Evaluating Art Therapy's Potential for UK Armed Forces Mental Health

This essay, originally published in the International Journal of Art Therapy, evaluates the potential application of art therapy within the UK Ministry of Defence's Department of Community Mental Health (DCMH) to address the mental health needs of UK Armed Forces personnel. It begins by considering the prevalence of mental health problems in the Armed Forces compared to the general UK population and details the current treatment pathways available. The paper reviews existing literature on art therapy for similar client groups, including UK veterans and military personnel in other countries, specifically highlighting the work of Combat Stress and research from the US, Russia, and Israel. The author hypothesizes that art therapy could be a suitable treatment option for UK Armed Forces personnel and proposes that formal research be undertaken to determine its efficacy within the DCMH. The essay also provides definitions of key terms, outlines the principles of art therapy, and contrasts it with current practices within the Defence Medical Service (DMS). The research suggests art therapy could offer a valuable addition to the mental healthcare available to military personnel.

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International Journal of Art Therapy
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Assessing the potential use of art therapy in the
United Kingdom Ministry of Defence Department
of Community Mental Health
Rachel Preston
To cite this article: Rachel Preston (2019): Assessing the potential use of art therapy in the United
Kingdom Ministry of Defence Department of Community Mental Health, International Journal of Art
Therapy, DOI: 10.1080/17454832.2019.1650786
To link to this article: https://doi.org/10.1080/17454832.2019.1650786
Published online: 10 Sep 2019.
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ESSAY PRIZE WINNER
Assessing the potential use of art therapy in the United Kingdom Ministry of
Defence Department of Community Mental Health
Rachel Preston
ABSTRACT
UK Armed Forces personnel experiencing mental health difficulties are not,at present,offered
art therapy as a treatmentoption.This paperconsiders the prevalence ofmentalhealth
problems for personnelcurrently serving in the Armed Forces compared with the UK general
population.The current treatment pathway for UK Armed Forces personnelis explained and
compared with a review ofliterature regarding arttherapy forthe similarclientgroups;
veterans in the UK and,military personnelin the United States,Russia and Israel.Much of
the UK media discussion aboutmilitary mentalhealth focuseson Post Traumatic Stress
Disorder(PTSD).The veterans charity CombatStress (along-side othercharities)carries out
vitalwork with PSTD sufferers.However,it is highlighted that PTSD is not the most prevalent
mentalhealth presentation forUK Armed Forcespersonnel.It is hypothesised thatart
therapy could be a suitable treatmentoption forUK Armed Forces personnelwith mental
health issues and it is proposed that formalresearch should be undertaken,to determine the
efficacy of art therapy with this client group at one of the Ministry of Defence Departments
of Community Mental Health.
Plain-language summary
Definitions:
• UK Armed Forces: Personnel currently serving in the UK military in either; the Army, Royal Navy,
Royal Marines or the RoyalAir Force.
• Veteran: A person who has left the Armed Forces having previously served for at least one full
day.
• Combat Stress:A UK based charity providing mental health support for veterans.
UK Armed Forces personnel experiencing mental health difficulties are not,at present,offered
art therapy as a treatment option at any ofthe Ministry ofDefence (MoD)Departments of
Community MentalHealth (DCMH).This paperprovidesa brief overview ofart therapy
before considering the prevalence of mentalhealth problems for personnelcurrently serving
in the UK Armed Forces compared with the UK generalpopulation.The current treatment
pathway for serving personnelis explained and compared to a review of literature regarding
art therapy forveteransin the UK predominantly looking atthe art therapy workshops
conducted by the charity Combat Stress with lead arttherapist Janice Lobban.The author
also considered papers submitted concerning art therapy for military personnelin the United
States,Russia and Israel.In addition she looked at the report from the AllParty Parliamentary
Group forArts in Health and Wellbeing.In conclusion,it is hypothesised thatart therapy
could be a suitable treatmentoption forthe UK Armed Forces.The authorproposes that
formalresearch could be undertaken,to determine the efficacy of art therapy with an Armed
Forces client group at one of the Ministry of Defence Departments of Community Mental Health.
