Combat Stress - Annual Review 2011

“I’ve come to understand that Stephen is as emotionally and psychologically injured as someone in a wheelchair” Lisa, partner to an ex-Welsh Guard

Annual Review Year ending 31 March 2011

Going forward New faces, new partnerships, new services The new Chief Executive of Combat Stress, Commodore Andrew Cameron, explains how the charity is changing – and growing – to meet the challenges ahead…

In the course of the last year, Combat Stress has strengthened its partnerships with key departments of state and Service charities.

The Enemy Within Appeal has also got off to an excellent start and, as a result, fundraising is up and awareness of the plight of Veterans suffering from psychological wounds has greatly improved. As stigma about mental health reduces, younger people are now seeking help too.

We presently have the resources to support six of our 14 planned Community Outreach Teams, and the Board plans to recruit the remaining balance, including Northern Ireland, in 2011. In addition, all of our Treatment Centres are being significantly upgraded, and clinical staff are receiving additional training to deliver

Chief Executive: Commodore Andrew Cameron

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top quality care. With the award of a Special Commission from the NHS in England that asks us to deliver co-morbid PTSD treatment, Combat Stress has been recognised as a national specialist centre. As a result, we will now be developing a much needed new service, to help some of our most traumatised Veterans.

On a personal note, it is a privilege for me to be the new Chief Executive of Combat Stress. I have inherited from my predecessor, Wing Commander David Hill, a vibrant and enthusiastic team. We are blessed with hugely supportive Trustees, Appeal Board, members, supporters and staff – all committed to improving the lot of Veterans suffering from mental ill health. However, there is still much for us to do to make support more accessible and even more effective.

On behalf of all our Veterans and their families, thank you for your continued interest and I hope you find this Annual Review informative.

Who we are

What we believe

What we do

Combat Stress was founded in 1919, shortly after WW1, and has an established history of caring for the mental health of Veterans across the UK and of providing support to their families. Just as our Armed Forces continue to engage in conflicts across the globe, so we retain our commitment to continuing and developing this crucial work.

Over the years nearly 100,000 Veterans have benefited from our support, and with the Armed Forces so committed this number will only rise. While our Service men and women strive to bring resolution and stability to the troubled areas of the world, we similarly work to provide the right mental health treatment to all those Veterans – Regular and Reservists – who require it.

At Combat Stress we believe it is the responsibility of all societies to look after their wounded – and the families of their wounded, too.

Government has a central role to play in this, but we think it should not be the duty of Government alone. Rather, care for our Veterans is the obligation of every citizen whose freedom and success depends upon the peace and security of their country. The guiding vision of Combat Stress is that all Veterans suffering from psychological wounds deserve access to prompt, specialised and appropriate treatment, care and support, delivered by qualified professionals who understand the military culture.

Combat Stress is already recognised nationally and internationally as a Centre of Excellence in the diagnosis, treatment and management of Service-related mental ill-health, and is currently consolidating its position as the leading provider of such treatment to Veterans in the United Kingdom. We believe that by working in tandem with the Ministry of Defence, the National Health Service, other Veterans’ charities and strategic partners, we can develop and sustain a regime of care that is well placed to manage the impact of trauma, to identify symptoms as early as possible, and to initiate suitable treatment.

At Combat Stress our aim is to provide prompt and suitable clinical care and support to Veterans with psychological injuries. To achieve this we offer courses of residential treatment at our short-stay centres in Ayrshire, Shropshire and Surrey, alongside a programme of long-term care through our new, multi-disciplinary Community Outreach teams. Through this two-pronged approach we hope to offer the best and most flexible range of treatments possible, and in doing so improve both early diagnosis rates and treatment quality. In addition, we strive to increase awareness and reduce the stigma associated with military-related mental wounds, including Post Traumatic Stress Disorder, in both the public at large and affected members of the Armed Forces.

“Care for our Veterans is the obligation of every citizen whose freedom and success depends upon the peace and security of their country” 3

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The mental health of Veterans There are numerous occupational hazards to working in the Armed Forces – from the threat of facing injury or death in the line of duty to coping with the enormity of their actions. The Veterans who are treated at Combat Stress suffer from a range of psychological injuries including mood disorders, anxiety states and the complex and debilitating condition Post Traumatic Stress Disorder (PTSD).

