Monday, July 11, 2011

PTSD Lower Among UK Vets: What Do They Know That We Don't?

Soldiers from the United States and the United Kingdom are fighting side by side in Iraq and Afghanistan. They are facing the same dangers and experiencing the same amount of death and destruction. You would expect, then, that they would be experiencing Post Traumatic Stress Disorder at about the same rate. You would be wrong.

Frequent Quarterbacker Brian (better known to some of you as my husband) sends along an article from Miller-McCune that points out that US soldiers experience PTSD at about 7.5 times the rate of UK Soldiers. There are a number of possible explanations for this, not the least of which is that the rate of PTSD in the general US population is much higher than in the UK, which suggests that our soldiers were more traumatized to begin with than theirs. UK troops also serve much shorter tours of duty than do US troops.

The article also alludes to the practice in the British military, which is common outside of the US but unheard of here, called "Third Location Decompression" (TLD). British troops, before they come home, go to Cyprus for 24-36 hours before they come home. They hang out and relax with their unit. It is mandatory.

I did a little digging about TLD, and discovered something important that I think Miller-McCune missed. During TLD, in addition to having barbecue and volleyball and even a limited amount of alcohol, soldiers get 45 minutes of psychoeducation. In other words, for 45 minutes someone explains to them that readjusting to civilian life is going to be difficult, and what they might expect. In addition, soldiers spend their TLD with the same people they served with, giving them some time away from the war zone but still with those with shared experiences to talk about what they went through.

I don't have any way of knowing whether 45 minutes of psychoeducation make all the difference in diminishing the incidence of PTSD among British troops. It seems like it's probably some combination of factors at work. But, as someone who is a big believer in early trauma intervention, introducing the idea that you might have problems and you might need help seems like an obvious positive. I compare this to the stories I've heard from US vets, who were screened for PTSD on the day they returned and told that, if they failed the screening, they couldn't go home (how honest would you be?), I have to imagine the British are getting things right. And besides, who among us couldn't benefit from a day with friends on a tropical island?


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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