Although not all veterans are severely affected, a military career carries significant mental health risks, particularly at times of war when substantial numbers of psychiatric casualties are usual. Research from the last decade shows that certain mental health-related problems in the armed forces, particularly harmful alcohol use and post-deployment violent behaviour, are a serious problem. Those who have left the forces during the last decade show markedly higher rates of a number of mental health-related problems, particularly PTSD and harmful levels of drinking. These issues are of particular concern in relation to ‘Armed Forces Day’, which serves among other things as a recruitment opportunity for the armed forces. But what are the mental health implications for those who enlist, particularly the youngest recruits who are most vulnerable to these risks?
The Origins of Mental Health Problems within the Military
Armed forces personnel are controlled from the moment they turn up for training, which steadily turns young civilians into operationally effective combatants by inculcating conformity with and obedience to the martial system. Whilst training includes conventional teaching of skills such as field-craft and handling weapons, its main objective is to reinvent how recruits think and behave (Hockey, 1986; Grossman, 2009). Training “breaks you down and then rebuilds you in a different way”, as one veteran has put it (Green et al., 2010). Another described training as operating on two fronts. First, it shapes minds by ‘indoctrinating’ recruits into the ideological values of the military system; and second, it ‘conditions’ behaviours by rewarding obedience and punishing dissent, to the point where all orders are obeyed without question or pause (Gee, 2013, personal communication with veterans).
Toy Soldiers: “Required to look and behave the same, recruits are anonymised and controlled”
In 1986, the sociologist and former soldier John Hockey wrote a detailed description of military training, which in large part still stands today. The training regime aims to dispossess recruits of their civilian role and build a new self-image in its place, explains Hockey. The process operates by making absolute demands of recruits which erode self-determination, autonomy of movement, privacy and choice of personal appearance. Required to look and behave the same, recruits are anonymised and controlled. The consequence of relentless activity is fatigue; of the demands of authoritarian power, anxiety; and of the absence of civilian norms and social support, disorientation (Hockey, 1986). Hockey says that this “socialisation under pressure” will “soften” recruits in readiness for the imposition of new personal self-images, values, and definitions of personal achievement.
An effect of these adversities is the deepening of peer bonds, which veterans frequently cite as the most valued benefit of an armed forces career. The growing camaraderie, for those who are not excluded from it by bullying, serves as a source of psychological freedom within a coercive system and a form of solidarity in the face of the arduous demands made by authority figures. On the other hand, it also serves the purposes of the military system. If one person fails in a task, the whole group is punished, ensuring that recruits exert peer pressure to reinforce collective compliance (Hockey, 1986, Eisenhart, 1975).
Once the enculturation of values and behaviours has gained the willing compliance of trainees, the socialisation process enters a new, less-rigorous phase, Hockey observed. As a measure of permissiveness returns, trust and humour between commander and commanded partially offset the strictures of the training regime. Trainees might no longer respond to their superiors’ gestures of leniency with relief, but rather with gratitude. With control secured through compliance rather than enforcement, the authoritarian application of power becomes less immediately necessary, although it remains omnipresent as the guarantor of military culture.
Trainers and trainees affirm hyper-masculine norms: aggression, stoicism and aversion to weakness. “Role effectiveness” is associated with “masculine potency”, according to Hockey. In the military group, the uniformity of this identity is enforced through the training process and reinforced by formal and informal (including illicit) hyper-masculine bonding rituals. Social and institutional pressures to conform create a strong insider-outsider dynamic, in which ‘military’ is understood in opposition to ‘civilian’, strength and weakness become gendered polar opposites, and values antithetical to a hyper-masculine ideal are resisted as threatening. Indeed, Hockey and others have found that weakness and failure are frequently associated with femininity or homosexuality (Eisenhart, 1975; Barrett, 1996; Woodward & Winter, 2006; Atherton, 2009).
