Information for professionals

All referrals to our service come via the Veteran’s Mental Health Transition, Intervention and Liaison Service (VMH TILS). The service is provided by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust. They provide more information for those wanting to make a referral on their website.

Find out more about the Veterans’ Mental Health Transition, Intervention and Liaison Service (TILS).

To be referred into the Veterans’ Mental Health Complex Treatment Service, you must:

• have served in the UK armed forces for at least one day
• have been referred by VMH TILS
• be registered or able to register with a GP practice in England

Contact details for TILS North of England: Call 0800 652 2867 or email VTILS@cntw.nhs.net

Eligibility Criteria

• All veterans who have been triaged and assessed by VMH TILS providers primarily in the North of England, or in exceptions from other VMH TILS providers where there are links to the North of England, and who are registered with a GP practice located in England or not registered with any practice but would be eligible to be registered with a GP practice located in England.
• All veterans will have mental health problems that are directly attributable to their military service.
• The VMH CTS is for personnel who present with complex mental health needs including post-traumatic stress disorder (PTSD) directly attributable to their military service who have not responded to interventions earlier in the pathway.
• All veterans who have confirmed military service and is evidenced by the (VMH TILS).
• All veterans irrespective of gender, age (18 years or over), ethnicity, sexuality, culture or physical abilities.
• Veterans who will benefit from the intensive provision of a range of mental health and social interventions. These may include (but are not limited to) substance misuse, occupational therapy, physical health, employment, accommodation, relationships, financial and trauma focused therapy.
• Veterans whose mental health needs and associated level of risk cannot be met by primary care, the IAPT service or other community services. The VMH CTS will support veterans who may have been excluded or struggled to engage with locally commissioned services, including secondary care or military charities.

Selection Criteria

• The CTS will accept referrals for veterans with complex mental health needs which are directly attributable to their military service and include:
• Significant cognitive, emotional and behavioural problems associated with a mental illness attributable to their military service.
• Longer-term severe disorders which are characterised by poor treatment adherence and increased levels of risk/vulnerability which cannot be managed solely by primary care or mainstream secondary care services.
• Dual diagnosis of mental illness and substance/alcohol misuse where the mental illness is the primary need, severe and complex in nature.
• The veteran has been unable to have their mental health needs met through mainstream service provision.
• There is an agreement to engage in the therapeutic pathway from the veteran, including the ability to travel to appointments within their locality.

Exclusion Criteria

• Any referrals made from a source other than TILS will not be accepted. An assessment and triage will need to be completed from TILS
• Any veteran who is not registered with a GP in England
• The patient should have mental health difficulties that are attributable to, or have been aggravated by their military service and be seeking treatment to address these difficulties
• We recognise that veterans may have mental health problems that have arisen as a consequence of their experiences prior to, or after service. But a referral would need to indicate that their military trauma is the significant factor, however, there may be other non-military traumas that CTS would not address
• The CTS will not accept referrals unless there is clear evidence of attempts having been made to engage the veteran in a locally available pathway which has been unsuccessful. Referrals from DCMH, Combat Stress or any other military service will not be accepted into CTS unless there is evidence of a triage from TILS and documented evidence of exploration of locally available services. **The only exception to this would be a direct CTS to CTS transfer of care**
• There needs to be clear evidence of attempts to engage the veteran in a local clinical care pathway and a rationale why local services cannot be explored again if there has been a previous level of engagement
• Any person whose veteran status cannot be confirmed
• Any veteran who has had a recent acute episode, within the last 3 months, including in-patient, MHA assessment or contact with local crisis services due to a deterioration in their mental health or an increase in risk (including risk to self, risk to others, self-neglect, violence and aggression) **we would strongly encourage TILS to liaise with CTS for any cases where recent acute contact has been of a very short term nature**
• If there is no agreement to engage in the therapeutic pathway from the veteran, including the ability to travel to appointments within their locality. However, home visits and more ad hoc appointments can be offered if there is an individual need as a consequence of symptoms that preclude a veteran from travelling
• Referrals must be documented using the CTS referral form, including current risk assessment and supporting referral information (TILS assessment, clinician letter). Referral information must be based on a recent assessment of the veteran which should ideally be conducted on a face to face basis and if this is not the case, the referral should indicate what form of assessment has been conducted.
• Referrals will not be accepted for any veterans already engaged, for treatment, or waiting for treatment or triage with a locally commissioned mental health pathway (including IAPT, Autistic Spectrum, Neuro services). If a veteran is pending an assessment for a locally commissioned service, acceptance of the referral by CTS would require a discussion about the individual circumstances and suitability for CTS

Decision Support

The above list of criteria is not exhaustive. There may be situations that fall outside the scope of this specification that will require clinical judgement.