The grainy CCTV images are chilling. They show David Bradley calmly placing his rucksack on the front desk of his local police station. Then the former soldier takes out of his waistband the handgun that he used to kill four members of his family.
At a court appearance last week, the 41-year-old pleaded guilty to four counts of manslaughter on the grounds of diminished responsibility. His victims included his aunt Josie Purcell, a retired carer, and his 70-year-old uncle, Peter, whom he shot dead at the home they shared near Newcastle.
What drove the former private in the Royal Artillery, who had served in the Gulf War, Bosnia and Northern Ireland, to execute his family in July last year is unclear. The NHS has announced that it will carry out two inquiries into Bradley's medical treatment. The psychiatrists who examined him after he was arrested said that he had been suffering from a lifelong mental illness. One also believed that he had a form of psychotic disorder triggered by his service in Northern Ireland.
It has also emerged that his family contacted the Ministry of Defence begging for help after Mr Bradley revealed he had an urge to kill, but their pleas were ignored.
Military welfare groups were quick to point out that the case of David Bradley is at the extreme end of the mental illness spectrum. Soldiers can suffer from Post-Traumatic Stress Disorder (PTSD), a natural response to threatening or traumatic events. Its symptoms include flashbacks, the shakes and exhaustion. But although the condition is associated with poor anger control, it rarely leads to murder.
Bradley's actions highlight the fact that soldiers can find themselves back on Civvy Street having been deeply damaged by their experiences on the battlefield. In a system that fails them, some may end up living rough or on the wrong side of the law; former servicemen make up a quarter of the population of homeless people in Britain, according to Shelter, the housing and homelessness charity.
In the US there are more than 100 hospitals dedicated to veterans that are fully funded by the government. In Australia, there is also an established network of treatment centres for former servicemen and women who have been either physically or mentally damaged in war.
But in Britain, seven of the eight military hospitals have closed since the early 1990s. The last dedicated military hospital, the Royal Hospital Haslar in Gosport, Hampshire, is due to close next month.
Tony Blair has promised to open wards managed by the military. In December last year, one such was opened in Selly Oak in Birmingham, offering beds for up to 16 soldiers. But the Ministry of Defence says that civilians will be treated on the same ward if there are spare beds.
Ministers say that military hospitals are inefficient and cannot match the outstanding and specialised care being offered by the NHS. This view has provoked outrage from MPs and campaigners who believe that soldiers should be treated alongside each other to help the healing process, especially if they are distressed.
General Sir Michael Jackson, the former head of the British Army, said recently on Newsnight that it was wrong to close military hospitals: "We must be able to devise a system between the two extremes where soldiers can be given treatment within the military."
Given the lack of dedicated NHS beds, the job of providing long-term support falls to charities such as Combat Stress. They have three treatment centres for soldiers suffering from psychiatric disorders after combat. These include Tyrwhitt House, a converted country house in Surrey. Pictures of Spitfire aircraft and Vera Lynn, the singer and Second World War forces sweetheart, line the walls and veterans of all ages can share their experiences with each other.
On a wall in the art therapy area, a soldier has pinned a poem expressing the desolation that many feel when they first come to the centre:
"Blank, I am not,
Frank, I will try and do justice, to the
Depths of despair,
And I that serviceman
In need of repair."
But the charity is struggling to meet record demand from soldiers seeking treatment, often after years of coping alone with nightmares and flashbacks. The number of inquiries has nearly doubled over the past two years. In 2005, Combat Stress received 600 new referrals, last year it had 930 and this year the figure is expected to rise to nearly 1,000.
Some of these are troops who fought in the Falklands War, but increasingly they now include soldiers from the ongoing conflicts in Iraq and Afghanistan.
Leigh Skelton, the clinical services director at Combat Stress, said the organisation is "still struggling" to fund the necessary support - the charity relies on the Ministry of Defence for nearly two-thirds of its funding. "If we can't get these people through the door then they will become another rough sleeper statistic or end up in the criminal justice service," he said.