Mental illnesses, including PTSD, rarely develop in isolation and are often accompanied by other mental disorders, such as depression, alcohol abuse, dependence, etc.

Social implications of psychological injuries An individual’s well-being has a profound effect on their quality of life. Apart from the direct health implications, it can also affect their relationships, motivation, energy levels, sleep patterns, as well as their ability to hold down a job.

©UK MOD Crown Copyright 2011

Key events 4

June

July

Aug

Sep

Oct

Nov

9 Combat Stress offers expertise to producers of the award-winning British film, In Our Name

This year, we have worked closely with the Department of Health to launch a new Helpline for those members of the military community living with mental health issues.

“The Combat Stress 24-Hour Helpline will provide free access to discrete, focused and specialist mental health and wellbeing advice for the military community,” says Peter Poole.

“The helpline, which is funded by the Department of Health, will be manned

by Rethink-trained professionals and will be available on a 24-hour basis, for 365 days a year. It is hoped to expand the service to text and emails in due course.”

Tyrwhitt House opens four new beds for carers

East Anglia, North West and South Wales Community Outreach Teams operational

Joint initiative to support GPs in identifying and meeting healthcare needs of Veterans

Lt Col Nick Bourton DSO MBE delivers the Hollybush Lecture

90 runners for CS in the London 10k Break Point event raise over £275,000

North East Community Outreach Team operational

New Operations Manager (Central) appointed

SuperCarClub charity auction in Monte Carlo raises £53,000

New Head of Clinical Service appointed at Hollybush House

New Head of Clinical Service appointed at Audley Court

Wales and The Midlands Community Outreach Team becomes operational

May

New 24-hour helpline for military community

Official opening of H4H Living Zone wing at Tyrwhitt House

April

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evelopments in our outreach services in 2010/11 have rolled out at a rapid pace. Our new Community Outreach Teams now offer specialist, community-based mental health and welfare support services in partnership with our existing, residential care to transform the treatment programmes for Veterans with wounded minds, and their families.

We now have six fully functioning Community Outreach Teams in place, with plans to deliver the remaining eight next year. It is an exciting and busy time, but already our teams are reporting on the positive impact their services are having on individual Veterans and their families. We are building our relationships with the NHS and other statutory and non-statutory services to raise awareness and better support the mental health and welfare support needs of Veterans in their communities.

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David Cameron PM visits Tyrwhitt House

2010

14 people run for Combat Stress in London Marathon

Operations Manager (South) appointed – our first in this role

Our biggest ever fundraising drive – The Enemy Within Appeal – is helping to fund the establishment of 14 Community Outreach Teams nationwide

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In their own words: Lisa, partner to an ex-Welsh Guard Stephen and I have been together for three years. He was diagnosed with PTSD by Combat Stress six months after I met him. At the moment we are in a cycle that happens every few months – he withdraws, and I have to give him the space he needs. It always seems to come at a point when our relationship is moving forward and, consequentially, I expect more from him. When he has withdrawn in the past he has also been verbally abusive, although this time he hasn’t been.

Stephen had been in the Welsh Guards for eight years, but it was after a particularly nasty ambush in Iraq – where he later went as a private military contractor – that he developed full-blown PTSD. (In hindsight, though, he felt he had lived with low-level PTSD for years.)

After 20 minutes of fighting, he and one other survived; 14 of his colleagues were killed – and one was beheaded. He told me about it on our first date.

One day he saw a TV advert for Combat Stress and rang the number; he knew he needed help, as he was suffering night terrors, violent feelings, flashbacks.

Stephen told me about the support group for partners at Combat Stress, as he was worried about me coping; he’s always concerned about that. Listening to others I realised the relationship scenarios tend to be very similar – controlling behaviour, bad tempers, sexual breakdown. It was reassuring; I no longer felt alone.

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No-one wants to hear that their partner has PTSD, but when I see past it Stephen is the most fascinating, sweet, kind-hearted, complex and attractive man I’ve ever met. However, I’ve come to understand that Stephen is as emotionally and psychologically injured as someone in a wheelchair.