ARTICLE HISTORY
Received 17 December 2018
Accepted 24 July 2019
KEYWORDS
Art therapy;Armed Forces;
mental health; Department of
Community MentalHealth;
DCMH;veterans;military
Introduction
This article discusses the potential use of art therapy in
the Ministry ofDefence (MoD)specialistoutpatient
mentalhealth service(Departmentof Community
MentalHealth (DCMH)).Like the UK generalpopu-
lation,service personnelencountersituations which
affect their mentalwellbeing.Most are able to adopt
appropriate coping strategies:nevertheless,a small
percentage (DefStats (Health),2017)need a greater
levelof mentalhealth support.The MoD has a clear
strategy regarding mentalhealth and wellbeing for
the Armed Forces (MoD,2017).However,it does not
include the use of art therapy (Lobban,2016b).Using
evidencerelating to the use of art therapywith
similar client groups;UK veterans and military person-
nel in other countries, it is recommended that a clinical
trialof art therapy could be undertaken within DCMH
to ascertain ifUK Armed Forcespersonnelwould
benefit from art therapy as a treatment option.
What is art therapy?
The British Association ofArt Therapy describes art
therapy as:
© 2019 British Association of Art Therapists
CONTACT RachelPreston [e-mail]
INTERNATIONAL JOURNAL OF ART THERAPY
https://doi.org/10.1080/17454832.2019.1650786

… a form of psychotherapy that uses art media as its
primarymode of expression and communication.
Within this context,art is not used as a diagnostic
tool but as a medium to address emotionalissues
which may be confusing and distressing.
Art therapists work with children, young people, adults
and the elderly.Clients may have a wide range of
difficulties,disabilitiesor diagnoses.These include
emotional,behaviouralor mentalhealth problems,
learning or physical disabilities, life-limiting conditions,
neurologicalconditions and physicalillnesses.(BAAT,
2019)
The interchangeabletitles Art Therapist/ArtPsy-
chotherapistare protected termsand membersof
this profession must have completed mandatory train-
ing at Masters Level on a course validated by the Health
and Care Professions Council (HCPC) and they must be
registered with the HCPC to practice (BAAT, 2019). Prac-
ticing arttherapists mustcontinue to engage in rel-
evant continuousprofessionaldevelopmentand
engage in regular clinicalsupervision to maintain the
safety and quality of their practice.
Art therapy may be used as an intervention with
individuals orgroups.Art therapists employ a range
of theoreticaltherapeuticapproacheswhich are
adapted to an arttherapy perspective as explained
by Hogan (2016),including;cognitive behaviouralart
therapy;solution-focused brief therapy;psychoanalyti-
cal (Freudian)art therapy;analytical(Jungian)art
therapy;Gestalt art therapy;person centred (Rogerian)
art therapy;mindfulnessart therapy;integrative art
therapy (the group-interactive model)and feminist
art therapy.Each art therapist employs the theoretical
model(s)that suits their,or their employing organis-
ation’s,preferred style and which,in practice,the pro-
vider finds works best with their client or group.
There is no one-size-fits-allapproach which makes
comparing treatment outcomes difficult.
Art therapy/psychotherapy is an intervention that
considerswhat is happening forthe clientin their
unconsciousthought processes.Neurosciencehas
shown thatexperience is captured by the senses as
images,smells,soundsand feelings(Van derKolk,
2014).Difficult or traumatic memories which have not
been processedcognitivelycan have a negative
effect on the emotions or behaviour of the individual,
howeverthe image making processes in arttherapy
can be used to help in reprocessing these memories
(Edwards,2014).
Art therapistsare recognised in the UK National
Health Service (NHS)as Allied Health Professionals.
They are employed in a varietyof settings;NHS,
social services,mainstream and specialeducation,
prisons, secure and residential care homes, within char-
ities,at galleries and museums,and,in private practice
(BAAT,2019).
