There are around 2.4 million veterans in the UK and 1.7 million households in England and Wales include at least one veteran. While most veterans adjust to civilian life relatively smoothly, some face significant challenges. The sudden lack of purpose and structure and loss of identity can feel overwhelming. Some may struggle to integrate into their local communities and experience isolation. Veterans exposed to combat may also suffer psychological trauma or live with long-term physical injuries and chronic pain. It is not surprising then that mental health issues are common among veterans.
While rates of common mental disorders (CMDs), such as depression and anxiety, are similar to those observed in the general population, veterans who served in recent combat operations experience significantly higher rates of poor mental ill health than the general population. These persistent mental health conditions carry serious consequences including emotional
distress, substance misuse, financial strain, risk of homelessness, social isolation, relationship breakdown, and in rare cases, violent behaviour. Yet many veterans still face barriers to accessing the care they need, including long waiting times and strict referral criteria, as well as social and behavioural barriers like the stigma about seeking help rooted in a ‘macho’ military
culture and the perception that civilian health services are not suited to the military experience.
PTSD Resolution is a charity that seeks to overcome these barriers by offering veterans suffering from CMDs tailored therapy through a network of over 200 accredited Human Givens
(HG) therapists. The HG holistic, evidence-based approach to mental health is described in more detail in the report. The therapy can be accessed through self-referral and is designed specifically to support those affected by service-related conditions such as PTSD, depression, and anxiety. Unlike some conventional health services, it imposes no strict acceptance conditions for clients. This results in higher client retention rates (90% of initial referrals agree to begin treatment) compared with other similar services.
This study evaluates the outcomes and economic cost-effectiveness of PTSD Resolution’s mental health therapy for UK veterans and assesses its economic viability. We find that veterans demonstrate reliable recovery from anxiety, depression, and psychological distress between the start and completion of the therapy with gains broadly sustained in the year after completion of
treatment.
We conclude that even under the most cautious assumptions, the PTSD Resolution programme is likely to be a cost-effective one. The benefits of the programme measured after one year outweigh costs if at least 10%-19% of the observed improvement in mental health can be confidently attributed to the therapy. Broader evidence on typical recovery rates for those that do not receive treatment suggests that over 65% of the improvements in mental health could be down to the programme. If we assume that natural recovery rates (i.e. without any support) for PTSD Resolution clients are in line with evidence from wider literature, then PTSD Resolution could be delivering between £0.5m and £1.1m of benefits each year. This is the equivalent of a potential per person benefit of between £1,200 and £2,800. This suggests that PTSD Resolution could be delivering between £1.50 and £3.40 of economic benefits for every £1 spent on the programme.
Even so, these estimates potentially undervalue the full benefit of the therapy. For example, improvements that do not meet the strict definition of recovery are excluded from the analysis. Also, the absence of long-term data means that the analysis cannot quantify potential lifelong benefits of sustained recovery from poor mental health. Evaluations based on short-term outcomes (i.e. only up to a year after completion) are therefore likely to underestimate the true lifetime benefits of tailored mental health programmes. A clear next step for the charity would be to build up its dataset with stronger follow-up data at the six and 12 months follow-up points post-completion and extend follow-ups past the one-year mark.
Despite some limitations, our analysis shows that veterans on the PTSD Resolution programme, on average, demonstrate reliable recovery from anxiety, depression and psychological distress between the start and completion of the therapy beyond what broader evidence on natural recovery rates would suggest. While some fade-out of these effects is observed in posttreatment follow-up scores, the gains are broadly sustained, particularly for anxiety and depression. This persistence of recovery under alternative scenarios for all three mental health disorders assessed strengthens our confidence in the validity of our findings.
Our findings support the provision of veteran-specific mental health services such as PTSD Resolution’s therapy as an effective and efficient use of charitable funding that improves mental health outcomes, achieves high client retention rates, and delivers economic benefits well above its costs.
“At 52 years old, my experience with PTSD Resolution has demonstrated that it is never too late to seek help. Their support has been transformative, helping me address long-standing issues and navigate recent personal challenges with resilience.”
Billy, UK Veteran, RAF