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The mental health of military service men and women returning from conflict is a hidden phenomenon which is not addressed by a medical professional until it’s too late. And one of the main reasons is that the Ministry of Defence and NHS do not always work together. This is a public health issue in the UK. In the US, Veterans Affairs and affiliate healthcare providers face a range of issues related to sharing of medical records, patient privacy and diagnosing symptoms related to mental health issues.
It is estimated that 1 in 4 homeless people are former members of the armed services. Thousands live rough or in sheltered accommodations; many abuse drugs and alcohol. Returning armed services personnel often end up on the streets or with severe mental health problems. While in the US, around 22 veterans commit suicide each day and the majority are homeless, in treatment facilities or lack the support services required to help them out of their downward spiral.
Mandy Sanghera, who is an international human rights activist, has often spoken out about mental health. She said: ‘How can we fail veterans who have fought for Queen and country. We need to support people back into civilian life. We need to remove the stigma around mental health – 1 in 4 are affected. We need to recognise the signs before it’s too late. We have a moral responsibility to support veterans globally.’
According to the Ministry of Justice, veterans represent between 4% and 5% of the UK prison population, raising concerns about the impact the Afghanistan and Iraq campaigns on mental health issues in the armed forces. Meanwhile, research by the US Department of Veterans Affairs showed that female veterans involved in the justice system have a high burden of mental health disorders (88%) and more than half have substance use disorders (58%). The male veterans have 76% and 72%, respectively.
The sad thing is that the negative social stigma associated with posttraumatic stress disorder (PTSD) and traumatic brain injuries (TBI) has caused veterans to hide and isolate from society. This behaviour of isolation impacts their ability to communicate rationally and leads to dangerous situations in the home, workplace and society in general. Often, we see children who are effectively part-time carers. It affects everyone; we have to educate and integrate those veterans who have faced life and death situations in active military service with a pathway back into society.
As a veteran who has faced these challenges firsthand, I’ve experienced the negative repercussions of not being aware of the available services. This lack of awareness and thoughts that the country, family and society don’t care caused me to withdraw and isolate from everyone. Eventually, it led me to losing my family, home, career, health and becoming another statistic as a forgotten veteran.
If we focused on prevention, we could help veterans before it’s too late. This approach would be more cost-effective by reintegrating veterans into becoming productive members of society rather than ending up in the criminal justice system.
We need to have real job and education opportunities for those who return from military service. With all the recent increase in gang violence across the UK, we could have military veterans as paid personnel to mentor and support young people. They have learned skills and have life experiences which young people may find interesting. Also most veterans are very disciplined: they could teach young people a thing or two.
We need to address some of the social issues which are failing veterans. Financial and career concerns are causing veterans anxiety and stress. Also, some are worried about staying in shape. If we want to support veterans then we need a joined up approach of services.
Relating to people
Even after you leave, the military is forever a part of who you are. You may not realise how much it has changed you until you try to hang out with people who cannot relate – or worse think they understand because of TV and films. It can be hard at first to re-connect with family and friends who have never served. One way to remedy that is to join a local veterans group or keep in contact with others in your unit.
Although alcohol and drug use is quite common among those in prison, service men and women reported distinct differences leading to their problematic use. Service men and women reported that their substance use was caused or exacerbated by trauma encountered in the military, difficulty adjusting to civilian life, and relational stress with friends and family.
Adjusting to civilian life
Adjusting to civilian life was hardest for people who could not find meaningful work or yearned for structure and accountability inherent in military services. Veterans say they often struggle with considerable differences between military and civilian culture and that this tension led to getting in trouble.
Adjusting to a new economic reality was a reason for economic hardship. Rather than adjusting to the differences in pay and lifestyle, some veterans took illegal actions such as theft, to compensate for the pay gap.
We need to support Veterans to navigate their way around the benefits system if we want to tackle inequalities facing veterans.
PTSD is a mental health condition characterised by either witnessing or experiencing a terrifying life event. Common symptoms include nightmares, severe anxiety, flashbacks, and obsessive or uncontrollable thoughts. These symptoms may occur immediately after the event or they may not develop until years later.
There are four types of PTSD: including intrusive memories; avoidance; adverse changes in mood and thought; and, emotional reactions and physical changes. Events commonly associated with PTSD are military or combat exposure, sexual violence, physical assault, childhood abuse or environmental factors such as weather related-events. Added to that, smoke, fire and loud screaming are triggers that make some re-live the events in the military.
I’ve attended several programmes that have taught me how to re-visit and manage instead of re-live and ‘act out’ when I am triggered by situations in society. Essentially, I’ve been given an opportunity to pick up the pieces of my life and see if I can become a productive member of society.
Military servicemen and women who complete their service obligations do have a tremendous skill which is unfortunately overlooked by employers, and we need to look at setting up social enterprise. We need to look at supporting those who need to take back control of their lives.
‘Social impact’ is combining profits and social outcome. In other words, believing that traditional charities can act more like for-profits to generate sustainable revenue and impact.
Sunny Dosanjh is a veteran of the US Air Force and is currently an American & Royal British Legionnaire.
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