Armed Forces mental health treatment
The Armed Forces have theirown Defence Medical
Service (DMS),which has close links with the Depart-
ment of Health and the NHS.Personnelexperiencing
mentalhealth issues are initially seen by their Medical
Officer (equivalent ofa GeneralPractitioner)and are
either treated locally or referred to one of sixteen mili-
tary Departments of Community Mental Health (DCMH)
providing outpatientmentalhealth care in the UK.
Inpatient care,if required,is provided under contract
by a consortium of NHS trusts (Hacker Hughes,2017).
The DCMH operate asa multi-disciplinary team
(MDT) staffed by a mix of military and civilian;mental
health nurses,psychologists,psychiatrists and mental
health socialworkers.Clinicians decide on the most
appropriate treatment for each individualwhich may
include prescribing pharmacologicalsupportand/or
engaging in a talking therapy.Most membersof
DCMH staff are trained in cognitivebehavioural
therapy (CBT)(Alford & Beck,1997)and some are
trained to deliver eye movement desensitising and pro-
cessing (EMDR) (Shapiro & Forrester, 1998) for the treat-
mentof trauma.Both these treatments are used in
accordance with the NationalInstitute for Health and
Care Excellence (NICE)Guidelines (NICE,2015).Treat-
mentis delivered as an out-patientservice once or
twice a week (Hacker Hughes,2017).There is no evi-
dence thatart therapyis a treatmentoffered by
DCMH (Lobban,2016b).It could be inferred that this
is because arttherapy isnot listed asa treatment
option in the Nice Guidelines.However,that argument
becomes self-fulfilling – arttherapy is notprovided,
therefore,research on its efficacy is notconducted.
Ergo,there is no evidence on which to recommend
art therapy as a treatmentoption.If DCMH were to
employ an arttherapistit is likely they would form
part ofthe MDT as they would in a NHS community
mentalhealth team.Concurrently,research into the
potentialbenefits ofart therapy as a psychological
intervention could be conducted.The DMS might con-
sider how they could commission and integrate an art
therapy provision in a DCMH for a trialperiod by con-
sulting with otherNHS or charitable providersof
similar interventions.
The MoD produce annual statistics about the Armed
Forces mentalhealth (DefStats (Health),2017).The
report covering,2016/2017 showed that 3.2% ofthe
Armed Forcespopulation were initially assessed to
have a mentalhealth disorder at their primary DCMH
appointment.This compares with a rate of3.5% in
the UK generalpopulation (NHS Digital,2017).The
DefenceStatistics(Health)report (2017)does not
include those treated locally by their MedicalOfficer.
Trend analysisshows that the numbersinitially
assessed with a mentalhealth disorder in the Armed
2 R.PRESTON

Forces have increased from 1.8% in 2007/2008.The
reportexplains thatthe increase may be a resultof
campaigns by the MoD to reduce stigma surrounding
mentalhealth,leading to individualsfeeling more
able to report to primarycare for help (Jones,
Campion,Keeling,& Greenberg,2018).
The statistics (Def Stats (Health),2017) show that of
those personnelassessed with a mentaldisorderat
initial presentation:63% presented with a neurotic dis-
order (32% adjustment disorder, 25% other neurotic dis-
orders and 6% post-traumatic stress disorder (PTSD)),
33%with a mood disorder,4% with psychoactive sub-
stance misuse and the remaining 2% presented with
other mental health disorders.Despite common
media reporting,statistically,PSTD is shown to be a
comparativelylow occurrence equating to two in
1,000 personnelwho are currently serving in the UK
Armed Forces (DefStats (Health),2017).This may be
due to a reluctance ofservice personnelwanting to
admit they have a problem.The charity Combat Stress
(Combat Stress,2019) reports that on average it takes
13 years from leaving the military for a veteran to seek
their help for mentalhealth problems.It may also be
because the Armed Forces have a robustsystem in
place to manage operational stress which includes pre
and post deployment exercises,briefings and decom-
pression tasks(Jones,Burdett,Green,& Greenberg,
2017). They also use a cadre of trained Trauma Risk Man-
agement (TRiM) practitioners and leaders from within
their own ranks to assessand manage personnel
involved in stressfuland potentially traumatic events
(Greenberg,Langston,& Jones,2008).This allows indi-
viduals to talk to a peer and process distressing events
shortly after the event takes place.When an individual
is experiencing difficultiesin coping with the after
effects of an event the TRiM practitioner is able to sign-
post to appropriate supportavailable from trained
medical or welfare staff (Jones, Burdett, et al., 2017).
