By Will Tullis, MA Investigative Journalism
This investigation reveals serious faults and deficiencies at leading military mental health charity Combat Stress. Health experts have said its miscommunication has “directly” impacted the mental health of veterans. At least 186 veterans have suffered, some of whom have attempted suicide.
New and exclusive revelations from former Combat Stress employees, as well as testimonies from 36 veterans and families who accuse Combat Stress of mistreatment, reveal the depth of the crisis.
Evidence seen by this investigation – including letters and emails between Combat Stress and veterans as well as an affidavit – suggests that the military charity has prematurely discharged patients “without explanation”, who still require treatment.
Also revealed is a failure in government policy when it comes to treating military personnel and veterans for mental health issues.
All this is despite the fact that military mental health charities are sitting on millions of pounds worth of funds – over ten times the funds of equivalent civilian mental health charities, which treat thousands more patients.
Six missed calls and a suicide: Lance Corporal Andy Stokes
“Coming home to find my husband had hanged himself is an image that will haunt me forever”, said Maud Stokes, the widow of army veteran Andy Stokes, her voice shaking. Maud, who lost her husband eight years ago, let out a sigh whilst she gathered her thoughts, “I came home with my 12-year-old daughter, opened the garage door and there he was. No one should have to see that. No one. For me, Combat Stress have blood on their hands”.
Maud Stokes, the wife of Lance Corporal Andy Stokes, is one of the 186 people in this investigation that blames Combat Stress directly for mistreatment. She believes that for Andy Stokes, that mistreatment might have proved to be fatal.
Stokes sought help from Combat Stress after suffering panic attacks, anger management issues and bouts of extreme depression after being discharged from the army in 2004. Stokes joined the army in 1980, serving in the Falklands War and Northern Ireland. A self-described “family man”, Lance Corporal Stokes had no pre-existing mental health conditions before joining the army. After returning from duty in the Falklands, his mental health deteriorated sharply.
With no aftercare, support or guidance from the army or the Ministry of Defence after leaving the army, Andy’s family turned to Combat Stress, a military mental health charity that has been operating in various forms for over 100 years. “His family didn’t know who or where to turn to,” explained Tony Smith, a friend and former comrade who served in the Falklands with Andy. “No one reached out and [Andy’s family] felt let down…the army trained him up to be a killer, put him through that hell and then just said ‘see you later’ and left him to it. It’s awful really.”
Tony Smith persuaded Andy to attend a consultation at Combat Stress, where a welfare officer accepted Stokes, who also served in Bosnia, onto a treatment programme. Andy’s family and friends thought that this would mark the start of his recovery.
In the end, however, Andy’s widow describes their first contact with Combat Stress as “the start of the long and painful road that led to Andy’s death.”
Stokes was put on a two-week course at Combat Stress’ Audley Court treatment centre in Shropshire, that comprised of meditation classes, sessions with welfare officers and psychiatrists, and arts and crafts.
After this course, Andy was told that he would be seen again in a few months. His widow said Combat Stress told Andy he could call “whenever he needed help”. However, this proved to be an empty promise from Combat Stress, in the mind of Andy’s friend and former comrade Tony Smith:
“Combat Stress washed their hands with [Andy]…they gave him an initial two-weeks treatment programme and told him that they’d be in touch to arrange the next one…[they said] he needed more treatment regularly…but then they never called. And when [we] tried to call they just gave excuse after excuse…and eventually, at the peak of Andy’s depression, they said he was discharged and did not need treatment anymore. It beggars beliefs. He killed himself not long after that.”
A few months after his course at Combat Stress, Andy Stokes’s mental health deteriorated again. Stokes suffered panic attacks and confided in Tony Smith that he was having suicidal thoughts. Smith says Combat Stress “simply weren’t interested” in a man who was, “on the brink”:
“…when Andy phoned me up multiple times and said he wasn’t coping and he was having suicidal thoughts, I told him don’t worry, I’ll get in touch with Combat Stress, I’ll get a welfare officer to visit you or somebody to phone you…but there was nothing. They just gave me false assurances.”