In sum, recruits are controlled and partly dehumanised by the system they serve in order to prepare them for war. Yet despite the tough training and conditioning of the military regime, and in some respects because of it, exposure to the traumas of warfare still assaults the psyche. Those most affected are infantry soldiers in prolonged or repeated front-line fighting. In the heat of warfare, soldiers cannot give voice to their strain and so help to ease it. The psyche ‘buries’ it, only to let it resurface with typically debilitating effects at homecoming or on discharge from the forces. Traumatically stressed personnel tend to turn to alcohol to help manage the effects, but which in excess makes matters worse. Compared with the general population, drinking habits deemed harmful to health are three times as common among troops deployed to Iraq or Afghanistan (McManus et al., 2009; Fear et al., 2010). The heaviest drinkers are the youngest personnel deployed in front-line roles (Gee, 2013).
‘PTSD Action Man’: A still from the current film campaign ‘Action Man: Battlefield Casualties’, challenging the lack of reality in military recruitment ads
Unsurprisingly, being shot at is among the most stressful experiences for a soldier, but still greater strain ensues from killing other people at close quarters or seeing others killed (Grossman, 2009). With few exceptions, the act of killing assaults the psyche of those who do it or witness it, but soldiers in war have no control over their situation – no freedom to choose whether to continue or stop. It is actually illegal to stop and leave; the crime is desertion, which since the 2006 Armed Forces Act has carried a maximum sentence of life imprisonment.
“the act of killing assaults the psyche of those who do it or witness it”
Many of the mental health conditions that soldiers experience reflect the conscientious, desperate rebellion of their own humanity against the base dehumanisaton of war. We think of such conditions as ‘mental health problems’ – and they are – but the primary injury is to the soul. The psychiatrist Peter Marin was among the first to propose that conscience played a role in the stress reactions of soldiers, which he characterised as their ‘moral pain’ (Marin, 1981). Whilst such reactions are commonly stigmatised as part of a mental health ‘disorder’, the experience, while highly stressful, can also be understood as the healthy response of a morally functional individual. A British Iraq War veteran told me that, given his immersion in war, something would be wrong with himself if he had not been experiencing a stress reaction afterwards.
Some of the moral and pastoral challenges of warfare fall to the padre – the military chaplain – but these too are tightly controlled by the system they work in. According to Nicholas Mercer, a former senior army officer who has since joined the Anglican priesthood, chaplains who speak out about abuses or challenge the chain of command are often made to be quiet. He was speaking from experience. When he tried to stop abuses of Iraqi detainees by British forces at the Umm Qasr interrogation centre – later detailed in a report by the International Committee of the Red Cross – he said he “was silenced by the Ministry of Defence” (Mercer, 2011). By his own account, he was “forced to run the gauntlet of some fairly unpleasant behaviour”, which he noted would be an intimidating experience for a young chaplain at the beginning of his or her career. In a letter to The Tablet, he wrote that he had known chaplains and other officers who had been sacked for doing their job (ibid.).
“The rate of common mental disorders in the armed forces as a whole is 30% higher than in the general population”
Perhaps the most complete example of the controlled consciousness of the agent of warfare is that of the drone operator, who remotely pilots an aircraft on the other side of the world. Operators of American drones work in pairs, sitting together in a small, dark room in Nevada, staring into a bank of screens for shifts of up to 10 hours at a time. The drone gets its name from its sound, like that of a bee, but the operators hear nothing but the whirr of their computers’ cooling fans; the job is mostly watching, waiting and being bored. For days or weeks, they spy on their monochrome, pixelated enemies from the disembodied, infra-red eyes of their drone as it circles high in the sky, thousands of miles away. Often, the operators get to know the daily routines of their targets – when they get up, where they go, where their families live – until the kill order comes through.
Manipulating hand-held controllers like those used for videogames, one operator flies the drone in while the other guides a Hellfire missile to a final, soundless flash of light that blanks the screen with white. When it clears, only scattered blotches of white are left on the screen; these are the bits of bodies glowing hot in close-up, relayed by the aircraft’s infra-red camera. The operators will not know whom they were watching or why they had to kill them, or who else might have been in the house they destroyed. They will not even have known the person giving the kill order, nor the observer who watched their every action, but again remotely, on another screen who knows where (Power, 2013).
