PTSD, depression, alcohol land more veterans in UK criminal justice system than Afghanistan

More veterans in UK justice system than in combat

LONDON — Depression, post-traumatic stress disorder and substance abuse are behind an alarming rise in the number of former British soldiers ending up in prison, a report says — and more veterans have had tangles with the law than there are British troops in Afghanistan.

The National Association of Probation Officers report, issued Friday, added that most veterans don’t receive adequate counseling or support when they leave the armed forces.

The report comes at a difficult time for Britain, which has sent thousands of troops to Afghanistan and whose National Health Service — a service that provides free health care to everyone — is already overstretched.

Many fear that as the situation worsens in Afghanistan more troops will return with a need for counseling.

“The (National Health Service) says they’re able to cope with the referrals they get,” said Harry Fletcher, assistant general secretary for Napo, which is a union. “But whether they can cope with a massive increase is another matter.”

By surveying probation officers across England and Wales, the union found that about 20,000 veterans have become entangled in the criminal justice system — compared to around 9,000 troops in Afghanistan.

The union estimated there are about 12,000 on parole or probation in England and Wales and another 8,500 veterans in custody in all of Britain, making up about 8.5 percent of the prison population, Fletcher said, compared to an estimated five percent of the prison population in 2001.

The Ministry of Justice said work was under way to match data on prisoners with the Ministry of Defense’s information on veterans to “identify both the scale and scope of the problem of veterans in custody.”

The defense ministry said in a statement that the majority of people who leave the military successfully return to civilian life, and that a report last year found that 94 percent of veterans got jobs within 6 months of leaving.

“A small minority can face serious difficulties and we provide a wide range of support, before, during and after leaving the services,” the ministry said. Programs have been set up for veterans in prison, including visits by psychiatrists, a spokesman said on condition of anonymity in line with department policy.

According to the data provided by probation officers, the majority of cases — most of which were for violent offenses like domestic abuse — had alcohol or drug misuse as a factor. Nearly half of offenders were suffering from diagnosed or undiagnosed PTSD or depression.

“I’ve been to prison, and I bumped into a lot of people in the short time I was in prison, ex-servicemen,” said Mark Smith, who left the British Army in 1997. “And a lot of them were in there for violence-related issues.”

A lance-corporal with the Coldstream Guards, Smith served in Northern Ireland, the first Gulf War and Bosnia. After he returned, he fell into trouble with the police, had flashbacks and nightmares, and tried to kill himself twice. He was eventually diagnosed with PTSD.

Smith said that once they leave the service, many veterans are essentially left to find their own way.

“I wish there was a lot more support so they could have their lives back after what they’ve been doing for their country.”

Smith found help at Combat Stress, a mental health charity for veterans, and is now waiting for an appointment with an NHS doctor to be treated for PTSD. But with a long backlog of cases, he estimated that could take as long as eight months.

There are places in the health service where veterans can find help. Along with the Department of Health, the Ministry of Defense recently set up a pilot program of six clinics across the country aimed specifically at providing treatment to veterans with mental health problems. The program is under evaluation, with a final report due in 2011.

Graham Fawcett, a clinical psychologist in the program’s London location, spends two days a week treating veterans, though he said he could stay busy full-time.

His 70 or so patients have problems ranging from PTSD to obsessive compulsive disorder and depression.

Fawcett — who is not a veteran but did spend time in hostile places as an aid worker — says the treatment for ex-soldiers and civilians is the same.

“We treat veterans no differently to any of our other clients, and the recovery rates are the same,” Fawcett told a recent meeting of politicians, charitable organizations and mental health professionals gathered to discuss veterans’ mental health care.

“This is in the community, with no other support. We find that once we entice veterans through the front door, it’s business as usual. The difficulty is getting them through the front door.”

The Department of Health said in a statement that mental health care for veterans is a priority, and that “the great majority of veterans with mental health problems are treated effectively within the NHS under mainstream mental health services.”

They also said that by next year, an additional 173 million pounds ($276 million) will have been invested in psychological therapies.

Those that don’t find help in the health service may, like Smith, find assistance with charities like Combat Stress, which assists veterans with mental health problems.

David Hill, the charity’s chief executive, said that the health service is capable of looking after veterans with mental health issues, but that in some areas, people are looked after better than in others.

“I think the fact is in some areas the NHS can do it, in some areas they’re doing it extremely well,” he said. “But it’s not consistent, it certainly doesn’t cover the entire United Kingdom, and in some places I suspect the NHS simply wouldn’t have the capacity to do that yet, and we are some time away from being in that position.”

Combat Stress usually sees veterans about 14 years after they’ve left the service — due in part to the reluctance of many veterans to seek help — but Hill said that veterans of conflicts in Iraq and Afghanistan are coming to them earlier.

“We’re usually not the first stop,” Hill said. “I think it’s fair to say that by the time the veteran comes to us they’ve all but given up, really, hope of getting help.”