Tony Smith claims he called Combat Stress on behalf of Lance Corporal Stokes three times, but that Combat Stress welfare officers didn’t take any “meaningful action” beyond simply saying they would “be in touch”, and neglected to send a welfare officer out to check on Stokes. Stokes then tried calling Combat Stress three times, according to his widow Maud and Tony Smith, but each time Combat Stress “fobbed him off”, Smith said:
“Andy tried phoning Combat Stress when he was talking about suicide but at first they fobbed him off and told him a load of sweet nothings that everything would be alright, then eventually they just ignored him, they didn’t want anything to do with him…let alone let him come back up to Audley Court [treatment centre] for another round of therapy”, explained Tony Smith, who was himself diagnosed with PTSD by Combat Stress in 2004.
The last conversation Tony Smith had with his friend and comrade Lance Corporal Andy Stokes was in 2012. “I asked [Andy] whether he’d heard back from Combat Stress yet…between us we’d called six times. Six times we’d told them it was a serious situation…and they’d just said they would be in touch. Andy told me he hadn’t heard back from them.”
The next call Tony Smith received from the Stokes household was from Lance Corporal Stokes’ wife, Maud. It was to tell him that Andy had hanged himself in the garage while Maud was picking their 12-year-old daughter up from school.
Tony Smith, understandably furious and still rocked with devastation by the suicide of his friend and former comrade, asked Combat Stress for answers. Smith says Combat Stress told him that Andy Stokes had “refused treatment” – a claim that Andy’s widow and Tony, and Andy’s phone calls to Combat Stress, say is untrue. Smith then organised a meeting with Combat Stress to discuss their handling of Andy Stokes’s case, where he says “they admitted they lied” and said that Stokes hadn’t in fact refused treatment:
“I went to [Combat Stress] I brought my file on Andy, they brought theirs, and I said ‘You are lying, Andy Stokes never refused treatment’, and then they admitted that I was correct, Andy Stokes had never refused treatment.”
Tony Smith then wrote a statement which he swore by affidavit – seen by this investigation – before handing it to the police.
Gus Hales, is a veteran who went on hunger strike against Combat Stress, complaining of similar mistreatment. He says he was also prematurely discharged. Hales and Smith gathered reports and names of veterans who had been mistreated by Combat Stress, including that of Andy Stokes, and sent it – as instructed by the police – to the CQC. Hales showed this investigation the CQC’s response, which says the CQC does not investigate complaints of that nature. “So who do you go to?” said Hales, lamenting a sense of institutional hopelessness, “the police are not interested, the CQC are not interested. And the CQC are not interested because it’s a charity…so we seem to be in this zone where these people are fireproof…immune from scrutiny [and] accountability.”
Hungry for justice: Gus Hales and the hunger strike against mistreatment
Lieutenant Gus Hales is a Falklands War veteran who went on hunger strike against Combat Stress after what he calls “disgusting, shocking mistreatment” from the UK’s longest-running military mental health charity. Gus Hales, who was prompted to join the military after the Birmingham pub bombings by the IRA in 1976, felt forced to go on hunger strike after being discharged by Combat Stress, “without explanation” and without being told who had sanctioned his discharge, when he still had severe mental health problems. Hales believes Combat Stress then lied to him about the reasons for his discharge, saying he was now “well” and no longer needed treatment:
“When they discharged me prematurely, I entered into a two-year battle of backwards and forwards letters with Combat Stress and I thought: sod this, if it is happening to me, it is happening to lots of other people. So, I thought I’m going outside and I’m going to go on hunger strike to try and raise some attention towards this.”
Gus Hales, joined the army in 1976 where he served in the 9th Independent Parachute Squadron of the Royal Engineers. Hales saw the army as the chance to escape his destiny as a miner and a factory worker in his native Nuneaton, and a chance to see the world. A man of the baby boomer generation, the former paratrooper grew up in an era where the fathers and grandfathers of Britain were military heroes, bathed in the glory of victory from both World Wars. Hales considers his generation of soldiers to have been part of a British Army at the peak of its professionalism: “We weren’t conscripts like our fathers and grandfathers who’d fought in the World Wars, we were volunteers – we wanted to be there and we had a sense of duty…we wanted to emulate the glory of our fathers and grandfathers.”
