Case Studies – Armed Forces Day

Case Study One

S.F. is a Veteran who was referred to the Complex Treatment Service for help with Post Traumatic Stress Disorder (PTSD). Her main symptoms were recurrent, unwanted memories about past experiences such as those whilst on tour in Iraq and a constant feeling of being unsafe. She described frequent flashbacks, disturbed sleep and heightened anxiety. This was impacting on her ability to engage in work or other meaningful activity.  When S. F. was referred to CTS, her main coping strategies for managing her PTSD symptoms included avoiding her thoughts and feelings by keeping extremely busy and putting on a mask when around others to look as though she was coping.

S.F. is now nearing the end of her therapy sessions with CTS. She has a number of coping strategies that she frequently uses including a grounding box, relaxation techniques as well as being more open with others about her difficulties. S.F. reports a significant reduction in her PTSD symptoms and an improvement in her mood and self-confidence. She is completing a mechanical engineering course with Mission Motor Sport which she is thoroughly enjoying.

S.F. said this about the support she has received from the Veteran Mental Health Service:

“When I was first referred, I was hoping to reduce my symptoms by even just 10% as this would be a huge change for me. I wasn’t expecting any miracles, I was just hoping for small but meaningful change. What’s happened is that I have learnt a lot about myself! I have also learned lots of different techniques to help me look after myself, like using my safe place and protective figure. My EMDR sessions have been particularly powerful and I found bringing my protective figure into my difficult memories really helpful. It hasn’t been easy though. I found EMDR processing work very difficult. I have also had to work really hard outside of my therapy sessions to make sure I apply things at home. I have learned to help myself by self-love, care, respect and boundaries. My advice to other veterans who may be struggling with their mental health is – don’t keep yourself closed. Reach out and get the ball rolling. You have to try.”

Case Study Two

Veteran G.P. was referred to the Complex Treatment Service for help with distress associated with his military service. His main distressing experiences concerned feeling on edge, not able to relax but not understanding why he felt this way, alongside intrusive thoughts and trauma memories. This led G.P. to cope in ways such as distancing from relationships, and reacting understandably to his experiences with anxiety, low mood and a sense of guilt. The result of having experienced these ‘symptoms’ and his ways of coping, meant that G.P. believed therapy may not help (as he had poor previous experiences of mental health support)and he was in some way ‘permanently stuck’ with how he experienced life, moving further from his values and feeling caught in a loop.

Former veteran G.P. had this to say about his experience of the Veteran Mental Health Complex Treatment Service:

When you were first referred to the CTS, what were your hopes and expectations?

“I didn’t have any hopes because of previous bad experiences. My expectations were that I was going to be fobbed off and that there would be a time limit of 6-8 sessions – I expected it to be like every other service I’ve used, people letting me down or not understanding, no common ground, not being able to relate.”

What did you learn?

“At the CTS it was all about the connection – I never felt berated or stigmatised. The CTS concentrated on coming up with ideas between us (not just given “off the shelf”). I have been given positive recognition for my efforts and it’s helped me realise what I’m doing and reinforces what I’m learning about myself. I’m not just told what to do.”

What were the main challenges for you and how did you overcome them?

“Previous experience of mental health support was not great – I felt like I was going around in circles and having to repeat myself – an endless loop and never moving further forward. It’s different at the CTS – there’s a connection, a human connection that is consistent. The conversations are two-way and focus on what my goals are, my recovery journey, my ways of coping with the pressure in my life since leaving the military.”

What single piece of advice would you give to other veterans who may be struggling with their mental health? 

“Reach out to the teams in Op COURAGE – they’re friendly, they’re approachable. You have to have the expectation that it will take time, it’s important to engage and try things before dismissing ideas, and if they don’t work then be honest with your therapist.”

Case Study Three

M.F. is an Army Veteran who was referred to the High Intensity Service (HIS) after suddenly being made homeless following the breakdown of a relationship. He was ‘sofa surfing’ at different friend’s houses and drinking excessively to numb his feelings. He was also experiencing daily suicidal thoughts and had started to formulate ways in which he could end his life. He had previously attempted suicide twice but was not receiving any support from mainstream NHS services. The High Intensity Service (Veteran Mental Health) together with the local NHS Crisis Resolution and Home Treatment Team assessed M.F’s needs and ensured he remained safe. M.F. was admitted as an informal patient to an acute male psychiatric ward. During his admission, the HIS team worked closely with ward staff to help plan appropriate support for M.F’s discharge, as well as help with him find accommodation via veterans charities. After several weeks, M.F. was discharged from the ward and now resides with his sister-in-law whilst alternative accommodation is being sought – HIS continue to support him with this and have helped him access local alcohol services. He is returning to work soon and is still receiving help with regards to engagement with veteran-specific activities. He will soon be ready for discharge from HIS.



Case Study Four

M.S. is a Veteran who was referred to the Complex Treatment Service for help with Post Traumatic Stress Disorder (PTSD). His main symptoms were recurrent, unwanted memories about his experiences on tour in Afghanistan and a constant feeling of being on guard which made it impossible for him to relax. His sleep was frequently interrupted by vivid nightmares, such that he avoided going to bed and used alcohol to get to sleep. He described feeling angry, irritable and getting into confrontations with other people. This was impacting on his relationship with his partner, his performance at work and his self-esteem.  His coping strategies for managing his PTSD symptoms included avoiding situations that would remind him of his traumatic experiences and numbing his emotions with alcohol.

When you were first referred to CTS, what were your hopes and expectations?

To find the right treatment for myself. To help me meet my own goals and ultimately to help me have a better understanding of my illness and ways to help myself and not just rely on therapists.

What did you learn?

Not all things can be fixed as easily as we’d like.

What were the main challenges for you and how did you overcome them?

Meeting new people and explaining myself time and time again. That’s something that happens a lot in the military but I’ve found not so much in civvy street. Learning to trust and open up to help myself. Trust in my gut and go for it. Holding back is not an option

What single piece of advice would you give to other veterans who may be struggling with their mental health? (what would you want them to know?)

Reach out, help is there! You aren’t just a number.

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