Nicola T. Fear

Mental health and psychological support in UK armed forces personnel deployed to Afghanistan in 2010 and 2011

BACKGROUNDnMost accounts of deployment mental health in UK armed forces personnel rely on retrospective assessments.nnnAIMSnWe present data relating to the burden of mental ill health and the effect of support measures including operational, family, welfare and medical support obtained on two occasions some 18 months apart.nnnMETHODnA total of 2794 personnel completed a survey while deployed to Afghanistan; 1363 in 2011 and 1431 in 2010. Their responses were compared and contrasted.nnnRESULTSnThe prevalence of self-report mental health disorder was low and not significantly different between the surveys; the rates of probable post-traumatic stress disorder (PTSD) were 2.8% in 2010 and 1.8% in 2011; for common mental health disorders the rates were 17.0% and 16.0% respectively. Remembering receiving predeployment psychoeducation, perceptions of good leadership and good family support were all significantly associated with better mental health. Seeking support from non-medical sources and reporting sick for medical reasons were both significantly associated with poorer mental health.nnnCONCLUSIONSnOver a period of 18 months, deployment mental health symptoms in UK armed forces personnel were fewer than those obtained from a military population sample despite continuing deployment in a high-threat context and were associated with perceptions of support.

Iraq and Afghanistan veteran presentations to Combat Stress, since 2003

BACKGROUNDnRecently, proposals have been made to improve mental health care for U.K. military veterans. Combat stress (CS), a veterans charity, has provided mental health services for veterans since 1919. Since 2003, service users have included veterans from the Iraq and Afghanistan conflicts; however, their pattern of help-seeking has not been evaluated.nnnAIMSnTo describe the characteristics of the veteran population of the recent Iraq or Afghanistan conflicts who sought help from CS between 2003 and May 2011.nnnMETHODSnCS Iraq and Afghanistan veteran clinical and welfare records were evaluated.nnnRESULTSnNine hundred and eighty-eight records were evaluated. The median time for veterans of recent conflicts to seek help from CS since discharge from military service was ~2 years, considerably shorter than the mean time of 14 years previously estimated by CS. Approximately, three-quarters of the veterans receiving a full clinical assessment (n = 114), received a diagnosis of post traumatic stress disorder (PTSD) (n = 87). Approximately half of the clinically assessed veterans self-referred to CS (51%); their most frequent diagnosis was PTSD.nnnCONCLUSIONSnVeterans who have served in Iraq and Afghanistan are presenting to Combat stress sooner, and at a younger age, than veterans of previous conflicts and operations.

Do military uniform and rank impact on the therapeutic relationship between military mental health clients and clinicians

Objective To measure the perceptions of military staff of the impact of wearing military uniform on the therapeutic relationship with mental health clients. Method A brief questionnaire was distributed to all military clinicians in Departments of Community Mental Health to measure their attitudes. Results There was a 67.9% (n=70) response rate regarding the impact of uniform on the therapeutic relationship. 20% of responses were positive, 31% negative, 37% mixed and 12% gave no answer. Conclusion There was no clear pre-existing literature on this issue. Overall, the wearing of uniform appeared to be perceived positively positive. There is a need to assess clients’ points of view in future studies.