Eight years ago, Lt Col Janet Pilgrim stood before the Queen to receive a medal known as nursing’s Victoria Cross for her selfless devotion in running a British field hospital under heavy fire.
The former senior Army medic once nicknamed ‘Florence of Arabia’ by newspapers sits at home battling flashbacks, depression and suicidal thoughts as she struggles to come to terms with what she faced that summer.
Her PTSD and depression have seen her abandoned and cast out by the Army, she feels, and left her at times to question whether she would have been better treated if she had lost a limb, rather than suffered mental wounds serving her country.
The 49-year-old believes her struggle is being mirrored across the Armed Forces, where many others psychologically scarred in Britain’s wars are being badly let down by a failing military mental health care system.
Treatment for soldiers, sailors and airmen needs overhauling she warns, because at present they are either treated in a civilian NHS that is unable understand their needs, or by military medical units that are poorly equipped and funded.
“I once told someone, I would have been better off losing a limb,” she told the Telegraph, “because you then get flown to Birmingham, you get treated by the top surgeons, you get put on a military ward and you have got a whole lot of welfare staff to look after you.
“A mental health patient gets none of that. You get thrown into the NHS mental health system that can’t cope with us and we can’t cope with it, then we are left out on a limb with nothing.”
The former officer in the Queen Alexandra's Royal Army Nursing Corps, who was tipped for promotion to Colonel before her illness, says: “If it was happening at my level, then what was happening to the guys who were junior, who didn’t speak out.”
Lt Col Pilgrim, of Terrington in North Yorks, was likened to a new Florence Nightingale in 2008 when, then a major, she was awarded a rare Royal Red Cross medal for her heroism running the field hospital at Basra air base in southern Iraq.
She commanded the tented wards over the grim summer of 2007, when Mahdi Army rebels were attempting to force British troops soldiers from the city. She and her staff treated a stream of 92 wounded and horribly maimed troops, 20 of whom died, while the air base was hit by rockets several times daily. Starved of sleep and always under threat of bombardment, she personally led the team who prepared bodies for repatriation and informed loved ones of their loss.
Her citation explained she was “utterly committed as a leader, loved by those she commanded, exceptionally gifted as a nurse; she was the very embodiment of what many aspire to be”.
Yet the responsibility and constant threat she had faced that summer was to take a terrible toll. Returning to personnel and training staff jobs in the UK, she found herself unable to concentrate and suffering flashbacks to that summer.
She said: “You are in charge of a hospital and it’s built in a tent, and your staff are terrified, the patients are scared stiff, and you are going around, trying to make sure everyone is okay, that you are going to have some hospital left at the end of it.”
A rocket that hit a nearby accommodation block killed three RAF Regiment gunners that July. The hospital’s welfare block was destroyed once and its power was cut by another rocket.
“There was a few staff I had to send home because they just couldn’t cope. They refused to go out and would always sleep in their flak jackets. You are working an 18 hour day. It was horrendous.”
Her condition deteriorated back home to where she could not eat, sleep or concentrate. She soon began to feel suicidal and turned to drink, but tried to keep her deterioration from her family.
She said: “I didn’t want them to worry and I was ashamed, because I’m a nurse, I’m an officer, there were younger ranks than me, why did it happen to me? The shame and the embarrassment about not being able to cope are really extremely hard to deal with and there is still a lot of stigma in the military about mental health.”
She was admitted to an NHS mental health ward in Darlington, but treated by staff who had never dealt with the military, in a ward with a constantly changing set of civilian patients.
Her bosses later tried to gradually ease her back to work with a desk job, but she again deteriorated when she was left adrift without guidance or support.
She was sent to another civilian mental health hospital in York, where staff had once again never treated a member of the military. When she left early in despair, she says the Army put her before a medical board and discharged her.
“I have had to jump through so many hoops just to try and get the support that I need, that it’s just devastating,” she said.
“I feel the Army just cast me out, they just didn’t care and I can’t believe that they would do that.”
She is now being given appointments by staff at a nearby RAF base, while she looks for a charity to fund more treatment. But she says the mental health team at the base is confined to an inadequate old building near the runway, where counselling sessions are constantly interrupted by the roar of aircraft taking off.
She said: “There are some very good staff who are working very hard, but are being expected to work in inappropriate facilities and with poor resources.”
Her anger at her treatment has been made worse by the fact one clinical psychologist told her if she had been correctly treated from the start, she would have been “still in uniform” and able to continue her job.
She told the Telegraph: “Mental health care within the military needs sorting out. We are the poor relation of those with physical injuries. There are so many people out there who have been through stuff.”
A spokeswoman for the MOD said it was unable to comment on individual cases. She said: “We are absolutely committed to the mental health of our Armed Forces and in general it remains good.”
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