scholarly journals The long-term mental health impact of peacekeeping: prevalence and predictors of psychiatric disorder

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 32-37 ◽  
Author(s):  
David Forbes ◽  
Meaghan O'Donnell ◽  
Rachel M. Brand ◽  
Sam Korn ◽  
Mark Creamer ◽  
...  

BackgroundThe mental health outcomes of military personnel deployed on peacekeeping missions have been relatively neglected in the military mental health literature.AimsTo assess the mental health impacts of peacekeeping deployments.MethodIn total, 1025 Australian peacekeepers were assessed for current and lifetime psychiatric diagnoses, service history and exposure to potentially traumatic events (PTEs). A matched Australian community sample was used as a comparator. Univariate and regression analyses were conducted to explore predictors of psychiatric diagnosis.ResultsPeacekeepers had significantly higher 12-month prevalence of post-traumatic stress disorder (16.8%), major depressive episode (7%), generalised anxiety disorder (4.7%), alcohol misuse (12%), alcohol dependence (11.3%) and suicidal ideation (10.7%) when compared with the civilian comparator. The presence of these psychiatric disorders was most strongly and consistently associated with exposure to PTEs.ConclusionsVeteran peacekeepers had significant levels of psychiatric morbidity. Their needs, alongside those of combat veterans, should be recognised within military mental health initiatives.

2014 ◽  
Vol 11 (4) ◽  
pp. 83-85 ◽  
Author(s):  
David Forbes ◽  
Olivia Metcalf

Australia has deployed over 25 000 personnel to recent conflicts in the Middle East and has been involved in peacekeeping missions. Australian veterans report elevated rates of mental health problems such as post-traumatic stress disorder, anxiety disorders, affective disorders and substance use disorders. Veteran healthcare is delivered through publicly funded services, as well as through private services, at primary, secondary and tertiary levels. Some of the challenges involve coordination of services for veterans transitioning from Defence to Veterans' Affairs, service delivery across a large continent and stigma inhibiting service-seeking. Initiatives have been introduced in screening and delivery of evidence-based treatments. While challenges remain, Australia has come a long way towards an integrated and comprehensive approach to veteran mental healthcare.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046996
Author(s):  
Kirsty Clark ◽  
John Pachankis ◽  
Kaveh Khoshnood ◽  
Richard Bränström ◽  
David Seal ◽  
...  

BackgroundDisplaced Syrians face psychiatric morbidity often resulting from displacement-related stressors (eg, resource scarcity). Both men who have sex with men (MSM) and transgender women among the displaced Syrians are particularly vulnerable to mental health challenges given that they also often face stigma-related stressors (eg, discrimination).MethodsBetween January and December 2019 in greater Beirut, 258 Lebanese-born MSM and transgender women and 230 displaced Syrian MSM and transgender women were recruited via respondent-driven sampling to complete an in-person survey assessing displacement-related stressors, stigma-related stressors, depression, anxiety and post-traumatic stress disorder. In the total sample, we first documented the prevalence of psychiatric morbidity among the displaced Syrians; we then assessed associations among displacement-related and stigma-related stressors and each psychiatric outcome.ResultsSixty-three per cent of Syrian participants met criteria for depression compared with 43.8% of Lebanese participants (p<0.001); 21.3% of Syrians met criteria for severe anxiety compared with 13.1% of Lebanese participants (p<0.05) and 33.0% of Syrians met criteria for post-traumatic stress disorder compared with 18.4% of Lebanese participants (p<0.001). Among Syrian MSM and transgender women, sociodemographic characteristics, displacement-related stressors and stigma-related stressors were uniquely associated with psychiatric morbidity.ConclusionDisplaced Syrian MSM and transgender women experience higher levels of psychiatric comorbidities than Lebanese MSM and transgender women in part due to compounding exposure to displacement-related stressors and stigma-related stressors. Informed by tenets of minority stress theory and intersectionality theory, we discuss mental health intervention implications and future directions.


2021 ◽  
Author(s):  
Marlee Bower ◽  
Amarina Donohoe-Bales ◽  
Scarlett Smout ◽  
Andre Quan Ho Nguyen ◽  
Julia Boyle ◽  
...  