“The support group for partners was reassuring; I no longer felt alone”

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’11 Next steps

Jan

Combat Stress chosen as one of the charities for the Royal Wedding Charitable Gift Fund

Launch of Combat Stress 24-Hour Helpline

2011

Team Hallin set world record for rowing across Atlantic

Key events

Having served in the Armed Forces, or worked closely with Service men or women as a civilian in a military environment, Veterans’ Mental Health Nurses are sensitive to the mental health needs of Veterans. Their chief responsibilities include: promoting greater engagement with local mental health services; assisting Veterans to navigate through the local health system;supporting colleagues in the assessment and planning of care for Veterans; and driving up standards of care for veterans within the NHS.

Recruitment for Community Outreach Teams in London, South East, South West, South Central, and North/Borders

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he services of Combat Stress are available, free of charge, to all personnel who have served in the Regular or Reservist British Armed Forces.

As part of The Enemy Within Appeal, and with the generosity of the Westminster Foundation, we will target our services to the TA and Reserve Forces. In the summer of 2011, we hope to establish a TA and Reserve Forces Liaison Team to cover the whole of the

What is a Veterans’ Mental Health Nurse?

Commodore Andrew Cameron starts as new Chief Executive

Combat Stress is targeting TA and Reserve Forces, appointing new Veterans’ Mental Health Nurses and delivering an intensive Chronic PTSD Programme

United Kingdom, providing an essential link between de-mobilised TA and Reservist personnel with mental health issues and the services of Combat Stress.

They will raise awareness of the needs of TA and Reservists, their families and employers, and liaise with the chain of command.

As a result of our Strategic Partnership with the Department of Heath, Combat Stress is currently working with a number of NHS Trusts to appoint Veterans’ Mental Health Nurses. These positions will work within the NHS, focusing on the care of ex-Service men and women.

The NHS has commissioned Combat Stress to deliver a new, intensive treatment programme for English Veterans with chronic, severe and comorbid Post-Traumatic Stress Disorder (PTSD). We plan to run our first programme at Tyrwhitt House in the autumn.

The Enemy Within Appeal has helped to maintain a high profile for the charity over the last 12 months. This has had a direct effect on showcasing our work to key stakeholders. Consequently, we are starting to see a decline in the time delay between people leaving the Armed Forces and turning to Combat Stress for help – currently an average of 13.1 years.

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The Enemy Within Appeal An integrated campaign to care for the escalating number of psychologically injured Veterans

T Photo: Geoff Pugh/The Daily Telegraph

he Enemy Within Appeal was launched on March 11 2010 by our Patron HRH The Prince of Wales and is being led by Dr Chai Patel CBE and a dynamic and multiskilled team of Board members.

Since it was very first devised, The Enemy Within Appeal has had three objectives: to transform our mental health services for Veterans; to raise awareness of the plight of

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Veterans suffering from psychological injury; and to encourage Veterans and their families to seek help sooner.

Thanks to the immense generosity and level of interest we have received from all quarters – the Government, media, strategic partners and our supporters – we have banked £16.1 million; established six of the proposed 14 multi-disciplinary Community Outreach Teams; raised our profile to encourage increasing numbers of Veterans to seek our support; been recognised as leaders in the field of mental health care; and entered into strategic partnerships with other service providers.

However, there is still much to do to realise the Appeal’s objectives – to deliver a more intensive, residential programme for Veterans with chronic PTSD; to address the stigma that surrounds mental health in the military community; to raise awareness of Combat Stress services; simplify the pathway to care for Veterans and their families; and further reduce the timelag for Veterans to seek help after leaving the Armed Services.

I was delighted to read about [what] the Appeal has raised; this is an exceptional amount, which is a testament to your hard work and that of your team, as well as your many fundraisers across the country. extract From letter to Combat Stress from

General Sir David Richards GCB CBE DSO ADC Gen Ministry of Defence

“You start to think that what you’ve just done isn’t normal”

In their own words: Dave, RAF I served in the RAF for 12 years as a senior aircraftsman. In 1988, I was stationed on the border of East Germany in a tactical rapid reaction force – if an aircraft crashed we would be first on the scene.

I experienced three horrendous crashes in a 14-day period. In one incident, an aircraft came down in a farmer’s field. The pilot didn’t eject and his body was scattered over a large area.

Afterwards, I remember thinking ‘this is not what I signed up for’. It’s only in the quiet of your room that you start to think that what you’ve just done and seen isn’t normal.

