PTSD on the Rise

On Friday it was headline news. After analysing 13,856 randomly selected, serving and ex-serving UK military personnel with national criminal records stored on the Ministry of Justice Police National Computer database, The Lancet had discovered that younger members of the armed forces returning from duty are more likely to commit violent offences than the rest of the population. The cause of such violent offences was instantly linked by the media to military service, and the possibility of having developed PTSD or suffered a traumatic brain injury.

The statistics need to be analysed in full before any such accusation or assertion can be made with absolute confidence. The fact remains that 94% of veterans returning from combat zones will not offend. Indeed, the report shows that overall criminal activity was slightly lower in military personnel than in people of the same age in the wider population. It is, however, a useful exercise in charting those who are at more risk within the wider military group, and the report found that those who were under 30, who had served in the junior ranks in a combat role, and experienced traumatic events, such as being shot at, were all linked to an increased risk of violence once returned from duty.

The wars in Iraq and Afghanistan have led to an increased interest in issues surrounding military mental health, and on Monday it statistics released by the Ministry of Defence showed that up to 11,000 serving members of the military have been diagnosed with mental conditions including post-traumatic stress disorder (PTSD) and depression since 2007. As ever, the question remains why? Why has there been such an upsurge in psychological casualties?

Here are a few of my observations, based on my experience of researching this phenomena, as to why this might be the case:
Greater Support: There is undoubtedly a far greater and more rigorous programme of support for military mental health now than at any time previously in British military history. Now that the MoD is expecting and actively looking for psychological casualties, it should come as no suprise that they are finding them. In addition, the very public campaign of support, and the fantastic work being done by military charities such as Combat Stress and Help for Heroes, means fewer service personnel are ashamed of coming forward and admiting they need help. While some elements of stigma certainly remain, they are being eroded.

Shared Experience: As the size of the armed forces declines, the proportion of the population with military experience is likewise declining. Thus, when veterans return from combat, or more crucially leave the military, there is a much smaller pool of shared experience on which they can call for support. This undoubtedly creates a sense of physical and more importantly mental isolation that will allow mental problems such as depression to develop.

Combat Intensity and Type: The regularity of tours, and the intensity of operations, that a smaller armed force is being called on to do, along with the highly stressful counter-insurgency operations themselves, is undoubtedly a factor. PTSD rates between those veterans who were engaged in conventional war, and those who conducted counter-insurgency operations, are markedly different.

The Nature of the Problem: PTSD does not develop overnight. It is a cumulative process that builds and feeds off other negative events. Those being diagnosed now may well have picked up their mental scars decades ago. Indeed, Combat Stress reports that it is still diagnosing Falklands veterans, testament to both the long-term germination of issues and the greater awareness that exists which encourages veterans to seek help. Given that operations are still ongoing in Afghanistan, these figures are not going to fall any time soon.

Economic Difficulties: As the UK economy stagnates, and the armed forces are faced with drastic cuts, the economic uncertainty is undoubtedly affecting veterans’ mental health. Work provides a sense of balance and self-esteem. When that is removed, or if a veteran struggles to find work, it can often prove the catalyst for mental problems that would otherwise be dormant to break forth uncontrolled.

Alcohol and Substance Abuse: Young UK service personnel are the products of the UK’s culture. Like many young people, problematic relationships exist with alcohol and other substances, which remain easily available. Alcohol, in particular, is in abundance within the armed forces where it can be bought for a heavily subsidised price. When abuse of these is combined with repressed emotions and memories, it can have disasterous consequences. Such situations are magnified by veterans attempting to self-medicating using drugs or alcohol, which only exacerbates any developing mental problems.

That is a very brief outline of an extremely complex issue, but hopefully sheds a little more light on why such developments appear to be occuring in greater numbers than ever before. The fact that those veterans who are struggling are getting the help they need is a major plus, and the widespread publication of the issue will help erode stigma and encourage those who are experiencing difficulties to come forward and seek help.

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