Silhouette of soldiers and helicopters during a military mission at dusk.

    We aren’t doing enough for veterans with PTSD

    25 October 2017

    Former army medic Sarah Bushbye, one of only four women ever to have been awarded the Military Cross, is recalling the onset of the post-traumatic stress disorder that almost drove her to a complete breakdown.

    ‘When you get home from Afghan, and you’re alive, you’re on a high for a while,’ she says. ‘I didn’t have any symptoms for the first month or so.’

    ‘But then I started getting really bad nightmares. I had insomnia every night so I was exhausted all the time. I found it impossible to retain information. I was constantly worried that something bad was going to happen to me.’

    ‘I found it difficult to walk over grass or by the side of a road with cars going past. Grass triggered memories of improvised explosive devices, with cars it was suicide bombers.’

    And there was intense joint and muscle pain; the result, Bushbye believes, of her system being continually flooded with adrenaline. Her medicine cabinet came to resemble a pharmacy, filled with painkillers, anti-depressants and sleeping pills.

    Bushbye, from Newcastle, had joined the army in 2003 at the age of 18. Her job was to provide routine medical care in medical centres and emergency care in the field. She loved it and was good at it, serving in Europe, Canada, Belize and the Falklands. And then, in 2009, in Afghanistan.

    She is, understandably, reluctant to talk publicly about her experiences there. In the hour-long incident in 2009 for which she was awarded the Military Cross, she crossed open ground under fire to treat four soldiers wounded – two of them mortally – in a suicide bomb attack in Sangin, Helmand province.

    Her citation for the medal, which she received from the Queen in 2010, says: ‘Ignoring the bullets cutting the air about her, she calmly moved between each casualty, determined to do all she could to care for them. The weight of enemy fire increased. With flagrant disregard for her own safety, Bushbye nevertheless continued to move between the casualties, personally administering CPR to one of the soldiers.’

    It took two years for army doctors to diagnose post-traumatic stress disorder and another two years of ineffectual treatment before she received a medical discharge. She finally left the Army in 2014. But that was not the end of her problems. Now, as well as dealing with PTSD, she had to cope with the transition to civilian life.

    ‘The Army tries to prepare you,’ says Bushbye. ‘It does try. You get courses on how to apply for a job, how to write a CV, that sort of thing.’

    But the preparation is woefully inadequate.

    ‘By the time I left, I was effectively institutionalised. I’d spent more than a decade not having to worry about how long it would take to get to and from work, not having to think about what to wear, what to cook, not having to deal with shopping, form-filling – all those things that civilians do without thinking about them.’

    ‘It was a huge, huge stress. I was in so much pain. I was all over the place with my PTSD. I’d done combat-focused Cognitive Behavioural Therapy, regular CBT, mindfulness courses, physiotherapy and had meditation for pain as well taking concoctions of drugs and I just wasn’t getting better. I really felt I was close to a breakdown.’

    What Bushbye discovered is that there is virtually nothing in the way of official help for heroes after they leave the military. Because there is no government body to deal with veterans, charities have to fill in and do what they can.

    ’I’d pretty much resigned myself to living a half-life – being in constant physical pain and, mentally, circling the drain,’ Bushbye says. Sadly, her story is far from unique.

    At the last official count in 2016, there were 15,280 women in the regular forces and 4,890 in reserve forces and between October 2015 and September 2016, 1,188 of them were assessed for a mental health disorder.

    If the numbers of females in active service seeking help for mental health disorders are this high, then how many veterans are suffering too? We simply don’t know because there are no official records.

    MP Emma Lewell-Buck is former chair of the All-Party Parliamentary Group into Social Work which has been investigating the provision of mental health services for veterans.

    ‘Support for veterans both male and female is simply not good enough in this country,’ she says. ‘Also, what services there are are tailored for male veterans. There is no specific support for women, as there is in other countries.’

    ‘What does it say about us as a country that we leave it to charities to help veterans living on the street or unable to get access to the mental health services they need? These are people who have literally risked their lives for us.’

    Indeed it was a charity that helped Bushbye take the first step on the long road to wellness.

    Forward Assist, a small charity of which Lewell-Buck is a patron, was set up by ex-Royal Marine and social worker Tony Wright to help former servicemen and women experiencing difficulties in adjusting to a new life as a civilian.

    ‘The needs of female veterans are essentially the same as men’s – they have difficulties with adjustment, assimilation and loneliness,’ he says.

    ‘The problem for women is that the context in which group support is currently offered – it is in most cases delivered in the company of male veterans. But female veterans told us they wanted gender-specific groups.

    ‘I would like to see a mixture of gender-specific holistic and clinical interventions specifically for female veterans. I want to see more talking therapies that don’t involve labelling women veterans with mental health disorders.’

    Wright had been to America to witness at first hand a pioneering course that he thought would work for some of the veterans that Forward Assist was helping. Earlier this year the charity paid for Sarah Bushbye to become the first Briton to attend Boulder Crest, a 37-acre rural complex nestling in the foothills of Virginia’s Blue Ridge Mountains.

    Boulder Crest’s seven-day Warrior PATHH (Progressive and Alternative Training for Healing Heroes) retreat provides a coordinated mix of activities such as archery and equine therapy alongside group discussions and talking therapies. Central to its philosophy is the notion of ‘post-traumatic growth’, the idea that the extreme stresses experienced in, for example, a war zone can lead to positive psychological change.

    Bushbye, who undertook the course along with six female US veterans, says it was a transformative experience: ‘Post-traumatic growth teaches that you’re not damaged,’ she says. ‘You’re not doomed to live a half-life. You use those things that have happened to you to turn yourself into a better version of the person you were before. It helps remove fear.’

    ‘I hadn’t slept properly for seven years yet I slept every night on that course. It gave an insight into how much better my life could be. My pain reduced massively and I now know I’m capable of that. It helps you come to terms with things that you might have been hiding even from yourself. Boulder Crest provides you with a set of practices that you keep doing after the course to help you maintain that.’

    She is also in regular contact with the other women who took the course. They are, in effect, a digital support group. Bushbye, who is currently studying for a degree in psychology and hopes to eventually become a neuroscientist, is in no doubt about the programme’s value.

    ‘We don’t have anything like Boulder Crest in the UK and we need it,’ she says. ‘We badly need it.’