The idea that Britain is facing a 'ticking time bomb' of traumatised veterans with potentially dangerous mental health conditions has been questioned by the president of the Royal College of Psychiatry (RCPsych).
Professor Sir Simon Wessely revealed that in a study of 17,700 soldiers who had either been deployed in Iraq, Afghanistan or at home, the vast majority (97%) had not developed post-traumatic stress disorder.
This is in contrast to surveys which show that the vast majority of the public believe that most service personnel return from Iraq or Afghanistan with physical and mental health problems.
Speaking at the RCPsych's International Congress in London on June 27, Professor Wessely said: "We must beware of reinforcing the already widespread view that most returning soldiers are dangerous, drug addicted, depressed and have physical and emotional problems.
"Over the 10 years of the study there still has been little that justifies the label of a ‘time-bomb’ or ‘tidal wave’ of veterans with mental health problems. Of course, the absolute numbers requiring and sometimes seeking treatment continue to increase with every year that we remain at war, but this is not a 'tsunami' or 'tidal wave'.
"Yet if we look across the Atlantic, then we do see significant and substantial increases in mental health problems after service personnel had returned home. Increases in PTSD were partly explained by the significantly longer tour lengths faced by US troops (one year compared to our 6 months), but even that could not explain why rates were continuing to increase in the months and years after deployment in the US, but not in the UK."
While PTSD was more likely in those who had been in combat, as opposed to simply deployed and those in the reserves, only alcohol misuse was increased in all who had deployed.
Those in the direct line of fire were most at risk, but while 22.5% of combat troops misused alcohol, only 6.9% were diagnosed with ‘probable’ PTSD. The figures for alcohol misuse were 14.2% and 3.6% respectively for those soldiers in supporting roles.
The study found little change in rates of PTSD even when troops had been deployed in war zones two or three times. Rates of PTSD were actually lower on subsequent deployments, although this can be countered against the fact that those who have developed mental health problems tended not to be redeployed.
Increased violent behaviour after returning home
By contrast, a study of 13,856 veterans unveiled at the same conference by Dr Deirdre MacManus, consultant psychiatrist for the London Veterans Service, found that 13% of soldiers said that they had been involved in violent behaviour in the weeks after returning home. Of those, a third reported violence against a family member. Some 6% had a record of a violent offence after they returned home.
Equally when looking at lifetime criminal records, it was clear that overall those who had served in the Forces had lower rates of all convictions, but they also had increased rates of violent convictions, and this was associated with deploying in a combat role.
Those who reported aggressive behaviour were more likely to have been involved violent behaviour before they joined the army and had difficulties adjusting to civilian life. The main issue on which mental health professionals needed to concentrate was alcohol misuse, which could lead to risky behaviour, such as promiscuity and dangerous driving.