Mental health in the military Flashcards
How is the military service perceived by the media?
Media often focuses on negative effects of military service
When did the research by King’s Centre for Military Health Research start?
2003, at beginning of Irak conflict, then Afghanistan
Who funds the research done by King’s Centre for Military Health Research?
UK Ministry of Defense
What does King’s Centre for Military Health Research cohort study consist of?
> Random selection of
- Irak and Afghanistan deployed personnel
- non-deployed serving personnel
> Sample:
- Royal Navy, Royal Marines, RAF, Army
- regulars and reservists
- men and women
- service leavers
- exclusion of special forces
> 2 phases of data collection (via postal questionnaires)
> N = approx. 10,000
What are the three key outcomes measures in the King’s Centre for Military Health Research cohort study?
- Probable PTSD (measured with PCL-C)
- Common mental disorders (measured with GHQ)
- Alcohol misuse (measured with AUDIT)
What do the prevalence of key outcome measures show in the King’s Centre for Military Health Research cohort study?
Common mental disorders and alcohol misuse are more prevalent than PTSD
- PTSD: 4% (n = 376)
- Common mental disorders: 19.7%
(n = 1908) - Alcohol misuse: 13% (n = 1323)
What is observed with the rates of PTSD in the armed forces compared to the general population?
PTSD is not more common in the armed forces
- it’s equal to the rates in gen. pop.
What is observed with the rates of alcohol misuse in the armed forces compared to the general population?
> Alcohol misuse is higher in armed forces than in gen. pop.
> Within armed forces:
- higher in regular personnel than in reserves
Which factors could account for the differences of alcohol misuse in the armed forces compared to the general population?
Age and gender
- there are more young men in armed forces
- young men drink more than other people
How do male military personnel compare with males in the general population, regarding alcohol misuse?
Males in armed forces drink more across all age groups compared to their equivalent in gen. pop.
How do female military personnel compare with females in the general population, regarding alcohol misuse?
- Females in armed forces drink more across all age groups compared to their equivalent in gen. pop.
- The differences are stronger than what is observed for male military, particularly at young age
- These differences with the gen. pop. decrease with age
Which types of deaths are more common within the military overall than expected?
- Non-recreational drowning
- Off road motor vehicle accidents
- Air transport accidents
- Heat injury
- Injury by firearms
- Alcohol-related conditions
What is the impact of the significant rates of alcohol misuse in the military personnel?
Long-term impact on personnel’s mortality
What are the differences of alcohol misuse within the military personnel between those who have been deployed and those who haven’t?
Increase of alcohol misuse in deployed personnel vs. those who haven’t been, when they return in the UK from deployment
- service personnel do not drink when deployed
What is observed on the rates of probable PTSD by deployment status?
Rates of PTSD remain at around 4%
- whether military personnel had or hadn’t been deployed
- and whether they were deployed in Irak or Afghanistan or somewhere else
-> serving in Iraq/Afghanistan is not the main risk factor for PTSD
What is the role of combat on the rates of PTSD, common mental disorders and alcohol misuse?
Military personnel who has been in combat have higher rates of PTSD, common mental disorders and alcohol misuse
- compared to those who haven’t been in combat
-> role army personnel has when they’re deployed has an impact on their mental health (and disorders)
What is the role of the number of deployments on the levels of PTSD symptoms among currently serving UK Army regulars?
Positive correlation between number of deployments and PTSD symptoms reduction
What could explain why the symptoms of PTSD in currently serving UK Army regulars decreases with the number of deployments?
Those who haven’t been deployed more than once may be more resilient than those who’ve been deployed once and came home
Which factors are associated with probable PTSD King’s Centre for Military Health Research cohort study?
- Childhood adversity
- Low rank
- Discharged from service
- Serious accident
- Combat role
Which factors are not associated with probable PTSD in King’s Centre for Military Health Research cohort study
- Deployment to Irak or Afghanistan
- Deployed somewhere else
What could explain the deployment effect observed in reservists (similar rates of outcome than regulars)?
> Reservists are
- more likely females
- more likely to hold higher ranks
- > makes them less likely to report PTSD
> Reservists reported:
- fewer previous deployments
- > less preparation (resilience)
- lower levels of comradeship and unit cohesion
- more self-reported traumatic exposures
- more problems adjusting to homecoming
- more likely to consider divorce
Why is the higher self-reported traumatic exposures reported by army reservists compared to army regulars important?
It means reservists are more likely to perceive that they were exposed to trauma then their regular counterparts
- evidence suggests perception of the trauma is more important than the trauma itself
What are the possible definitions of a veteran?
- Left service to retire
- Deployed on operations (not necessarily overseas)
- Deployed overseas in combat mission
- Left service after four years
- Completed basic training
- Deployed overseas
- Completed a minimum of one day’s service
What are the statistics on veteran outflow from the UK Armed Forces?
18,750
- 49.5% service leavers with 4 years or more
- 50.5% early service leavers (less than 4 years)
