Some troops return from war with post-traumatic stress disorder, but veterans are not victims. There is no epidemic of men damaged by war
Feeding the myth: Bradley Cooper in “American Sniper” (©WARNER BROS PICTURES)
It’s no wonder that we think soldiers are damaged goods. Legions of them are said to return from deployment to Iraq or Afghanistan suffering from post-traumatic stress disorder (PTSD). We read about homeless veterans living on the streets of Britain, unable to cope after the trauma of combat, the walking wounded powerless to adapt to civilian life. The situation has become so distressing that senior military staff worry because more than 90 per cent of the public regards the armed forces as a charity. These “narratives of distress” are bought into by the public and the media alike, engaging popular interest and sympathy. Yet soldiers don’t want to be seen as victims and do not appreciate the stereotyping. They consider themselves professionals, not heroes, not villains, and not victims.
Professor Nicola Fear, Director of the King’s Centre for Military Health Research at King’s College London, is concerned because so much focus is put on PTSD, which is not the most prevalent disorder among service personnel. She thinks it obscures the bigger picture, part of which is the high level of alcohol misuse. While young men drink, young men in the military drink more than their civilian counterparts, and that has nothing to do with combat. Most mental disorders have multiple causes and there is rarely a straightforward link. Fifty per cent of PTSD is not related to deployment but other experiences, factors associated with background and alcohol abuse as well.
The vast majority of soldiers just get on with the job. We no longer have a conscript army, for which attrition rates were horrendous, but a volunteer force that is well-trained and well-maintained. “The reason the British military exists is to deliver fighting power,” says retired Major General Tim Cross, a veteran of three tours in the Balkans and two tours in Iraq, “not to be nice. There are no prizes for coming second on a battlefield. We need a tough military organisation able to operate in demanding, brutal environments like Iraq, the Balkans and Afghanistan. Men and women join to be part of a tough organisation.” They are trained to deal with difficulty, and there is a rigorous selection process. The statistics for PTSD seem to bear this out: 4 per cent of the army as a whole suffer from it, and 7 per cent of front-line units, compared to 3 per cent of the entire population.
As Fear points out, the media contributes to the problem by portraying soldiers as mad, sad or bad, concentrating on the ones who have fallen through the gaps. Last month, the Express ran a story claiming a 44-year-old “war hero” who served in the British Army from 1989-1993 and was a veteran of the Falklands and Cyprus campaigns, was forced to sleep in his car. Unfortunately, the Falklands War took place in 1982 and there was no conflict with Cyprus.
Over time the narrative in films, which frames these paradigms for each generation, has changed. In response to the genre of war movie in which everyone had a good time, “now movies portray soldiers as victims who return damaged, and no one comes back happy,” says Dr Lisa Kingstone (my cousin), also of King’s College London, who has written about trauma and war in literature and film.
“Movies and the media create these tropes of masculinity because how many people talk to soldiers and know them intimately any more?” she asks. “These tropes are about grace under fire, justice and glory. John Wayne’s films were shown to the military to model patriotism, loyalty to your comrades, and selflessness, characteristics that men were supposed to embody. In film, combat either makes you a man or it unmans you. There is not much in between.”
War continues to be great movie material. In both The Hurt Locker and American Sniper, the protagonist is portrayed as someone who was exceptional as a soldier but couldn’t function in civilian life and had to stay in a war context. “The conclusion,” says Kingstone, “is that war ruined men for anything but war.” Back in 1946, the Oscar-winning The Best Years of Our Lives had the same message: three soldiers return from war and can’t reintegrate into society (but want to be like everyone else). What helps spread this image is that many of these were popular and award-winning films. Going back even further, Hemingway’s novels glorified war but in his short stories soldiers fell apart. You have to read both to see both sides.
When soldiers returned with parades after the Second World War, people expected veterans to tell them entertaining adventure war stories, but Tim O’Brien wanted to expose “the true war story” after Vietnam. It took O’Brien 20 years to write about his experiences in The Things They Carried, a book that explores the brutality in the theatre of war with his band of brothers and the fiasco that unfolds. “A sensitive writer, O’Brien wanted to go to Canada but his family and community pressured him to go to war and it destroyed him,” says Kingstone. “Born on the Fourth of July, and The Deer Hunter tell a similar story of disillusioned and devastated Vietnam vets. Apocalypse Now shows men falling apart during the war.”
