Download Transition Information Sheet 10

HEADQUARTERS REGIONAL COMMAND
Resilience and Well-being
Transition IPPD Information Sheet 10
Mental health and Wellbeing is a major component of our general health and is as
important as our physical health. Regrettably it is often not properly understood
or ignored until Service personnel (SP) and their families are forced to confront it.
Emotional Well-being and developing personal Resilience will better equip members
of the military community to manage the pressures of modern life. This is a vitally
important life-skill which everyone needs to know.
Contents:
1. Introduction
Introduction
6. Risk and Protective
Factors
1.The pressures experienced by SP can be greater than those experienced by the general public. Military
training, culture and ethos provides SP with a mind-set and skills to generally cope with instances of intense
pressure and stressful situations at work. The Service community (parents, spouse/partner and dependents)
may also experience pressures caused by Service life. This can add to the general ‘ups and downs’ that
everybody experiences. A person’s emotional well-being is their ability to be able to function in society and
meet the demands of everyday life. The opposite of high emotional well-being is severe psychological distress.
Most individuals as they progress through life will to some degree experience both of these states which is
normal. Understanding and being able to recognise these challenges will enable SP and their families to seek
help at the earliest opportunity.
7. Challenges of Military
Life
Aim
8. Mental Ill Health
2. This Information Sheet seeks to introduce the military community to Mental Health, Well-Being and
Resilience so that individuals:
2. Aim
3. Stress
4. Mental Health
5.Resilience
9.Depression
10. Adjustment Disorder
11. Anxiety
12. Expressions of Despair
13. How to help
somebody seek help
14. Direction
15. Summary
16. Sources of
Information
•
Have a basic understanding of mental health
•
Understand the factors that can have an effect mental health.
•
Inform the military community of the symptoms of common mental health problems
•
Understand what individuals can do to protect themselves by building resilience
•
Provide access to more information and support
Stress
3. Stress is the feeling of being under mental or emotional pressure. The usual demands of life will cause
stress. When under stress your nervous system creates hormones which prepares your body for action by
raising blood pressure, increasing breathing and heart rate, muscles tighten and you become ‘sharper’.
Therefore stress can be positive as it prepares your body to react to a threat or can increase your performance.
As the cause of the pressure subsides stress level return to normal. However, the nervous system does not
distinguish between stress caused by physical and emotional threats. Individuals can extend the period of
stress if they are unable to manage their stress-levels. Failure to manage stress effectively can cause chronic
stress which in turn can affect your general health and leave you vulnerable to mental health problems such as
depression and anxiety. There is little you can do to avoid stress so it is important to recognise the symptoms
of stress and find effective coping strategies which should not include smoking or drinking. It is also important
to know that individuals can ‘burnout’ as a result of physical and emotional exhaustion that comes from
prolonged stress. This can lead to reduced feelings of personal accomplishment and not looking after oneself.
This can happen in any job or set of circumstances. More information is available at http://www.nhs.uk/
Conditions/stress-anxiety-depression/Pages/understanding-stress.aspx
Mental Health
4. Our mental health influences how we think and feel about ourselves and others, how we interpret events and
our capacity to learn, communicate and sustain relationships. It also influences our ability to cope with change
and deal with life events. Each year in the UK, one in four people will experience some kind of mental health
problem. Recent research has suggested that SP are no more likely to suffer from mental health problems than
the general public, the most common problems are adjustment disorders, anxiety and depression. Mental health
illnesses can be diagnosed and treated, but mental health is something that people sometimes ignore due to a
lack of understanding or because of the stigma that it carries which stops them from seeking assistance. This can
make the problem worse and negatively impact on the people closest to them.
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Transition IPPD Information Sheet 10
Resilience
5. Resilience is an ability to adapt successfully in the presence of stress, pressure, risk or adversity such
as trauma, family and relationship problems, serious health problems or workplace and financial stresses.
Resilience is not an extraordinary quality and is present in most people. It is something that an individual is
born with and can be further developed through life experiences. A resilient person can still suffer emotionally
from the difficulties and distresses that they face but they are better prepared to cope and react without it
significantly affecting their mental well-being.
Risk and Protective Factors
6. There are factors in society that can trigger or increase the risk of suffering poor mental health. Being
aware of these will better inform individuals and may possibly identify the cause of their distress. There are
also established protective factors that if adopted will improve personal resilience which will assist individuals
to cope and overcome stressful events. Many are life-style choices or disciplines that can be learned which
can really make a difference. These are shown in the table below.