The Falklands War proved to be the formative experience of Gus Hales’s life and has shaped his mental and physical health ever since. “Of course, you see some terrible things…you see your mates die in front of you…in your arms,” Gus recounted. “I spent most of my time [in the Falklands] on land. You advance, you clear out any targets, get in some firefights, and move forward…there’s no time for blubbing or feeling sorry for yourself in that situation if you want to remain an effective fighting force…you’ve just got to get on with it so you can complete the objective.”
Whilst this traditional military approach to mental health perhaps proved key to Gus’s survival and the successful British military campaign in the Falklands, Gus credits this “get on with it” approach to mental health as a potential reason as to why he developed PTSD after returning from the Falklands in 1982. Gus says he experienced panic attacks, anxiety and depression, but it wasn’t until ten years after he had returned from the Falklands, in 1992, that his mental health situation deteriorated to the point where he knew he needed to seek help. It was a few years after this point, in 1995, that Hales contacted Combat Stress for help. It was Combat Stress who diagnosed Hales with PTSD that same year:
“I went for an assessment at Combat Stress who diagnosed me [with PTSD] and they said in order to manage this condition I could come [to Combat Stress] for three two-week periods a year [for] what they call ‘respite care and remedial’ so…that helps you improve your condition”.
Hales says the way his Combat Stress treatment was funded was through the Veterans Agency – the executive agency of the Ministry of Defence – in Norcross, Blackpool. Combat Stress would write to the Veterans Agency to request funding to treat Gus, who would then fund him to go for treatment at Combat Stress. Hales was told by both Combat Stress and the Veterans Agency – a claim backed up by written correspondence that this investigation has seen – that for his PTSD and specific condition, he would need six weeks of treatment a year in order to successfully manage his condition. Hales says that the treatment was working and that it was “doing what they said it would do”, leading him to seek it every year to manage his mental health.
However, in 2015, Combat Stress told Gus Hales that he no longer needed the treatment he deemed so vital to managing his health and wellbeing, and the treatment provided by Combat Stress suddenly stopped. Hales says he wasn’t given any notice or reason by Combat Stress as to why they had halted his treatment programme: “The Veterans Agency told me central government stopped the funding from Norcross (Blackpool) who in turn used to give that money to Combat Stress, so it all stopped…but Combat Stress didn’t give me a reason.”
Combat Stress then discharged Hales without – he says – notice or his consent, claiming that he didn’t need to be treated any more and that his condition was fine, even though Gus Hales himself was still suffering from severe mental health problems and felt he needed treatment to be continued. Hales also claims his premature discharge by Combat Stress was contrary to Combat Stress’s own diagnosis and advice:
“One thing that leaves a bitter taste is the hypocrisy…the contradicting messages: when I first went [to Combat Stress] they told me I needed to have this treatment for life. But then all treatment stopped. I then entered into a bit of a battle with Combat Stress asking why’s my treatment stopped, why did you tell me that I had to have this for life, then you’ve just said you can’t come in anymore. It was shocking really.”
Hales strongly criticised Combat Stress’s handling of the situation, saying that the charity sent multiple welfare officers – none of whom were medical professionals – to his house to discharge him: “That’s how callous they were…it was wrong on a professional and psychological level. They sent people to tell me – on the doorstep of my own home – that I was discharged, and I no longer needed treatment. And they refused to give me a reason. I was appalled by this. I thought: if this is happening to me it will be happening to others.”
Hales claims that he asked Combat Stress why they had decided to discharge him, to which, according to Hales, Combat Stress replied: “that’s none of your business”. Hales got into a long battle via correspondence with Combat Stress, seen by this investigation. None of the correspondence gives a medical reason for discharge.
Several other of the veterans who were treated by Combat Stress spoken to in this investigation said they were discharged prematurely when they still needed treatment.
