Examination of Witnesses (Questions 460
- 469)
WEDNESDAY 7 JULY 2004
PROFESSOR KEITH
HAWTON AND
PROFESSOR SIMON
WESSELY
Q460 Mr Jones: Could you suggest
anything in the training which could be improved?
Professor Wessely: That is where
the US programme is very nice. They have some very nice training
material, very simple, straightforward, aimed particularly at
NCO ranks. It is very neat and very quick. Most of these things
are just reminding people that their own commonsense judgments
are actually quite accurate.
Professor Hawton: I have to say
that I have looked through that training material briefly. I should
like to see it backed up a little bit with real-life examples
rather than checklists of things to look out for. What would be
useful might be to have young actors role-playing the sorts of
things to look for.
Q461 Mr Jones: We saw some of that
a few weeks ago at RAF Halton where they are doing that training
with a very good actress.
Professor Hawton: You remember
these things much better than when you just see a checklist of
items.
Q462 Mr Jones: The Armed Forces suggested
to us that awareness training could sometimes be counter-productive
for junior personnel. What is your experience?
Professor Wessely: It depends
what you mean. If we are talking about other ranks, teaching people
the symptoms of post-traumatic stress disorder or depression for
themselves I have to say I share that view. It is not something
I favour. What we are talking about here is teaching people who
have to spot, who have the Duty of Care, to recognise those signs
and symptoms. I am certainly absolutely not in favour of giving
every recruit a briefing on suicide; I am definitely absolutely
not in favour of that. I could see that being very counter-productive.
Professor Hawton: We may have
some disagreement here. I agree with your last point, but I think
being aware of some of the basic symptoms, things to look out
for, to know whether or not you or someone else is becoming depressed,
is different. That is worthwhile. It is such a common problem.
As we have said, people often do not recognise it, particularly
young males. I personally would favour trying to have that as
something which is in their consciousness, that young people do
sometimes develop these problems and these are the common things
which we know signify this is happening.
Q463 Mr Jones: How do you get a recruit
to realise that they are suffering from depression and it is not
just an off day, which we all have, do we not?
Professor Wessely: We do.
Q464 Mr Jones: What is the difference
between the off-day and actual depression?
Professor Hawton: It is persistence,
is it not? Persistence and depth of feeling and how it affects
your functioning.
Professor Wessely: It is not just
feeling sad, it is actually being sad and not being able to go
to work. Because there is a disagreement on that one issue between
us, I would make a strong plea that that therefore suggests we
really do not know and it would be a research question. There
are many things, for example psychological debriefing, which we
thought was a terribly good thing and only when we actually did
proper controlled trials, did we actually show it did more harm
than good. This is another area where we genuinely have uncertainty.
It would be nice if that could be subject to proper research,
because we do not know. That is the truth. If we cannot agree,
we probably do not know.
Q465 Mike Gapes: Professor Hawton
and Professor Wessely, this has been an extremely valuable session.
Before we conclude, may I ask whether there is anything we have
not touched on that you would like to add to what you have said?
Professor Hawton: There is one
specific point which we briefly touched on which goes back to
suicide and to the availability of firearms—I understand
that all four cases from Deepcut involved firearms—and this
question of how that specific risk might be reduced.
Professor Wessely: You have probably
come to this conclusion anyway, but suicide is a solitary activity
and I do not particularly like the idea of 16-year-olds on their
own with guns. Suicide is a solitary activity and it very rarely
happens in company. That is generally true, is it not?
Professor Hawton: Absolutely;
yes.
Q466 Mike Gapes: What about the question
of whether we put too much pressure or push new recruits too far?
Is that an issue which needs to be looked at? Does that involve
risk?
Professor Wessely: We are not
experts on military training, so we do not know. A training which
was completely without stress would not be a training. It is not
medical school. I was told by one officer very genuinely that
on the whole, nevertheless, if you are going to have a breakdown
it is better you have it on a base in England than in Basra. That
is probably a legitimate point. Other than saying that it has
to have some elements of stress in it, because war is a stressful
business and you might as well come prepared, after that it is
a technical question which we are not really qualified to address.
Q467 Mike Gapes: You mentioned very
early on that one of the risk factors was drug abuse and you said
that was increasing. Is there any evidence that—this gets
us into very controversial areas—smoking cannabis has an
effect on people years later, and given the rising incidence,
this has led to possible mental health problems?
Professor Hawton: Professor Wessely
can comment because he has done research on that, but I do not
know of any evidence linking cannabis with long-term risk of suicide,
although there may be, because of the associations we know with
long-term risk of psychosis, for which there is now clear evidence.
Professor Wessely: We are pretty
convinced that it does increase risk of psychosis, which is not
really a problem within the military. We have not done research
on drug abuse in the Armed Forces for the reasons that we would
not believe the answers people gave us and in order to get the
trust of the research that is just a no-go area for us. They tell
us about alcohol, no problem, but I am afraid we cannot help you
on drugs, we just do not touch it.
Q468 Mr Cran: I just want to be clear
about what you were saying. You were saying that mixing of guns
and so on with people who were possibly going to exhibit mental
illness in the future—
Professor Wessely: No, I was making
a general point that successful policies to reduce suicide have
almost invariably been about means. Those are the things which
have worked. Clearly you cannot have Armed Forces without guns,
but opportunity. From analysis of those cases, and it might be
that the psychological autopsy shows that even more, these happened
in private. I would have thought, looking at where people are
alone with guns—
Q469 Mr Jones: Then I did understand
your answer; it was just that I articulated my question rather
badly. My observation of the thing is that recruits' access to
live ammunition is very strictly controlled; I mean very strictly
controlled. I was just wondering whether you had any information
or had a view that the strictness was not strict enough.
Professor Wessely: That is well
beyond our knowledge. I do not know. They know much more about
firearms than we do.
Mike Gapes: Gentlemen, may I thank you
very much for coming. We are very appreciative.
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