The long-term impact of experiences in battle is not fully known and could leave veterans vulnerable
By Matt Chorley
Sunday, 1 August 2010
British troops in action: their psychological stress is described as a 'timebomb'
Troops leaving the Armed Forces may be put through psychological profiling in a new effort to identify those at risk of developing mental disorders linked to their experience on the frontline. The Secretary of State for Defence, Liam Fox, who has described the impact of mental illness among service personnel as a "time bomb", believes developments in science means more could be done to stop the most vulnerable "falling through the safety net". Some 180,000 troops are thought to have been deployed to the two conflicts since 2001. The long-term impact of their experiences in Iraq and Afghanistan on those who return to civilian life is not known; in some cases, symptoms from past trauma may not emerge until many years later.
However, Combat Stress, the ex-services mental welfare society, reports a 72 per cent rise in referrals in the past five years. On average, veterans are waiting 14 years between discharge and seeking the charity's help. Comparisons to US forces show Britain has not yet experienced the sharp rise in serious mental conditions and suicide rates seen in America.
A study by King's College London earlier this year found 4 per cent of British armed forces suffered from post-traumatic stress disorder (PTSD), but 20 per cent had symptoms of common mental disorders. Research of 10,000 soldiers showed 13 per cent were misusing alcohol, but those who had served in Iraq or Afghanistan were 22 per cent more likely to abuse alcohol than those who had not.
But Dr Fox is damning of the service offered to those suffering from mental health problems and is concerned about the unknown impact of the recent conflicts on the state of veterans' health, especially those of reserve forces. "There is an excess vulnerability there which we will pay a very high price for, and if we are not careful and we do not try to identify people who might be at risk, we will be as a society potentially sitting on a mental health time bomb," he warned.
Plans are being put in place by the Ministry of Defence to set up a clinical trial of post-deployment screening, which would examine how effectively those who have been adversely affected can be identified and provided with help as early as possible. "In this country, frankly, the quality of care we give to people with mental illness we simply would not accept for any other sort of illness that afflicts one in four of the population," Dr Fox said. He believes it is a "measure of how civilised we are as a society" how the most vulnerable, including those with mental illness, are treated. Too often it is a "Cinderella service" in healthcare because "they are the very people who will least be able to complain or least want to make their voices heard".
Conservative MP Dr Andrew Murrison, a former medical officer in the Royal Navy, who served in Iraq in 2003, is conducting an independent study into the health of serving personnel and veterans, with a particular focus on mental health. Ministers have received his initial findings, and full publication is expected shortly.
Ministers are particularly concerned that there is not enough co-operative working between the MoD, the NHS and social services. It could mean dropping what Dr Fox regards as "some of the less than justifiable medicals at the point of discharge from the Armed Forces", to examine advances in science and move towards "psychological profiling to see who might be most vulnerable and to proactively follow them up rather than waiting to see if they fall through the safety net".
He told the Commons defence select committee he is particularly concerned about troops from the reserve forces adjusting to an abrupt return to non-military life. "If you are coming home with a group of comrades who have been through the same experience, at least you have people to talk to who have been through the same thing. If you are in the reserves, you can be in Helmand on Friday and you can be the milkman in Dorset the next Friday, on your own with no one to talk to, and potentially an uninterested population that cannot understand."
The MoD provides community psychiatric nurses in Afghanistan to provide care and treatment on the frontline. There are also two UK-based teams of psychiatrists and mental health nurses who are available to deploy to Afghanistan at short notice. Across the UK there are 15 military departments of community mental health across the UK.
Labour MP John Woodcock, a member of the defence select committee, said spending cuts in the public sector should not hamper work for veterans. "We do absolutely need to do more. Our duty to the troops is fundamental. The resources have to be found."
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