The “culture of trauma” clearly exists, and there is no question that some people need help and genuinely suffer, but the epidemic of PTSD that is portrayed on our screens and in our newspapers is widely exaggerated, according to Hugh Milroy, who served 17 years in the RAF and fought in the Gulf War in 1991. He is now CEO of Veterans Aid, a charity looking after street homeless and socially excluded veterans. He has been involved with the charity for 20 years and has a PhD on homeless veterans. Exaggeration about veterans in crisis from various sources is part of his daily life. One concern is the constant claim that there are thousands of veterans living on the streets.
Some media outlets and charities have made wild claims over the years. “I’ve heard shocking numbers like 5,000 to 10,000 homeless heroes living on the streets,” says Milroy. “The internet doesn’t help, as people read these numbers and once said often enough it becomes a truth. Yet the government data indicates that at the moment on any given night, around 3,500 sleep rough in all of England, and around 2 per cent of those might have a military connection.”
However, there are more than 2,500 military charities in “a very crowded space”, says Fear, and there are many other initiatives by government agencies including the NHS. The British armed forces employ approximately 140,000 people. Each year about 20,000 leave, including 5,000 untrained staff; 2,000 receive a medical discharge; and 150 have mental disorders, including about 20 with PTSD. According to the Ministry of Defence, there are 385 military charities catering for mental health issues, primarily PTSD.
As Fear points out, the military has a very effective mental health capacity with its own in-service provision staffed by nurses, psychologists and psychiatrists. “It is much easier for soldiers to get seen by mental health professionals in the military than for the general public. The services place a lot of emphasis on making it as easy as possible to access and try to remove any stigma.”
That hasn’t stopped some charities and media outlets promoting sad stories that give an impression of “an ocean-going disaster” as Milroy says. He is dismayed watching people exploit the veteran community and public with what is virtual “sadness pornography”.
Milroy gets three to four approaches from the media each week, and believes the script, like a movie, has already been written: “Journalists want the story of the homeless vet, grossly let down by the military, suffering from PTSD with no one to help and nowhere to go.” The reality is that once a soldier is discharged he is part of general society in Britain. However, the government initiative the Armed Forces Covenant should in theory ensure that the wounded, injured and sick are cared for.
“I am totally convinced that if you are in crisis in the UK, you are lucky if you are one of the military family as there is additional cover from the veteran charity world,” says Milroy. “That said, I am increasingly uncomfortable that the Government may be abrogating its responsibility towards veterans under the guise of its Covenant by off-loading responsibility to the Third Sector.”
What VA deals with is the impact of poverty, not damage as a result of military service, and poverty goes hand in glove with mental health issues. A recent Joseph Rowntree Foundation report concluded that 13 million Britons live in poverty: 6.5 million are working poor. The charity Mind reported that one in four people will have mental health problems. Inevitably, some will be veterans. “People talk about veterans as if they are a sub-species and trot out phrases like ‘failed transition’,” says Milroy, “but veterans need to be like everyone else, and the problems they have are nearly all unrelated to military service so that really calls into question the huge sums spent on ‘research’.”
Another urban myth is that many veterans are in prison. Milroy is working with a major prison looking at inmates claiming to be veterans. “Shockingly,” he says, “on checking over 50 per cent had never served.” The Ministry of Justice recently confirmed that numbers of vets in prison continue to be small. “That hasn’t stopped yet more charities being created to deal with the problem,” he says. The recent briefing by Forces in Mind Trust confirmed this. “It is very rare for us to come across clients with a formal diagnosis of PTSD,” says Milroy, “but we see many “chancers” making false claims of about the scars of war.
While there is still a long way to go, treatments, resources, understanding and attitudes are light years ahead of where they once were, thankfully, and while stigma still exists it is far less pervasive. The issue now is what happens when the love affair with the military fades and the veterans who need help are forgotten.
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