3 Mental health
12. It may take a number of years for the full extent
of mental health issues for troops who deployed to Iraq and Afghanistan
to be known because it can take a long time for problems to emerge
or for individuals to get help.[31]
Research suggests that overall rates of mental health issues are
not that different between regular soldiers who have deployed
and those who have not deployed, although symptoms of Post Traumatic
Stress Disorder are 50% higher in deployed troops who have experienced
combat.[32]
13. Nevertheless, we were concerned that mental health
issues are not being picked up in troops. War is extremely stressful
and we were surprised that the reported incidence of mental health
problems in the military is lower than that of the general UK
population given the traumatic events some troops experience.[33]
The Department recognised the importance of ensuring problems
are identified, particularly given the stigma that is still attached
to mental health, and provides services to support those soldiers
who do seek help.[34]
14. The Department has three community mental health
nurses in Afghanistan to provide mental health support and a consultant
psychiatrist visits every three months. The Department was confident
that this was enough and would send out additional resources as
required. The Department pointed out that those who have problems
are brought back to the UK.[35]
There are mental health professionals at Headley Court to help
the seriously injured. There is no routine assessment of the mental
health of other troops returning from Afghanistan although they
can access outpatient mental health support at specialist military-run
facilities known as Departments of Community Mental Health.[36]
In 2008-09 soldiers were far more likely to be referred to mental
health specialists in Iraq than in Afghanistan which the Department
believes is due to the nature of the combat at various times.
When troops are being shot at and can shoot back, it is a lot
less stressful than when they are being bombed or suffering indirect
fire.[37]
15. Returning British Forces report lower levels
of mental health symptoms than American and Canadian Forces. The
Americans screen soldiers for mental health symptoms when they
return from deployment, and some coalition partners do one-to-one
interviews.[38] The UK
does not medically screen because its research suggests it is
harmful. The Department has built up a package of support within
the military and uses general processes for managing stress instead
of clinical screening. This involves more experienced soldiers
on the ground checking that fellow soldiers are okay and pointing
to the availability of professional mental health services for
those having problems (Figure 2).[39]Figure
2: Military stress management support processes
| PROCESS
| DESCRIPTION
|
| TRAUMA RISK MANAGEMENT
| More experienced soldiers provide support to those who experience a traumatic event, and help individuals to recognise if they need specialist help.
|
| DECOMPRESSION
| Mental health and stress management briefings are given to returning troops in Cyprus during a short period of relaxation.
|
| POST OPERATIONAL STRESS MANAGEMENT
| Line managers interview troops three months after they return.
|
Source: Q 15; C&AG's Report, Figure 24
16. The Department acknowledged that there has been
a concern around mental health issues in Reservists who have been
deployed.[40] Members
of the Territorial Army may be back in their civilian life when
mental health symptoms develop and so do not have access to the
standard military support. The Department reassured the Committee
that Reservists got as good treatment for mental health conditions
as regular soldiers.[41]
However, we express concern that there is less oversight of Reservists
to identify those who develop mental health problems. The Department
was confident that recent measures it had put in place, such as
a pilot to give Reservists access to decompression systems, are
closing the gap in oversight when Reservists return from Afghanistan.[42]
All troops who leave the Services can access mental healthcare
through the NHS, mental health pilots or mental health assessment
programmes for veterans. This relies on the individual or their
family, friends or GP identifying that they need help.[43]
31 C&AG's Report; para 4.4 Back
32
Q 19; C&AG's Report, para 4.2; King's Centre for Military
Health Research Back
33
Qq 20 and 21 Back
34
Q 22 Back
35
Qq 25-27 Back
36
Qq 15 and 24; C&AG's Report, paras 4.6 and 4.7 Back
37
Qq 22 and 23; C&AG's Report, Figure 23 Back
38
Qq 19 and 24; C&AG's Report, para 4.7 Back
39
Qq 15 and 24 Back
40
Q 19 Back
41
Qq 10 and 11 Back
42
Qq 30 and 31 Back
43
Qq 10 and 55-56 Back
| 
