UK Ministry of Defence Launches New Study on Impact on Veterans of Iraq/Afghan Engagements

By Defense.Info

The new study, which follows on from similar reports conducted after the Falklands War and the First Gulf War, will investigate cause of death, including rates of suicide, for all personnel who deployed to conflicts in Iraq and Afghanistan between 2001 and 2014. This will cover personnel who are still in service, and those who have now transitioned into civilian life.

While rates of mental disorder are lower in the military (3.1%) than the general population (4.5%), the MOD routinely carries out research into those who have served on large scale combat operations, in order to more accurately assess the effects of deployment.

Previous studies into mortality rates of those who served during the 1982 Falklands 1982 Falklands and 1990/91 Gulf conflicts found that they were no more likely to take their lives than the wider population, while rates of suicide within the military remain low.

This latest research will be conducted in collaboration with NHS Digital, and will match the MOD’s service database with corresponding NHS records in order to track causes of death. It will compare findings with the general population, as well as all personnel who served during the same period outside Iraq or Afghanistan.

Minister for Defence People and Veterans Tobias Ellwood said:

“Our Armed Forces do a magnificent job, and we owe a huge debt of gratitude to each man and woman who has laid their life on the line to keep our country safe.

“Most transition successfully into civilian life once they have put away their uniforms, but we cannot afford to be complacent. Mental health problems can affect us all, and the wellbeing of our people remains a top priority.

“By conducting this vital new study, we are furthering our understanding of the wellbeing of our people so we can continue to provide the best possible care to all who have served.”

The study will work alongside the ongoing research by King’s Centre for Military Health Research and Imperial College in order build as detailed a profile as possible of those who served on these operations.

The MOD’s Defence People Mental Health and Wellbeing Strategy is working to challenge the stigma surrounding mental health issues, to ensure that all who serve, and have served, can enjoy a state of positive physical and mental health. It aims to offer the tools and support necessary for each of the Armed Forces’ men and women to lead a long and healthy life, during their service, and following their transition back into the civilian community.

The MOD has committed to spending £22 million a year on mental health, and has set up two 24/7 helplines for serving personnel and veterans, so that there is always somewhere to turn in times of crisis. This year, the MOD will launch the new Defence Transition Service, a specialist support system that will provide an additional layer of care for those preparing to leave service, who are most likely to face difficulties once they leave the Armed Forces.

The majority of veterans go on to lead successful and healthy lives once they have left the Armed Forces. They leave with strong values and transferrable skills, demonstrating qualities such as leadership, resourcefulness, adaptability, and the ability to work under pressure.

Of the veterans who use the MOD’s Career Transition Partnership upon leaving the Armed Forces, 86% are in education, training, volunteering or in a job within six months. The MOD continues to run the largest apprenticeship scheme in the country.

And this story published on June 1, 2015 highlighted one aspect of the impact of the Afghan war on the UK and its veterans.

Imperial College London researchers have calculated that £288 million is the cost of lifetime care for amputee veterans from the Afghanistan conflict.

Roadside bombs or Improvised Explosive Devices (IEDs) were a leading cause of injury in UK Armed Forces personnel serving in the conflict in Afghanistan, which occurred between 2001 and 2014. More Service men and women have been surviving blast injuries in recent years, thanks to better protection equipment, improved medical care and the rapid extraction of casualties. However, surviving patients have complex wounds and the long-term medical and financial impacts of their injuries are still being investigated.

Researchers from The Royal British Legion Centre for Blast Injury Studies (CBIS) at Imperial College London have carried out a comprehensive analysis highlighting the extent and nature of amputations on British service personnel from the Afghan conflict and calculated the long-term healthcare costs. This is the first study to place a figure on the long-term cost of care for British amputees in this context.

The team say understanding the projected healthcare costs will enable policy makers to more adequately prepare for the needs of these veterans in the future. The study also sheds light on the continued research needed to understand the long-term impact of these blast injuries.

It was found that from the first roadside blast casualty in 2003, to the UK’s withdrawal in 2014, there were 265 casualties who sustained 416 amputations. The most common type of amputation from IEDs was above the knee, with 153 casualties, followed by 143 below the knee.

The team calculates that medical support for these veterans over an average remaining lifetime of 40 years will be approximately £288 million, when the combined cost of trauma care, rehabilitation and prosthetics are factored in.

However, the overall costs could climb even higher when factoring in: illnesses, not directly related to blast injuries; amputees receiving new prosthetics, following design improvements; and economic losses resulting in veterans being forced to drop out of the workforce due to their injuries.

The study, published today in the journal Clinical Orthopaedics and Related Research, highlights the need for policymakers to develop a long-term approach to caring for amputees.

Professor Anthony Bull, co-author of the study and Director of CBIS from Imperial College London, said: “The Centre is focused on supporting the military to ensure the best care possible for veterans who have their lost limbs while serving their country. Understanding the cost implications is an important part of planning how to care for injured veterans in the long-term, in order to make their lives more comfortable. Ongoing evaluation of these injured soldiers will be needed to assess the level and specialisation of care required as they age. It is likely that these veterans will be subjected to chronic health problems experienced by the general population as well as specific issues as a result of their injuries. The lives of these servicemen and women could be improved if policymakers develop more effective and sustained medical and social support.

“Our research is a great example of scientists from the Blast Centre and Ministry of Defence working together to shed light this massively important issue. However, we still have a very long way to go to understand the long-term impact that these injuries have on our servicemen and women. That is why we are working with The Royal British Legion and the Government to carry out more research in this field.”

Sue Freeth, The Royal British Legion’s Director of Operations, said: “This is the first attempt we know of to publish an independent estimate of the lifetime health care cost of the British service personnel seriously injured by IEDs in Afghanistan. The Legion has been concerned for some time that the lifetime care of seriously injured veterans was under-estimated. This paper should alert health commissioners to the scale of the problem, and help them to plan ahead to meet the lifetime health care needs of this generation. Many of the injured veterans from Afghanistan have survived only because of the innovation of modern military and NHS medicine and medics on the battlefield, and the need for a lifetime of health care to support them is in danger of being over looked as the spot light moves away from this conflict.”

A breakdown of the healthcare costs by the researchers show the base cost over 40 years of single amputees was £0.87 million ($US 1.34m) for a transtibial or below the knee amputees, £1.16 million ($US1.79m) for a through-knee amputee, and £1.16 million ($US1.79m) for a transfemoral or above the knee amputees.

The researchers compared their costs to a study carried in 2010, which shows the estimated healthcare budget needed for US amputee veterans from the Afghan conflict. The study showed the lifetime cost of healthcare for veterans who had lost an arm was $US0.82m, $US1.46m for veteran’s who’d lost a leg, $US2.12m for those who’d lost both arms and $US2.90m for multiple limbs.

CBIS researchers are now collaborating on a longitudinal study with the British Military and King’s College London to investigate the health and well-being of veterans over a 20 year period. The aim is to find ways of improving the long-term support for people who have sustained blast injuries.

The Royal British Legion Centre for Blast Injury Studies (CBIS) is the first collaboration of its kind in the UK, where civilians including engineers and scientists are working alongside military doctors, supported by charitable funding, to improve protective gear and develop better treatments for people injured from roadside bomb.