A former Combat Stress welfare officer, who wished to remain anonymous, worked at the military mental health charity for three years, supports some of Hales’ claims. He was involved in discharging veterans via correspondence and home visits. The Combat Stress “whistle-blower” claimed that there was “little to no” medical basis for discharging the veterans:
“We were told by senior staff that we didn’t have the funds to keep treating all these people who still needed to be treated, so we had to make tough decisions…there was no doctor involved in the discharge process, just welfare officers. We were cutting corners in the name of time and money. It didn’t sit right with me personally and I feel even worse about it now looking back but at the time you’re kind of institutionalised…you feel like when you’re working for a charity you’re doing a good thing…so we were forced to discharge some patients to make room for others. We were told that’s how the charity sector works, due to funding constraints”.
The former Combat Stress employee told us that this process was a means of ensuring veterans got an equal allocation of treatment, to ensure fairness, but that this “definitely let down” hundreds of veterans who still needed treatment:
“I suppose you can see the logic: to make sure everyone is treated when you’re operating on a budget and there are funding constraints…but when you’ve got people crying out for help, people saying they’re suicidal or they still need help and we just had to tell them ‘sorry you’re discharged’…I can understand why that leaves a sour taste…it was hard to discharge people who clearly needed more treatment…there was a culture of deceit”.
Another former Combat Stress employee, who worked in an administrative and communications role, backed up these claims: “I’m not in the business of pointing fingers and saying who’s got this percentage of the blame and who’s got that…[but] something that did trouble me when I was [at Combat Stress] was having to tell desperate men, people in tears, that ‘sorry there’s nothing we can do, ta-ra’. That didn’t sit well with me…because you don’t know what they’re going to do next when you put that phone down.”
“Deeply concerning”: The medics’ verdict
Beth Niven, a mental health specialist whose son Luke attempted suicide after leaving the army in 2016, says that Combat Stress’s procedures are “shameful” and claims that the military charity’s culture of prematurely discharging patients could actually do “more harm than good” for veterans with mental health problems: “It’s a disgrace that Combat Stress can let down their patients like this – by abandoning them when they still need treatment they could be inflicting deep distress onto veterans who have already been through really traumatic experiences…the fact that there is no medical basis for discharge too is not just disappointing, it’s dangerous”.
Niven had been a practicing NHS nurse for over twenty years when her son Luke was discharged from the army for failing a drugs test. When Luke tried to take his own life, his mother Beth was dragged headfirst into the discussion on military mental health. This personal experience, along with her professional expertise, makes her more qualified than most to comment on matters of veterans mental health treatment: “I used to think this whole business [of independent military charities for treatment] wasn’t perfect but was necessary because these military charities have more expertise than the NHS on these things…[but] the way they treated my son and others has left the NHS and the country to mop up the mess.”
Chiraag Thakrar, a doctor and neuroscientist at the University Hospitals of Leicester NHS Trust, corroborated Niven’s claims, highlighting that not seeing a course of treatment through is “tantamount to abandonment” and can cause lasting damage. Thakrar reviewed the testimonies and evidence collected in this investigation and gave a damning verdict: “Abandoning patients halfway through a course of therapy, which is what Combat Stress appear to have done…is at best poor practice and at worst irresponsible… this evidence suggests that Combat Stress are responsible for the [mental health] crises their discharged patients have gone onto face. Of course, there are other factors but it would be dishonest to claim they are blameless.”
After two years of battling Combat Stress, Gus Hales says he wasn’t given any satisfactory answers about the reasons for his discharge, let alone the possibility of receiving further treatment. Hales started campaigning to get answers. It was at this point that other veterans who had been treated by Combat Stress heard about Hales’s situation and realised it sounded harrowingly familiar: “When people heard about my battle with Combat Stress, loads of people came out the woodwork and started saying to me: ‘hang on a minute, this is exactly what happened to me’.” Two years since being discharged without explanation, Hales was still waiting for answers from Combat Stress and decided enough was enough: the then 62-year-old Falklands Veteran would go on hunger strike.
“…when I got nowhere with two years of backwards and forwards letters, [I went] to camp outside [Combat Stress’s Audley Court centre] property until I get some answers. And the only way I could bring any attention to this was to go on hunger strike leading up to the 2018 signing of the Armistice. 100 years after the end of the first world war we were still treating soldiers in this way.”
