Soldiers on peacekeeping missions who witness atrocities are at risk of developing mental health problems, as are those exposed to combat, a large study of Canadian military personnel shows.

The findings, from a survey of 8,441 men and women on active duty, found that as many as 31 percent were in need of treatment for psychological problems, but most didn’t get care, Dr. Jitender Sareen of the University of Manitoba in Winnipeg and colleagues report.

The results show, Sareen told Reuters Health, that “untreated mental illness in the active military is common and an enormous problem.”

Among the men and women surveyed, nearly 15 percent met criteria for mental disorders such as major depression, post-traumatic stress disorder (PTSD), and alcohol dependence, while a little more than 23 percent said they needed mental health care. Most of the people who actually had mental disorders hadn’t sought treatment, the researchers found.

Researchers increasingly believe that the definition of need for mental health care should be broadened to include both people with diagnosable mental health problems and those who think they need help, Sareen noted, which would mean that 31 percent of the men and women in the current study were in need of treatment.

Soldiers who had been deployed on peacekeeping missions but hadn’t witnessed atrocities or been exposed to combat were actually less likely than their peers to have mental disorders or to say they needed treatment, the researchers found. But being deployed on a combat mission and witnessing atrocities significantly increased the risk of having mental health problems and perceived need for treatment.

The findings can help the military identify soldiers who most need mental health help, Sareen noted. “One of the key risk factors seems to be exposure to multiple traumas,” the researcher noted. “Screening programs and early intervention programs should really try to help soldiers who have been exposed to numerous traumatic events.”

Sareen added that the current trend of moving mental health services out of specialized clinics and into primary care clinics may be helpful to the military; it may reduce the stigma attached to seeking mental health care.

SOURCE: Archives of General Psychiatry, July 2007.