The first part of this series (JCN, 28(5): 30–32) provided the background to the study, which used semi-structured interviews with 18 nurses based in Afghanistan during 2013 to focus on factors affecting the delivery of mental health care in the field. This, the second part of the series, details the results of the study in the form of analysis of the interviewees’ verbatim transcripts. The study offers an insight into the role of deployed mental health nurses and examines some of the challenges they face. The findings demonstrate that managing the mental health of armed forces personnel on an operational deployment requires the ability to develop trusting relationships, identify factors leading to stress, and help staff to feel supported.

Executive Summary * Effective Military Mental Health care requires practitioners with extensive knowledge of service provision and structures, and who have the correct clinical competencies that are underpinned by academic qualification/s and experience. * Veterans are a heterogeneous group, differing by factors such as age, gender and length of service. These factors are extremely important during transition, and initiatives to support ex-Service personnel and their families are hindered through a lack of understanding of the veteran community. * NHS Mental Health care provision is extensive and comprehensive, although is areas such as Northern Ireland, it is Combat Stress that provide bespoke veteran care options, funded through charitable contributions. * Many veterans are unaware of their entitlement to priority medical services, or the wider provisions available to them. * Veterans are unwilling to disclose problems associated with their former military life, often believing that civilians, including healthcare professionals, do not appreciate military culture and “cannot understand” their experiences. * Receiving quick, appropriate support requires GPs and other healthcare professionals having sufficient awareness of the NHS and veteran specific services, and on the patients MH condition being correctly identified. * Stressors identified during the transition period are just as likely to negatively impact on the spouse and family. * There is an assumption that the small local veteran charities may be doing harm, although there is limited evidence to substantiate this view, and there is a requirement to understand why some veterans prefer this option