In the last 100 years, Psychiatry has made significant advances, gone are the days when recovery from a psychiatric disorder was reliant on the draining of blood from Galen’s Four Humours (Greek physician, AD 129 – 216) Yet how far have we really come in understanding Mental Health and what does recovery looks like?

It is not surprising that having ‘mental health’ problem carries with it a great deal of stigma as the the early response and treatment involved sending individuals to institutions (asylums) for so called treatment and never letting them out!

Throughout our lives we have probably all been guilty of using slang terms to describe those who have a mental illness. Children are taught to view people as either ‘normal’ or ‘abnormal’ based upon the behaviour they could see, and how the person fitted into or didn’t fit into their communities. Using labels like, ‘schizo’, ‘crazy’ or other clinically diagnostic labels like ‘ Personality Disorder’ ‘ Post Traumatic Stress Disorder’ or Anxiety can trap suffers into thinking that they have ‘something’ wrong with them or worse, that this ‘something’ means they are broken and defective.

Labels are overly used in psychiatry and it does not sit well with me. In my experience it can give some people licence to behave badly, ‘it’s not MY fault I’m sick’. Even the term ‘mental illness’ or ‘mental health’ has negative connotations implying that there is a right and wrong way to be.

Psychiatry is often based on a chemical imbalance theory or uses a medical model to diagnose and inevitably treat mental illness. Often taking into consideration genetics, patterns of behaviour and the presentation of clinical symptoms. This model of treatment loses sight of and strips away those personal life experiences that influence all behaviour be that good or bad. People forget that reacting to trauma and the associated stressors is perfectly normal.

This level of misunderstanding can often lead professionals down a rabbit hole, if the clients presenting issues are not understood the fall back position is to rely on the trusty medical model. Creating a false sense of hope for the patient and the family. Sometimes making them believe that medication is the only way to manage mental illness and when the ‘magic pill’ outcome fails , trust and hope is often destroyed.

In my experience working with Veterans is no different. Returning to civilian life after serving in the military is a difficult challenge that thousands of Veterans must face. For some, this will necessitate that they will need to learn how to manage both physical and psychological wounds.

Many of the Veterans we work with often identify with feeling that life is harder for them to manage than most. Yet, what if a large part of the problem didn’t have anything to do with mental illness or impositions faced during transition? What if it had more to do with a lack of community connection, boredom, loneliness and not understanding how to manage difficult thoughts and feelings ?

For serving military personnel time is structured with numerous tasks to complete, service personnel are always busy and rarely on their own. There isn’t enough time to think or feel, in fact it is actively discouraged.

In the civilian world time is a Veterans enemy. Suddenly they are thrown into a world where employers expect employees to work autonomously even when they are part of team. Colleagues go home to their families, the landscape is constantly changing and expects constant adaptation. There is no protective military cocoon.

Medicalising veterans issues doesn’t help anyone. I have a growing sense of unease that instead of helping Veterans we are trapping them in state of unwellness.

Don’t get me wrong, some Veterans will need medication to help them with their problems and traditional psychiatry can and will help.

Yet, we have found the adoption of a psychosocial model to support veterans gain control over their individual and social environment results in far more positive and sustainable outcomes.

Teaching Veterans how to ask for help, coping skills, resilience, problem solving, self regulation, the importance diet and nutrition and the challenges that they are likely to face during a life lived well. For example, relationship breakdown, loneliness, unemployment and the impact of growing old disgracefully, not only empowers Veterans, it also provides them with individual tools that allow them to face and solve problems as well build resilience to deal with life’s stressors.

Psychiatrist, Professor Sir Simon Wessely, was probably right when he said,’ his heart sank every time there was a mental health awareness week’ simply because;

“ We don’t need more people to be aware. We can’t deal with the ones who are already aware”

In summary, lets look at different ways to support veterans, especially ones that don’t label them or stigmatise.

Paula Edwards

Salute Her Project Lead & Mental Health Therapist.