Mental Health and the Armed Forces, Part One: The Scale of mental health issues

Abstract: Focus on mental health has increased over recent years. Media coverage, particularly during the conflicts in Iraq and Afghanistan, and Armed Forces charities have made the public much more aware of mental health conditions in Servicemen and women, such as Post Traumatic Stress Disorder (PTSD). The perception that most Service personnel leave the Armed Forces ‘mad, bad or sad’ is, however, not only a myth but harmful to veterans. The vast majority leave with no ill-effects and have a positive experience from their time in service. The support and sense of community offered by the military environment might have improved the mental health in some or at least delayed the onset of pre-existing conditions. Indeed, this distorted public perception may be amplifying the stigma surrounding veterans’ mental health, discouraging them from seeking help, and overly focussing attention on PTSD, when conditions such as depression are much more common. The limitations of Government data mean that it is likely to underestimate significantly the total number of serving personnel and veterans with mental health conditions; but we believe that the true figure will still be small. The Ministry of Defence reported that the rates of diagnosed mental health conditions in serving Armed Forces personnel have nearly doubled over the last decade to around 3%—slightly lower than the rate in the general public. However, this is the figure only for those who seek help. Academic research suggests that the true rate of veterans with mental health conditions could be as high as 10%. Certain groups, such as those in combat roles and deployed Reservists in Iraq and Afghanistan, also show higher rates of probable PTSD than the rest of the Armed Forces. Nevertheless, the small minority of serving personnel and veterans who do suffer from mental health conditions, especially those who are severely affected by conditions such as PTSD, clearly need timely and appropriate provision of care. The UK Government has sought to make improvements in its provision of mental health care to veterans, but problems remain. It is still taking too long for veterans to access treatment when they need it, and levels of care vary across the UK. There is also the risk that some can still fall through the gaps as they transition from the care of the Ministry of Defence into the National Health Service. We shall be examining in detail the provision of mental health care to serving personnel and veterans in Part Two of our inquiry. We are particularly concerned that the Armed Forces Covenant principle of priority treatment when conditions are service-related is not being consistently applied across the UK. Confusion over how it should be implemented in both clinicians and veterans adds to the perception that the health service is failing veterans. The Ministry of Defence urgently needs to clarify this in its future veterans’ strategy.