Combat Stress (charitable organisation)

The Veterans' Mental Welfare Society, more commonly known as Combat Stress is a British registered charity offering residential and community treatment to former members of the British Armed Forces suffering from a range of mental health conditions including posttraumatic stress disorder (PTSD).

The charity was formed in 1919, as the Ex-Services Mental Welfare Society, following the First World War when the effects of shell shock were becoming known.

World War I
The soldiers returning home from World War I suffered greatly from the horrors they had witnessed. Many returning veterans suffered from post-traumatic stress disorder, called shell shock at the time.

In 1915 The British Army in France was instructed that: Shell-shock and shell concussion cases should have the letter 'W' prefixed to the report of the casualty, if it were due to the enemy; in that case the patient would be entitled to rank as 'wounded' and to wear on his arm a 'wound stripe'. If, however, the man’s breakdown did not follow a shell explosion, it was not thought to be ‘due to the enemy’, and he was to [be] labelled 'Shell-shock' or 'S' (for sickness) and was not entitled to a wound stripe or a pension.

In August 1916 Charles Myers was made Consulting Psychologist to the Army. He hammered home the notion that it was necessary to create special centres near the line using treatment based on: He also used hypnosis with limited success.
 * Promptness of action.
 * Suitable environment.
 * Psychotherapeutic measures.

In December 1916 Gordon Holmes was put in charge of the northern, and more important, part of the western front. He had much more of the tough attitudes of the Army and suited the prevailing military mindset and so his view prevailed. By June 1917 all British cases of “Shell-shock” were evacuated to a nearby neurological centre and were labelled as NYDN–Not Yet Diagnosed Nervous”. "But, because of the Adjutant-General’s distrust of doctors, no patient could receive that specialist attention until Form AF 3436 had been sent off to the man’s unit and filled in by his commanding officer." This created significant delays but demonstrated that between 4-10% of Shell-shock W cases were "commotional" (due to physical causes) and the rest were "emotional". This killed off shell-shock as a valid disease and it was abolished in September 1918.

During the war, 306 British soldiers were executed for cowardice, many of them victims of shell shock. On 7 November 2006 the government of the United Kingdom gave them all a posthumous conditional pardon.

Present work
The Charity was formed at a time when there was little known about mental health problems affecting ex serviceman who had returned home after serving in conflict zones.

Currently the organisation is helping over 4,600 people who are ex British Armed Forces but demand is expected to rise due to British Forces being deployed on operations in Afghanistan and Iraq.

Support is currently being given to those who suffer from:
 * Clinical depression
 * Raised anxiety states
 * Phobic disorders
 * Obsessional compulsive disorder
 * Bi-polar illness (manic depression)
 * Substance abuse (drug and alcohol)
 * Psychotic conditions in a non-acute phase
 * Posttraumatic stress disorder (PTSD)

This support is delivered throughout England, Scotland, Wales and Northern Ireland through three treatment centres (Hollybush House, Ayr, Ayrshire, Scotland; Audley Court, Newport, Shropshire, England and Tyrwhiytt House, Leatherhead, Surrey, England) and numerous community outreach teams.

Services
The services provided:
 * Welfare officers - a vital link between the charity and veterans
 * Treatments for PTSD which include:
 * CBT: Cognitive behavioural therapy
 * Behaviour therapy
 * Cognitive therapy
 * Solution-focused therapy
 * Eye movement desensitisation and reprocessing (EMDR)
 * Art therapy
 * Anger management
 * Anxiety management
 * Sleep hygiene
 * Social skills training
 * Drugs maintenance and assessment for general practitioners (Dr's)
 * Physical exercise and outdoor activity
 * Occupational and recreational therapies
 * Treatment centres
 * Carer support