Inside the centre caring for soldiers with mental scars

Lieutenant Colonel Mark Earnshaw and Dr Zahoor Syed chat in a patients bedroom at the Inpatient Mental Health Treatment Centre

A new approach to caring for military personnel suffering from mental illness was praised by top brass yesterday, in the same week that former soldiers spoke out about the psychological problems which persist years after combat. BEN KENDALL reports on attempts to help our battle-scarred troops.

Fatalities and injuries on the frontline dominate the public consciousness - but beyond the physical consequences of combat lies another, potentially as devastating, danger of war.

One in twenty men and women in our armed forces suffer from a range of mental illnesses, from post traumatic stress to depression and anxiety disorders, while serving their country. Many more develop problems years after service.

This is despite the fact that basic training includes “healthy warrior” tests, designed to ensure those who are most vulnerable to such conditions do not join up.

Although the conditions of service men and women broadly reflect mental illness in the wider community, service personnel operate in a highly charged, often volatile environment. Perhaps crucially, say Ministry of Defence experts, they have access to lethal weapons so any sign of a psychiatric condition must be addressed.

Visiting the Cavell Centre, a psychiatric wing in Peterborough which serves troops across East Anglia, surgeon commander Neil Greenberg, said: “The MoD takes mental health care of its personnel really seriously. We, quite correctly, rely on having a healthy workforce to carry out the demanding tasks asked of us.

“If there is any suggestion somebody is suffering from mental illness, we need to assess them immediately to see if they are fit to handle weapons, whether they can be deployed or whether they are fit for any form of duty.

“Just as our personnel give us their best whilst they carry out their duty, we aim to do the same for them in provision of health care.”

Earlier this week sufferers of post traumatic stress disorder spoke out about their condition. Many say the stigma of mental illness within the armed forces delayed them coming forward.

Others have said that, although they receive good care while serving their country, once they leave the armed forces provision within the NHS is often inadequate.

The comments came after Chanice Ward, 29, from Barford, who had died of a self-administered overdose of painkillers and anti-depressants after suffering from post traumatic stress since serving in Bosnia and Kosovo.

An inquest last week said this may have been a case of self-medication gone wrong rather than suicide but she struggled to cope with her condition for years.

Peter Doolan, from Dereham, is another whose life was changed after he saw action in Iraq in 2005. He is now receiving help but said one of the hardest things was facing up to the fact he needed help for the disorder.

In the past Britain's highest-decorated serving soldier, L/Cpl Johnson Beharry, criticised the government for failing ex-servicemen and women suffering mental health problems. He said it was “disgraceful” that some veterans struggled to get treatment, adding that the army provided “first-class” treatment but ex-soldiers were forced to wait on the NHS.

The MoD's new approach sees seven dedicated facilities established across the country, the best equipped being in Peterborough, provided by NHS trusts. Previously the private Priory Group had overseen care.

Although these are solely for serving personnel, one aim of this is to ensure that there is a cross-over between military care and the wider health service.

The Edith Cavell hospital provides four in-patient beds dedicated to military personnel which are available 24/7. These are used for the most severe cases while community care continues for others. Many staff at the unit have served in the military or experience of treating military personnel.

There are more than 4,000 new cases of mental illness within the services each year. Only a minority - 213 last year - require inpatient care. But it is unclear whether the increased operational tempo experienced this decade will take its toll with a surge in the future.

Lt Col Mark Earnshaw, from the MoD's joint medical command, said: “It is true to say that our remit finishes the day a person's contract is terminated.

“This new approach should mean that anyone who suffers from a mental illness is already within the NHS by the time they are discharged and should therefore have better access to the help that is available to the wider community.

“It will also mean that NHS staff can gain experience of dealing with military personnel. The conditions that these people are diagnosed with are no different to those that exist outside the armed forces, but there experiences and attitudes may differ.

“There are also procedures in place to make sure men and women receive care once they leave. Anybody who is medically discharged will remain under the supervision of a military social worker during the first year.”

Troops will be treated either by the facility closest to their base - RAF Marham and Honnington as well as the Swanton Morley based Light Dragoons are served by Peterborough - or closest to their family, depending on their preference.

In the less serious cases, Defence Community Mental Health Units intervene to offer help in the community. Flt Lt Mark Anthony works within a unit at RAF Marham and said the priority was to help individuals continue working and return to normal as much as possible.

The ultimate aim is to ensure that service men and women are given the help they need to return to work - in many cases to fighting on the frontline.

Cdr Greenberg said: “Part of the assessment involves grading their condition to see whether they can still deploy and fight. This requires a very high standard of occupational fitness but the emphasis has to be on helping people continue to serve.”

One issue the MoD is keen to tackle is the stigma of mental illness. Cdr Greenberg said there was no evidence this was worse than in society as a whole but, being a male dominated and traditionally macho vocation, there were obstacles to overcome.

“This is something we have to be aware of and work hard to overcome,” he said. “We have relatively early detection rates, not least because service men and women work closely together so it is easy to spot if something is not right.

“But we can't be complacent. There is a perception that seeking help could adversely affect your career when in fact the opposite tends to be true.”

The contract at Peterborough runs for five years at a cost of £3m a year. It is hoped that the deal could extend beyond this period.

Lt Col Earnshaw said: “The intention is for this to be a long-term deal and we may re-assess and increase the provision if there is a surge in demand.

“By having this longevity, we can develop a lasting relationship with the NHS which can improve the care we provide while people are in the armed forces and beyond.”

The Service Personnel and Veterans Agency operates a dedicated hotline for troops with health issues. Contact 0800 169 2277.

Have you or somebody close to you suffered physically or psychologically since returning from war? Contact Ben Kendall on 01603 772423 or email ben.kendall@archant.co.uk