by Polly Curtis

Thousands of frontline veterans of the wars in Iraq and Afghanistan are facing escalating mental health problems, alcoholism and family breakdown, an extensive examination of the British military has found.

Prolonged periods in conflict are linked to higher levels of post-traumatic stress disorder, psychological distress and problems at home, researchers report in the British Medical Journal online.

The Ministry of Defence said it would study the findings to try to better understand mental health problems in the military, but last night there was pressure on the government to address accusations that the military is currently overstretched, forcing personnel into longer tours of duty. Opposition MPs said the burden on the military was another reason to begin phased withdrawal from Iraq.

The Kings College London military health centre's study of 5,547 veterans of overseas tours focused on the 20% who were deployed for more than 13 months within a three-year period, the maximum recommended time limit set by the government and known as the "harmony guidelines".

Nicola Fear, one of the researchers, said: "We asked about problems with partners, children, financial problems and whether their families were receiving enough support. Being deployed for 13 months or more was associated with significantly higher problems at home. It could be that people aren't home long enough to adjust from military to family life."

They found that nearly one in four of those deployed for longer than 13 months had "severe" alcohol problems compared with one in 10 of those deployed for less than five months.

Post-traumatic stress disorder is running at a rate of 5.2% of those deployed above the 13-month limit compared with 3% of those who spent less than five months in conflict.

The study covered the period since 2001 and included tours of duty by service members of the army, navy and Royal Air Force in Afghanistan and Iraq as well as Kosovo and Sierra Leone. The researchers found that uncertainty about when personnel would return home was linked to mental distress.

They conclude: "A clear and explicit policy on the duration of each deployment of armed forces personnel may reduce the risk of post-traumatic stress disorder. An association was found between deployment for more than a year in the past three years and mental health that might be explained by exposure to combat."

The findings come after warnings that the forces are overstretched in Iraq and Afghanistan. The Commons defence committee has said the military is currently "overstretched". Of those questioned for the BMJ study 86% had spent time in Iraq. The latest figures suggest there are 46,370 civilian and service military personnel on active service abroad.

The report prompted immediate political criticism. The Liberal Democrat defence spokesman, Nick Harvey, said: "Our armed forces are suffering the consequences of massive overseas commitments caused in no small part by the illegal war in Iraq."

Shadow defence secretary Liam Fox said: "The government's failure to share the burden of operations with our allies is adding to the pressures.

"Harmony guidelines that are meant to allow troops to rest and recuperate are habitually breached, leaving our troops feeling used and abused by the government."

An MoD spokesman said: "We will of course study the research and work with the researchers to improve our understanding of the effect of operations on personnel.

"Before their deployment every member of the armed forces will know the length of their operational tour. But there will always be occasions where unforeseen circumstances will impact on their return. The MoD works hard to minimise the effects and will not keep personnel in operations unnecessarily."

He said that the latest figures showed that of all personnel less than 1% of the Royal Navy, 12% of army and 6% of RAF personnel were exceeding the harmony guidelines.

Adherence to the guidelines had improved, he claimed and mental health nurses had been deployed in Iraq and Afghanistan to support troops. The harmony guidelines were more specific for each of the armed forces than the researchers allowed for, he added.

The under secretary of state for defence, Derek Twigg, said the BMJ research would be studied to see how the number of troops who suffer from mental illness can be reduced. He insisted the military was not over-stretched.

"The vast majority of British troops do not have their tours extended and are on operations for no longer than six to seven months. As such it indicates that our current policies on the duration of tours are right," he said.

"We are taking steps to remind the small number of troops who see their tours extended about the support that is available to them. We have, for example, mental health nurses in Iraq and Afghanistan."
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