scholarly journals Do Junior Entrants to the UK Armed Forces have worse outcomes than Standard Entrants?

2021 ◽  
pp. bmjmilitary-2021-001787
Author(s):  
Margaret Jones ◽  
N Jones ◽  
H Burdett ◽  
B P Bergman ◽  
N T Fear ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Physical Symptoms ◽  
Self Report ◽  
Adult Service ◽  
Self Harm ◽  
The Uk

IntroductionThe UK is the only permanent member of the UN Security Council that has a policy of recruiting 16 and 17 year old individuals into its regular Armed Forces. Little is known about the consequences of enlisting as a Junior Entrant (JE), although concerns have been expressed. We compare the mental health, deployment history, and pre-enlistment and post-enlistment experiences of personnel who had enlisted as JEs with personnel who joined as Standard Entrants (SEs).MethodParticipants from a large UK military cohort study completed a self-report questionnaire between 2014 and 2016 that included symptoms of probable post-traumatic stress disorder (PTSD), common mental disorders, alcohol consumption, physical symptoms and lifetime self-harm. Data from regular non-officer participants (n=4447) from all service branches were used in the analysis. JEs were defined as having enlisted before the age of 17.5 years. A subgroup analysis of participants who had joined or commenced adult service after April 2003 was carried out.ResultsJEs were not more likely to deploy to Iraq or Afghanistan but were more likely to hold a combat role when they did (OR 1.25, 95% CI 1.00 to 1.56). There was no evidence of an increase in symptoms of common mental disorders, PTSD, multiple somatic symptoms (MSS), alcohol misuse or self-harm in JEs in the full sample, but there was an increase in alcohol misuse (OR 1.84, 95% CI 1.18 to 2.87), MSS (OR 1.51, 95% CI 1.04 to 2.20) and self-harm (OR 2.13, 95% CI 1.15 to 3.95) in JEs who had commenced adult service after April 2003. JEs remain in adult service for longer and do not have more difficulties when they leave service.ConclusionsJEs do not have worse mental health than SEs, but there is uncertainty in relation to alcohol misuse, MSS and self-harm in more recent joiners. Monitoring these concerns is advisable.

scholarly journals O5C.3 The mental health impact of deployment to iraq and afghanistan: what does the current data show?

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A46.1-A46
Author(s):  
Sharon Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Outcomes ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Health Impact ◽  
Current Data ◽  
Mental Health Outcomes ◽  
The Uk ◽  
The Impact

The longer term mental health outcomes of UK serving and ex-serving personnel have been the subject of much speculation. The latest research findings from the third phase of a longitudinal study will be presented, which is the only military cohort study of its kind in the UK. Data was collected among 8093 personnel between 2014 and 2016. The study examined the prevalence of mental disorders and alcohol misuse, whether rates differed between serving and ex-serving regular personnel and the impact of various deployment exposures. The prevalence of probable posttraumatic stress disorder was 6.2% (95% confidence interval (CI) 5.5–6.9), 21.9% (95% CI 20.8–23.0) for common mental disorders and 10.0% (95% CI 9.2–10.9) for alcohol misuse. Deployment to Iraq or Afghanistan and self-reported role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel. There was no association with number of deployments for any outcome. The findings highlight the importance of the continued monitoring of following personnel throughout their military career and beyond. The implications of the study outcomes will be discussed in the light of the mental health provision for serving and ex-serving personnel.

scholarly journals Do carers care for themselves? A population-based study

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Foteini Tseliou ◽  
Mark Atkinson ◽  
Shantini Paranjothy ◽  
Pauline Ashfield-Watt
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Behaviour ◽  
Dietary Habits ◽  
Common Mental Disorders ◽  
Smoking Status ◽  
Health Behaviours ◽  
Well Being ◽  
Self Report ◽  
Informal Carer

