Criminal responsibility and PTSD - 2

There is a campaign underway now in the UK to make a verdict of 'not guilty on the grounds of diminished responsibility' plea to mentally ill people accused of crimes other than murder. The previous post relates the efforts of a similar campaign group working to protect veterans in the States. The problem with these efforts is that they are seen in some quarters as a 'criminals' charter', and it is unlikely the Ministry of Justice would embrace the idea of automatically giving veterans any privileged position in mental health defence cases.

The obvious way to resolve this dilemma is to have a proper tracking system that offers veterans the best possible services at the earliest possible moment when things start to unravel. There would be problems connected with privacy, data protection and (the real difficulty) cost, but how much does it cost to keep a man in prison each year, and what is the human cost down the line when families break up because of post-traumatic problems?

Criminal responsibility and PTSD

A groundbreaking verdict for US Veterans with Post-Traumatic Stress Disorder (PTSD) was decided in Canyon City, Oregon on October 19 when former soldier Jesse Bratcher, on trial for murder, was found guilty by reason of insanity. It was the first trial in the U.S. where a Veteran's PTSD was successfully considered to mitigate the circumstances of a crime.

Bratcher was a model citizen before joining the Army, with no criminal or juvenile history. He strictly adhered to the rules of engagement in Iraq, twice refusing to fire on civilians. There, he witnessed the death of a friend from an IED explosion, which commanders reported drastically changed Bratcher's mental state.

The US National Veterans Foundation President Shad Meshad said "This is a significant decision, for Jesse and for Vets around the country, who were law abiding citizens before they went to war and who have been accused of crimes since returning home. The military and the VA have not done enough to diagnose soldiers and Veterans with PTSD and provide them with needed counseling and support to ease their readjustment to civilian life."

Resolution Sponsors - Thank you SCS

At the recent Defence Systems and Equipment International exhibition in London's Docklands, business consultancy SCS agreed to sponsor treatment of an Iraq or Afghanistan returnee with post-traumatic symptoms.

SCS is a leading independent consultancy providing a range of technical services primarily but not exclusively for the defence and security sectors. Its main client is the MOD and its agencies; other clients include NATO, major defence contractors, other Government Departments and a range of blue-chip non-defence businesses.

Resolution would like to thank SCS for this support, and would very much like to hear from other defence-related businesses with an interest in the welfare of our servicemen

Call for action by the National Council of Women

The following resolution on Service Personnel and Post-Traumatic Stress Disorder was passed by the NCW at its conference:

The National Council of Women, in Conference assembled, mindful of the emotional distress suffered by returning service personnel and their families, urges the Ministry of Defence to:

1. take steps to remove any stigma from acknowledging post-traumatic stress;

2. take the necessary action to treat Post-Traumatic Stress Disorder early (however late it may manifest)

3. note the high success rate claimed by the charitable organisation RESOLUTION, staffed by civilians and some ex-soldiers who have trained as counsellors, and

4. recommend the inclusion, in the funding of community mental health initiatives, of some funding for a small and closely-monitored pilot study into RESOLUTION.

Submitted by: NCW Health Committee

Proposer. Valerie Alasia, Chairman, NCW Health Committee.

Seconded by: Dr, Maureen Beauchamp, Secretary, NCW Health Committee

Proposer's Speech:

In the light of media reporting of the suffering of returning serving personnel and their families and, eventually, the wider public, the Health Committee has researched the provision of help and counselling for our servicemen.

Commonsense, kindness and thrift would suggest that those returning from combat zones should debriefed and for offered help as soon as possible. But it is recognised that post-traumatic stress may take years to manifest in these proud people, whilst causing deterioration in quality of life and behaviour. Unlike the days of the troopship, those returning now are flown in, perhaps from scenes of carnage, directly to the company of family and friends who cannot share those experiences. They should be given a clear explanation of potential difficulties and available treatments, and told that there is no stigma attached to the condition.

The Government, correctly, wishes to use methods and organisations approved by NICE. Approval, understandably, requires an assessment of efficacy - usually a two-year survey with a statistically positive outcome.

The waiting time for National Health appointments is governed by NHS guidelines. Returning combatants may take some time to refer themselves; thus their Post-traumatic Stress Disorder may be more deep-seated and more difficult to alleviate. The cost to society through anti-social behaviour, addictions, imprisonment and hospital admissions should be weighed against the cost of wider and earlier intervention.

The Health Committee learned, at its recent Seminar on Maternal Mental Health issues, that to be mentally ill is still regarded by many as weak or shameful, instead of being an illness to be acknowledged and treated in the same way as any physical disorder. How much more difficult must it be for those whose occupation is to be brave and uncomplaining in the face of unimaginable horrors (and for their families) to recognise problems and to ask for help.

We heard speakers from "Resolution" a charitable, nationally based organisation staffed by civilians and some ex-soldiers who have trained as counsellors. They spoke of the relative ease with which early, or late, post-traumatic horrors can be faced and dealt with, but for which they have only empirical and anecdotal evidence to demonstrate the effectiveness of their treatment. A course costs £600. A week in an NHS hospital or HM prison costs much more, and not just financially.

We note that Government has promised 300 more counsellors for returning servicemen. Perhaps they will look at the success-rate for "Resolution", investigate the treatment correlation with NICE guidelines, and recognise the potential for delivering wider, better, cheaper treatment now.