Given their physical distance from their warfare, drone operators can come surprisingly close as witnesses to its inhumane effects, but in all other respects they are in the dark. Orders are made somewhere else and people are killed somewhere else; the operators’ stuffy room of screens is the one place where nothing happens. They are dehumanised not only by the killing that is the substance of their job, but also by their ignorance of its purposes and near-total lack of autonomy in respect of it. Their paralysis as human beings – which is to say, sensing, thinking, choosing, loving beings – is almost absolute, save for the rebellion of walking out of the room and into a court martial.
I described them above as agents of warfare, but this is true in only the thinnest sense, for these human operators are almost wholly reduced to an inanimate part of the war machine, as remotely controlled as the drones they remotely control. Even so, they have to witness and verify their own kills, peering into their grainy grey screens to check that the person they were supposed to eviscerate is indeed in bits.
Brandon Bryant, who flew drones for several years, described to GQ magazine one scene he watched on the heat-revealing infra-red screen after his kill:
‘The smoke clears, and there’s pieces of the two guys around the crater. And there’s this guy over here, and he’s missing his right leg above his knee. He’s holding it, and he’s rolling around, and the blood is squirting out of his leg, and it’s hitting the ground, and it’s hot. His blood is hot. But when it hits the ground, it starts to cool off; the pool cools fast. It took him a long time to die. I just watched him. I watched him become the same colour as the ground he was lying on.’ [cited in Power, 2013].
When they eventually leave the US air force, drone operators are awarded a scorecard showing the number of people they have killed. Brandon Bryant’s read: “Total enemies KIA: 1,626.” War by remote control is truly, coldly remote, but the killing is still killing: “blood is hot”.
Now Britain has its own small but growing drone fleet operated from Waddington in Lincolnshire. The same base is also home to the annual RAF show, where families can watch military planes fly past for £62 (£118 if you want to sit down; RAF, 2014). For a premium, families can buy a VIP experience in enclosures named after Hugh Trenchard and ‘Bomber’ Harris, architects of the Second World War strategic bombing campaign, which by targeting the residential hearts of German cities massacred 800,000 people (Messenger, 1984). In that war, the vain expectation of the bomber offensive had been that the mass-murder of civilians would create such a ‘moral effect’ in German society that Hitler would surrender. By naming the spectator areas after these RAF luminaries, the air show implicitly celebrates as heroic their policy of massacre. From these vantage points, surrounded by the arms trade logos of Boeing, BAE, Raytheon and others, mum, dad and the kids can watch a Lancaster fly over. Perhaps this year they will get a peek at its successor, the Reaper drone, while waving the Union Flag.
David Gee has written and campaigned extensively on the ethics of military recruitment and the mental health of veterans. His first book, Holding Faith: Creating Peace in a Violent World, explored nonviolence and social change; and his most recent work Spectacle, Reality, Resistance: Confronting a Culture of Militarism is a compelling analysis of the rising culture of militarism in Britain. He is a co-founder of ForcesWatch.
Appendix: Psychology and the Military
“It’s OK to question these things. It’s not OK that people with a vested interested are pushing the notion of a noble military career to children” (Ben Griffin, founder of Veterans for Peace UK, former SAS soldier)
In the armed forces, harmful drinking has been found to be more than twice as common as in the general population (13.0% vs. 5.4%); the problem is more common among deployed than non-deployed personnel. Studies have found the prevalence of PTSD among personnel deployed to Iraq and/or Afghanistan to be about 20% higher than in the general population (3.2% vs. 2.7%), whereas among those not yet deployed it was found to be about the same (2.8% vs. 2.7%). The rate of common mental disorders in the armed forces as a whole has been shown to be about 30% higher than in the general population (19.7% vs. 15.0%), but the prevalence of self-reported self-harm has been approximately 50% lower (4.2% vs. 8.0%), as has the long-term incidence of suicide.
