Soldiers' mental illness risk rises along with tours of duty "We need to recognise that some form of anguish is a normal human reaction to abnormal events": Chief of the Defence Force General David Hurley. Australian soldiers exposed repeatedly to combat and trauma in Afghanistan or Iraq face a 15-fold increase in risk of mental health problems such as post-traumatic stress disorder, a major study has found. The study of about 14,000 military personnel who had served in the Middle East Area of Operations found that cumulative exposure to trauma such as being fired upon or handling dead bodies was particularly stressful and likely to cause mental health problems. "These findings covered post traumatic stress, major depressive syndrome, panic and other anxiety syndromes, and alcohol misuse," the report said. The risk was "most pronounced for cumulative number of exposures" raising concerns about special forces soldiers, many of whom have served five or more tours of duty. A separate report that studied about 3000 military personnel before and after they were deployed to the Middle East Area of Operation - which includes Afghanistan - found that although most were in good physical and mental health on their return, nearly one in 50 reported post traumatic stress symptoms after their deployment. Launching the report, Chief of the Defence Force, General David Hurley, said people should remember that the defence force was "ordinary Australians .... who are asked to deal with extraordinary events." "We need to recognise that some form of anguish is a normal human reaction to abnormal events," he said. But he added that not everyone experienced trauma, and warned against exaggerated forecasts of a flood of PTSD sufferers among the tens of thousands of Australians who had served in the Middle East. "The term a tidal wave, or a tsunami, of PTSD has been used to predict our state as operations draw down to a reduced level in Afghanistan," he said. This language is provocative and emotive and points to a simplistic view of military mental health. Given Australia had been involved in the Middle East and difficult border protection operations for 12 years, a flood of cases could be expected already, but "our data does not support this view." Retired army Major-General John Cantwell, a PTSD sufferer himself, has been prominent in warning of a "tidal wave" of cases among Afghanistan veterans. General Hurley said he was not attacking General Cantwell, whom he admired for his "compassionate and heartfelt" discussion of the issue.