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Trauma Risk Management (TRiM)

Personnel exposed to the operational environment will experience stress to a greater or lesser degree. This is quite normal but only a small number will suffer from stress that leads to mental health issues. Further to that, only a small percentage will encounter Post Traumatic Stress Disorder (PTSD).

Soldiers run the risk of operational stress through the pressure of deployment and their possible exposure to extremely traumatic situations and events. It is Army policy that mental health issues be properly recognised and treated, and that all efforts are made to reduce the stigma associated with them.

Here are some steps to recovery:

Occupational hazard

Some people might think that a person encountering operational stress is in some way weak, and that they should not talk about it. This is wrong - stress reactions are normal human responses to difficult situations and it is important that they are discussed and addressed.

The Army strives to make everyone understand that operational stress is an occupational hazard, and that people in difficulty should be supported at all levels.

Early warning

The number of soldiers who are diagnosed with Post Traumatic Stress Disorder (PTSD) is very small, especially in relation to the total number deployed.

But some do need support in the field after traumatic incidents and occasionally after they return home. It's therefore important to identify those most at risk of developing problems and ensure that support is provided at an early stage.

Support from within

In addition to both pre- and post-deployment briefings, the Army has a system in place called Trauma Risk Management (TRiM.) It is not a medical process, or therapy - it is designed to identify service personnel at risk after traumatic incidents.

Soldiers are often reluctant to talk to strangers when they are in difficulty, and often it is their mates whom they turn to for help. For this reason, TRiM is delivered by trained people already in the affected soldier's unit.

TRiM-trained personnel undergo specific training in the management of people after traumatic incidents. Those who are identified as being at risk after an event are invited to take part in an informal interview which establishes how they are coping.

The process is repeated after a month and a comparison of the outcomes is made, allowing early identification of those who may be having problems so that help can be given early.

Specialist treatment

Most people will feel much better after 4-6 weeks, but the small minority who are not doing well should have been identified by the TRiM process and directed to help.

Support services available include the Unit Padre, Unit Welfare Officer/Regimental Medical Officer and the more specialised psychiatric staff of mental health teams, both in the UK and in theatre.

Only a very small number of personnel are diagnosed with PTSD and it should be remembered that it is a treatable condition. The Army has specialists who can and do effectively treat those in need.

TRiM is a process that has already been used on operations in Iraq and Afghanistan for the last two years. It has developed credibility among those it is intended for and increased awareness of operational stress and detection of its effects. It has also led to a reduction in stigma that is often associated with mental health problems.

We do not stigmatise those who are wounded in action and PTSD is simply a wound to the mind. It will heal if it is treated properly and the sooner those in need are identified, the more effective their treatment is likely to be.