Background Informal caregiving has become an integral part of many societies, however there is increasing concern about the well-being of carers and how they manage their care-related responsibilities in conjunction with their health and mental health. Previous studies have reported mixed results with some proposing that carers are intrinsically healthier. Aims To explore the association between different levels of caregiving and health behaviours and mental health status. Methods Data were collected through HealthWise Wales (HWW) and linked to healthcare records (N=27,455). These included self-reported data on level of caring responsibilities (0;1-19;20-49;50+ hours per week), whether or not they left employment due to their caring role, mental health using the short Mental Health Inventory (MHI-5) and health behaviour data on smoking status, physical activity and dietary habits. Data on current diagnosis of Anxiety and Depression were drawn from linked healthcare records. Separate logistic regression models adjusted for age, gender and socio-economic status were fitted to assess the association between intensity of caring responsibility and each mental health and health behaviour outcome. Results Of the 14,451 HWW participants who had complete records, 3,856 (26.7%) reported being an informal carer. Intense carers (20-49 hours per week) were more likely to be physically inactive (OR:1.27, 95%CI:1.04-1.56), smoke cigarettes (OR:1.49, 95%CI:1.11-2.00) and eat unhealthily (OR:1.48, 95%CI:1.13-1.93). They were more also likely to self-report (OR:1.87, 95%CI:1.51-2.32) or have a diagnosis of depression or anxiety (OR:1.57, 95%CI:1.26-1.97). Other levels of caregiving intensity also demonstrated the above associations. Carers who had given up work to care were more likely to be smokers and have common mental disorders. Conclusion Being an informal carer is associated with unhealthy behaviours and common mental disorders, with a gradient effect dependent on the level of caregiving activity. New interventions that can support carers to improve their health and wellbeing are urgently needed.

scholarly journals Help-seeking and receipt of treatment among UK service personnel

2010 ◽  
Vol 197 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Amy C. Iversen ◽  
Lauren van Staden ◽  
Jamie Hacker Hughes ◽  
Tess Browne ◽  
Neil Greenberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Help Seeking ◽  
Service Use ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Service Utilisation ◽  
Professional Help ◽  
Military Health ◽  
The Uk

BackgroundFor armed forces personnel, data on help-seeking behaviour and receipt of treatment for mental disorders are important for both research and policy.AimsTo examine mental healthcare service use and receipt of treatment in a sample of the UK military.MethodParticipants were drawn from an existing UK military health cohort. The sample was stratified by reserve status and by participation in the main war-fighting period of the Iraq War. Participants completed a telephone-based structured diagnostic interview comprising the Patient Health Questionnaire and Primary Care Post-Traumatic Stress Disorder Screen (PC–PTSD), and a series of questions about service utilisation and treatment receipt.ResultsOnly 23% of those with common mental disorders and still serving in the military were receiving any form of medical professional help. Non-medical sources of help such as chaplains were more widely used. Among regular personnel in receipt of professional help, most were seen in primary care (79%) and the most common treatment was medication or counselling/psychotherapy. Few regular personnel were receiving cognitive–behavioural therapy (CBT). These findings are comparable with those reported for the general population.ConclusionsIn the UK armed forces, the majority of those with mental disorders are not currently seeking medical help for their symptoms. Further work to understand barriers to care is important and timely given that this is a group at risk of occupational psychiatric injury.

scholarly journals Self-reported auditory problems are associated with adverse mental health outcomes and alcohol misuse in the UK Armed Forces

2021 ◽  
Author(s):  
Fred N. H. Parker ◽  
Nicola T. Fear ◽  
S. A. M. Stevelink ◽  
L. Rafferty
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Uk ◽  
Hearing Problems

Abstract Purpose Auditory problems, such as hearing loss and tinnitus, have been associated with mental health problems and alcohol misuse in the UK general population and in the US Armed Forces; however, few studies have examined these associations within the UK Armed Forces. The present study examined the association between auditory problems and probable common mental disorders, post-traumatic stress disorder and alcohol misuse. Methods 5474 serving and ex-service personnel from the UK Armed Forces were examined, selected from those who responded to phase two (data collection 2007–09) and phase three (2014–16) of a military cohort study. Multivariable logistic regression was used to examine the association between auditory problems at phase two and mental health problems at phase three. Results 9.7% of participants reported ever experiencing hearing problems alone, 7.9% reported tinnitus within the last month alone, and 7.8% reported hearing problems with tinnitus. After adjustment, hearing problems with tinnitus at phase two was associated with increased odds of probable common mental disorders (AOR = 1.50, 95% CI 1.09–2.08), post-traumatic stress disorder (AOR = 2.30, 95% CI 1.41–3.76), and alcohol misuse (AOR = 1.94, 95% CI 1.28–2.96) at phase three. Tinnitus alone was associated with probable post-traumatic stress disorder (AOR = 1.80, 95% CI 1.03–3.15); however, hearing problems alone were not associated with any outcomes of interest. Conclusions The association between auditory problems and mental health problems emphasises the importance of the prevention of auditory problems in the Armed Forces: through enhanced audiometric screening, improved hearing protection equipment, and greater levels of utilisation of such equipment.