I left the Force in 1994 and quickly landed a job in Swindon, but by 1996 things started to really fall apart – I was getting two hours’ sleep a night, was drinking heavily, having flashbacks, and feeling severely paranoid. We moved north but things got worse again and, after getting into a fight, my employers told me to get help. A counsellor put me in touch with Combat Stress.

My first assessment was a lifechanging experience – you know that you’re not alone. Being at Combat Stress and getting the diagnosis of PTSD makes you realise that you are not a freak, a coward or a weak person. PTSD is a normal reaction to a series of totally unexpected events that you are simply not equipped to deal with.

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In their own words: Anita, partner to an ex-TA soldier

“When

I rang Combat Stress, Andy was furious because he didn’t want to go”

Andy comes from a military family, and spent five years in the regular Army. We’ve been together since 1992, and have one son. I met him when he was in the Territorial Army.

After we got engaged in 1997, he went on a military manoeuvre with the TA to collect a boat from Malta.

On the return journey Andy, a TA colleague called Ray, and the skipper sailed into a Gale Force 9 storm. The boat upturned, Andy saved the skipper’s life twice, Ray drowned and for eight hours Andy was lost at sea.

Andy has a green beret and trained as a Commando, but the fact he couldn’t save his friend – who had been calling out to him – had a profound effect. He couldn’t shake it off.

Nevertheless, he remained with the TA and went to Iraq in 2003 to do one tour of duty.

I noticed a big difference in him around 2005; he started having problems sleeping.

Living on a short-fuse became Andy’s norm, and I’d walk around on eggshells. Then, one day, we were watching a TV programme about a Veteran who’d served in war-torn countries. As this guy talked

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about his experiences, I said to Andy: “This is just like you!”

I rang the BBC, who put me in touch with Professor Harry Lee at St Thomas’ Hospital in London. He gave us Combat Stress’s details. When I rang Combat Stress, Andy was furious because he didn’t want to go, but I knew it would be worth the stress if it meant our family would benefit.

Andy was diagnosed with PTSD and other complications in 2005. The first time I went to the support group for partners I kept saying: “Yeah, I’m fine”. The second time, I sat there and cried my eyes out.

Despite having PTSD, Andy is a great dad and a wonderful person. He goes to Combat Stress three times a year for treatment; it is invaluable to him – and to us as a family.

Combat Stress saves lives and saves families.

Working towards our goals How Combat Stress is making progress – and making a difference

Capacity building Sometimes short-stay treatment centres offer the best way to deliver treatment to Veterans.

During the past year the charity has dramatically increased its capacity in this area, with more beds available for Veterans and improved clinical areas that are suitable for bespoke treatment programmes. An example of this is the opening of a new wing at Tyrwhitt House – made possible by £3.5m of funding from fellow military charity Help for Heroes.

It provides more living space, improved kitchen and laundry facilities, and a new nurses’ station, as well as facilities to accommodate carers alongside Veterans.

Cross-organisation partnerships

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DAYS

HOURS

Helpline staff are always there to provide a listening ear

Many important UK institutions have made an increasing commitment to Veteran mental health issues.

What’s more, Combat Stress has entered into various successful partnerships to bring treatment to more ex-Servicemen and women.

These include fellow charities, MoD, DH and NHS Trusts.

In addition, Government Ministers pledged in November 2010 to work across departments to improve services.

Over the next year we will…

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C omplete recruitment for our 14 nationwide Community Outreach Teams to reach all parts of Britain.

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R educe waiting times of Veterans seeking help, and improve our service delivery.

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E xpand and develop more bespoke Residential Treatment programmes.

£10m

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44.2

5

The annual requirement for voluntary income to run our specialist services

years

The decreasing average age of our active Veteran base

S trengthen and build on our existing healthy and cooperative relationship with the NHS.

E nsure that our workforce is suitably trained and equipped to meet the requirements of our methods of service delivery.

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R educe stigma through a new campaign.

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Accomplishments and successes Major milestones achieved during the 2010/2011 financial year

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he Prime Minister personally delivered T to Combat Stress Veterans and staff his commitment to implement Dr Andrew Murrison’s recommendations in Fighting Fit, his review of healthcare, and his support for Veterans.

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he extensive refurbishment of our Treatment T Centres.

stablished six of the proposed 14 multiE disciplinary Community Outreach Teams, who conducted over 1,000 consultations.

