Why Is the UK’s PTSD Rate So Much Lower Than the U.S.’s?

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ISAF Photo / British Royal Army Sergeant James Elmer

British Royal Marine Commandos launch a mission in southern Afghanistan's Helmand Province.

Among the most interesting presentations at last week’s DoD-VA Suicide Prevention conference was one titled Time Bombs or Tidal Waves? The View from Blightly. It compared and contrasted the different psychological consequences of war in the United States and the United Kingdom. Dr. Simon Wessely, a long-term colleague and friend, presented his research.

His facts and figures are provocative:

— The rate of PTSD among regular British soldiers deployed to the wars was no higher than those that were not deployed, and stayed at about 5%. (Depending on the study, the U.S. rate ranges between 15 and 20%). Thr UK rate was higher among reservists, and those in combat roles.

— PTSD is not the main mental health problem facing the UK armed forces, nor does it seem to be increasing.

— Combat arms soldiers have less PTSD — but more alcohol use — than reservists.

— Reservists consistently have more PTSD but less alcohol than regulars – reasons lie less in theatre, and more at home and homecoming.

— Overall the group most at risk of all problems (drink, drugs, poor mental health, unemployment, trouble with the law, debt etc.) are the Early Service Leavers — those with less than four years in uniform.

A few related facts, which may help explain the differences:

— The British Army is older, has more officers, and fewer reservists.

— They had less exposure to combat in Iraq, but the same in Afghanistan.

— Their tours are shorter.

This is only a brief summary, so if you want more details, you can review his many publications in the scientific literature (but then you will miss how witty Professor Wessely is in person).

One issue worth pondering is what to do with those in both militaries who leave early? In the U.S., they are less likely to be eligible for care by the VA, and more likely to end in the public mental health system. Or on the streets, where they end up costing the taxpayers even more in medical costs.

Professor Wessely was asked whether we should — as we do now — give the most to those who have given the most, or alternatively give the most to those who need the most. He deliberately didn’t provide an answer.