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Ms Abbott: To ask the Secretary of State for Defence (1) what provision has been made for the psychological rehabilitation of members of the armed forces returning from military operations; how much funding has been made available for such provision in 2009-10; and if he will make a statement; 
(2) what percentage of members of the armed forces returned from military operations with (a) a psychological disorder and (b) post-traumatic stress disorder in the latest period for which figures are available; and if he will make a statement. 
Mr. Kevan Jones: Diagnosis and treatment of mental health disorders in the armed forces is performed by fully trained and accredited mental health personnel, and measures are in place to increase awareness at all levels and to mitigate the development of operational stresses. In Afghanistan, we deploy uniformed mental health nurses to provide the necessary in-theatre care and treatment for our personnel. If personnel need to leave the operational environment, then their care continues either on an out or in-patient basis in the UK.
In the UK, our mental health services are configured to provide community-based mental health care, primarily through our 15 military Departments of Community Mental Health (DCMH) across the UK (plus satellite centres overseas), which provide out-patient mental health care. The DCMH mental health teams comprise psychiatrists, mental health nurses, clinical psychologists and mental health social workers. A wide range of psychiatric and psychological treatments are available (including psychological therapies, environmental adjustment and medication) where appropriate. The Defence Mental Health Services have particular expertise in treatments for psychological injury.
For the relatively small number of patients who need it, in-patient care is currently provided by a group of seven NHS trusts located throughout England and Scotland, led by South Staffordshire and Shropshire NHS Foundation Trust (SSSFT) through a central MOD contract.
The organisational structure of the Defence Medical Services means that comprehensive figures for mental health care expenditure cannot be provided without disproportionate cost as the sums involved are disaggregated and embedded in the budgets of individual military units and overall operational budgets. Under the contract with SSSFT, payment for in-patient care is made on a case-by-case basis; as a point of comparison, payments totalling £3.3 million were made for in-patient care in 2008-09; most of this was paid to the previous in-patient provider.
Since July 2007 the Defence Analytical Services and Advice (DASA) organisation has reported on the Psychiatric Morbidity of the UK Armed Forces. Quarterly reports for 2007 and 2008 are available in the Library of the House and on the DASA website found at the following link:
Willie Rennie: To ask the Secretary of State for Defence pursuant to the answer of 15 July 2009, Official Report, column 377W, on armed forces: mental health, what recent inspections of the Department of Community Mental Health have been carried out. 
Mr. Kevan Jones: The Healthcare Commission reported its review of the Defence Medical Services (DMS) in March 2009. As part of that review it looked at the provision of mental health care and visited military Departments of Community Mental Health (DCMHs) in Plymouth, Lisburn and Cranwell.
All three Defence Medical Services have processes for inspecting DCMHs, utilising a Common Healthcare Assurance Framework which is based on the Department of Health's "Standards for Better Health". All DMS units will be subject to a biennial set of visits, utilising the framework, from the single services. In addition, the post of inspector-general has been established recently within the Surgeon General's Department and his team will visit units as part of his clinical audit and assurance activities.
Willie Rennie: To ask the Secretary of State for Defence pursuant to the answer of 15 July 2009, Official Report, column 377W, on armed forces: mental health, what mechanisms are in place for monitoring the health of service personnel diagnosed with a mental health disorder. 
Mr. Kevan Jones: Service personnel who are identified as suffering from a mental health condition will be followed up or referred on by the medical staff who first had contact with them. Some personnel will have their conditions managed wholly by primary care staff, who also have the capability to downgrade medically personnel if required; to treat and refer on personnel to military Departments of Community Mental Health (DCMHs); or to liaise with DCMH staff if advice is required, including cases where direct referral to an in-patient facility might be appropriate.
Patients are provided with appropriate treatment and care. If patients cannot be returned to a medically fit state consistent with continuing service, then they will be medically discharged from their service. If this route is required, DCMH social workers will continue to support discharged personnel for the year following discharge to ensure they are getting appropriate care within the NHS.
Willie Rennie: To ask the Secretary of State for Defence pursuant to the answer of 15 July 2009, Official Report, column 377W, on armed forces: mental health, what mental health assessments are provided for service personnel who report to the Department of Community Mental Health. 
Mr. Kevan Jones: Personnel who are referred to one of the military Departments of Community Mental Health (DCMHs) will undergo a routine biopsychosocial assessment which will comprise an interview with a mental health professional. This usually takes the form of a one-to-one interview, although further reports (for example, from medical providers or from the chain of command) may be requested and psychometric questionnaires might be used where appropriate. The initial DCMH assessment will focus not just on the problem that led to referral but will take a holistic approach to the difficulties that an individual might be experiencing at the time of referral.
