Military duties and Mental health.
The physical and mental health of returning military personnel has long been a cause of worry to their families, some members of the medical profession and the Military; it has been the topic of a well known Folk Song (Jonny I hardly knew you) reflecting post-conflict health and life as far back as the 1800s .
Poor Mental health is still a figure of great stigma in the UK, especially among young men and is an issue that must be assessed as fully as possible – this is possibly a hidden socio-economic cost of war, which is potentially a lifelong personal and public burden.
With such long standing recent military conflict in the middle East it was good to see that a report released last week – by the Academic Centre for Defence Mental Health and the King’s Centre for Military Health Research and Biostatistics, and the Institute of Psychiatry, King’s College London, – assessing the mental health of troops fighting in the Middle East has suggested that post traumatic stress disorder (PTSD) following combat was relatively minor – at approximately 4 %.
Questionnaires were the method for collecting this data. The cohort study assessed the effects of combat in Iraq and Afghanistan over a six year period (2003 -2009) with questionnaires completed by 9,990 respondents from the armed services. However, this figure only equates to 56% of the 17,812 initially identified and asked to participate[i]. With a response uptake of only just over half of those asked to participate, it could lead people to wonder if possibly, some of those who did not respond, may have been the very personnel who were indeed traumatised and affected psychologically by combat.
The questionnaires required self evaluation – and so must have relied on military personnel identifying their own problems and highlighting them. Some of these may not even wish to admit to themselves that they have been psychologically harmed – as this could imply weakness which is perceived as stigma, especially amongst young personnel.
Other earlier research by the Mental Health Foundation showed that the number of ex-soldiers who received criminal records following their return civilian life is thought to be as high as 41% [ii] and those who live rough is approximately 25%[iii] . Another report identified that the number deaths from Suicides following the Gulf war, was over 75% higher than the number of soldiers killed in conflict.[iv] Each of these figures suggests poor adjustment to civilian life and very possibly poor mental health issues.
The report last week identified alcohol abuse as being particularly high for ex-military personnel who had been in combat, at 13%. Apart from being an important issue in its own right given the effects on physical health, alcohol could well be used to mask depression, anxiety and PTSD.
This higher percentage of alcohol abuse, combined with the 44% of those invited who did not participate in the research, may suggest this could actually reflect hidden poor mental health – which is even more worrying, as this goes unrecognised and so untreated.
Although this report is important to understanding wider health issues and potentially helping to plan post-combat support, there is still much to be done. Perhaps it is necessary to follow up ex-personnel and assess their mental health and progress over a number of year’s post-conflict, in order to get an even more complete picture and to reduce the mental health burden and socio-economic implication that may occur for themselvs and their families.
Iseult Roche
Quality and Sustainability
[i] http://www.nhs.uk/news/2010/05May/Pages/armed-forces-wellbeing-military-health.aspx
[ii] www.mentalhealth.org.uk/EasySiteWeb/getresource.axd
– Shelter (November 2002) Armed Forces Project Report London: Shelter.
[iii] Ballintyne, S and Hanks, S. (2000) Lest We Forget: Ex-servicemen and homelessness. Crisis
[iv] Defence Analytical Services Agency (16 Jan 1997) Written Questions to Parliament
Ref 11038.
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