As many as one in 10 soldiers serving in Iraq and Afghanistan – a much higher proportion than previously expected – will develop a mental health problem due to the stress and horror of combat, according to the head of one of Britain's leading forces' health organisations.
Commodore Toby Elliott, the chief executive of Combat Stress, the mental health charity charged by the MoD with helping to treat traumatised servicemen, warned this week of a potential time bomb of casualties bearing mental scars. His comments came as The Independent on Sunday this week looks at the toll on troops' mental health as part of its ongoing campaign to see the Military Covenant honoured.
Current figures which show that about 6 per cent of soldiers develop some form of mental illness were likely to prove an underestimate, he said.
The brutal nature of life on the front line in Iraq is illustrated by a recent case of a 24-year-old private who served there for six months. During interviews with Combat Stress staff, he described how a high-explosive round fired from a 30mm cannon went straight through an enemy soldier's chest and "obliterated" him.
The private, who cannot be named, said: "There were numerous occasions that I saw people being shot dead. The terrorists would also use kids as human shields and they'd be shot or blown up as if they did not exist. I was also shot at on numerous occasions, again not thinking about it at the time due to the adrenalin.
"A friend was also killed after an accident when a barrier fell from a height, landing on his head. This really did wreck me at the time as we became very good mates which is what you need out there. I genuinely believe the start of all these problems was so many killings in such a short time and feeling helpless."
The soldier developed depression, mood swings and alcohol and drug problems. He ended up becoming homeless because his family couldn't cope and he was arrested several times for threatening behaviour. Eventually he was diagnosed as suffering from post-traumatic stress disorder (PTSD) by Combat Stress. After seeming to respond to treatment he died of a heroin overdose earlier this year.
His case is typical, Combat Stress says. Commodore Elliott said: "A lot of the veterans on our books don't realise they have mental health problems until they have left the service. The average guy will not seek help for 13 years." One of the reasons is that soldiers are reluctant to talk about their problems because of the culture of the Army, and the male psyche, is not to complain or admit "weakness", Commodore Elliott added.
While veterans have the option to seek help on the NHS, many find it difficult to be treated in a civilian environment. In a PTSD support group, for example, a soldier's harrowing story can traumatise civilians who are there to talk about a car accident or sexual assault. This has the double impact of making the civilian's own trauma feel trivial and the soldier more isolated.
"Part of the problem is that a lot of these people are just not prepared to talk to civilians," Commodore Elliott said. "They need to be dealt with in a quasi-military environment."
A study by King's Centre for Military Health Research in London last month showed that the so-called "overstretch" in the armed forces, which means troops are serving longer in theatre, is adding to the problem. Current evidence shows that other forms of mental health problems, such as depression and alcoholism, are on the rise.
The MoD said it takes the issue of mental health seriously, with sufferers able to be treated at the renowned Priory Clinic if necessary.
A spokesman said: "Our mental health services provide community-based mental health care in line with national best practice."
Ruined lives: 'If you break a man, give him help'
Former Coldstream guardsman Justin Smith, 32, a married father of three, has been diagnosed with post-traumatic stress disorder. He says he has been abandoned by the Army and told by the NHS that he would have to pay some of the costs towards his treatment. When he left the Army in 2005 after two tours of Iraq, he had to declare his family homeless.
"It's not as simple as getting help from a mental health team," he said. "They are trained in many things, but helping someone get over seeing their close friend shot in a war is not one of them. Soldiers need specialised help."
"I'm damaged goods now. The Army doesn't want me, and I don't want them. But [if you] break a man, get him help to fix him again, and then get rid of him. Don't just break him and leave him to pick up the pieces."
Further information: For advice on Combat Stress, email email@example.com or call 01372 841600
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