The aim of medical support in the Armed Forces is to
get individuals back to operationalfitness as expedi-
ently as possible.It is acknowledged thatthere are
roles in the Armed Forceswhere returning to full
time duty while experiencing mentalill health carries
a risk. Therefore,the medicalofficerwill consider
imposing employmentlimitationsthat mitigate the
risks.This enables the service person to be employed
to the best of their ability while attending out-patient
appointments.The limitations are lifted once the indi-
vidualhas recovered (Defence MedicalService,2017).
Service personnelwho are unable to work due to
injury or illness be it physical or mental will be reviewed
by their unit medical officer and/or their specialist care
team and a determination willbe made about how to
manage their care while the individual is on long term
sickness absence (Defence Medical Service, 2017). They
might be referred to one of the recovery centres which
are funded by both charitable and public money as
part of the Defence RecoveryCapability(NHS
Choices,2015).The centres do not employ art thera-
pists but they do employ occupationaltherapists and
provide a variety of creative activity workshops (such
as art,woodturning,stone carving and horticulture)
with facilitators drawn from each particularcreative
discipline.The workshops are accessed by both in-
patientsand out-patients,and it is recognised that
these activitieshave a therapeutic effect(Help for
Heroes,2017).
In cases where return to duty is notfeasible the
Service person is supported by a care team in their
transition to civilian living.On leaving the Armed
Forces, medical care is transferred to the NHS. NHS pro-
viders have funded specialist veteran units as part of
the UK government’scommitmentto the Armed
ForcesCovenantin recognition thatsome veterans
need additionalsupport(Ashcroft,2014).In addition
there are many charities dedicated to supporting the
Armed Forces and Veteran community (COBSEO, 2017).
Art therapy research with veterans in the UK
and the US
The charity,CombatStress(CombatStress,2019),
specialisesin the care of UK veteranswith mental
health issues.They employed theirfirstart therapist
in 2001 (Lobban,2017).Lobban has written a number
of papers aboutart therapy with the veteran client
group (Lobban,2014,2016a,2016b,2017).She has
also published a book detailing the framework she
uses in her work with veterans(Lobban,2017).
Further,she has been the subject ofa video relating
to the provision ofart therapy to veterans (McArdle,
2011).Notwithstanding the low prevalence ofPTSD
reported by the MoD (DefStats (Health),2017),art
therapy at Combat Stress focuses primarily on clients
who are experiencing complex PTSD recognising that
formaldiagnosis ofthe condition may notbe made
untilafter the individualleaves the Armed Forces as
sometimes,accessingtreatmentcan take years
(Lobban,2017).
Combatstressdeliverart therapyat residential
centres where veterans also have access to a number
of other clinicians and they are also able to socialise
and share their experiences with other former Serving
personnel which contributes to feelings of community
and bonding (Lobban, 2017). The Intensive PTSD Treat-
ment Programme (ITP) has NationalSpecialised Com-
missioning from the Department ofHealth,it is a six
week programme with a number of psychological treat-
ments conducted in groups and individual therapy ses-
sions.Art therapy group sessions are a mandatory part
of the programme and last 75 min, once a week (six ses-
sions in total). Art is made in response to a theme. After-
wardsreflection and discussion around the images
takesplace (Lobban,2017).Evidenceof Lobban’s
INTERNATIONAL JOURNAL OF ART THERAPY 3

experiences of working with this group is detailed in
many published case studies (Lobban,2014,2016a,
2016b,2017b;Lobban & Murphy,2018;Palmer,Hill,
Lobban,& Murphy,2017).Standardised psychological
outcome measures are used at Combat Stress and a
research study of the results suggests that 87 percent
of veterans who completed the programme between
2012 and 2014 saw a reduction in their PTSD symptoms
and co-morbid anxiety and depression,angerand
alcoholuse, and this was maintained attheir six-
month follow-up (Lobban 2017b).