“PTSD Action Man” complete with “with thousand-yard stare”; “legs really don’t work”; and “benefits cancelled” letter. Today’s youngest recruits have twice the long-term suicide risk than their civilian counterparts.
Among personnel who have left the forces in the last decade, the prevalence of PTSD, alcohol misuse, common mental disorders and self-harm is appreciably higher in each case than that found in either current armed forces personnel or the general population. Compared with the general population, studies of ex-armed forces personnel have found that PTSD (for those deployed to Iraq and/or Afghanistan) and alcohol misuse are both more than three times as common (Alcohol: 16.8% vs. 5.4%; PTSD: 9.2% vs. 2.7%); prevalence of common mental disorders has been found to be about 90% higher (28.3% vs. 15.0%); and self-harming behaviour approximately 30% higher (10.5% vs. 8.0%). The long-term suicide rate has been about the same as among the general population, while the youngest recruits have been at nearly twice the long-term suicide risk faced by their civilian counterparts in the same age group.
Although veterans are less likely overall to have a criminal record, lifetime offences of a violent nature are more common than in the general population (11.0% vs. 8.7%). One study found that the rate of violent offending among Iraq and Afghanistan War veterans after they returned from their deployment was twice what it was before they enlisted. The rate of self-reported post-deployment violent behaviour is also high; one study found that 12.6% of Iraq War veterans reported having behaved violently towards family members or others within weeks of returning from their tour of duty.
Those who enlisted into the Army at 16 and passed out of training have been approximately twice as likely to die in Afghanistan as those who enlisted as adults; part of the reason is likely to be the disproportionate number of 16 year olds joining the Infantry. The UK is the only country in Europe to recruit 16-year-olds into its armed forces.
The studies show a high degree of co-morbidity (symptoms of more than one problem at once), with strong associations found between the six mental health-related problems investigated in this report. For example, personnel screening positive for PTSD were found to be approximately four times as likely to report homecoming violent behaviour as those without such symptoms, about three times as likely to have committed a violent offence after deployment, and nearly eight times as likely to report a history of self-harming behaviour.
Young soldiers recruited from disadvantaged backgrounds are also substantially more likely than other troops to return from war experiencing problems with their mental health (ForcesWatch report, ‘The Last Ambush’). The report highlights a particular concern for the youngest recruits, who can enlist from age 16 and may be as young as 15 when they first apply. This group is unlikely to be aware of the mental health risks of their prospective career, unlikely to be told of them, and unlikely to be able consider seriously their real-life implications at that age. The report calls for the policy of recruiting from age 16 to be reviewed so that the greatest burden of risk is not left to the youngest, most vulnerable recruits to shoulder. Raising the minimum age of recruitment to 18 would also ensure that recruits share the risks more equally and that they accept them at the age of adult responsibility. To sign the petition to raise the recruitment age to 18, click here.
Alternative Recruitment Poster by Darren Cullen, who also made the ‘Battlefield Casualties’ short film. An exhibition of the film and props will show at the Red Gallery, 1-3 Rivington Street, London EC2A 3DT from 23 June to 2 July. The films will be online from 23 June at veteransforpeace.org.uk
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Saturday 27th June 2015 has officially been designated ‘Armed Forces Day’, an annual event set up after the 2008 National Recognition of the Armed Forces Day inquiry report. Events and military recruitment stalls will be organised throughout the UK. The event is held in June “to enable the maximum number of people including school children to attend”.
On the same day, Southampton Quakers are hosting ‘the other’ Armed Forces Day, an alternative day of creative expression, dialogue and workshops that include veterans, artists, historians, and mental health workers, to explore in greater depth the conscience of war, and the psychological context of militarism. The event also features Veterans for Peace UK, ForcesWatch, and a special showing of the acclaimed short film ‘Action Man: Battlefield Casualties’. Full details here.
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