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26 October 2018 | Comment | Article by Simon Ellis

An Insight into PTSD and the Armed Forces

It is estimated that 1 in 3 people who experience a traumatic event are affected by post-traumatic stress disorder (PTSD)[1]. The condition is not confined to those who experience traumatic events during their service in Her Majesty’s Armed Forces, but it is recognized as something that afflicts many current and former military personnel.

The types of traumatic event that can cause PTSD range from serious road accidents and terrorist attacks, to being held hostage or witnessing a natural disaster. It is unclear why some develop the condition and others do not; however, it is clear that the mental and emotional impact of serving in the armed forces can take its toll on many service men and women.

Many are familiar with the term ‘shellshock’. It was first coined during the First World War to describe the strange symptoms of those who broke down in the trenches: vacant eyes, trembling limbs and shuffling gaits. However, the introduction of PTSD as a diagnostic category[2] would not find its way into the field of psychiatry until 1980 – owing much to political and social influence in the aftermath of the Vietnam War.

Those suffering with PTSD often relive the traumatic experience(s) through flashbacks and dreams and experience feelings of isolation, irritability and guilt. Someone with PTSD may also suffer with insomnia and find concentrating difficult. These symptoms are often severe and persistent enough to have a significant impact on the individual’s day-to-day life, which in turn can lead to unemployment, relationships breaking down, drug and alcohol abuse, homelessness and suicide.

PTSD can develop immediately after the individual experiences a traumatic event or it can occur weeks, months and even years after the event – meaning many veterans discharge from the armed forces without a diagnosis. There are a number of reasons why a diagnosis might not be made until an individual leaves the armed forces. These can include misdiagnosis whilst in service or a failure to spot and treat the onset of symptoms, to the individual developing the symptoms associated with PTSD much later.

The rise of PTSD

In July 2017, the Ministry of Defence published the Annual Medical Discharges in the UK Regular Armed Forces[3]. This shows that between April 2012 and March 2017, the MOD recorded a total of 2,118 armed forces personnel who were medically discharged for mental and behavioural disorders. Not all of those were recorded as suffering with PTSD, and, of course, this does not include those who are diagnosed with mental health conditions after they leave the armed forces.

According to this document, the number of medical discharges due to PTSD between 2012 to 2017 were 665, 63 and 32 for the Army, Navy and RAF respectively. In that five-year period both the Army and Navy saw increases in the number of service personnel discharged for PTSD. In addition to this, Combat Stress, the biggest veterans’ mental health charity, reported in 2015 that the number of ex-forces seeking help had risen by 26% year on year.

This significant increase can be interpreted in many ways. Greater awareness and campaigns to reduce stigma, which has been a major barrier to accessing treatment, has helped to identify victims of PTSD. On the other hand, many would argue that the demands of modern warfare – particularly the recent conflicts in Afghanistan and Iraq – has been the main driver behind this worrying increase.

Studies indicate that treating symptoms when they first arise can lead to individuals leading better lives by managing their condition. In addition, early treatment can also reduce the impact PTSD has on the ability of an individual to seek and hold down regular employment, which in turn saves on prolonged healthcare and welfare costs. Moreover, mental health, particularly PTSD, is one of the main factors for ex-service personnel offending, becoming homeless and in the worst instances: taking their own lives. Ensuring adequate aftercare and resettlement programmes are in place can help prevent these avoidable outcomes.

Support for sufferers

There are support mechanisms available to those suffering with PTSD, although access to these is often a contentious issue. These can be accessed through a GP or charities like Combat Stress[4] and MIND[5] who offer a number of treatments, ranging from cognitive behavioural therapy (CBT) to eye movement de-sensitisation and reprocessing (EMDR).The above-mentioned therapies are not for everyone, with outcomes ranging in success. However, the above-mentioned therapies are not for everyone and PTSDUK[6] report that alternative therapies such as yoga, massage and acupuncture can also help.

Furthermore, support mechanisms can be accessed for those who find themselves in the criminal justice system. This can be due to substance or alcohol misuse, both of which are closely associated with PTSD. A key charity specializing in this particular area is Care After Combat[7]. The charity’s aim is to reduce the number of veterans re-offending by helping ex-forces build the skills and confidence that will ensure their transition back into civilian life is as smooth as possible.

As well as treatment for the condition, victims of PTSD may be entitled to make a claim for compensation. This can be by way of a Government payment under the Armed Forces Compensation Scheme or War Pension Scheme, or via a civil claim for compensation. For further information on the AFCS and War Pension claim visit the gov.uk website.

Many veterans may not be aware that they are entitled to bring both types of claim. If one claim is turned down, this doesn’t mean the other claim is bound to fail. Veterans should ensure they seek expert advice about their entitlement to bring a claim.

If you think you may be entitled to civil compensation, please contact Hugh James on 029 2078 5691 or visit our website at hughjames.com/military.

Further information on military claims can also be found on our website.

[1] https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/

[2] https://www.ptsd.va.gov/professional/PTSD-overview/dsm5_criteria_ptsd.asp

[3] https://www.gov.uk/government/statistics/uk-service-personnel-medical-discharges-financial-year-201617

[4] https://combatstress.org.uk/get-help/how-we-help/our-treatment

[5] https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/treatment/#.WrLNqZPFJAY

[6] https://www.ptsduk.org/

[7] https://careaftercombat.org/

Author bio

Simon Ellis is a Partner with Hugh James and has worked with the firm for more than 25 years, having trained and qualified here. Simon heads up the Military Department, advising and assisting current and former military personnel with various health conditions and injuries. He specialises in claims such as hearing loss, non-freezing cold injuries, compartment syndrome and military injury cases. He is often asked to advise on more unusual claims in the military context.

Disclaimer: The information on the Hugh James website is for general information only and reflects the position at the date of publication. It does not constitute legal advice and should not be treated as such. If you would like to ensure the commentary reflects current legislation, case law or best practice, please contact the blog author.

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