Mental health

2021 ◽  
pp. 767-794
Author(s):  
Charlotte Hanlon ◽  
Asnake Limenhe
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Learning Disability ◽  
Common Mental Disorders ◽  
Adjustment Disorders ◽  
Post Traumatic Stress ◽  
Self Harm ◽  
Post Traumatic

Suicide and deliberate self-harm?, Acute behavioural disturbance?, Common mental disorders?, Severe mental disorders psychoses?, Disorders due to substance abuse?, Withdrawal states?, Adjustment disorders and bereavement?, Post-traumatic stress disorder?, Intellectual learning disability?, Disorders in children and adolescents?

scholarly journals Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq

2007 ◽  
Vol 190 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tess Browne ◽  
Lisa Hull ◽  
Oded Horn ◽  
Margaret Jones ◽  
Dominic Murphy ◽  
...  
Keyword(s):  
Iraq War ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Well Being ◽  
Physical Symptoms ◽  
Self Report ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Unit Cohesion

BackgroundDeployment to the 2003 Iraq War was associated with ill health in reserve armed forces personnel.AimsTo investigate reasons for the excess of ill health in reservists.MethodUK personnel who were deployed to the 2003 Iraq War completed a health survey about experiences on deployment to Iraq. Health status was measured using self-report of common mental disorders, post-traumatic stress disorder (PTSD), fatigue, physical symptoms and well-being.ResultsReservists were older and of higher rank than the regular forces. They reported higher exposure to traumatic experiences, lower unit cohesion, more problems adjusting to homecoming and lower marital satisfaction. Most health outcomes could be explained by role, experience of traumatic events or unit cohesion in theatre. PTSD symptoms were the one exception and were paradoxically most powerfully affected by differences in problems at home rather than events in Iraq.ConclusionsThe increased ill-health of reservists appears to be due to experiences on deployment and difficulties with homecoming.

scholarly journals Effects of home on the mental health of British forces serving in Iraq and Afghanistan

2012 ◽  
Vol 201 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Kathleen Mulligan ◽  
Norman Jones ◽  
Mark Davies ◽  
Peter McAllister ◽  
Nicola T. Fear ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
General Health Questionnaire ◽  
Armed Forces ◽  
Home Front ◽  
Post Traumatic Stress ◽  
The Family ◽  
Military Support ◽  
Mental Health Effects

BackgroundMost studies of the mental health of UK armed forces focus on retrospective accounts of deployment and few sample personnel while they are deployed.AimsThis study reports the results of a survey of deployed personnel, examining the perceived impact of events at home and military support for the family on current mental health during the deployment.MethodSurveys were conducted with 2042 British forces personnel serving in Iraq and Afghanistan. Prevalence of common mental disorders was assessed with the 12-item General Health Questionnaire (GHQ-12) and post-traumatic stress disorder (PTSD) was assessed with the PTSD Checklist – Civilian version (PCL-C).ResultsThe prevalence of common mental disorders was 17.8% and of probable PTSD was 2.8%. Perceived home difficulties significantly influenced the mental health of deployed personnel; the greater the perception of negative events in the home environment, the greater the reporting of adverse mental health effects. This finding was independent of combat exposure and was only partially mitigated by being well led and reporting subjectively good unit cohesion; however, the effect of the totality of home-front events was not improved by the latter. Poor perceived military support for the family had a detrimental impact on deployment mental health.ConclusionsThe armed forces offer many support services to the partners and families of deployed personnel and ensuring that the efforts being made on their behalf are well communicated might improve the mental health of deployed personnel.

scholarly journals Psychiatric Morbidity among Spouses of Men with Alcohol Dependence

2017 ◽  
Vol 03 (01) ◽  
pp. 010-014
Author(s):  
Vishal Shah ◽  
Prakash Behere ◽  
K Mishra ◽  
Animesh Sharma ◽  
Kanika Kumar
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Alcohol Dependence ◽  
Common Mental Disorders ◽  
Global Mental Health ◽  
Psychiatric Morbidity ◽  
Controlled Study ◽  
Suicidal Risk ◽  
Increased Risk ◽  
Self Harm

Abstract Objective: To assess the common mental disorders among spouses of men with alcohol dependence and to compare common mental disorders among spouses of alcoholics and nonalcoholics. Study design: This was a cross-sectional controlled study. We evaluated 50 cases (including the indoor and outdoor patients) whose husbands were diagnosed as having alcohol dependence and 50 controls whose husbands had no alcohol dependence but some other illness, admitted to our rural medical college using the global mental health assessment tool-primary care (GMHAT-PC) version including the sociodemographic profile sheet and history of patient's illness. Results: Anxiety (16%) and depression (36%) were higher in wives of alcohol-dependent men. Stress was higher (6%) in cases as compared with controls (4%). When comparing diagnosis and age-wise distribution, depression was higher in cases (28%) as compared with controls (14%) in age group of 31 to 40. There were 23 (46%) out of 50 spouses of men with alcohol dependence syndrome, whose diagnosis by GMHAT-PC came out as no mental illness; still they had some score in the anxiety rating, but this score was not enough for them to be diagnosed under anxiety disorder. Even in controls, anxiety score to a certain extent was present in 26% spouses. The GMHAT-PC self-harm scoring system was used to assess the risk of self-harm. It was found that three (6%) spouses had mild suicidal risk and one (2%) had severe suicidal risk, whereas in controls, it was absent. Conclusion: Alcohol abuse is associated with an increased risk of committing criminal offences. An alcoholic can disrupt the routine family life. The women are primary caregivers in most of these cases. Therefore, understanding mental health status of spouses of alcoholics is of utmost importance. It can help in early detection of psychiatric morbidities and help in early intervention.