The ITP is in contrastto talking interventionsat
DCMH which may consist of weekly sessions,possibly,
over a more extended time frame either as a standa-
lone intervention or as part of a range of other treat-
ments from the multi-disciplinaryteam (Hacker
Hughes,2017).
During 2016,Lobban visited the United States to
meet with art therapistsworking with US veterans
(Lobban,2016b)she studied examples of art therapy
being used to support veterans at the US Department
of Veteran Affairs Healthcare facilities.She also met
art therapists working with serving military personnel
at the NationalIntrepid Center ofExcellence (NICoE),
WalterReed NationalMilitary MedicalCenterand at
Intrepid Spirit One,Fort Belvoir Community Hospital.
In her executive summary Lobban (2016b,p. 5) notes:
Findings reveal that in the US, policy recommendations
have promoted the inclusion of creative arts therapies
within healthcare teams across the military continuum
from pre-deployment/activeduty status to post-
deploymentreintegration and veteran status.US art
therapists have therefore been able to devise innova-
tive programmes to treat a range of mental health pro-
blems including PTSD.Outcomes include:symptom
reduction;resiliencebuilding; increased insight;
reduction of socialisolation;enhanced coping;stimu-
lation of positive emotions.
Following her visit to the USA,Lobban (2016b) made a
number of recommendationssuggesting how art
therapy could be used in a widermilitary context
including in NHS SpecialistVeteran Services,and
Defence Medical ServicesRehabilitation.Lobban
suggested that greater use of public or private partner-
ships could be used;and, also thatinvestmentin
research should take place to provide the evidence
base forart therapy in the military contextthatwill
encourage service commissioning.However,Lobban
does not explicitly recommend art therapy within the
MoD DCMH organisation.
The progress of art therapy with military populations
in the US is captured in a recently published book
(Howie,2017) and many published papers (Alexander,
2015;Campbell,Decker,Kruk,& Deaver,2016;Collie,
Backos,Malchiodi,& Spiegel,2006;Jones et al.,2017
Malchiodi,2016;Salmon & Gerber,1999;Walker,
Kaimal,Gonzaga,Myers-Coffman,& DeGraba,2017;
Walker,Kaimal,Koffman,& DeGraba,2016).Research
on both sides of the Atlantic demonstrates that the out-
comes arttherapists achieve with serving personnel
and veterans, particularly those with PTSD and/or Trau-
matic Brain Injury (TBI) is effective. Indeed, an American
PatientSatisfaction Survey carried outat the NICoE
between November2012 and June 2014 rated art
therapy fifth highest on a list of forty one options for
assisting recovery (Jones et al.,2017).
Other art therapy research with military
personnel
Art therapy research with military personnel is also con-
ducted in other countries.Kopytin and Lebedev (2015)
conducted a study in St Petersburg,Russia with male
soldiers who had seen service in combatareas both
within Russiaand in other global locations.The
research examined the effects of humour in art in the
course of an interactive art therapy group.This study
revealed that humour plays an important role in veter-
an’s art therapyand the frequencyof humorous
responseswas significantly greaterthan in another
similar study of non-veterans (Silver,2002).It was con-
cluded that humour enabled the veterans to engage in
the therapeutic process in a way thathelped them
overcome avoidance,anxiety and resistance using a
method thatenabled them to feelsafe in revealing
underlying tensions(England,Martin,& Rosamond,
2017).The particulartype ofmilitary banter/humour
can make it difficult for service personnel and veterans
to interact with those unused to the military environ-
ment (Busuttil,2017).Kopytin and Lebedev (2015)
highlight the importance of understanding the unspo-
ken culture and language that forms the character and
identity of those who serve in the military.
Harel-Shalev,Huss, Daphna-Tekoah,and Cwikel
(2017)conducted a study aboutthe experiences of
females in support roles in the IsraeliDefence Force.
