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The Royal College of Psychiatrists Improving the lives of people with mental illness

British ‘stiff up lip’ leaves war veterans’ mental health overlooked

Embargoed until 03 June 2009

An Australian psychiatrist believes Britain’s stiff upper lip culture, its class system and the NHS means we are not supporting the mental health needs of war veterans adequately. 

Speaking today at the Royal College of Psychiatrists’ Annual Meeting in Liverpool, Professor Alexander McFarlane said Britain has a “peculiarly ambivalent” relationship with its armed forces. As a result, he believes British war veterans experiencing mental health problems are not supported as well as they are in countries like the USA and Australia.

Professor McFarlane, who is professor of psychiatry at the University of Adelaide and head of the Australian Centre for Military and Veterans’ Health, claims there are a significant number of British troops with post-traumatic stress disorder (PTSD) who are not being treated. He cited a study published in The Lancet in 2003 which said that deployment in Iraq had not had any effect on British soldiers - apart from a slight increase in physical symptoms. In contrast, a recent study in the United States showed that 300,000 troops returning home has symptoms of PTSD and 322,000 had mild traumatic brain injury (MTBI).

Professor McFarlane said that soldiers tend to have a ‘stiff upper lip’ and do not readily complain – but British soldiers are just as vulnerable to PTSD as the military in other countries. He also pointed out that Australia has a special system of healthcare for veterans. The Australian government has recently conducted a review of veteran mental health, and released an extra AUS $80million for the welfare of veterans.

But Britain has no separate government department dealing with the health of veterans, he said. Once someone leaves the armed forces, it is assumed that the NHS will treat any subsequent mental health problems. However, research has shown that veterans who have post-traumatic stress disorder are often missed in the civilian health sector because staff are not adequately trained.

Professor McFarlane said: “When you have a known infection like swine flu, there’s a major attempt to identify those who are at risk. I would argue that people who have served the nation have had a known toxic exposure and if we want people to volunteer for those roles we have to care for them.

“There is a cost socially and morally if we don’t take care of these people. One of the tests of a modern society is how veterans are dealt with and managed.”

Professor McFarlane told conference delegates that part of the blame lies in the UK’s history. In the past, British officers were drawn from aristocracy – meaning they were distanced from the suffering of their men.

He said: “The might of [Britain’s] empire was built on the cost of the lives and the suffering of its military, and historically it didn’t provide those veterans with healthcare and pensions. But we live in a different age now and the question is: Is the UK is trapped by its past?”

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Annual Meeting of the Royal College of Psychiatrists, BT Convention Centre, Liverpool, 2 -5 June 2009


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