Mr Skelton, a psychiatrist, believes officials have failed to grasp that the experiences of such patients are unique - and that soldiers will only open up and respond to treatment where they are in a secure therapeutic environment with fellow servicemen.
The British Legion told The Independent on Sunday that it was "very worried" that not enough is being done to address PTSD, especially among reservists. Members of the Territorial Army are increasingly being called up for active service because of the conflict in Iraq.
Some improvements have been made, and an assistance centre for Territorial Army soldiers is now up and running at Chilwell in Nottingham. But Lisa Wise, from the British Legion, said that reservists suffer through the lack of a debrief when they return from their duties. "It is a great concern because reservists go back to their day job, where they have to integrate back into society without soldiers around them," she said. A survey by King's College London, published last year, found that more than twice as many TA officers as regular soldiers suffer from conflict-related mental illness.
Worryingly, psychological damage suffered during combat can take years to emerge, which means support is not just needed now but in decades to come - Combat Stress is still treating veterans of the Second World War. But once soldiers are discharged from the Army they waive their right to treatment through the military. Soldiers may be declared "fully fit" on initial assessment, only to face queuing for treatment on the NHS years later.
The Army's culture is such that talking about the psychological impact of conflict is hard to do, and once a soldier leaves the army "family" he or she may feel cut off from the rest of society. Such isolation is debilitating for anyone suffering from a mental illness, but especially so for troops, who often feel set apart from civilian life.
Postings by former servicemen and women on internet army messageboards show how let down they sometimes feel by their treatment once they return from the battlefields in Iraq and Afghanistan.
Leigh Skelton says that there is a sense of betrayal among the troops. "Soldiers are told they are a priority, they are special, but their GP doesn't know that," he said. "What is it about England that it does not provide?"
Additional reporting by Lauren Veevers
Case Study: 'I saw my best friend die in combat'
Greg is a veteran of the first Gulf War. His life has been devastated by Post-Traumatic Stress Disorder, but it has taken him more than 15 years to seek help.
At the age of 22, he joined the 1st Battalion, Staffordshire Regiment and shortly afterwards was sent to the Saudi Arabian desert for armed combat training. But nothing could have prepared Greg for the psychological impact of war. When his best friend was hit by a rocket, Greg had to carry the shattered pieces of his body from the battlefield. "The top of his leg had gone and the tendons. His arm was 15 yards away but he was still shaking. I was so pumped up with adrenalin that I didn't have time to think," says Greg, who was the company medic.
Being able to pull the trigger earns a soldier respect. Greg was good at it, which meant he was under pressure to perform. "People think anyone can pull the trigger but some can't do it - not even the hardest blokes. Unfortunately I could. It's nothing to be proud of. You don't eat or sleep when you are in combat. Your heart is pumping so hard in your chest - it's like heartache but 100 times worse."
Greg left the army in 1995. He tried to block out his nightmares and flashbacks through self-medication. Cannabis helped calm him, speed kept him awake.
"GPs do not have a clue about what you go through. You don't want to be on your own, you want to be distracted from your thoughts. The worst thing was television - it was Iraq, Iraq, Iraq. And that would trigger it. Three, four hours of nightmares. It intrudes into everything and even puts you off your food."
The Army had been Greg's life, and the new one he tried to make for himself once he left soon disintegrated. His marriage broke down, he lost his job and at one point was sleeping in his car. Then he was arrested for assault - which proved to be his salvation. Greg's probation officer realised that he was deeply damaged by his war experiences and urged him to contact Combat Stress. Now he is receiving professional treatment at one of its centres.
"I'd heard about Vietnam but I didn't know what I was suffering from," says Greg. "It was something we didn't talk about in the Army, like getting killed. It's like being an alcoholic. You have to stand up and say 'I've got a problem.' In the US they really care for their troops, but our government sends you there and doesn't seem to care. Where would this country be without individuals on the front line?"Reuse content