Guest editorial
| Date | 20 March 2017 |
| Pages | 4-5 |
| Published date | 20 March 2017 |
| DOI | https://doi.org/10.1108/JPMH-09-2016-0041 |
| Author | Matthew Green |
| Subject Matter | Health & social care,Mental health,Public mental health |
Matthew Green
Time for a radical rethink on how we approach veterans mental health services
Mementoes of Dave Salt’s former life were dotted all around his bedsit: photos from far-flung
deployments, military-themed novels, and a figurine of a soldier standing guard on a shelf.
But the starkest evidence of Dave’s service was not to be found in his souvenir collection: it was
there in the shadows behind his eyes.
Dave’s gaze was too sunken and saddened for man in his early 40s. He made a determined
effort to be friendly, but there was a flatness in his voice that robbed his words of feeling.
He had managed to stay off the vodka, for a time, but he knew that just one drink would
be his unravelling.
It was July 2014, and I had gone to visit Dave in Leamington Spa to hear about his lonely battle
with post-traumatic stress disorder (PTSD) sustained during a career spanning Northern Ireland,
Bosnia, Iraq and Afghanistan. He talked about the night terrors that made sleep impossible, and
how the slightest trigger could plunge him into a deeply immersive, high-definition flashback.
Pandemonium would erupt in his local Tesco as Dave –convinced he was under fire –started
yelling military call signs. Police and ambulance crews knew him by name: in the past few years,
he had been admitted to hospital more than 30 times:
“The first half bottle of vodka is medicine, because it calms you down. And it was better than any
diazepam –whatever-pam,”Dave said. “And so it went on, until I was on about two and a half litres of
vodka for breakfast. When you hit that low, it’s death. You’re a dead man walking.”
Just over two years to the day after he uttered those words, Dave was found dead at his flat.
After serving almost 20 years in the army, he died alone –finally succumbing to alcoholism
caused by his attempts to numb his symptoms of PTSD. He had been variously in the care
of the Ministry of Defence, the NHS and the charity Combat Stress, but none had been able
to save him. He was 45.
Across Britain, in quiet cul-de-sacs and terraces, on downtrodden estates and in picturesque
villages, many more men and women like Dave are feeling invisible walls inexorably closing in.
Yet, as I saw first-hand while researching Aftershock, with the right care, remarkable
transformations are possible –even for trauma survivors who feel damaged to their very core.
Many more lives could be saved, many families kept intact –but only if the military mental health
community dares to re-imagine the failing status quo.
First, we need to acknowledge the limits of what can be said with any certainty about the
prevalence of PTSD and other psychological disorders among service personnel. The King’s
Centre for Military Health Research puts the prevalence of PTSD at about 4 per cent for the
military as a whole, rising to 7 per cent among battle-tested infantry. These figures are widely
quoted in media stories and official reports, but are almost never accompanied by a crucial
caveat: the studies are based primarily on self-report questionnaires.
In Aftershock, Surgeon Captain John Sharpley, the MoD’s Chief Psychiatrist, estimates that
some 90 per cent of service personnel suffering mental health problems do not seek treatment
due to stigma. It is, therefore, questionable whether it is safe to assume that such personnel will
respond entirely truthfully to mental health surveys, even when assured their responses are
confidential. King’s has provided the most comprehensive data set on inner life of the British
military –but like any scientific research, its findings cannot be seen as the last word. When it
comes to the subjective, stigma-laden world of psychological distress, it is self-evident that what
researchers are capable of measuring is not necessarily the same as what is there.
Matthew Green is a Journalist
in Editorial Division, Portobello
Books, London, UK.
PAG E 4
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JOURNAL OF PUBLIC MENTAL HEALTH
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VOL. 16 NO. 1 2017, pp. 4-5, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-09-2016-0041
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