In theirart therapy study they were able to identify
three themes as the main stressors for women as:the
responsibility for others in life threatening situations;
the military as a firstprofessionalwork experience;
and,the interaction between military and gender hier-
archies.The reported prevalence of mentalhealth dis-
orders in UK Armed Forces women is 6.3% compared
with 2.8% in men (Def Stats (Health),2017).As men-
tioned earlier,there has been considerable focus on
treatmentoptions forPTSD and TBIalthough these
conditionsare, statisticallylow. Def Stats (Health)
(2017) show that more than 90% of initial assessments
at a DCMH are for non PTSD related mental health pro-
blems.It is feasible thatart therapy may also be an
appropriate intervention to supportthe recovery of
these individuals.Having served as a woman in the
UK Armed Forces and having experienced periods of
4 R.PRESTON

anxiety and depression (Figure 1),the authorfeels
there may be benefitin conducting an arttherapy
study to ascertain some of the stressors that arise for
women in comparison to men in the UK Armed Forces.
Potential research
It has been discussed in this paper that the MoD do not
employ art therapists nor do they use art therapy as a
treatmentintervention formentalhealth conditions.
It is inferred by the author that this is due to the NICE
guideline recommendation thattreatmentfor PTSD
should be CBT followed by EMDR.However,without
employing an arttherapistto conductresearch with
an armed forces personnelclient group,one is never
going to gather the evidence required to change the
recommended treatment.
Evidenceis being gathered bythe UK charity
Combat Stress and at NICoE in the US which suggests
that art therapy is a beneficialtreatment for UK veter-
ans and US military personnelexperiencing PTSD and
TBIs.As yet,art therapy as a treatment option has not
yet been introduced in any ofthe DCMH settings.
This could be explained due to the statistical evidence
gathered (Def Stats (Health), 2017) which suggests that
only 6% ofserving armed forces personnelreport as
suffering from PSTD.
However,art therapy is a treatment option that can
be used to address the full range of emotional,behav-
ioural and mentalhealth issues(BAAT,2019);the
statisticalevidence (DefStats (Health),2017)shows
that 90% ofthe MentalHealth conditions presenting
at DCMH are:mood disorders (33%),adjustment dis-
orders (32%) and non-PSTD related neurotic disorders
(25%),it is suggested thatart therapy research may
be focused in addressingone of the prevailing
conditions.
It is not the intent of this paper to discuss a specific
intervention orresearch method thatcould be used
within a DCMH as a proposalwould need discussion,
ethicalscrutiny and agreementwith key personnel
before work could begin.However,this paperis a
call to arms (pun intended)to pave the way to
employ an arttherapistto conductclinicalresearch
in this field.
Advice on funding for academic research is available
from the Research Council(Research Council,2017)
and it is normalfor the findings to be published in a
peer reviewed journal.The Academic Departmentof
MilitaryMental Health (ADMMH),based at King’s
College London (KCL), have undertaken numerous aca-
demic studies into the mentalhealth of Armed Forces
and Veteran personnel(Kings College London,2017).
ADMMH supported CombatStressin the studies
undertaken by the arttherapy departments used by
veterans.KCL has a good working relationship with
the MoD and both organisation’s ethics boards scruti-
nise requests for Armed Forces personnel participation
in research carried out by KCL academics and students
(Kings College London,2017).
Figure 1. Remember.Mixed media,R.Preston,2018.
INTERNATIONAL JOURNAL OF ART THERAPY 5

The MoD has drawn extensively on the research
conducted by the ADMMH to draw up the recently
published Defence People MentalHealth and Well-
being Strategy 2017–2022 (MoD,2017).The strategy
recognises that society is changing and that the inci-
dence ofpeople experiencing poormentalhealth is
as prevalent in Defence (including military and civilian
workforce) as it is in the general population. The MoD’s
strategic aimsdemonstrate a top managementled
commitment to supporting mentalhealth for all.Art
therapy is not specifically mentioned but it could be
delivered under this strategy as an innovative interven-
tion eitheras a mentalhealth treatmentor in the
support of organisationalwellbeing.