Gus Hales went on hunger strike to demand answers from Combat Stress for 18 days. Hales was forced to end his hunger strike after advice from a doctor, but by then Hales had received testimony from 150 other veterans who had been treated by Combat Stress, who claim they were discharged under similar circumstances.
Suicide, prison, homelessness and no treatment from Combat Stress
One of these names was Darren “Daz” Lynch, a 50-year-old veteran who served in Northern Ireland, Bosnia, and Iraq. Lynch, from Barrow-on-Furness, suffered extreme PTSD and depression after returning from duty, and was treated by Combat Stress in 2010, after attempting suicide.
Combat Stress discharged Darren Lynch over the phone in 2012, shortly after Darren’s brother, who also served in the army, had committed suicide. Lynch claims Combat Stress gave no medical reason for his discharge: “They just said I was discharged and that I didn’t need treatment anymore and that was that…even though I was in a really, really bad place. My brother had just committed suicide and had been in a very similar situation to me: he was in the army and had depression…and [Combat Stress] knew this.”
This investigation saw Darren Lynch’s discharge letter from Combat Stress. The letter – barely 200 words long – states that Lynch’s treatment is complete. It gives the Combat Stress helpline number, telling Lynch to call it should he feel the need.
A year after Lynch’s medically unexplained discharge from Combat Stress, he barricaded himself in his bedroom and attempted suicide by overdosing on painkillers and antidepressants whilst drinking alcohol. It was the first of three suicide attempts made by Lynch after being discharged by Combat Stress.
Gus Hales tried to get in touch with Combat Stress on behalf of Lynch, but says he received no satisfactory response: “They didn’t want to know,” claimed Hales “they just said he’d been discharged and that was that, there was nothing they could do beyond point us in the direction of their helpline…but there was no treatment offered to [Darren Lynch].”
Darren Lynch sank into a deeper spiral of darkness and depression, culminating in his arrest in 2014 for hitting his wife. When the police arrived to arrest Darren Lynch – who served in the Royal Engineers – they only managed to handcuff one hand, at which point Darren swung the handcuff into a police officer’s face. He was charged with domestic violence and assaulting a police officer. He was ordered to attend a mandatory anger management course in Cheshire, which Lynch claims he had no means of getting to from his home in Liverpool. It was after missing these mandatory anger management sessions that Lynch was sent to prison for three months, where his mental condition worsened further. When he was released from prison, Lynch was homeless, and spent six months living in his car. Stil, he says, he had no correspondence, support or explanation from Combat Stress.
“It’s all so hard to take,” said Lynch “my brother going, me almost going…Combat Stress definitely made my situation a whole lot worse, they’re useless. I dread to think of how many people have committed suicide because of them.”
Cutting funds or hoarding funds? Government policy and charities with millions in the bank
Government policy on military mental health provision has been to have veterans assessed and treated by independent charities which receive government funding and private donations, rather than by the NHS. The logic behind this is because the military charities – many of whom are staffed by veterans with army experience themselves – are deemed to be better equipped with the expertise to understand the situation of soldiers, explained Jack Davies, a policy adviser in the Ministry of Defence. It is also down to economic factors too, Davies explained: “Although [former veterans minister] Tobias Ellwood allocated £10m extra funds to veteran care recently, the Ministry of Defence has seen its budget shrink in real terms, and so this model [of veterans being treated by independent charities rather than the NHS] is seen as more sustainable, as well as giving veterans the opportunity to be treated by experts who understand their situation. The Ministry of Defence has listened to experts after years of careful consultation and the feedback has always been that veterans want – and respond better to – treatment from people who understand what they’ve been through.”
Gus Hales sees this as an abdication of responsibility on the part of the Ministry of Defence and the government: “I can’t think of any other organisation where you could be injured and then get farmed off to a charity. When you are farmed off to a charity, their primary concern is to make sure they’ve got enough money for running costs, so they’re always in this game of trying to get enough money to treat people. That’s a flaw because if they haven’t raised enough money, then they’re going to have to make decisions about treating some victims over others.”