scholarly journals Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study

2018 ◽  
Vol 213 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Sharon A. M. Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Armed Forces ◽  
Mental Health Outcomes ◽  
Post Traumatic Stress ◽  
King's College ◽  
Post Traumatic ◽  
The Uk

BackgroundLittle is known about the prevalence of mental health outcomes in UK personnel at the end of the British involvement in the Iraq and Afghanistan conflicts.AimsWe examined the prevalence of mental disorders and alcohol misuse, whether this differed between serving and ex-serving regular personnel and by deployment status.MethodThis is the third phase of a military cohort study (2014–2016; n = 8093). The sample was based on participants from previous phases (2004–2006 and 2007–2009) and a new randomly selected sample of those who had joined the UK armed forces since 2009.ResultsThe prevalence was 6.2% for probable post-traumatic stress disorder, 21.9% for common mental disorders and 10.0% for alcohol misuse. Deployment to Iraq or Afghanistan and a combat role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel.ConclusionsThe findings highlight an increasing prevalence of post-traumatic stress disorder and a lowering prevalence of alcohol misuse compared with our previous findings and stresses the importance of continued surveillance during service and beyond.Declaration of interest:All authors are based at King's College London which, for the purpose of this study and other military-related studies, receives funding from the UK Ministry of Defence (MoD). S.A.M.S., M.J., L.H., D.P., S.M. and R.J.R. salaries were totally or partially paid by the UK MoD. The UK MoD provides support to the Academic Department of Military Mental Health, and the salaries of N.J., N.G. and N.T.F. are covered totally or partly by this contribution. D.Mu. is employed by Combat Stress, a national UK charity that provides clinical mental health services to veterans. D.MacM. is the lead consultant for an NHS Veteran Mental Health Service. N.G. is the Royal College of Psychiatrists’ Lead for Military and Veterans’ Health, a trustee of Walking with the Wounded, and an independent director at the Forces in Mind Trust; however, he was not directed by these organisations in any way in relation to his contribution to this paper. N.J. is a full-time member of the armed forces seconded to King's College London. N.T.F. reports grants from the US Department of Defense and the UK MoD, is a trustee (unpaid) of The Warrior Programme and an independent advisor to the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee (unpaid) of Combat Stress and Honorary Civilian Consultant Advisor in Psychiatry for the British Army (unpaid). S.W. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the Department of Health, Public Health England or the UK MoD.

scholarly journals Perceived stigma and barriers to care in UK Armed Forces personnel and veterans with and without probable mental disorders

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Victoria Williamson ◽  
Neil Greenberg ◽  
Sharon A. M. Stevelink
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Help Seeking ◽  
Barriers To Care ◽  
Common Mental Disorders ◽  
Armed Forces ◽  
Perceived Stigma ◽  
Telephone Interviews ◽  
Related Stigma ◽  
Health Related

Abstract Background Previous studies have found that perceptions of mental health related stigma can negatively impact help-seeking, particularly in military samples. Moreover, perceptions of stigma and barriers to care can vary between individuals with different psychiatric disorders. The aim of this study was to examine whether perceptions of stigma and barriers to care differed in a UK military sample between those with and without a current likely mental health diagnosis. Method Structured telephone interviews were carried out with 1432 service personnel and veterans who reported recent subjective mental ill health in the last 3 years. Participants completed self-reported measures relating to perceived stigma, barriers to care and psychological wellbeing. Results Those meeting criteria for probable common mental disorders (CMD) and PTSD were significantly more likely to report concerns relating to perceived and internalised stigma and barriers to care compared to participants without a likely mental disorder. Compared to individuals with likely CMD and alcohol misuse, those with probable PTSD reported higher levels of stigma-related concerns and barriers to care – although this difference was not significantly different. Conclusions These results indicate that perceptions of stigma continue to exist in UK serving personnel and military veterans with current probable mental disorders. Efforts to address particular concerns (e.g. being seen as weak; difficulty accessing appointments) may be worthwhile and, ultimately, lead to improvements in military personnel and veteran wellbeing.

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