Risk Factors
Protective Factors
Bereavement
Supportive Parents
Family history of mental ill health
Friends
Childhood neglect
Economic Security
Family Breakdown
Educational Achievement
Poverty/Debt
Employment
Social disadvantage
Good physical health
Longterm caring (family member)
Optimism
Illness
Problem solving skills
Abuse
Opportunities in life/choices
Bullying/Discrimination
Physical activity
Low Self-esteem
Sense of community/belonging
Violence
Diet/Healthy lifestyle/ Learn to relax
Victim/fear of crime
Focus on what you can control
Poor coping strategies (Drugs, Alcohol, Self harm)
Don’t judge yourself too harshly
Living in isolation
Engage in pleasurable and challenging activities
Unemployment
Culture, ethos, values and standards
Challenges of military life
7. With Service life comes specific challenges which may result in stress. SP and those in the military
community should understand the existence of these challenges and build their personal resilience and adopt
supportive life style choices to be able to cope well without adversely affecting their emotional well-being.
Will occur:
•
Undertaking professional and personal development training
•
Posting to new appointment
•
Move house/relocation
•
Career progression (greater responsibility/new challenges)
•
Leave the Army: Find alternative career/employment
•
Leave the Army: Adjust to civilian society(culture, values and standards, ethos).
•
Leave the Army: Find civilian accomodation post discharge
May occur:
•
Seperation (Parents, spouse, children, friends)
•
Working in high stress situations in challenging environments
•
Poor work life balance (burn out)
•
Illness / injury
•
Childrens schooling challenges
•
Personality frictions at work
•
Spouse employment challenges
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Mental Ill Health
8. There are different types of mental health problems. The most common in the military are Adjustant
Disorders, Depression and Anxiety. The symptoms of mental health problems can present themselves as other
medical conditions such as a virus, heart condition or general lethargy so many people will not associate their
state of health with their emotional well-being. Most mental health problems can be overcome relatively
quickly with the correct support. Even severe and complex conditions can be managed so meaningful and
satisfying lives can be led. Key to recovery is early identification and referral. This information sheet will not
attempt to describe each mental health problem listing specific symptoms. Instead a list of general symptoms
of the most common conditions will be offered to assist individuals and family members to identify that a
problem exists in order that assistance can be sought at the earliest opportunity.
Depression
9. The existence of some of the symptoms listed below which adversely affect how you live your life for a
period of 2 -3 weeks may indicate depression:
Continous Sadness
Change in sleeping routine
Lack of energy and tiredness
Loss of self-confidence and low self-esteem
Feeling guilty
Difficulty in concentrating or making decisions
Change in eating habits(too much or loss of appetite)
Loss of enjoyment and interest in things that were once
enjoyable
Slow in movement, agitated and unable to settle.
Reduced Libido (Sex drive)
Adjustment disorder
10. Adjustment disorders are states of emotional disturbance and distress that can arise in the period of
adaption after a significant life-change or stressful event that affect the integrity of an individual’s social
network such as bereavement, separation, divorce, a personal accident, leaving the Armed Forces, retiring.
Adjustment disorder is the most prevalent mental health disorder suffered by SP. Symptoms occur after 28
days of the stressful event. Symptoms can include:
•
Psychological: Depression, anxiety, worry, poor concentration and irritability.
•
Physical: Rapid breathing, diarrhoea and tremors
•
Behavioural: Aggression, deliberate self harm, abuse of alcohol, drugs misuse, social difficulties and
occupational problems
Symptoms in children and teens tend to be more behavioural in nature, such as skipping school, fighting or
poor behaviour. Adults tend to experience more emotional symptoms.
Anxiety
11. Anxiety, or worry, is a natural response when faced with danger or stress. An anxiety disorder is different
to normal anxiety because it can be more severe, longer-lasting and interferes with a person’s work or
relationships. Anxiety disorder symptoms can be divided into physical, psychological and behavioural:
Physical:
Palpitations, chest pains, rapid heartbeat, flushing
Dizziness, headache, sweating, tingling and numbness
Shortage of breath
Choking, dry mouth, nausea, vomiting, diarrhoea
Muscle aches and pains (especially neck shoulders and
back) restlessness and shaking
Psychological:
Unrealistic and excessive fear and worry about past and
future events
Mind racing or going blank
Decreased concentration and memory
Difficulty making decisions
Irritability, impatience, anger, confusion
Restlessness, on edge, nervousness
Tiredness, vivid dreams
Unpleasent and unwanted repetitive thoughts
Behavioural:
Avoid situations
Repetitive compulsive behaviour(excessive checking)
Distress in social situations
Urge to escape from situations(flight)
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Expressions of Despair
12. Distress, turmoil and despair can also be expressed through actions such as Self-harm, Risk-taking and
Eating disorders. These can be treated as problems in their own right but can also be present alongside other
problems such as depression, anxiety or psychotic illness.