The COVID-19 pandemic, as well as the recent bushfires and flash floods, have resulted in significant and unprecedented mental health impacts in Australia. Despite the known impacts, there is a paucity of research directly asking Australian community members about their mental health experiences and what they perceive to be the most important mental health issues in the context of the pandemic. This study utilises qualitative data from Alone Together, a longitudinal mixed-methods study investigating the effects of COVID-19 on mental health in an Australian community sample (N = 2,056). Of the 1,350 participants who completed the first follow-up survey, a total of 1,037 participants, who ranged in sex (69.9% female), age (M = 40-49 years), state/territory of residence, and socioeconomic status, shared responses to two open-ended questions regarding the most important issues for mental health in Australia and the impact of COVID-19 on their individual mental health. Responses were analysed using thematic analysis. Participants described COVID-19 as primarily impacting their mental health through the disruption it posed to their social world and financial stability. A key concern for participants who reported having poor mental health was the existence of multiple competing barriers to accessing good mental health care. According to participant responses, the pandemic had pressurized an already over-burdened mental health service system, leaving many without timely, appropriate support. Further absent or stigmatising rhetoric around mental health, at both a political and community level, also prevented participants from seeking help. Insights gained from the present research provide opportunities for policymakers and health practitioners to draw on the expertise of Australians’ lived experience and address priority issues through targeted policy planning. This could ultimately support a more responsive, integrated and effective mental health system, during and beyond the COVID-19 pandemic.


2021 ◽  
pp. 000486742110493
Author(s):  
Olatunde Olayinka Ayinde ◽  
Oluwasemiloore Peace Atere ◽  
Ugonna Ibeawuchi ◽  
Toyin Bello ◽  
Abiola Ogunkoya ◽  
...  

Objectives: Anti-police (#EndSARS) protests took place in October 2020 across several Nigerian cities, resulting in deaths, injuries and loss of property, but the psychological sequelae of these protests have not been studied. Method: In a cross-sectional online survey, we collected data on psychiatric morbidity and potential risk factors from 426 Nigerian social media users, who self-identified as participants or non-participants in a recent anti-police protest. Results: We found elevated rates of psychiatric morbidity, with worse outcomes for protesters compared to non-protesters (psychological distress [44.2% vs 29.8%], depression [26.0% vs 14.9%], anxiety [51.0% vs 29.8%], post-traumatic stress disorder [7.4% vs 1.8%], current substance use [11.2% vs 4.5%] and suicidal ideation [7.1% vs 4.4%], respectively). After adjusting for the effects of COVID-19 pandemic and previous mental health diagnosis, the predictors of poor mental health among non-protesters were being unmarried (odds ratio = 7.4, p = 0.01) and low resilience (odds ratio range = 4.1–5.4, p < 0.03) while for the protesters, the predictors were low resilience (odds ratio range = 2.9–4.7, p < 0.01), being from Northern Nigeria (odds ratio = 4.7, p < 0.01) or residing in Northern Nigeria (odds ratio = 2.8, p = 0.03), being under-/unemployed (odds ratio range = 2.1–2.5, p < 0.04), holding the view that the protest was caused by the state of the economy (odds ratio = 2.0, p = 0.01), belief that the protest had a direct negative impact on the protester (odds ratio = 2.3, p = 0.04) and willingness to participate in future protests (odds ratio = 4.13, p = 0.02). Conclusion: We conclude that participating in the #EndSARS protest was associated with significant psychiatric morbidity. There is need to recognise and address the mental health sequelae of collective actions, and invest in programmes that build resilience and address socio-political determinants of mental health, especially with a focus on youth.


2017 ◽  
Vol 41 (S1) ◽  
pp. S724-S724
Author(s):  
S. Giorgi ◽  
N. Guguahsvili ◽  
T. Oniani ◽  
G. Kanaldarishvili ◽  
E. Lelashvili

BackgroundThe following study shows that PTSD, depression and anxiety present actual and urgent problem in military field. These disorders appear to be highly co-morbid that results in much more complicated treatment process and outcome. Service members of Georgian armed forces participate in various international peacekeeping operations on the regular basis, though there are no researches conducted so far to provide evidence for mental health problem prevalence in Georgian deployed military personnel.MethodCollection of the data took place during the period of 2014–2015 years after six months of service members returning from the international peacekeeping mission back to their homes. The sample for this research were represented by 2799 servicemen who actively engaged in ISAF peacekeeping missions. All of them were male, with average age: M = 29.3 (SD = 6.3). The data for the following research were collected using self-administered assessment measures, namely PCL-5 for PTSD screening and PHQ for depression and Anxiety and somatic complaints assessment.ResultsPTSD appeared to be significantly predicted by range/level of anxiety and depression symptom urgency, nevertheless after joint/combine integration of these variables in one regressional equation, just symptoms of depression remained as statistically reliable explanatory factor for the significant percentage of the somatic symptom range variation.ConclusionIt would be wise to recommend mental health care specialists particularly to bear in mind the possibility of co-existing depression and anxiety symptoms in patients with PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2019 ◽  
Vol 65 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Shailaja Bandla ◽  
NR Nappinnai ◽  
Srinivasagopalan Gopalasamy

