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

  • Kathleen Mulligan (a1), Norman Jones (a1), Mark Davies (a2), Peter McAllister (a3), Nicola T. Fear (a1), Simon Wessely (a1) and Neil Greenberg (a1)...

Abstract

Background

Most studies of the mental health of UK armed forces focus on retrospective accounts of deployment and few sample personnel while they are deployed.

Aims

This 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.

Method

Surveys 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).

Results

The 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.

Conclusions

The 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.

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Copyright

Corresponding author

Norman Jones, Academic Centre for Defence Mental Health, King's College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. Email: norman.jones@kcl.ac.uk

Footnotes

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These authors contributed equally to the work.

Declaration of interest

N.G., M.D. and P.M. are full-time members of the UK armed forces. N.J. is a full-time reservist. Both N.G. and N.J. are currently seconded to King's College London. N.F., S.W. and K.M. are employed by King's College London which receives funding from the UK Ministry of Defence. S.W. is also honorary civilian consultant advisor in psychiatry to the British Army and is a trustee of Combat Stress, a UK charity that provides service and support for veterans with mental health problems.

Footnotes

References

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

  • Kathleen Mulligan (a1), Norman Jones (a1), Mark Davies (a2), Peter McAllister (a3), Nicola T. Fear (a1), Simon Wessely (a1) and Neil Greenberg (a1)...
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eLetters

Effects of home on deployment mental health

Noel J Scott, Consultant Psychiatrist
09 October 2012

Dr JN Scott TD FRCP MRCPsych Malone Medical Chambers

142 Malone Road

Belfast BT9 5LH

(028) 9066 5239

07860 444 208

jnscot@msn.com

14 September 2012Correspondence EditorBritish Journal of Psychiatry 17 Belgrave Square London SW1X 8PG

Effects of home on deployment mental health

Even allowing for the rise of secularism in our society, I find the lack of mention of the Armed Forces Chaplaincy department surprising in the paper by Mulligan et al 1 on the influence of home life on deployment mental health. Looking at psychiatric diagnosis and outcome 2 in Op Telic 1, I identified welfare and pastoral care liaison as one of the three mainroles of our Field Mental Health Team. To this end we made full use of Chaplaincy support, as an aid to making specific contact with folk at hometo share information, allay fears, or ensure family needs were being met.

We used the 'Adjustment disorder' (F43) category, and further sub-divided this into either mostly Theatre-related (t), or mostly Home-related (h). Of 170 cases, 116 were F43; t = 77 (66%), h = 39 (34%). So Home-related issues comprised a significant area of concern, for which Chaplaincy involvement was robustly encouraged as appropriate, and proved ideal, to provide immediate spiritual and moral support, and also to more readily ensure a future home link thereafter as required. Every possible opportunity was thus taken to 'normalise' the person's psychological reaction state, and re-direct concerns into non-psychiatric areas of resolution. Such an approach served to boost morale and enhance mental health, by 'improving the visibility of home front support' 1.

Declaration of Interest J.N.S. served in a Field Mental Health Team during the 2003 Gulf War (Op Telic 1).

1Mulligan K, Jones N, Davies M, McAllister P, Fear NT, Wessely S, etal. Effects of home on the mental health of British forces serving in Iraq and Afghanistan. Br J Psychiatry 2012; 201: 193-198.

2Scott, JN. Diagnosis and outcome of psychiatric referrals to the field mental health team, 202 Field Hospital, Op Telic 1. J R Army Med Corps 2005; 151: 95-100.

J.N. Scott, Consultant Psychiatrist, Malone Medical Chambers, 142 Malone Road Belfast BT9 5LH. E-mail: jnscot@msn.com

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Conflict of interest: J.N.S. served in a Field Mental Health Team during the 2003 Gulf War (Op Telic 1).

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