How to help somebody seek help
13. Most people experiencing mental health problems will speak to friends and family about it before
speaking to a health professional. The practical and emotional support that family and friends can offer can
be extremely valuable.
Emotional support. When someone lets you know they are experiencing difficult thoughts and feelings it is
common to feel that you do not have the training or experience to help. However just being there is enough.
The following may be helpful:
Listening:
Being available to listen is the start point. It may not happen immediately but letting the
person know that you are there when they are ready to talk will be reassuring.
Offer reassurance
Let them know that they are not alone
Stay calm
It may be upsetting to hear that someone you care about is distressed but try and stay calm.
Don’t make assumptions
Try not to assume you know what has caused the problem or what will help.
Be patient
Let the person set their own pace for seeking help
Practical support. The following practical help may be useful:
Information
Help the individual to find information so they can consider what might work for them
Questions
Help the individual to compile a list questions that can be discussed with their doctor.
Administration
Offer to help with administration such as keeping notes, prescriptions and appointments
Practical tasks
Offer lifts to appointments. Help arrange for childcare. Assist with routine tasks to make the
time to seek help.
What to do if someone does not want help. Seeing someone that you care about struggling with their
feelings but won’t accept help can be frustrating and distressing. Remember you must respect the wishes
of the individual and that there will always be limitations on the support you can offer. You can be patient,
offer emotional support and reassurance, inform them where support can be found when they are ready and,
most importantly don’t forget to look after yourself. You should not: force or pressurize someone to talk, force
someone to get help (if they are over 18) or see a health care professional for someone else – they will only offer
general information - they will not offer any specific advice without consent.
Direction
14. Mental Ill-Health is not something that only happens to others – it can happen to you and can occur at any
time. Building your personal resilience can provide some mitigation to slipping into poor emotional well-being.
Being able to identify the possible causes and symptoms of mental health problems will allow individuals to seek
the appropriate support without delay. Ignoring the symptoms may make the condition worse and risk causing
longer-term problems that may have a serious impact on your personal emotional well-being in the long-term.
Soldiers: You have an obligation to yourself and your colleagues to understand mental health issues and
support those that appear to be affected. There is no stigma to mental health issues. Identification and rapid
referral are key to a prompt resolution.
Family members: Be aware that your serving member of the family may be reluctant to acknowledge mental
health problems and may attempt to hide them whilst at work. Hiding mental health problems from family
members at home is more difficult. Therefore family members have a part to play in identifying problems and
ensuring that the correct support is found.
Summary
15. Personal well-being and resilience directly influences how people deal with the challenges of life.
Understanding that personal well-being will change reflecting the ups and downs of life is important and
should provide a sense of confidence as this is perfectly normal. A general understanding and developing
personal resilience assists individuals to cope when faced with distress. However, there may be occasions
when individuals cannot manage on their own. Having an understanding of some of the causes of poor wellbeing and the symptoms that arise as a consequence will enable SP and members of their families to identify
problems early and seek the appropriate support and assistance. Your general health is vital to you and to the
army. Mental well-being is a key component of this and needs to be managed rather than ignored or denied.
HELPLINES
Combat Stress / Rethink
Helpline:
Call 0800 138 1619 or txt
07537 404719 (Mon – Fri
0900 to 1730 hrs)
SSAFA Forces Line:
Call 0800731 4880
Samaritans Helpline:
Call 116 123
Sources of information
16. More information on mental health is available at the following links;
http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/low-mood-stress-anxiety.aspx
https://www.bigwhitewall.com/landing-pages/landingV3.aspx?ReturnUrl=%2f#.WJMV94QgWM8
http://www.army.mod.uk/welfare-support/23239.aspx
http://www.sussexarmedforcesnetwork.nhs.uk/wp-content/uploads/2016/03/20160304-Pathways-for-Mental-Health.pdf
http://www.firststeps-surrey.nhs.uk/self-help/
http://www.mind.org.uk/information-support/helping-someone-else/how-to-cope-when-supporting-someone-else/lookingafter-yourself/
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