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Managing mental health issues in Helmand

This news article was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

In a stark diversion from his traditional role, a Company Sergeant Major in Helmand is helping his unit to talk through any problems they may have and overcome any mental health issues.

Company Sergeant Major (CSM) Stuart Potter is currently on the front line in Helmand province with 1st Battalion The Royal Irish Regiment, in the southern Nad ‘Ali area.

He operates the TRiM (Trauma Risk Management) system which teaches soldiers to spot signs of mental distress in their colleagues.

The aim is to encourage troops to talk about their problems and seek help at the earliest stage from the team of community psychiatric nurses and consultant psychiatrists who are on hand in Afghanistan to provide any care and treatment needed.

It’s a far cry from CSM Potter’s day job at the battalion’s headquarters in Shropshire where he is more used to being feared by his troops for his hard line on discipline. He explained:

In the UK I enforce discipline; I shout at soldiers about their uniform, being late for work or having a ‘few too many’.

In Afghanistan, sometimes I shout, but mostly I listen. I listen to soldiers telling me how they put themselves into danger for their mates, how they extracted a casualty while under fire. How they were scared when they thought their number was up.

CSM Potter says that listening is vital on the front line:

On patrol it can go from having a laugh with kids and building up trust with local nationals to lying in an irrigation ditch trying to locate the enemy in a blink of an eye.

No matter who you are, the realisation that you are in someone’s sights, that someone wants to kill you, is traumatic; that’s where TRiM comes in.

After every patrol the patrol base commander holds a debrief; they discuss the patrol and identify any lessons learnt, everyone has their say.

This is the first and, in my view, the most important part of the TRiM process. There is no blame or shame. We all say what we feel.

At this point, commanders and I can identify people who may be struggling after an incident. What is traumatic for one isn’t always traumatic for others.

I then have a chat with that soldier. If, after a discussion, the soldier still doesn’t feel himself then we can begin an individual risk assessment, with the soldier’s consent.

I then reassess the soldier at 72 hours and 28 days after the incident. At any point during the process, if the soldier shows signs of acute stress, then I inform the medical chain.

He explained that during his 18-year Army career, approaches to mental healthcare have changed dramatically:

As soldiers and blokes we often find it hard to express our feelings. For years there has been a stigma attached to feeling shame or upset. When I first joined the Army, some would have said it was a sign of weakness.

But now it’s 2011 and I encourage my soldiers to discuss their feelings, with mates, commanders and with me. As soldiers we understand what other soldiers are going through.

The introduction of TRiM has encouraged soldiers to talk. We discuss things that upset us. An injured mate, an injured child or a close call with the enemy. By discussing these things with fellow soldiers it ensures there is no build-up of stress or emotions and we all get it out in the open.

The most important thing is that I am not a counsellor; I am a soldier in their chain of command who is looking out for them.

As CSM, it is also Sergeant Major Potter’s job to ensure that all patrol bases are manned and equipped, and balanced with the correct skills set, for example the right type and number of weapon systems, vehicles, signallers and medics.

Since joining the Army in 1992, CSM Potter has served in Northern Ireland, Macedonia, Kosovo, Sierra Leone, Iraq and now Afghanistan twice, having previously been there in 2008.

For more information about Trauma Risk Management see the stories at Related News.