An understanding of military culture is essential if practitioners are to provide a service that suits the needs of former soldiers, say Michelle Louise Black and Elizabeth Collier

The very nature of working in conflict zones makes former soldiers vulnerable to symptoms of post-traumatic stress disorder (PTSD). The culture of the military can also mean that personnel do not seek help and can endure symptoms for years.

The two main treatments recommended for veterans diagnosed with PTSD – group therapy and exposure to trauma – have been shown to reduce PTSD symptoms. Even though these are recommended, veterans are not receiving evidence-based treatments due to the lack of training and reduced numbers of healthcare staff. There are high dropout rates from treatment because of the stigma of mental illness and because veterans feel that healthcare professionals do not understand them. Also, in some cases, veterans cannot be treated if they are experiencing a comorbid mental health problem or addiction. It is recommended that more research is carried out with veterans who are diagnosed with PTSD.

The combination of treatments and treatment specific to the era in which the veteran served might further improve recovery from symptoms. It may also be beneficial to develop an intense educational programme for health professionals about the military and their needs.