Military rehabilitation
The secondment was a positive experience for all staff involved , allowing time to meet new challenges , to learn and to share that learning with our substantive teams ."
Military rehabilitation
Feature
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T he task of developing a more armed forces and veterans-aware occupational therapy service was set by NHS Highland as part of its larger three-year Armed Forces and
Veterans Project .
In line with the Scottish Government focus on improving the mental health and wellbeing for the armed forces and veteran ’ s community , initial work focused on the creation of a teaching package and associated learning materials with emphasis on mental health related issues .
However , recognising that the majority of occupational therapists across NHS Highland work within physical rehabilitation , community or housing , the remit was expanded to reach as many occupational therapists , students and support workers as possible .
Setting up the team
The team consisted of a lead occupational therapist and three occupational therapists , all seconded on a part-time basis to the Armed Forces and Veterans ( AF & V ) team to provide the equivalent of one full-time post .
The team was appointed for one year and came from a variety of backgrounds in physical rehabilitation , housing and mental health . The team was spread across the NHS Highland area and routinely worked hundreds of miles apart .
MS Teams rapidly became the best way to collectively store information , work collaboratively and meet regularly online ; indeed the project was successfully delivered with only one in-person meeting .
The secondment was a positive experience for all staff involved , allowing time to meet new challenges , to learn and to share that learning with our substantive teams . Balancing pressures of substantive roles and the project work was difficult at times , but the benefit of shared experience and knowledge across the four team members outweighed this challenge .
Access to services
Scotland does not currently have the equivalent of Op Courage or the Veterans Trauma Network , and very few occupational therapists are directly employed by the military third sector , or work exclusively with veterans .
Most members of the AF & V community will therefore be seen by occupational therapists working within the core NHS or social services and are unlikely to be specifically identified or recognised as armed forces and veterans .
There is currently no standardised practice or documentation of the question ‘ have you or a
The secondment was a positive experience for all staff involved , allowing time to meet new challenges , to learn and to share that learning with our substantive teams ."
member of your immediate family ever served in the British military ’, or similar , and as such this will not be routinely considered in triage for occupational therapy services .
In line with the Armed Forces Covenant for the purposes of this work , veterans are defined as ‘ anyone who has served at least one day in HM Armed Forces ( Regular or Reserve ) or Merchant Naval Seafarers , who have seen duty on legally defined military operations ’ ( Office of Veterans ’ Affairs 2020 ).
Research indicates that a veteran ’ s first contact with NHS services is often related to physical causes , even if there may be underlying mental health issues .
Between 2015 and 2020 , the Ministry of Defence ( 2020 ) identified one of the top causes for medical discharge as musculoskeletal disorders and injuries . Pain , especially chronic pain , is prevalent in 41.2 % of veterans , according to Sharpe et al ( 2019 ), and is another common reason for armed forces and veterans to contact NHS services .
Creating the training
The topics were limited to 21 and grouped into six categories . These were :
• An introduction to the Armed Forces Covenant and the history of occupational therapy and its relationship to the armed forces .
• Physical health topics , including physical trauma , muscular-skeletal disorders and injuries , amputees and prosthetics , appearance altering combat wounds , hearing impairment , sight loss , traumatic brain injury and pain .
• Mental health topics , including depression , anxiety , criminal justice , dementia , substance misuse ( drugs , smoking , alcohol ) and posttraumatic stress disorder ( PTSD ).
May 2023 OTnews 29