Ashley Ryan, a student at City & Islington College, intends to enroll in 2014 for War Studies at King’s College London. Joseph Ryan, PhD, is studying for a PsychD in Psychotherapeutic and Counselling Psychology, specialising in trauma, at the University of Surrey.
On Thursday 3 October 2013, the MoD announced that 5,058 military personnel were diagnosed with mental health conditions over the previous year, representing a rate of 27.1 per 1,000 personnel at strength .
Recent media attention focused on an ‘upsurge’ in PTSD cases. The MoD, however, said most of the increase in mental disorders was due to an alteration in reporting methods. Without the change, there would have been only a 3% rise . So, the figures don’t show big increases; rather, they demonstrate for the first time the extent of mental health problems faced by the military.
Since 2007, 22,600 personnel experienced mental health issues during or after deployment to Iraq or Afghanistan . Adjustment disorder was common, accounting for 61% of all neurotic disorders . Other prevalent conditions included depression and alcohol abuse. Increased drinking – a form of self-medication – is a common and traditionally acceptable response to stress among the armed forces.
PTSD remains relatively uncommon, accounting for only 10% of neurotic disorders reported since April 2007 . The impact of the condition, however, sometimes gets lost in the statistics … PTSD is debilitating and, if untreated, worsens progressively, sometimes to the point of suicide. It also has a negative effect on family, friends and colleagues.
Army 2020 plans will increase risk factors associated with PTSD. Since 2001, both regulars and reservists have experienced greater exposure to combat and trauma, due to the scale of operations in Iraq and Afghanistan. Although operations are scaling down, our military presence isn’t due to end anytime soon – and for troops it remains to be seen whether the end of these conflicts will bring a lull in engagements or merely a change of scenery.
The change to lengthier deployments (of 8-9 months) means extended immersion in theatre, compounding the chances of multiple traumatic events occurring. This may partly explain the higher rates of PTSD in the US military, which sees deployments of 12-15 months.
The planned increase in reserve forces (from 15,000 to 30,000) suggests that reservists will be rotated from deployment to civilian life more regularly. Research indicates they have an elevated risk of mental health problems; indeed, the chief executive of Combat Stress stated that rates of PTSD among veterans are 50% higher in reservists.
Reservists may have lower morale and unit cohesion, and greater perception of exposure to trauma. On homecoming, they feel less supported by the military than regulars, experiencing increased marital discord, employment issues and lack of social support. Rapid reintegration into society also causes a sudden loss of the deep bond and camaraderie between members of a unit that they experienced in theatre; whereas for regulars this continues between deployments and, indeed, on their next tour.
The armed forces face severe budget cuts and more than 11,000 personnel have been made redundant since 2011, with further reductions planned. The psychological impact of risking one’s life on operations, combined with disillusionment and loss of morale caused by redundancies, disbandment or merging of regiments, and lack of support from the general public for military action in recent years, has yet to be fully felt.
In summary, the problem isn’t that mental health issues (including PTSD) are common or spiking, because they aren’t – yet. But changes to army structure and deployment length will intensify risk factors as we move towards Army 2020, placing additional pressure on the mental resilience of our men and women in the field. As such, many more personnel are likely to experience PTSD, with even greater numbers suffering common mental health and alcohol problems (which can lead to other social concerns – unemployment, homelessness, imprisonment, etc).
It is time to recognise this and plan accordingly, making provisions for effective mental health treatment for serving personnel (whether regulars or reservists) and veterans alike.
 Ministry of Defence, ‘UK Armed Forces mental health: Annual Summary & Trends Over Time, 2007/08 – 2012/13’ (3 October 2013). ()
 Ministry of Defence, Defence News, Official News Blog of the UK Ministry of Defence, ‘Defence in the Media: 4 October 2013: Mental health support for Service personnel’ (4 October 2013). ()
 Tom Whitehead, ‘Mental disorders among Afghan veterans rise,’ Telegraph (3 October 2013).