Vol. 451 No. 4
1 Mr. M. Smith asked the Minister for Defence if he has studied a report commissioned by PDFORRA which claims that there are high levels of untreated post-traumatic stress disorder among soldiers who have served overseas; and if he will make a statement on the matter.
3 Mr. Clohessy asked the Minister for Defence the policy, if any, the Defence Forces have on the management of stress and post-traumatic stress disorder within the Defence Forces; and if he will make a statement on the matter.
19 Mr. E. Byrne asked the Minister for Defence if his attention has been drawn to concerns at the incidence of post-traumatic stress disorder among servicemen and former servicemen who served in Vietnam; the proposals, if any, he has to provide professional counselling facilities to servicemen, both in the field and after their return; and if he will make a statement on the matter.
21 Mr. M. Smith asked the Minister for Defence if he has studied a report commissioned by PDFORRA which claims that there are high levels of untreated post-traumatic stress disorder among soldiers who have served overseas; and if he will make a statement on the matter.
I propose to take Questions Nos. 1, 3, 19 and 21 together.
I recently received a report from Dr. Miriam Moore on post-traumatic stress disorder among United Nations veterans. It is a substantial report and it is at present being studied in the Department. The report by Dr. Moore is based on a very small limited group. It is invalid to extrapolate from such a sample. The suggestion in some media reports that up to 50 per cent of United Nations veterans may suffer from post-traumatic stress disorder is invalid and alarmist and an incredible exaggeration. The Army Medical Corps carried out the field work of a study to identify post-traumatic stress disorder. The results of this study are now undergoing computer analysis but preliminary impressions are that the incidence of post-traumatic stress disorder in this group is no higher than that found elsewhere.
The Defence Forces have in place a comprehensive system for dealing with the prevention and treatment of post-traumatic stress disorder. Before being selected for overseas service, and indeed for certain duties at home, personnel undergo a thorough medical examination and a similar medical examination is carried out on their return from such duties. In addition, each contingent going to Lebanon includes two medical officers plus a number of other medical personnel.
Prior to departure for overseas service all personnel are trained to the highest level. This training includes battle inoculation exercise which simulate stressful situations which they may experience while on overseas service.
Under the guidance of their educational psychologist the Defence Forces have introduced an educational programme dealing with: (a) stress awareness, appreciation and coping skills during basic cadet and recruit training; and (b) stress identification and management skills during leadership courses.
A critical incident stress debriefing programme has also been introduced which encourages members of the Permanent Defence Forces to deal with the emotional aspects of an incident involving major stress immediately after the event. A critical incident stress debriefing team is assigned to each battalion going overseas.
Where an individual is felt to be suffering from post-traumatic stress disorder he is examined by, and placed under the care of, a civilian consultant psychiatrist. If the services of other specialists are recommended these are also arranged without delay. The psychiatrist determines the treatment that the individual requires and this is provided through the medical corps or, if considered necessary, in a civilian hospital.
Notwithstanding the training and medical examination members of the Defence Forces must undergo before they go overseas, will the Minister not accept that it is probably likely that post-traumatic stress disorder is more prevalent among veterans because of the nature of their work, the risks they encounter in foreign territories where there may be land-mines and other stresses and they would probably not be comparable to circumstances obtaining for groups at home?
Common sense would dictate that what the Deputy said is true. I have just returned from the Lebanon and even though matters are relatively stable at present, stress situations exist among battlions in smaller outposts. Fortunately, in recent times people have not lost their lives or suffered serious injuries, but there has been a number of stressful incidents. I note the Deputy's point.
Dr. Miriam Moore's report included a number of exclusions in the preface which were completely ignored in some media comment. The preface states that no conclusions can be drawn from the study regarding the prevalence of post-traumatic stress disorder among the veteran population as a whole. The persons interviewed had to be volunteers and, therefore were not a representative sample of Irish UN peace-keeping. A number of other clarifying points are also included in the preface. Dr. Moore was particularly upset by an alarmist heading that appeared in one newspaper which gave the impression that 50 per cent of Irish UN veterans were suffering form this type of disorder. That view is unfair to them and is not factual.
I accept that. I do not want to be alarmist about this matter, but I wish to ensure that the Minister and the Department will be sympathetic in dealing with various circumstances that come to light when the final report is properly reviewed.
This is a sensitive subject. It is alarming that representative bodies of the Defence Forces considered it necessary to obtain advice from a professional body outside the Defence Forces. Does the Minister consider that those representative bodies were dissatisfied with reports they received from members of the Defence Forces?
The Army has completed a report on this matter and it is currently analysing aspects of it. I gave Dr. Moore a copy of it when she presented her report to me. I cannot speak for the representative bodies and the fact that they considered it prudent to conduct a study in their own right. I would not like to comment on the matter other than to say that Dr. Moore's work is appreciated. I am anxious to point out that it has been taken out of context, something about which she is concerned. Her report and the report being undertaken by the Defence Forces will increase our store of knowledge and, accordingly, I welcome them.
Are Defence Forces personnel who suffer from a low level of stress sent overseas on second and third duties?
As the Deputy is aware, overseas duties are voluntary. People volunteer for such service and must undergo a rigorous medical examination and an intensive training programme to determine their suitability. The present system is established to prevent the matter to which the Deputy referred and I do not believe significiant numbers of people suffering from that type of stress are being deliberately sent oversea. Some members of the Defence Forces suffering stress may sometimes slip through the net, but I am satisfied that the measures in place to deal with this matter are effective.
Does the Minister know whether the members of the Defence Forces themselves consider the figure quoted in the newspapers is vastly inflated?
Yes, absolutely.
I am pleased about that.
