Monday, 12 May 2014

THE INVISIBLE WOUNDS OF WAR


THE INVISIBLE WOUNDS

 

 

Western military intervention in the conflicts in Iraq and Afghanistan are coming to an end, but the legacy will linger for years, especially the invisible wounds caused by Post Traumatic Stress Injury (PTSD).  Yet another less glamorous or newsworthy aspect of life in military service tends to be neglected. This is not post traumatic stress disorder but the more ordinary anxiety and depressive conditions which tend to be low key, chronic mental health problems that are less easy to diagnose and treat. These emotional and psychological problems acquired by younger soldiers in battle are not always apparent but are in effect a ticking time bomb which can explode months or years later requiring intervention and support in terms of mental health assessment, drug and alcohol abuse, domestic violence, child abuse, and homelessness.

 

It does not help that the UK recruits 16 year old children to all three branches of the military and is the only European country to reserve the right to deploy under-18 year olds in war fighting situations. There are clear contradictions in the British government’s use of minors in battle zones with its legal obligations under the 1992 UN Convention on the Rights of the Child (CRC) and the 1989 Children Act to protect and safeguard children.

 

The Government has ensured that the needs of military power and political control override the best interests of those under-18s in the armed forces. Article 38 of the CRC emphasises the particular vulnerability of children as civilians and soldiers in armed hostilities and recommends signatories refrain from sending children into battle.

If the non-deployment of personnel under the recommended CRC minimum ages would destabilise the unit that they are part of, then the MOD reserves the right to deploy younger recruits. The government claims that once children are trained in the Armed Forces, they are considered to be professionals and are treated as such. They play an important role in their unit, and their removal would undermine the effectiveness and cohesiveness of the unit. This would be demoralising and unpopular among other soldiers and add to the training burden.

 

The World Health Organisation recognises that young soldiers exposed to conflict situations can more easily develop Post Traumatic Stress Disorder (PTSD) leading to persisting patterns of problematic behaviour and functioning. These problems may not emerge until years later or after the symptoms are revealed by alcohol and drug addiction, domestic violence, self harm and/or criminal behaviour for example. Many young soldiers may be withdrawn, depressed, go AWOL, and display difficulties in social relationships. Or they leave military service altogether.

 

The majority of army recruits are from poorer socio-economic groups where a higher proportion of children and young people are at greater risk of developing mental health problems. The British army recruits in low income, high unemployment, and disadvantaged areas where children with few academic or career prospects are able to sign up to 6 year minimum service contracts at 16 years of age- captivated by glamorous images of travel, adventure, machismo, national pride, and employable skills training.

 

The adverse publicity over the culture of bullying and suicides at military training establishments such as Deep Cut revealed a tiny, previously hidden, glimpse of what many vulnerable young people may also be subjected to on a routine basis once they enter service. While toughening them up for what lies ahead the cost to their self-esteem and emotional well-being is very high.

 

CD’s/DVD’s computer games and literature that emphasise war as fun, exciting and a professional activity are widely distributed in schools, youth clubs, websites and military recruitment offices. What potential recruits will not realise is that since 1971, twenty four  under 18 year olds have died and 10 were seriously physically injured while on active military service in the British army.

 

Young recruits under 18 years of age are still legally defined as children- even though in the context of uniforms, regiments and all the paraphernalia of the armed forces, these young people may look a lot older than they are. The evidence suggests that, paradoxically, they may be psychologically and emotionally immature due to earlier childhood neglect and deprivation and thus more at risk of developing mental health difficulties under the strain of intense combat.

 

Suicide rates among young men in civilian life prompted the government to invest new resources in child and adolescent mental health services. Until very recently the yearly rate of suicides among young men between the ages of 16 and 25 had risen steeply since the 1980’s. What is less well known is that the suicide rate among the equivalent age group in the army is actually higher. Among the three armed services ex-soldiers have the highest rate of suicide.

 

Shortfalls in recruitment targets and retention problems mean it is likely that the military will enlist previously unsuitable candidates and therefore increase the proportion of young recruits at risk of developing mental health problems and ultimately suicide, as a result of a pre-existing vulnerability to mental health problems erupting under the stress of combat- particularly in the current context of relentless, high anxiety conflict in Afghanistan.

 

The yearly recruitment of under-18s now represents one third of the annual intake into the armed forces. When vulnerable 16 year olds sign up to their service contracts it is doubtful that it is with fully informed consent of themselves or their parent/guardian or really understanding the implications for their future mental health. For many the prospect of a secure immediate future, with a paternalistic employer and a sense of importance will offer some hope in an otherwise bleak and impoverished life with few prospects.

 

The consequences for a generation of young recruits are considerably worrying. Military commanders recognise that managing the mental health of young recruits is a challenge, and recently, new measures have been put in place to help junior officers spot troubled young soldiers early. However, the use of young soldiers in combat situations in order to maintain operational levels poses an increased risk to their current mental health and will invariably produce invisible wounds leading to long-term problems for them, their families and society long after the physical scars of combat have healed.