Claire French

Stigma and mental health in the Royal Navy: A mixed methods paper

Background: US research suggests that military personnel suffering from mental health problems are reluctant to seek help because of stigma. Aims: First, to identify the prevalence of mental health stigma beliefs in a UK military sample. Second, to investigate whether distressed personnel report more stigma than those who are not distressed. Method: A survey of 1599 naval personnel was undertaken as part of a larger trial prior to examining the effectiveness of a novel trauma support program. Results: The presence of internal stigma was substantial and significantly higher for distressed personnel. The prevalence of stigma about other peoples mental health problems was low. Junior personnel reported being more uncomfortable in discussing emotional issues with their peer group than senior staff. Conclusions: Internal stigma remains a significant barrier to help seeking within the Royal Navy, especially for distressed personnel. This may be especially problematic for junior personnel who are known to be particularly vulnerable to developing mental health problems.

The Use of Psychological Decompression in Military Operational Environments

This article reviews the use of psychological decompression as applied to troops returning from active service in operational theaters. Definitions of the term are considered and a brief history is given. Current policies and practices are described and the question of mandatory decompression is considered. Finally, the evidence base for the efficacy of decompression is examined and some conclusions are drawn. This article highlights variations in the definition and practice of decompression and its use. Although there is, as yet, no evidence that decompression works, there is also no evidence to the contrary. Given the lack of knowledge as to the balance of risks and benefits of decompression and the absence of any definitive evidence that decompression is associated with improved mental health outcomes or that lack of decompression is associated with the reverse, it is argued that the use of decompression should remain a matter for discretion.

Unmet expectations in primary care and the agreement between doctor and patient: a questionnaire study

Background  Questionnaires completed respectively by doctor and patient may give conflicting views of what actions the doctor took during a consultation in primary care. This disagreement will affect an assessment of whether patient expectations of care were met, and may itself be influenced by fulfilment of expectations.

Transition Back into Civilian Life: A Study of Personnel Leaving the U.K. Armed Forces via "Military Prison"

OBJECTIVE The purpose of this study was to identify the factors associated with poor outcomes for personnel leaving the United Kingdom Armed Forces early. METHOD We studied a population thought to be at high risk of poor outcomes: those leaving the Services early via the United Kingdom Military Corrective Training Centre. Participants were interviewed 1 week before leaving (predischarge) and followed up 6 months later. One hundred eleven participants completed predischarge interviews. Seventy-four (67%) were successfully followed up and interviewed 6 months later. RESULTS Thirty-eight of those followed up (56%) were classed as being disadvantaged after leaving. Being disadvantaged at follow-up was associated with: having predischarge mental health problems, receiving an administrative discharge, or having a short sentence length. CONCLUSION Factors associated with poor outcomes on leaving were often interrelated, making causal relationships complex. However, this study does provide a basis from which to identify, at the point of discharge, those most at risk of further disadvantage.