There are currently 2.5 million veterans in the UK, according to the most recent government statistics. That number is expected to shrink to 1.6 million by 2028, according to a government study. But with the post-9/11 wars to consider, and the fact that PTSD often doesn’t set in in its most insidious form for as many as five to ten years after a soldier returns from conflict, Beth Niven worries about a new wave of veterans with severe mental health problems appearing in the next few years that the current system doesn’t appear capable of dealing with:
“My son served in Iraq when he was only 20 years old,” said Niven, “the things he saw there changed him irreversibly…he attempted to take his own life…and I know that in the coming years, we’ll see more and more and more cases like his that the system in its current state just doesn’t seem capable of dealing with”.
Combat Stress and other military charities have long cited financial and funding problems as the reason for why they can’t treat all the veterans all of the time, which seems like a reasonable explanation to Max Heron, an army officer who has used the Combat Stress helpline: “It’s the community, knowing there are people who know what you’ve been through who can speak to you, that’s what I like about it…and with funding cuts from government, I don’t think you can blame them for not being able to treat the thousands of people who need treating.”
In January 2020, Combat Stress announced it would stop taking new referrals due to funding cuts that originated from government cuts in NHS funding. The NHS says that they are “committed to providing veterans with the best care possible” and restructured their approach to veterans care.
Gus Hales says this is a “good thing” and that veterans should be treated by the NHS. Combat Stress chief executive Sue Freeth, however, does not see it this way. Freeth claims that the NHS will be overwhelmed and claims that “80% of the veterans seen by Combat Stress” have either gone to the NHS and not had their needs met or feel unable to use NHS services.
Until 2018, Combat Stress received £3m a year from NHS England. Now, 90% of Combat Stress’ income comes from private donations.
However, despite claims of a funding “crisis”, an analysis of Combat Stress’ accounts in this investigation shows that Combat Stress – the fifth wealthiest military charity in the UK – is sitting on funds of £19.15m. This is more than ten times the funds of the fifth biggest civilian mental health charity, Young Minds. Combat Stress’s £19.15m funds is also only marginally less than the £20m funds of the UK’s wealthiest civilian mental health charity, Mind.
A recent investigation by The Times found that military charities in the UK were sitting on reserves of £275m, leading to accusations that the charities were “hoarding” cash. Iain Overton, a former conflict reporter and executive director of Action On Armed Violence, an organisation that aims to reduce conflict worldwide said that the public felt uncomfortable scrutinising charities and that this could lead us to “sleepwalk” into a “disaster” of charities hoarding funds.
This is a view shared by Phil Miller, an investigative journalist who specialises in military investigations and foreign policy:
“My feeling is that most journalists are reluctant to scrutinise the military or military charities, and this allows a lot of abuse to occur. For example, during Gus [Hales’] hunger strike it would often only be me covering it for the Morning Star and a reporter from the Daily Express. Also look at the [negative] reaction to Novara Media’s Aaron Bastani when he said around Remembrance Day that the British Legion had lots of money in reserve that didn’t seem to be reaching veterans, and veteran welfare should be done by the state not charities.”
Johnny Mercer, the defence minister, declined a request for comment.
This investigation put the allegations to Combat Stress who said: “Combat Stress is a charity run by veterans for veterans. In no way would we seek to deliberately cause harm or distress to any of our patients. As many of our staff members are former soldiers, we know the struggles veterans face and we have made it our mission to help veterans facing mental health, social and financial issues. To claim that Combat Stress is directly responsible [for the worsening of some patients’ mental health] neglects the life-changing, and often lifesaving, work Combat Stress has done to help thousands of veterans and their families. We have conducted a review into all patients who have been improperly discharged and encourage those who feel they have been improperly discharged to come forward. Over the last decade the number of patients seeking help from Combat Stress has doubled to more than 2000 each year…we no longer receive substantial income from NHS England following redistribution of their funding”.
Combat Stress issued an apology to Gus Hales and, as a result of this investigation, has asked Darren Lynch to get in touch to arrange a meeting.