By Richard Allen Greene
BBC News website
Tens of thousands of US soldiers - and untold numbers of Iraqi veterans and civilians - are suffering psychological trauma from the war in Iraq. The numbers of UK troops showing signs of post-traumatic stress disorder (PTSD), anxiety and depression are much lower. But experts warn that they may only be the first of many.
Martin Hazard's Iraq experience might not sound so bad on the face of it.
A communications officer, he worked gruelling 30- to 36-hour shifts, and people often depended on him for their lives.
He regularly had to stay at his post, even when his camp was being shelled, because his work was so critical.
But he saw little in the way of face-to-face combat, and came home to the UK in August 2003, before the insurgency gathered steam.
Even so, he often has to drink himself to sleep, two years later.
"I don't get more than three hours' sleep a night - and then I hit the bottle," he says.
Little things prey on his mind, he says. He suffers from nightmares, and has become confrontational, his wife Sara adds.
His symptoms are the classic ones of PTSD - a psychological condition that can affect people who have been through difficult experiences.
Campaigners and mental-health experts who work with soldiers say cases like Martin Hazard's are going to become more common among British troops who served in Iraq.
Shaun Rusling of the National Gulf Veterans and Families' Association says his organisation has already been contacted by more than 50 Iraq veterans showing signs of psychological trauma.
"They are most certainly suffering from true PTSD - serious mood swings, nightmares, sweats and fevers, attention deficit," he says.
And Combat Stress, a charity for veterans with mental health problems, is treating about 25 veterans of the current conflict with PTSD.
Not all were traumatised by combat itself - such as a mechanic in the reservist Territorial Army, who was called up to fix machinery.
"He goes out from his normal life and is asked to repair a refrigeration unit, which is of course the home of many dead bodies," says Morag Heggie, the head of clinical services at Combat Stress's Audley Court counselling centre.
"That is not what he was expecting, and people are shovelling in more bodies and saying: 'Hurry up.'"
Sooner than expected
The executive director of Combat Stress, Toby Elliott, takes it as a warning that the charity is already treating so many veterans of an ongoing war.
"It takes an average of 14 to 15 years for a regular soldier to seek help," he says, adding that many more veterans are likely to find themselves experiencing Iraq-related PTSD in the coming decades.
But, he adds, there are powerful reasons for soldiers not to admit they are having mental health problems - doing so could jeopardise their careers.
"You know bloody well that if you say you are feeling wobbly in the head, the first thing is that they will take your rifle away from you," he says.
"Even if you are retained, you probably won't get promoted."
And unlike in the United States, where a generation of Vietnam veterans introduced the notion of PTSD to the general populace, there is still suspicion of the concept in the UK, not least among soldiers.
George Bremer, 55, served as an artilleryman in Northern Ireland at the height of the Troubles in the early 1970s - and he shares the doubts many serving and former soldiers express about psychological trauma.
"I'm surprised so many people are coming back saying they're stressed," he says.
He went through many of the experiences which psychiatrists say can trigger PTSD - being fired on, returning fire, handling dead bodies - and says he was unnaturally alert for a few months after he came home.
But then, he says, he got over it.
"A lot of people rely on crutches, which I don't think is beneficial. Psychological stress is a symptom of political correctness in the 21st Century where everyone has to be stressed or depressed."
Little information about the mental health of UK troops in Iraq is available yet - but a major study should be published late this year or early next year, says Dr Amy Iversen of the King's Centre for Military Health Research.
About 75,000 UK troops have served in the Iraq theatre since the invasion in March 2003 - many of whom have done multiple tours, the Ministry of Defence says.
Neither pre- nor post-deployment mental health screening is standard in the UK armed forces.
The Ministry of Defence said in a statement it was "committed to providing the best available health care to the few servicemen and women suffering from mental health problems.
"All personnel have access to trained mental health staff whilst deployed", the statement said, adding that soldiers being demobilised receive a medical examination which includes questions about mental health.
About 10% of UK troops airlifted out of the war zone between January and October 2003 suffered primarily from psychological problems, according to a study published in the British Journal of Psychiatry.
Dr Anne Braidwood, a medical adviser to the UK Veterans' Agency, says British troops may show lower levels of psychological trauma than their US counterparts because their situations are different.
US soldiers "consistently have been subjected to very high levels of combat and insurgency. In addition they are less used to peacekeeping than we are."
Another small scale-study suggests a successful deployment can actually be good for a soldier's mental health.
But its author, Jamie Hacker-Hughes of the King's Centre, says the troops he studied were professional soldiers on successful, short-term missions.
"If you're not doing what you're trained to do, or you're a reservist, or Territorial Army (TA), it is more difficult," he says.
Toby Elliott of Combat Stress says TA soldiers are seeking help in disproportionately high numbers - although only 10% of the troops deployed to Iraq have been from the TA, 50% of those in treatment at Combat Stress are.
That could be partly because TA veterans do not have access to Ministry of Defence medical services, he says.
They may also have more difficult readjustment problems than regular army soldiers, who tend to remain in a military environment - often among the same group of people they served with - after Iraq.
TA troops return to their civilian lives.
Peter Mahoney was one such TA soldier. He served with the Royal Logistic Corps, and found the transition back to civilian life unbearably difficult.
Before going to Iraq in 2003, he was "a party animal, a happy-go-lucky bloke," his wife Donna says.
When he returned, he "became like a recluse", she says. He was argumentative and racist, and would disappear for hours alone on his motorcycle.
A year after his return, he killed himself.
"His enthusiasm for life had dwindled," Donna says. "He wasn't nice at the end. He wasn't the same man."
On Friday: What treatment is available for combat stress.