Troubles veterans in GB '˜only hit by mental health problems years later'

Concerns among veterans about suicide rates are mounting '“ but figures are not formally collected. Philip Bradfield and the Johnston Press Investigations Unit report

Tuesday, 24th July 2018, 9:00 am
Updated Tuesday, 24th July 2018, 11:39 am
Youths bombarding an Army Saracen at a junction on the Whiterock Road in Belfast in 1980. The soldiers inside ignored the children

Veterans of the Troubles who live in Great Britain are surprised to find that significant mental health issues relating to their service can affect them many years after they have left the Province, a specialist doctor has said.

Dr Walter Busuttil, director of medical services at charity Combat Stress, said many veterans from Great Britain try to “shake the dust off their feet” in relation to the Troubles and are “embarrassed” many years later to find they are suffering mental health issues as a legacy of tours where they faced off against terrorists and saw friends and colleagues killed.

Asked if Great Britain-based veterans of the Troubles might take longer to be diagnosed for post traumatic stress disorder (PTSD) than those based in Northern Ireland, because they may be more isolated from informed help, Dr Walter Busuttil said he believes this is a major issue.

Sign up to our daily newsletter

The i newsletter cut through the noise

Dr Walter Busuttil, Medical Director and Consultant Psychiatrist with charity Combat Stress

“I think in Northern Ireland there is a unique environment there in that people who remain there are perhaps aware of the dangers caused to their mental health by the Troubles in that they will know people that have been for help,” he said.

“Whereas once you leave Northern Ireland many people just dust their shoes of Northern Ireland and go and live in another country and they think that they have left the Troubles behind them. Of course they haven’t. And then they are very isolated so there is no one to discuss anything with really and perhaps they are too embarrassed to ask for help as well.

“So anecdotally it is understandable that if people are living in isolation in other parts of the UK, that they are perhaps less aware and perhaps less likely to ask for help.”

Asked if this is evident among his client base of over 3,000 veterans, he replied: “Absolutely”.

“So the veteran who has served in Northern Ireland or maybe was born in Northern Ireland and leaves Northern Ireland finds it surprising, perhaps, to imagine 10-15 years later that he has got a problem related to Northern Ireland.”

This is “not uncommon” among veterans living in England Scotland and Wales, he said. “It happens. We have the huge rate in terms of 13.3 years before people ask for help [in relation to Northern Ireland service]. So that is a pretty clear kind of figure isn’t it for Northern Ireland veterans.”

The biggest source of PTSD for UK military veterans has up until recently been from their service in Northern Ireland, he said.

Dr Busuttil says there has been a dramatic increase in demand from veterans for their services for mental health support, from 950 to 2,500 in the period 2007 to 2014 – and that 82% of the clients have PTSD.

Much of this rise could be due to better education and awareness of his organisation and the issues – they do not know.

“The veterans helpline sees 12-14,000 calls a year. So we are extremely busy.”

“Of course there are still Northern Ireland veterans coming forward for the first time who served in the Troubles. But maybe in late 2016 the combined number of Iraq and Afghanistan veterans across the UK compared to the Northern Ireland veterans in terms of who is coming forward, in fact overtook Northern Ireland.

“In total the UK Iraq and Afghanistan veterans have overtaken UK soldiers that have served in Northern Ireland.”

More Northern Ireland veterans who have served in Iraq and Afghanistan are now coming forward for mental health support.

“Probably, they haven’t quite overtaken the ones who have served in Northern Ireland in the Troubles but they are coming close. We don’t have figures, it is anecdotal but that is the feeling now from the clinical staff on the ground.”

Some 82% of these veterans have PTSD, usually with depression and alcohol dependency also a common factor.

The demand for the charity’s services varies over time according to how long ago the conflict was and when veterans start to feel the impact.

“The top of the pops used to be Northern Ireland, then the Balkans (Bosnia, Kosovo) and then Gulf War I and the Falklands. And since 2007 Iraq and Afghanistan have, combined, have increased quite dramatically ... they have overtaken Northern Ireland.”

Northern Ireland veterans were only overtaken as the largest block in late 2016, but still make up a significant proportion of clients.

On average it appears that veterans are coming forward sooner and sooner for mental health support. The average number of years soldiers wait after leaving the military is as follows:

• Afghanistan: 2 years

• Iraq since 2003: 3.3 years

• The Balkans: 5.8 years

• Gulf War I: 8.7 years

• Falklands: 14.9 years

• N Ireland: 13.3 years

The reason younger veterans come forward sooner is due to better education, he said. “So the longer you have been a veteran with a chronic mental illness, the less likely it is that you will have real support around you.

“Many times it is the support you have around you that makes you go and get help.”

Dr Busuttil also said the NHS commissioned the charity in 2011 in England and Scotland to support veterans, “but not really in Wales or Northern Ireland, so there has been a gap in service provisions for veterans”.

He added: “I think there is a significant need [in Northern Ireland] and it is not being properly addressed.” At the moment Northern Ireland veterans who need residential care travel to Scotland, but he asked: “Why should they be travelling abroad to get residential treatment?”

However, the Health and Social Care Board responded that only “small numbers” of local veterans require treatment that cannot be provided in Northern Ireland and that it agreed with Combat Stress in 2014/15 that such cases would be referred for treatment in Great Britain. The board added that “to date, these numbers remain low”.

The board is currently establishing a new Regional Managed Care Mental Health Trauma Network, it added.


UDR/RI aftercare: 9042 0145

UDR Ben Fund: 028 9042 0652

Royal Irish Ben Fund: 9042 0629

Veterans UK (MoD pensions/compensation): 0808 1914218

The Samaritans: 116123

Lifeline 0808 808 8000

Alcoholics Anon: 0800 8177 650

Vets’ Gateway: 0808 802 1212

Combat Stress: 0800 138 1619

Help for Heroes: 01980 844280

RBL: 0808 802 8080

SSAFA: 080 731 4880