Retrospective cohort study of compliance with post-deployment screening in the Canadian Armed Forces

ObjectiveCanadian Armed Forces (CAF) personnel who return from certain international deployments are required to complete post-deployment screening (PDS) 90 to 180 days post-deployment; the primary goal of PDS is early detection of mental health problems that aims for reduced delays to care provision. We investigated service members’ compliance with the PDS completion requirement and the factors associated with this compliance; a secondary objective was to investigate completion timing.DesignThe study used a retrospective cohort of CAF personnel (n=28 460) who had deployments over 01 January 2009 to 31 December 2014; inferences were based on a probabilistic sample (n=3004).Primary outcomeThe primary outcome was PDS completion. We assessed the timing of PDS completion, comparing non-compliant (early, late or no completion) with compliant completions (90 to 180 days post-deployment) among deployments that required screening. Kaplan-Meier plots summarised time-to-completion and logistic regression assessed the covariate associations with compliant completion. Covariate-adjusted marginal compliance prevalence differences (MPD) were computed.Results67.3% (95% CI65.0 to 69.6) of deployments that required PDS had one completed; 43.3% (95%CI 40.6 to 46.0) were completed within the compliant period. Compliant completion was higher with lower ranks (MPD=10.6%, relative to officers), combat arms occupations (MPD=8.4%), Afghanistan deployments (MPD=19.2%), longer deployments (MPD=10.1%) and among those without a past mental health problem (MPD=9.7%).ConclusionsOur findings suggest that some selective processes may be occurring where those perceived to be at higher risk for post-deployment mental health problems are more compliant with PDS completion. However, PDS completion and compliant completion were lower than expected and this suggests a need to reinforce instruction on the guidelines and objectives of PDS among service members in the CAF.

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Impact of Canadian Armed Forces Veterans’ Mental Health Problems on the Family During the Military to Civilian Transition

Military Behavioral Health ◽

10.1080/21635781.2019.1644260 ◽

2019 ◽

Vol 8 (2) ◽

pp. 148-158 ◽

Cited By ~ 2

Author(s):

Heidi Cramm ◽

Deborah Norris ◽

Kelly Dean Schwartz ◽

Linna Tam-Seto ◽

Ashley Williams ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Armed Forces ◽

Health Problems ◽

Canadian Armed Forces ◽

The Family ◽

The Military

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Deployment-related mild traumatic brain injury, mental health problems, and post-concussive symptoms in Canadian armed forces personnel

BMC Psychiatry ◽

10.1186/s12888-014-0325-5 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 28

Author(s):

Bryan G Garber ◽

Corneliu Rusu ◽

Mark A Zamorski

Keyword(s):

Mental Health ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Mental Health Problems ◽

Armed Forces ◽

Health Problems ◽

Canadian Armed Forces

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Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-018-1562-6 ◽

2018 ◽

Vol 54 (2) ◽

pp. 145-156 ◽

Cited By ~ 5

Author(s):

Jennifer A. Born ◽

Mark A. Zamorski

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Armed Forces ◽

Health Problems ◽

Canadian Armed Forces ◽

Population Attributable Fractions ◽

Attributable Fractions

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Effectiveness of a mobile phone-based intervention to reduce mental health problems in healthcare workers during the COVID-19 pandemic: A randomized controlled trial (PsyCovidApp trial) (Preprint)

10.2196/preprints.27039 ◽

2021 ◽

Author(s):

Maria Antònia Fiol-DeRoque ◽

Maria Jesús Serrano-Ripoll ◽

Rafael Jiménez ◽

Rocío Zamanillo-Campos ◽

Aina María Yáñez-Juan ◽

...

