Veterans’ mental health plight was foreseeable and foreseen

By Celia Richardson, the director of campaigns for the Mental Health Foundation (THE GUARDIAN, 08/08/07):

Your article on the escalating mental health problems among frontline veterans of the Iraq and Afghanistan wars raises serious questions about how we repay the people who risk their lives for us (Iraq veterans suffer stress and alcoholism, August 3).You report a new study by the British Medical Journal online. But as long ago as February 2003 our charity warned that soldiers who were then being deployed in Iraq could suffer serious psychological trauma following conflict. We knew that more Falklands veterans had committed suicide than were killed during the conflict. We also knew that almost five times the number of soldiers who lost their lives in the previous Gulf conflict had since committed suicide. Evidence showed that one in four homeless people at that time had served in the armed forces.

“Prolonged periods in conflict are linked to higher levels of post-traumatic stress disorder, psychological distress and problems at home,” you report. The alcoholism and family breakdown referred to are common consequences for people who go to war. What they witness there is far outside the experience of civilian life, and when the resulting trauma makes them ill they need practical, specialist treatment. This is part of the debt we all owe them. In the US, returning troops are offered early intervention readjustment counselling, and the government funds a national centre for post-traumatic stress disorder. Neither is available in Britain.

When we interviewed veterans from the Falklands war and the previous conflict in the Gulf, we uncovered many distressing stories. Veterans with mental health problems are in a catch-22 situation: those experiencing mental health problems during service are likely to leave the forces, at which point they lose access to the mental health services provided by the Ministry of Defence. They must then rely on the NHS, whose resources are notoriously overstretched and who cannot offer the specialist help needed by veterans. Mental health problems may be exacerbated (or, in many cases, caused) by post-service factors, such as trouble with transferring to civilian life or marital problems.

Mountains of evidence show that proper investment is needed for returning soldiers. The government knows the mental health consequences when it chooses to enter a conflict. It can and should plan accordingly. Soldiers who have been traumatised need early intervention and they also need to be treated and cared for long after their war is over. There is a charity, Combat Stress, which does a remarkable job treating veterans, but it cannot do it alone.

During our 2003 campaign we asked the then health secretary what plans he had in place to ensure these well-known side effects of war were spotted and dealt with following the coming conflict. The answers were far from reassuring.

Mental health problems faced by servicemen and women are not going to go away. We cannot keep asking them to fight our battles and then leave them to fend for themselves when they return.