Background: Floods are the most common type of natural disaster, which have a negative impact on mental health. Following floods, survivors are vulnerable to develop PTSD (post-traumatic stress disorder), depression, anxiety and other mental health problems. Aim: The aim is to study the psychiatric morbidity in the persons affected by floods during December 2015. Materials and methods: This study was carried out in Chennai and Cuddalore. In total, 223 persons who were directly exposed to floods were assessed. PTSD Checklist–Civilian Version, Beck’s Depression Inventory, Beck’s Anxiety Inventory and World Health Organization–Five Well-Being Scale (WHO-5) were used in the study. Chi-square test was used to compare the means. Results: Overall, psychiatric morbidity was found to be 45.29%; 60 (26.9%) persons had symptoms of PTSD. Anxiety was found in 48 (27.4%) and depression was found in 101 (45.29%) persons; and 11 (4.9%) persons have reported an increase in substance abuse. Conclusion: Following disaster like floods, there is a need for better preparedness in terms of basic necessities and medical and psychological assistance, particularly emphasizing the needs of older persons in order to prevent the development of psychiatric problems.


2020 ◽  
Vol 70 (3) ◽  
pp. 155-161 ◽  
Author(s):  
R Ricciardelli ◽  
S Czarnuch ◽  
T O Afifi ◽  
T Taillieu ◽  
R N Carleton

Abstract Background Many public safety personnel (PSP) experience trauma directly or indirectly in their occupational role, yet there remain barriers to accessing care or seeking help. Aims To understand how PSP interpret different potentially traumatic events and how perceived eligibility for being traumatized is determined among PSP. Methods We analysed open-ended comments provided by over 800 PSP in a survey designed to assess the prevalence of post-traumatic stress injuries and other mental disorders. Results We found evidence that a trauma hierarchy may exist among PSP. Certain experiences may be interpreted as more traumatic, based on both the event and the PSP role in the actual event. For example, involvement in a shooting may be interpreted as more traumatic than arriving on the scene later. Similarly, a single event may be deemed more traumatic than an accumulation of events. The role of the individual and social context in shaping experiences and interpretations of trauma may be largely ignored in line with confirmation biases. Conclusions The role that individuals and social contexts play in shaping experiences and interpretations of trauma appear suppressed by perceptions of a trauma hierarchy, facilitating systematic discrediting or valuation of some experiences, therein evidencing that trauma is subjective and reinforcing barriers to care seeking. A trauma hierarchy may also propagate stigma and legitimize discrimination regarding mental health. We argue that recognizing, engaging with, and dismantling the perception of a trauma hierarchy may help create a respectful and open occupational culture supportive of mental health needs.


2012 ◽  
Vol 201 (4) ◽  
pp. 268-275 ◽  
Author(s):  
Brandon A. Kohrt ◽  
Daniel J. Hruschka ◽  
Carol M. Worthman ◽  
Richard D. Kunz ◽  
Jennifer L. Baldwin ◽  
...  

BackgroundPost-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence.AimsThis prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal.MethodAn adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war.ResultsOf the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose–response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure.ConclusionsConflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in postconflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.


2003 ◽  
Vol 183 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Jeremy Coid ◽  
Ann Petruckevitch ◽  
Wai-Shan Chung ◽  
Jo Richardson ◽  
Stirling Moorey ◽  
...  

BackgroundAbusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.


Author(s):  
Cathy Carter-Snell ◽  
Sonya L. Jakubec

Women who have experienced intimate partner violence or sexual assault are well known to have extremely high rates of mental illness such as post-traumatic stress disorder and depression, as well as high rates of chronic illness, re-victimization, and suicide. The purpose of this in-depth analysis of the literature was to determine the relative impact of selected risk and resilience factors and the quality of existing evidence. The analysis of risk and resiliency pertaining to mental health impacts was guided by a social-ecological model, examining individual, relationship, community, and societal influences. An improved understanding of these factors and the quality of evidence underlying them can inform future research and interventions aimed at preventing or reducing the mental health impact of these crimes, and point to a direction for more inclusive examinations of the literature.


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