feel that you’ re weak for having it,’ says Paul, in one of the video interviews featured on the website of veterans’ mental health charity Combat Stress.‘ You feel you’ re a freak for having it. I’ d never heard of PTSD before.’

After joining the Royal Navy at 16 he’ d served in the Falklands, where he witnessed horrific scenes including taking part in a casualty evacuation for some young soldiers who’ d driven over a landmine, sustaining terrible injuries.‘ I couldn’ t stop looking at them, and I never did get to find out whether they lived or not. I was an alcoholic when I came back.’

It is, however,‘ incredibly difficult’ to ask for help, he states,‘ because then you’ re admitting that you’ ve got a problem.’ Indeed, previous

research by Combat Stress had found that many veterans were putting off seeking any help for their alcohol issues until they were in their 60s – and often even then only after having been admitted to hospital.

More than 60 per cent of the veterans the charity supports have been involved in two or more military operational tours, and there can clearly be a cumulative impact. The more tours someone does the more likely they are to experience something traumatic, but being in situations where letting their guard down even fleetingly could prove fatal can lead to a constant state of hyperarousal that’ s impossible to shake.

SELF-MEDICATION This ongoing hypervigilance – especially around crowds or noise – is one of the main PTSD

symptoms among veterans, and many will self-medicate with alcohol.‘ Up to 50 per cent of veterans referred to Combat Stress report problematic, hazardous or potentially dependent levels of alcohol misuse,’ its consultant clinical lead Dr Lee Robinson tells DDN –‘ predominantly as a means to cope or mitigate the impact of traumatic experiences during their service’.

Previous studies, such as one published by Sheffield Hallam University in 2017, found that treatment was far more likely to be successful if people were able to access veteran-specific services. WithYou now offers tailored support to veterans, and is the first drug and alcohol service provider to receive a Gold Award in the Ministry of Defence’ s employer recognition scheme( ERS). Its team includes

people who have military backgrounds themselves, while Change Grow Live has partnered with Liverpool John Moore’ s university to evaluate treatment outcomes for veterans compared to non-veterans.

‘ It’ s true that some veterans are less likely to engage in non-veteran services due to the perception of stigma and lack of understanding of military history or trauma,’ says Robinson.‘ But a range of initiatives are improving the knowledge and confidence of non-veteran services, which should help those veterans get the help they need at the earliest opportunity. Understanding the military training, culture and the range of roles, deployments and experiences can certainly help provide the scaffolding to support successful outcomes.’

So does it usually take a long time for services to be able

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