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Posttraumatic Stress ◽

Healthcare Workers ◽

Primary Outcome ◽

Mental Health Problems ◽

Controlled Trial ◽

Health Problems ◽

Psychotropic Medications ◽

Randomized Controlled

BACKGROUND The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to healthcare workers (HCWs), who are facing heavy workloads under psychologically difficult situations. OBJECTIVE This trial aims to evaluate the effectiveness of a psychoeducational mobile Health (mHealth) intervention to reduce mental health problems in HCWs during the COVID-19 pandemic. METHODS We carried out a blinded randomized controlled trial. HCWs caring for COVID-19 patients in Spain were randomly assigned (1:1) by a computer-generated randomization sequence to the PsyCovidApp intervention (App targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control App (general recommendations about mental healthcare). Data collection was conducted telephonically at baseline and two weeks. The primary endpoint was a composite of depression, anxiety, and stress. Secondary endpoints were insomnia, burnout, posttraumatic stress, self-efficacy, depression, anxiety, and stress. Differences between groups were analyzed using general linear modeling, according to an intention-to-treat protocol. RESULTS Between 14 May and 25 July 2020, 482 HCWs were randomly assigned to PsyCovidApp (n=248) or the control App (n=234). At two weeks, complete outcome data were available for 436 (91%) HCWs. No significant differences were observed between the groups at two weeks in the primary outcome (standardized mean difference -0.04 [95% CI -0.11 to 0.04]; p=0.15) and in the rest of the outcomes. In our prespecified subgroup analyses, we observed significant (p<0.05) improvements among HCWs consuming psychotropic medications in the primary outcome, and posttraumatic stress, insomnia, anxiety, and stress. Similarly, among HCWs receiving psychotherapy, we observed improvements in the primary outcome, insomnia, anxiety, and stress. CONCLUSIONS In HCWs assisting COVID-19 patients in Spain, PsyCovidApp, compared with a control App, reduced mental health problems at two weeks only among HCWs receiving psychotherapy or psychotropic medications. CLINICALTRIAL ClinicalTrials.gov NCT04393818

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Relationship between obesity and health problems in help-seeking military veterans

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2019-001155 ◽

2019 ◽

pp. jramc-2019-001155

Author(s):

Victoria Williamson ◽

A Rossetto ◽

D Murphy

Keyword(s):

Mental Health ◽

General Population ◽

Physical Health ◽

Help Seeking ◽

Mental Health Problems ◽

Psychological Treatment ◽

Mental Healthcare ◽

Armed Forces ◽

Health Problems ◽

Physical And Mental Health

BackgroundUK Armed Forces (UK AF) veterans may be particularly vulnerable to obesity and its comorbid physical and mental health problems.AimTo examine the relationship between body mass index (BMI), physical health problems, mental health disorders and sociodemographic characteristics in UK AF veterans engaged in psychological treatment.MethodsInformation regarding veteran BMI, demographic characteristics, physical health conditions and mental health problems was collected and analysed using univariate and multivariate regression analyses. Rates of veteran obesity were also compared with the UK general population.ResultsOf the 384 help-seeking veterans, 37.5% (n=151) were overweight (BMI 26–30) and 35.5% (n=143) were obese. Obesity in help-seeking male veterans was two to four times higher than that of the general population of UK. Higher scores on measures of anger and common mental health problems were significantly associated with greater BMI. Problems with physical systemic functioning and mobility were also significantly associated with greater BMI.ConclusionsThe results indicate that treatment-seeking UK AF veterans exhibit higher levels of obesity compared with the general population, and clinically significant physical and mental comorbidities. The findings highlight a need for mental health services to offer treatments that effectively integrate physical and mental healthcare in the treatment of people with mental health problems.

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Mental Health During Naval Deployment: The Protective Role of Family Support

Military Medicine ◽

10.1093/milmed/usz436 ◽

2019 ◽

Vol 185 (5-6) ◽

pp. e703-e710

Author(s):

Morten Nordmo ◽

Sigurd William Hystad ◽

Sverre Sanden ◽

Bjørn Helge Johnsen

Keyword(s):

Mental Health ◽

Family Support ◽

Protective Factor ◽

Mental Health Problems ◽

Psychiatric Symptoms ◽

General Health Questionnaire ◽

Health Problems ◽

Service Members ◽

Multilevel Regression ◽

High Degree

Abstract Introduction Minor mental health problems among service members deployed in combat areas are relatively common, but social support is a protective factor. With the advent of digital communication, as well as more frequent family separations, a stable family support system may be more important than before. In this exploratory study, we aimed to test the relationship between perceived family support and the development of minor psychiatric symptoms during a 4-month naval counter piracy mission in the Gulf of Aden. Materials and Methods We measured minor mental health problems with the general health questionnaire 12 (GHQ-12) and family support at three intervals, 3 weeks before deployment, 2 months into the mission, and at the end of deployment. We used mixed multilevel regression analysis to analyze the main effects of family support and time, as well as their interaction. All analyses were controlled for military rank. Results We found that minor psychiatric symptoms increased at both midway (B = 0.51, P < 0.05) and toward the end of the mission (B = 0.72, P < 0.01). The results also showed that receiving more family support is associated with fewer psychiatric symptoms (B = −0.87, P < 0.01). Family support also moderated the development of symptoms toward the end of the mission (B = −0.73, P < 0.01). The buffering effect was such that service members with a high degree of family support experienced no increase in minor psychiatric symptoms during the deployment. Conclusions The results indicate that naval deployment is associated with a small increase in minor mental health problems and that having a high degree of family support buffers this effect. Efforts to increase support among military families may positively influence the wellbeing of naval sailors during combat missions.

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