The costs of conflict: Meeting the mental health needs of serving personnel and service veterans

Abstract

Military mental health has, until recently, been a neglected and marginalized area of interest and although both World Wars saw important advances, in peacetime we typically forget lessons learned in earlier conflicts. Since 2003 however, with high intensity war-fighting on two fronts involving the service personnel of many nations, attention has, once again focused on the immediate and long-term emotional and psychological impact of combat. Whilst we know a lot about posttraumatic stress disorder (PTSD), much less attention has been paid to a variety of other equally, if not more salient yet superficially less dramatic problems facing service personnel deployed on operations, but which are much more likely to lead to mental disorder than traumatic events and the ‘horrors of war’. This article describes some of these broader yet less tangible and under-researched issues and discusses the provision of services for the burgeoning veteran community.

The mental health of service personnel and veterans is politically sensitive and attracts significant public and media interest. Understanding and responding appropriately to the needs of this group should be of concern to all mental health professionals and it has important consequences, not only for affected individuals but, for the public perception of mental health services as a whole.

Declaration of interest: M.P.D. is the NHS clinical lead for the MoD's inpatient mental health contract and chairs the UK's Royal College of Psychiatrists Fair Deal Campaign. D.A.A. sits on the Independent Expert Medical Group (IMEG) set up by the Ministry of Defence and chaired by Sir Anthony Newman-Taylor. The authors alone are responsible for the content and writing of the paper.