Mental health alert for UK troops leaving Iraq

LONDON - As Britain prepares to pull hundreds of troops out of Iraq, doctors and nurses at home are getting ready to treat not only their physical wounds, but also the psychological ones.

More than four years of conflict in Iraq, and six years of fighting in Afghanistan, have taken a toll on the armed forces, both in terms of the number killed -- at last count 252 -- as well as the number mentally and physically wounded.

In the past week, the government has taken steps to tackle both aspects of the problem, amid criticism from the families of returning soldiers and some veterans' groups that not enough is being done to assist those fighting the unpopular wars.

One move was to increase the lump-sum payments made to soldiers severely wounded in attacks to as much as $570,000.

But potentially more crucial in the long term was a decision to increase funding to Combat Stress, a charity that helps veterans suffering from severe war-induced mental conditions.

Combat Stress was founded a year after World War One to help servicemen returning with what was then called "shell shock" but today is often defined as post-traumatic stress disorder (PTSD).

The charity has around 8,000 patients on its books, including veterans of World War Two, the Falklands War, the first Gulf War, the Balkans and now Iraq and Afghanistan.

The decision to increase its funding -- by a substantial 45 percent -- comes amid evidence that many more soldiers returning from Iraq and Afghanistan are being diagnosed with psychological damage than those returning from previous conflicts.

The reason may be due to soldiers being more willing these days to come forward with their problems, but it is also due to the intensity and unpredictability of today's conflicts.

"In World War Two, a soldier generally knew when fighting was going to happen on a given day and was prepared for it," said Dr Nigel Hunt, associate professor of health psychology at the University of Nottingham and an expert in PTSD.

"In Iraq, it's so unexpected. Nothing may happen to a soldier for days or weeks, and then on an ordinary patrol, a bomb will go off. That unpredictability can be very disturbing."


"MENTAL HEALTH CRISIS"

Combat Stress says soldiers as young as 21 are now coming to it for help as early as 11 months after being discharged from the army. Before Iraq and Afghanistan, the average time it took people to come forward with problems was 13 years.

"If this is just the tip of the iceberg, then the future is going to be interesting ...," said Robert Marsh, a spokesman for Combat Stress. "In five years' time, who can tell how many veterans there will be needing our support?"

The Ministry of Defence says its figures show a very small number of soldiers returning from Iraq and Afghanistan have PTSD -- officially somewhere around 3 cases per 1,000 troops.

But experts say the MoD only counts soldiers who are still in the army, where a support structure remains around them. The symptoms of PTSD kick in when soldiers leave the force.

"It's when they go home, when they go into the civilian world and see that people aren't really too bothered about what they've been doing," said Hunt. "Many people think the wars in Iraq and Afghanistan were wrong and that can hurt soldiers."

Since 2000, a year before the war in Afghanistan began, Combat Stress has seen the number of new cases it has to handle more than treble, from around 300 a year to 1,000.

Hunt says he's glad to see the government stepping up support for organisations like Combat Stress, but worries not enough is being done and calls the situation a crisis.

"We've got people waiting for two years or more for treatment for PTSD," he said. "You can't wait that long for treatment for PTSD, you need it right away."