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he launch of the Combat Stress 24-Hour T Helpline, offering specialist mental health advice.

The establishment of Combat Stress on the Charity Brand Index for the first time in its history. We are now rated as number 95 of the UK’s 125 most recognised charities. he successful execution of a joint annual T conference with the Royal British Legion in Newcastle in November 2010.

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rofessor Mark Creamer, Director of the P Australian Centre for Post-traumatic Mental Health, delivered a successful training day in December 2010.

o raise awareness, we established a strategic T partnership with TRBL and delivered successful presentations at numerous conferences including MIND, many NHS Trusts, the Reserve Forces, etc.

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ur participation in assorted research projects, O including Psychology Doctorates and Masters Degree Theses, and in the MoD/NHS Veterans’ Clinical Pilot evaluation.

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T he steady upskilling of staff to deliver our clinical programme.

4,600 Number of Veterans with wounded minds that we helped during 2010/11

837 Veterans attended 100 support groups run by our new team of Community Psychiatric Nurses

Number of days of treatment provided at our three Treatment Centres

5,693 Number of domiciliary visits made by our Regional Welfare Officers in 2010/11

Having served in the Army for 20 years, Robert understands the pressures of being a soldier. After joining the Royal Engineers as an apprentice in 1987, he spent five years as a regular soldier in the ranks before going on to Sandhurst in 1992. He completed two tours of Northern Ireland, was in the first Gulf conflict, and then served in the Balkans before leaving the Army in 2007 as a Major.

Today, Robert uses his Service background in his role as a Regional Welfare Officer to build a good rapport with clients. He says: “Clients are usually very anxious so I reassure them it’s ‘ok’ if they get emotional during our session.

I go through their childhood history, what their background was like and then through their Service life. We will then go back to the key traumatic incidents that happened and work through them. We then look at what’s happened to them since leaving the Forces.”

Robert’s biggest client base is in Ayrshire – where the Combat Stress Hollybush House treatment centre is located – with rapidly growing numbers in Glasgow. He is constantly receiving new referrals, most recently through Glasgow’s Helping Heroes initiative – a one-stop shop to help Veterans apply for benefits and jobs.

Meetings are held in Veterans’ homes, where Robert draws on personal experience to help clients.

“When they talk about a particular place in West Belfast or the Balkans, I understand: the geography, the terms a soldier uses to explain his job, the equipment he’s been carrying, the tension, and the training. I can look someone in the

eye and know what they are talking about without looking puzzled. Clients are then more willing to talk about their Service experiences and what has happened to their lives since leaving the Forces.”

Robert recalls a recent meeting with a Veteran who was angry and emotional, having seen his life fall apart during the last 20 years. He adds: “My job can be draining but it’s also very rewarding because I know that man was in a far better place when I left to when I first walked in.”

Pictured: John Bromley, Regional Welfare Officer

In their own words: Robert Lappin, Regional Welfare Officer

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Summarised financial statement

Community outreach services

Cost of community outreach service

2011 £2,170,000

2010 £1,719,000

Financial year ended 31 March 2011

Community outreach teams Regional Welfare Officers Community Psychiatric Nurses Mental Health Practitioners

14 14 7 7

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INCOMING RESOURCES In pursuing the key objective of delivering mental health care to Veterans, Combat Stress raised funds in six major areas.

Visits made by Welfare Officers No. of first-time contact visits

5,693 775

5,900 803

Clinical & community outreach services Donations & events Legacies Service charities Investment income Other

Clinical appointments First-time appointments 568 Follow-up appointments 1,712 Support groups No. held 100 No. of clients attending 837 Carers groups No. held 23 No. of carers attending 94

2011 £000s 4,411 7,772 2,169 1,588 219 6 16,165

2010 £000s 4,454 5,443 1,170 1,276 195 7 12,545

Income from the Veterans Agency to fund the cost of treatment and travel for qualifying war pensioners amounted to £3.1 million (2010: £3.1 million). The Scottish Government contributed £1.2 million (2010: £1.2 million) to the cost of Veterans resident in Scotland attending Hollybush House.