To ask the Secretary of State for Defence pursuant to the answer of 15 July 2009,
Official Report, column 377W, on armed forces: mental health, whether the Department of Community Mental Health provides treatment for (a) nicotine, (b) alcohol, (c) drug and (d) other addictions. 
Mr. Kevan Jones: Our military Departments of Community Mental Health (DCMHs) provide treatment for addictive behaviours, with referral to in-patient facilities if this is necessary, where individuals are retained in service. Smoking cessation services are provided within primary care. It is frequently the case that such treatment is provided in conjunction with chain of command-led workplace support. Personnel with an addiction that is incompatible with continuing service in the HM armed forces will be supported by military mental health staff during the discharge process.
Mr. Ellwood: To ask the Secretary of State for Defence how many active service personnel are known to have committed suicide following service in either Iraq or Afghanistan since those engagements commenced. 
Mr. Bob Ainsworth [holding answer 20 July 2009]: We are aware of a total of 27 regular service personnel whose deaths have been recorded as coroner confirmed suicides or open verdicts and who had previously served in Iraq or Afghanistan. The areas of deployment are:
24 who had been deployed to Iraq only;
one who had been deployed to Afghanistan only;
two who had been deployed to both operational theatres.
Additionally there are currently nine deaths that are classified as violent and unnatural causes, where the mechanism is consistent with suicide, but have yet to be confirmed as either a suicide or open verdict by a coroner.
Bill Rammell: The requirement and actual figures for instructors in phase 1 and 2 training for the services as of 3 July 2009 is shown in the following table (rounded to the nearest 10). There is a difference between the required and actual strength of instructors due to the posting process, operational manning requirements, instructors leaving post, and instructors being able to cover more than one course.
|(i) Phase 1||(a) Required instructors||(b) Actual instructors|
|(ii) Phase 2||(a) Required instructors||(b) Actual instructors|
|(1) Phase 1 instructor figures for the Army include those at the Infantry Training Centre Catterick, where the combined Phase 1/Phase 2 Combat Infantryman's Course is taught and the Phase 2 Infantry Course for those who completed their Phase 1 training at either the Army Foundation College Harrogate or at the Army Training Regiment Winchester.|
The instructor numbers shown for each service include the defence colleges which are grouped together under that service. The Defence Intelligence and Security College (DISC) and Joint Medical Command (JMC) which do not provide phase 1 training, do not fall under single service management and are therefore shown separately.
Dr. Fox: To ask the Secretary of State for Defence what the drop-out rate is of each recruit training establishment listed in the Ofsted report on the duty of care for recruits and trainees in the armed forces. 
Bill Rammell: The drop-out percentages for financial year 2008-09 (termed as Premature Voluntary Outflow-this comprises all those who elected to leave the service of their own accord) for the training establishments listed in the Ofsted report on the duty of care for recruits and trainees in the armed forces, are shown in the following table. The percentages shown are typical of what the Department expect given the nature of the military training undertaken:
|Training establishment||Drop-out rate (percentage) (rounded to nearest 1 per cent.)|
Bill Rammell [holding answer 20 July 2009]: The mandatory sitting 14 days for the PCAL2 Review Note submitted in the Departmental Minute to Parliament on 26 June expired on 17 July. However, the PCAL2 underwrite is still subject to the normal process of negotiation and agreement with the preferred bidder, which is ongoing.
Lynne Featherstone: To ask the Secretary of State for Defence how many people under 18 years old serving in the armed forces have been court-martialled in each of the last five years; and what charges were brought at each court-martial where proceedings have been completed. 
Mr. Kevan Jones: I refer the hon. Member to the answer given to the hon. Member for North Devon (Nick Harvey) on 1 September 2008, Official Report, columns 1446-47W. Further to that answer, I can add that the number of service personnel under 18 years old court-martialled in 2008, and the charges they faced were as follows:
1 x Battery
1 x Battery
1 x Assault occasioning actual bodily harm and the supply of drugs
Lynne Featherstone: To ask the Secretary of State for Defence how many (a) males and (b) females under 18 years old of each (i) age, (ii) ethnic origin and (iii) disability have been detained with adults in the Military Correction Training Centre in Colchester in each of the last five years. 
Bill Rammell: The Military Correction Training Centre (MCTC) is a key pillar of the military criminal justice system, which has proved to be successful. It is not a prison; it is a military unit, established for military corrective training. It provides detention facilities for men and women of the armed forces and can hold a number of different categories of detainees, the majority of whom are not sentenced for criminal offences and return to their military duties on release.
The provision of information broken down into the categories requested may lead to the identification of one or more of the individuals. This information is regarded as sensitive data and its release would contravene the Department's policy on disclosure and confidentiality.
|Number of personnel|
|(1) Fewer than 5.|
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