The vast majority of ex Service personnel do not experience mental health problems either in Service or after. Around 20,000 Service personnel leave the Armed Forces each year. On average there are 150 medical discharges each year due to mental health problems (out of a total of around 1,600 medical discharges). The numbers that leave the Forces with undiagnosed or hidden mental health problems is unknown.
Risk factors for mental health issues that affect Service personnel include:-
- Violent or traumatic experiences in combat
- Disruption and instability in home life
- Repeated or prolonged deployments
- Alcohol related
These can be magnified by the transition from Service to civilian life with the social factors mentioned previously compounding the situation. Veterans may mask psychological symptoms or consider them normal. Disclosure to a civilian health worker may be difficult with Veterans sometimes feeling that they would not be understood or indeed appear “weak”.
The most common Mental Health issues affecting Veterans are:-
- Anxiety disorders (including PTSD)
- Substance misuse (mostly alcohol)
Anxiety disorders may be further sub classified into:-
- panic disorder,
- obsessive-compulsive disorder (OCD),
- post-traumatic stress disorder (PTSD),
- social phobia (or social anxiety disorder),
- specific phobias
- generalised anxiety disorder (GAD)
Anxiety disorders are common in the general population. Most GPs will be familiar with the management of anxiety disorders, however the Veteran population may have more complex issues and will often have more than one sub type of anxiety co-existing. Anxiety disorders may have co-morbidities, such as alcohol misuse or depression. The anxiety disorder may be resistant to treatment if the co-morbidities are not addressed.
Treatments for anxiety disorders are well covered in a BMJ learning module, which can be found clicking here.