RESOURCES EXPENDED

No. of active Veterans registered No. of new contacts Net increase in active Veterans registered Residential treatment

No. of treatment centres No. of admissions for treatment Days of treatment delivered Percentage occupancy Cost of treatment

2011 4,678 1,447 297

2010 4,381 1,303 398

2011 3 2,639 24,442 81.7% £8,280,000

2010 3 2,581 24,087 80.5% £7,353,000

47% (2010: 40%) of the cost of treatment was met from charitable sources after taking account of funding received from the Veterans Agency, the Scottish Government, local authorities and other fees.

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Independent Auditors’ statement to the Trustees of the Ex-Services Mental Welfare Society We have examined the summarised financial statements of the Ex-Services Mental Welfare Society for the year ended 31 March 2011.

Respective responsibilities of trustees and auditors The trustees are responsible for preparing the summarised financial statements in accordance with applicable United Kingdom law and the recommendations of the charities SORP. Our responsibility is to report to you our opinion on the consistency of the summarised financial statements with the full financial statements and the Trustees’ Annual Report. We also read the other information contained in the summarised annual report and consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the summarised financial statements.

We conducted our work in accordance with Bulletin 2008/3 issued by the Auditing Practices Board.

Opinion In our opinion the summarised financial statements are consistent with the full annual financial statements and the Trustees’ Annual Report of the Ex Services Mental Welfare Society for the year ended 31 March 2011.

Neil Finlayson (Senior Statutory Auditor). For and on behalf of Kingston Smith LLP, Statutory Auditor Chartered Accountants and Registered Auditors, Devonshire House, Goswell Rd, London, EC1M 7AD

STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 MARCH 2011

Unrestricted Restricted Totals Totals

Funds Funds 2011 2010

£’000s £’000s £’000s £’000s Incoming resources from generated funds: Voluntary income Donations 4,235 1,281 5,516 3,386 Legacies 2,169 - 2,169 1,170 Service charities 994 594 1,588 1,276 Capital appeals - 2,044 2,044 1,281

7,398 3,919 11,317 7,113 Activities for generating funds Fundraising events and trading 210 2 212 776 Investment income 219 - 219 195

429 2 431 971 Incoming resources from charitable activities Clinical services 4,399 - 4,399 4,442 Community outreach services 12 - 12 12

4,411 - 4,411 4,454 Other incoming resources Other income 6 - 6 7

6 - 6 7 Total incoming resources 12,244 3,921 16,165 12,545 Resources expended: Activities for generating funds Cost of generating voluntary income 1,260 - 1,260 923 Fundraising trading 203 - 203 249 Investment management fees 6 - 6 29

1,469 - 1,469 1,201 Charitable activities Clinical services 4,546 2,307 6,853 6,235 Community outreach services 910 1,260 2,170 1,719 Treatment centre maintenance and improvements 341 1,086 1,427 1,118

5,797 4,653 10,450 9,072 Governance costs 143 - 143 133 Total Resources Expended 7,409 4,653 12,062 10,406 Net incoming/(outgoing) resources before transfers 4,835 (732) 4,103 2,139 Transfers between funds (109) 109 - Net incoming resources/(resources expended) 4,726 (623) 4,103 2,139 Net gains/(losses) on investment assets 164 - 164 1,338 Actuarial (losses) on defined benefit pension scheme 288 - 288 (1,567) Net movement in funds 5,178 (623) 4,555 1,910 Fund balances brought forward at 1 April 14,953 952 15,905 13,995 Fund balances carried forward at 31 March 20,131 329 20,460 15,905

Balance Sheet at 31 March 2011

Fixed assets Tangible assets Investment

Current assets Less current liabilities Defined benefit pension scheme liability Net assets

2011 £’000s

7,471 9,536 17,007 5,220 (1,332) (435) 20,460

6,931 6,122 13,053 5,337 (1,397) (1,088) 15,905

Funds Unrestricted funds General fund Investment revaluation reserve Defined benefit pension scheme deficit Designated funds Restricted funds Total Funds

9,758 537 (435) 10,271 329 20,460

7,509 948 (1,088) 7,584 952 15,905

2010 £’000s

The Statement of Financial Activities and Balance Sheet are not the full statutory accounts but are a summary of the information which appears in the full accounts. The full accounts have been audited and given an unqualified opinion. The full accounts were approved by the Trustees on 25 May 2011 and a copy has been submitted to the Charity Commission and Registrar of Companies. These summarised accounts may not contain sufficient information to allow for a full understanding of the financial affairs of the Ex-Services Mental Welfare Society. For further information, the full annual accounts including the auditor’s report, which can be obtained from the Ex-Services Mental Welfare Society, Tyrwhitt House, Oaklawn Road, Leatherhead, Surrey KT22 0BX, should be consulted.

