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Mental health of Iraq and Afghanistan reservists causes alarm

Ministers must find more money to support thousands of army reservists as evidence grows that part-timers who served in Iraq and Afghanistan are more likely to suffer from serious mental health illnesses than regular soldiers who served alongside them, two leading military charities are warning.

Amid concerns there will be a sharp increase in the overall number of veterans needing expert help over the next five years, the Royal British Legion and Combat Stress say the government must focus on the so-called “weekend warriors” who have become a mainstay of British military operations and will be used to cover deep cuts to the full-time army.

The charities say reserves who fought abroad in recent years are twice as likely to develop serious mental health issues, such at post-traumatic stress disorder (PTSD), but they return to civilian life without proper support for themselves or their families.

The warning comes as some charities have reported a marked rise in the number of veterans coming to them needing help. At the start of a major series in the Guardian on the Iraq war, one former major general said he feared a “bow wave” of new cases would emerge over the next decade.

With the Ministry of Defence wanting to double the number of reservists to 30,000 over the next five years, Chris Simpkins, the director general of the Royal British Legion, and Commodore Andrew Cameron, chief executive of Combat Stress, said: “There is now a pressing need to seriously address the support requirements of reservists and their families.”

In an article for Comment is free, Simpkins and Cameron said: “We must work with the reservist community to raise awareness of mental health conditions and reduce the stigma associated with admitting to mental health issues … we are very clear that now is the time to develop resources, and we suggest that communities and health services that have increased numbers of reservists must receive more funds.”

Drawing on studies by the King’s Centre for Military Health Research, the charities say there is strong evidence to suggest reservists are more prone to mental health problems.

A five-year study of more than 500 reservists who served in Iraq showed they were twice as likely to get PTSD compared with regular soldiers. The report said reservists had “significantly elevated rates of common mental disorders” and warned that “rates of mental illness may continue to rise in the months and years after reservists have returned home”.

The charities say: “The reasons behind this increased risk aren’t fully known but … the differences between support networks for regulars and reservists may provide an answer.

“Unlike their colleagues in the regular forces, reservists do not have an extended period of time surrounded by their peers when they return home from duty, and often swiftly return to their civilian role, without the opportunity to share experiences with others who have served alongside them.

“These support networks are hugely important and the Royal British Legion and Combat Stress, alongside other armed forces charities, are working to minimise social isolation and improve integration between civilian and military life in the reservist community.”

Although UK forces pulled out of Iraq three years ago, and will have left Afghanistan by the end of next year, concern about the welfare of veterans is increasing, with some charities noting a sharp rise in referrals.

The most serious mental health problems, such at PTSD, often do not present themselves for a decade. Cameron said Combat Stress was still getting referrals from men who had served in Northern Ireland.

The charity registered a 29% increase in the number of Iraq war veterans it helped last year, bringing the total to 1,231. It is treating almost 500 Afghan war veterans – there was a 71% increase in the number of new referrals last year.

Major General Tim Cross, who served in Iraq, told the Guardian the problems faced by ex-servicemen would increase as the decade wore on. “I think we are building up. I’ve said for quite a while we [have] got a bow wave coming. PTSD on average takes about 11 years to really show,” he said. “A lot of the Falklands veterans have gone through really difficult times and they now say, I think it’s probably true, more Falklands guys have committed suicide than died during the campaign.”

A similar delayed reaction would happen with Iraq and Afghanistan, he said.

The MoD has set aside £7.2m to improve services for veterans and the government has appointed Lord Ashcroft to conduct a review focusing on the needs of military personnel as they undergo the transition to civilian life.

According to MoD statistics, 964 service personnel were medically discharged in the past five years suffering from mental and behavioural disorders – the second most common cause for discharge.

Of these, only 195 were suffering with PTSD. Though officials say the prevalence of this condition within the armed forces is roughly the same as the general population, there is suspicion among charities, and veterans that this does not reflect the true extent of a problem that might take years to develop.

Professor Marilyn Flynn, an expert on mental health issues in the military, said there was little incentive for serving personnel to admit they may have a problem: “If you say you are not fine, you go into limbo. There is no incentive to admit you might have a problem. You are neither one thing or another. There is a tremendous incentive to say that you are fine.”

Cameron said: “Do we need to do more for veterans? Yes. Can we do more? Probably. Can the charities do it themselves? No. A broken arm is obvious and easy to treat. A broken mind is not.”