Question to the Ministry of Defence:

To ask the Secretary of State for Defence, what steps he has taken with the Secretary of State for Health and Social Care to ensure that NHS practitioners are informed of the vulnerability to suicidal ideation of veterans impacted by Lariam; and what steps veterans can take with his Department to help improve awareness within the NHS of the nature and effects of mefloquine toxicity.

Mefloquine is recommended as an effective anti-malarial by international health agencies, including the World Health Organisation. Ministry of Defence (MOD) and the National Health Service both follow National Institute for Care and Excellence guidelines on the prescription and management of side effects associated with mefloquine.

The MOD is engaged with NHS England (NHSE) through the NHSE Armed Forces Clinical Reference Group. This group has recently reviewed the clinical management of the side effects associated with mefloquine. As symptoms can resemble acute psychiatric conditions, clinicians are advised to assess patients individually and are expected to take a full drug and alcohol history, including any previous mefloquine use.

In England, Op COURAGE and Op RESTORE provide a broad range of specialist mental health, physical and wellbeing care services to veterans, with similar services available in Scotland, Wales and Northern Ireland.

I would encourage any Veteran who is struggling with their mental health to self-refer or seek the support of their GP to access Op COURAGE, the Veterans' Mental Health and Wellbeing Service. The side effects that may be experienced whilst taking, or with a history of having taken mefloquine, will be treated according to the diagnosis; for example, if the patient is experiencing depressive symptoms, the treatment for depression will be instigated.