Incoming resources

Resources expended

£16,165,000 1.4% Investment income

27.3% Clinical & community outreach services

9.8%

13.4%

13.4% Legacies 9.8% Service charities

£12,062,000 12.2% Activities for generating funds

1.2% Governance

12.2%

27.3% 18.0% 48.1%

68.6% 48.1% Donations & events

18.0% Community outreach services

68.6% Clinical services

Registered Company No. 256353. Registered Charity No. England & Wales 206002, Scotland SC038828

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Patron His Royal Highness The Prince Of Wales KG KT GCB OM AK QSO PC ADC

President General Sir Redmond Watt KCB KCVO CBE Vice Presidents Mr Dennis Bailey Air Vice-Marshal Nigel Baldwin CB CBE General Sir Edward Burgess KCB OBE Lieutenant General Sir Roderick Cordy-Simpson KBE CB Air Chief Marshal Sir David Cousins KCB AFC Vice Admiral Sir Geoffrey Dalton KCB Commander The Lord Effingham RN Dr. Charles Goodson-Wickes DL Brigadier Charles Grant OBE General Sir Charles Huxtable KCB CBE The Hon Bernard Jenkin MP Lieutenant General Sir John Kiszely KCB MC Dr. Paddy Linehan MD BCh FRCGP MRCS DCH D(Obst) RCOG

Air Marshal Ian Macfadyen CB OBE FRAeS RAF The Lord Moonie Surgeon Captain Morgan O’Connell RN FRCPsych

The Rt. Hon. Sir Malcolm Rifkind KCMG QC Derek Twigg MP Major General Sir Evelyn Webb-Carter KCVO OBE

His Grace The Duke of Westminster KG CB OBE TD DL

General Sir Roger Wheeler GCB CBE Air Marshal Sir Robert Wright KBE AFC FRAeS FCMI

Board of Trustees Major General A P N Currie CB (Chairman) Mr R. Bieber MBE MA (Deputy Chairman) Mr R A H Nunneley (Honorary Treasurer) Colonel P Baxter Air Commodore O. Delany OBE MBA BA FCIPD FCMI FBIFM

Mrs J. Green OBE MA Major General W E B Loudon CBE

We are extremely grateful to all our supporters, including:

Ms H. Pernelet Mr A. Pollitt OBE MA Mr T. Royle MA FRSE Mrs C. Sterba Dr S. Walton BSc MSc PhD CPsychol CSci AFBPsP MRI CDir

Colonel R.L. Ward RM Professor C S Wessely MA BM BCh MSc MD FRCP FRPsych F Med Sci

Appeal Board Tony Banks Simon Blagden MBE Benedict Brogan Brigadier Ed Butler DSO CBE Major General Peter Currie CB General the Lord Richard Dannatt GCB CBE MC DL

Sir Roy Gardner Duke of Hamilton Lord Hutton The Hon Bernard Jenkin MP Miss Nicola Jones Josh Lewsey MBE Dr Chai Patel CBE FRCP (Chairman) Ms Helen Pernelet Ashok Rabheru CVO DL Julian Sainty Ms Carole Stone Directors Chief Executive Commodore Andrew Cameron MA FCMI RN Director Finance & Administration Mr Ray Salmons MSc FCIS Director Fundraising & Communications Miss Jessica Dallyn (Interim) Director Medical Services Wing Comdr Walter Busuttil MB ChB MPhil MRCGP FRCPsych

Director of Operations Mrs Paula Smyth RMN Dip Mgt Director Strategy Policy & Performance Lieutenant Colonel Peter Poole MBE MILT Deputy Director Human Resources Miss Natalie Styles MSc MCIPD

Combat Stress, Tyrwhitt House, Oaklawn Road, Leatherhead, Surrey KT22 0BX Registered Charity Number: 206002 Charity Number Scotland: SC 038828 Company limited by guarantee: Registration Number 256353

www.combatstress.org.uk

01372 587000