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The Increase of Adverse Mental Health Outcomes in German Land Forces after Deployment Overseas

Since 1959, the German Army had its troops deployed to more than fifty countries, following the most extended deployment in Afghanistan in the International Security Assistance Force (ISAF) mission since 2002. German soldiers have a long and outstanding history of operating under difficult and dangerous conditions. The stress that soldiers initially experience is categorised as traumatic stress, derived from battle exposure in hostile environments, where land forces get injured or killed in all likelihood. Key characteristics of Afghanistan’s security architecture are the multiple security challenges emanating from the weak and unstable government that fuelled the political conflicts in hostile environments, which are seen as hotbeds for terrorists. The contributions made by the German military across its security landscape are guided by the claim to protect their national security interests in this region, which requires the coordinated action of all instruments of national military power and diplomatic influence across multiple departments. Lengthy deployment periods paired with exposure to traumatic events facilitate adverse mental health outcomes among land forces who internalise their mental health problems after combat. Soldiers who have experienced war are traumatised by its effects (Hunt et al., 2012), therefore, the casualties of war and combat are not just those killed or wounded, but they are people who cannot bear their memories of what has happened during their military deployment. Soldiers have mental health problems as a direct consequence of exposure to combat, and many of the soldiers never learn to deal with these prevalent memories. War trauma, which arises out of a complex interaction of personal, social, and political forces, is about the bodily experience as much as emotional feelings (Hunt et al., 2012). Traumatised soldiers lose the coherence in their memories as they cannot fully reconstruct their traumatic experiences in combat zones; therefore, their mental wellbeing fundamentally alters how they are linked (Hunt et al., 2012).

Little is known about the frequency of trauma exposure and the development of adverse mental health outcomes such as Posttraumatic stress disorder (PTSD), depression, and anxiety among German forces after being in a combat zone. Land forces are at constant risk for developing mental health problems at war, and the need for mental health services is greater during conflict. PTSD is commonly known as a ‘trauma-related mental disorder with anxious and depressive features, resulting from exposure to one or more events involving actual or threatened death or serious injury’ (Todd et al., 2015). Worth mentioning is that land forces with symptoms of PTSD are suffering from a severe and insidious injury, one that was thrust upon them by exposure to traumatic incidents that involved killing, injury, or witnessing the death of other veterans.

It is very unrealistic to expect the society in which we live to understand what exactly veterans go through during past deployments in Afghanistan. The only perceptions of war and what it feels like to go to war are propagated through media sources, reports, and what is shared on social media.

From a civilian perspective, it is difficult to imagine what German forces experienced during their deployment in war. However, it is communicated through media reports that allow for a better understanding of why soldiers return psychologically injured or emotionally exhausted. Recent data demonstrate that 49,2% of the soldiers returning from the battlefield experienced at least one traumatic event, and 13% experienced more than three (Wittchen, 2012). Interviews with soldiers witness that the cases of mental health outcomes are persistently high, especially when deployed to high-risk combat zones: ‘Seeing the events at the Hindu Kush in northern Afghanistan and the country fallen to the Taliban in mid-2021 led to a re-trauma’ (Küstner, 2021). The interviewed German soldier has been deployed seven times to Afghanistan, where he was confronted with witnessing death of Veterans and killing of other people. Furthermore, he claimed that seeing Afghanistan fallen to the Taliban prompted his feelings of anger and hatred, resulting in night-mares and panic attacks (Küstner, 2021). In 2018, 182 German soldiers were diagnosed with PTSD, which is twelve more cases than in 2017, and in total, 279 soldiers were diagnosed with adverse mental health outcomes resulting from battlefield exposure in Afghanistan (Thurau, 2019).

Recently published reports reveal that many soldiers have chronic PTSD, and there needs to be more emphasis on providing adequate treatment options. After a military deployment overseas, mental health outcomes need to be considered a part of a comprehensive physical and psychological network finely matching each other. This can contribute to a rethinking of German politics, as adverse mental health outcomes increasingly affect the perceived ‘objectivity’ of the consequences of military operations. Current overseas deployment in Mali or Kosovo could be a ‘second Afghanistan’ with similar outcomes.

There had been 81 289 soldiers deployed overseas (Kowalski, 2012), and with the troop withdrawal of German and coalition forces, the focus is now on the European foreign and security policy, revealing a niche for military health topics which need to be considered for future military deployments in contemporary conflict or combat zones. In honour of the 160,000 soldiers who served in Afghanistan for the past twenty years, the German Bundestag’s great tattoo was performed on October 13, 2021 (Schmeitzner, 2021). The military ceremony is the German Land forces’ way to draw a reliable conclusion for fighting in Afghanistan. German federal president Frank-Walter Steinmeier claimed that the German military had accomplished the mission which the politics have assigned. Also, he concluded that in the current times of instability and insecurity, German politics and the military component is investing more in its defence to demonstrate a strong nation against terrorism.

However, research priorities focusing on military suicide in land forces reveal that suicidality is directly associated with PTSD, depression, and anxiety. Therefore, there is the need to implement transparent treatment options and a sense of awareness of mental health problems to ensure a strong and unified military presence with soldiers having resilient mental health in future military deployments. Thus, the focus should be placed on underexplored areas of Veterans suffering from a severe injury sustained from life-threatening exposure to traumatic experiences. Learning lessons from Germany’s longest war in Afghanistan will provide a more comprehensive understanding leading to more respect and sensitisation towards land forces serving to protect our country.

Written by Lina Stahl 

 

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