In 2014,an All-Party Parliamentary Group on Arts,
Health and Wellbeing was convened with an inquiry
report (APPG, 2017)published in July 2017.The
report highlights the benefits of the arts in maintaining
health and wellbeing.In this context the APPG were
considering the arts in generaland not specifically art
therapy.The APPG acknowledge thatthe UK is in a
time of austerity and that funding for the arts is in com-
petition with otherbids for financialsupport.The
reportsuggested that,with investmentin the right
research,there is likely to be demonstrable evidence
to support engagement in art,as individuals or as a
community,delivering a positive effect on health and
wellbeing which willin turn save costs in the future.
Among the recommendations it was suggested that
each NHS organisation takes responsibility ata stra-
tegic levelfor arts,health and wellbeing as an insti-
tutionalpolicy.Although notspecified the MoD and
DMS could be included in this list as clinicalcommis-
sioners if they saw merit in the delivery of art therapy
as a treatment option in DCMH.
Conclusion
Art therapy is an established therapeutic intervention
that is practised by postgraduate,HCPC state regis-
tered,professionals.They are trained to work with
clientsin a psychotherapeuticframeworkand are
able to provide support to people of allages who are
experiencingemotional,behaviouraland mental
health issues (BAAT,2019).
Personnelserving in the UK Armed Forces are as
likely to experience poor mentalhealth as the general
population although the difficultiesthat this group
encounterare different(Def Stats (Health),2017).
Mental health support in the UK Armed Forces provided
by DCMH is in accordance with NICE guidelines.The
MoD has a clear strategy (Ministry ofDefence,2017)
for Armed Forces mentalhealth and wellbeing with a
plan that looks to the future.However,there is no pro-
vision of art therapyfor Armed Forcespersonnel
(Lobban, 2016b). Combat Stress art therapy department
in consultationwith Kings College London has
produced research that evidences the benefits ofart
therapy with veterans who have PTSD (Lobban,2017).
There are a number of published research papers study-
ing military personnel who enrolled in art therapy pro-
grammesin the US and Russia supportingthe
hypothesis that art therapy improves the health and
wellbeing of those who are currently serving or,have
served in the military(Alexander,2015;Campbell
et al., 2016;Collie et al., 2006;Jones et al., 2017;
Kopytin & Lebedev,2015;Malchiodi,2016;Salmon &
Gerber,1999;Walkeret al.,2016,2017).A study in
Israelhypothesised thatstressors forwomen in the
IDF were notthe same astheir male counterparts
(Harel-Shalev etal.,2017).The APPG inquiry report
(2017)recommends that health authorities and com-
missioning groups consider their policies with regard
to supporting the arts in health and wellbeing activities
and investing in research to measure these benefits, this
could be taken to include the MoD.
There is very little research into the applicability of art
therapy for the serving Armed Forces population seeking
support at DCMH. It is therefore suggested that the use of
art therapy with UK Armed Forces personnel presenting
for treatment at DCMH is likely to produce a beneficial
outcome forthe health and wellbeing ofthis client
group.Outcomeswould need to be evidenced and
reported by research conducted by a qualified art thera-
pist working within DCMH. Appropriate research funding
would need to be made available and academic support
provided by an appropriate research institution.
Disclosure statement
No potentialconflict of interest was reported by the author.
Notes on contributor
Rachel Preston graduated with an MA in Art Therapy from the
University ofDerby in 2018.Her studies explored her own
experience ofculturaltransition from being in the Armed
Forces to becoming an art therapist and a veteran (Figure
1). She spent25 years in the RoyalAir Force working in
support ofArmed Forces colleagues in diverse roles across
human resources, welfare support, training and development,
project management and, civilian housing and homelessness
support.Her experience ofworking with service personnel
and familiesin distressled her to believe her natural
empathy would be suited to providing therapeutic support.
As an arttherapist,Rachelhas worked with women in a
mental health in-patient service and she is currently providing
an art therapy service to schools in Lincolnshire.
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