comes down to this problem solving approach. Recognising, understanding and addressing the underlying problems and not just hiding it away. If you’ve got schizophrenia, you need your medication – it’s not ok to not be ok.

Encouraging realistic solutions to mental health challenges, Adrian advocates for effective, evidence-based treatments to reduce the stigma associated with seeking help:

We’re not stigmatising the person, it’s the illness that’s stigmatising them. My job is not to destigmatise, the best way to do this is to have effective, robust, evidence-based treatments. If we have better outcomes, that is going to reduce the perception of things. There are massive issues with stigma. A lot of it is societal, it’s across mental health.

When we discussed how veterans might be able to identify warning signs of mental health challenges for themselves or their peers, Adrian highlighted something very simple yet significant: a change in that person’s life.

The common patterns are a change. It might be a change in behaviour, or might be more a change in attitude. If something has changed there has been something to change it. When you look back in the journey that point was always there. You normally get comments along the lines of: I came back from this tour and I was doing this… and that was fine, I was carrying on, then they leave service and actually it’s not ok anymore – but it was that change that was the intervention point. Don’t try and diagnose yourself just recognise there’s a problem.


Editor’s note:

 This news piece was taken from the latest NIVSO newsletter.

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