Many veterans will face solitary mental battles long after they have finished fighting with comrades in Afghanistan
By Caroline Wyatt
Defence correspondent, BBC News
In the run-up to Armed Forces Day on 27 June, some veterans warn that fierce fighting in Afghanistan - and the legacy of the Iraq conflict - could lead to more personnel needing help for mental trauma.
Former serviceman Andy Lorimer knows exactly how that feels.
"Friends said I wasn't the same. I started drinking, and cut myself off from everyone," he says.
"I couldn't remember things. It came as a real shock to be diagnosed with a mental health disorder."
Mr Lorimer works as a director of Talking2Minds in Scotland, a charity run by veterans for veterans aimed at treating post-traumatic stress disorder (PTSD).
For him, being diagnosed with the illness came out of the blue.
Veterans say gardening helps prevent them dwelling on past horrors
He had enjoyed a long and distinguished career in the RAF, also serving with the Parachute Regiment and special forces in almost every conflict of the past 18 years including Northern Ireland, the Balkans and Iraq.
Tall and softly-spoken, Mr Lorimer, 46, was medically discharged in 2003, suffering physical injuries and mental trauma.
Like many former servicemen, he struggled to find treatment to address years of accumulated trauma from harrowing experiences.
Typically, PTSD can involve flashbacks, nightmares, insomnia and constant alertness for threats which may no longer exist.
One of the main NHS treatments - cognitive behavioural therapy - did little to help Mr Lorimer.
It was only in 2007 that he was introduced to a former Army colleague, Mick Stott, who was also a qualified trainer in neuro-linguistic programming (NLP).
"After the first session I slept peacefully for the first time in years without medication," says Mr Lorimer.
Described as an "owner's manual for the brain", NLP teaches people to control their thoughts and behaviour.
Talking2Minds uses it to help others who have spent years battling the demons of their past combat experience.
"I believe PTSD within the military is on the rise, but that it can be treated. You can be brought back to a life you can enjoy and not dwell on the past," says Mr Lorimer.
He has been lucky to enjoy the strong support of his family but says more government funding is needed.
Another charity has taken a different approach to helping veterans with combat stress.
In a tranquil spot in Ayrshire, horticulturalist Anna Baker Cresswell set up Gardening Leave after seeing a friend take his own life after returning from the Falklands.
It offers a walled garden and horticultural therapy to former service personnel.
"What the veterans say they enjoy most about coming here is that they are together," she says.
"Veterans like being outside and having something semi-structured to do because when they focus on something else which is meaningful, it stops their intrusive thoughts and their flashbacks."
Former soldier Peter Southall suffered for decades.
He served in Northern Ireland during the early 1970s but it was not until he found himself contemplating suicide some 30 years on that he sought support.
Planting seedlings in the walled garden offers the first real peace of mind he has enjoyed for a long time, he says.
His son has just returned from serving in Afghanistan.
However, Mr Southall is optimistic that today's soldiers, sailors and airmen will not have to wait so long for help in dealing with the psychological wounds of war.
"There seems to be a lot more co-operation happening now, and more awareness," he says.
L/Cpl Stephen Moger, who served with the TA in Iraq in 2004, is one of the younger veterans with PTSD who are being helped by the charity.
"It really came to light after I had one particularly bad night and I wanted to drive into oncoming cars.
"It was the thought of my mum and dad that stopped me and the very next morning I went to the doctor."
He and the other veterans are referred to Gardening Leave from nearby Hollybush House, a treatment centre run by the veterans' mental health charity Combat Stress.
Gary Walker is head of clinical services at the charity which celebrates its 90th anniversary this year.
He says veterans are now approaching the charity much earlier - around the age of 45, rather than in their 60s - perhaps partly due to better awareness of mental health issues.
"People have often had their symptoms for very many years, sometimes 14 to 20 years," he says.
"During that time, the intensity of their symptoms increases markedly and so it makes it very, very difficult for them.
"Unfortunately, with cutbacks in mental health especially, people are fire-fighting long-term enduring illnesses."
The latest MoD figures show that in the first six months of 2008, 1,636 servicemen and women were diagnosed with a mental disorder by defence medical services.
That amounts to 8.3 per 1,000 - or less than 1% of those coming forward for help in that period while still serving.
Of that number, 66 people were given an initial assessment of PTSD.
The MoD says that incidence of PTSD within the military remains low, although it has started a project with the NHS to introduce community-based mental health pilot schemes for veterans.
Guilt and shame
They aim to provide assessment and treatment within the NHS, helped by military mental health experts and veterans' charities.
The Medical Assessment Programme is available to all veterans deployed on operations since 1982.
It is run by consultant psychiatrist Prof Ian Palmer, who says that guilt, shame and "not wanting to let the team down" prevent people from seeking help.
"Once veterans are in a system, be it NHS or anywhere else, the treatment is the same. The difficulty is getting people to come forward."
So, even when the help is there, many former personnel will be battling the mental wounds of conflict alone long after the fighting is over.
Prof Palmer insists their trauma is treatable and they do not have to suffer for the rest of their lives.