Can mental health and readjustment be improved in UK military personnel by a brief period of structured postdeployment rest (third location decompression)?

Jones, Norman; Fear, Nicola T.; Fertout, Mohammed; Wessely, Simon; Greenberg, Neil

doi:10.1136/oemed-2012-101229

Cited by 25 publications

(24 citation statements)

References 29 publications

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“…Several partners used “holiday-type” third locations (e.g., Cyprus or Crete). While it was a practice used by several partners there was no evidence yet to support its use (Jones et al, 2013). A holiday-type third location had the advantage of providing a good rest and recuperation (R&R) environment that facilitates unwinding of service personnel.…”

Section: Resultsmentioning

confidence: 99%

Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners

Vermetten

Greenberg

Boeschoten

et al. 2014

European Journal of Psychotraumatology

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BackgroundFor years there has been a tremendous gap in our understanding of the mental health effects of deployment and the efforts by military forces at trying to minimize or mitigate these. Many military forces have recently systematized the mental support that is provided to support operational deployments. However, the rationale for doing so and the consequential allocation of resources are felt to vary considerably across North Atlantic Treaty Organisation (NATO) International Security Assistance (ISAF) partners. This review aims to compare the organization and practice of mental support by five partnering countries in the recent deployment in Afghanistan in order to identify and compare the key methods and structures for delivering mental health support, describe bottlenecks and illustrate new developments.MethodInformation was collected through document analysis and semi-structured interviews with key military mental healthcare stakeholders. The review resulted from close collaboration between key military mental healthcare professionals within the Australian Defense Forces (ADF), Canadian Armed Forces (CAF), United Kingdom Armed Forces (UK), Netherlands Armed Forces (NLD), and the United States Army (US). Key stakeholders were interviewed about the mental health support provided during a serviceperson's military career. The main items discussed were training, prevention, early identification, intervention, and aftercare in the field of mental health.ResultsAll forces reported that much attention was paid to mental health during the individual's military career, including deployment. In doing so there was much overlap between the rationale and applied methods. The main method of providing support was through training and education. The educative focus was to strengthen the mental resilience of individual soldiers while providing a range of mental healthcare services. All forces had abandoned standard psychological debriefing after critical incidents. Instead, by default, mental healthcare professionals acted to support the leader and peer led “after action” reviews. All countries provided professional mental support close to the front line, aimed at early detection and early return to normal activities within the unit. All countries deployed a mental health support team that consisted of a range of mental health staff including psychiatrists, psychologists, social workers, mental health nurses, and chaplains. There was no overall consensus in the allocation of mental health disciplines in theatre. All countries (except the US) provided troops with a third location decompression (TLD) stop after deployment, which aimed to recognize what the deployed units had been through and to prepare them for transition home. The US conducted in-garrison ‘decompression’, or ‘reintegration training’ in the US, with a similiar focus to TLD. All had a reasonably comparable infrastructure in the field of mental healthcare. Shared bottlenecks across countries included perceived stigma and barriers to care around mental health...

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Section: Resultsmentioning

confidence: 99%

Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners

Vermetten

Greenberg

Boeschoten

et al. 2014

European Journal of Psychotraumatology

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“…In previous studies, we have evaluated a number of interventions which seek to improve military mental health and well-being. RCTs have evaluated UK BATTLEMIND, a resilience promotion intervention25; Trauma Risk Management, a peer support intervention26; and a further comparative study using propensity score matching methodology of decompression, a form of structured post-deployment rest, which seeks to improve readjustment and well-being 27. On each occasion we have demonstrated limited benefit or specific small effects, particularly among those with arguably the greatest need, such as combat personnel and those with substantial operational exposure.…”

Section: Discussionmentioning

confidence: 99%

Resilience-based intervention for UK military recruits: a randomised controlled trial

et al. 2018

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ObjectivesWe evaluated a military resilience intervention which aimed to help UK military recruits to manage their personal health and well-being more effectively.MethodsTrainers within six pre-existing training teams were randomly allocated by team to deliver a resilience-based intervention (SPEAR) or usual training (control) during recruit training. 23 trainers delivered SPEAR; 18 delivered the control training. 707 recruits participated (n=358 SPEAR and n=349 controls). Outcome measures were obtained before and after recruit training and 3 months later. Measures of post-traumatic stress disorder (PTSD), common mental disorder (CMD) symptoms, alcohol use, homesickness and mental health stigmatisation were obtained at baseline. Repeat baseline scales plus measures of help-seeking, cohesion, leadership and training impact were obtained at the two follow-up points.ResultsResponse rates were 91.7% (baseline), 98.1% (post) and 73.6% (follow-up). Following adjustment for potential confounders, levels of PTSD, CMD symptoms, alcohol misuse, help-seeking and homesickness were not significantly different between groups at any measurement point. Stigmatisation was significantly lower among SPEAR recipients at baseline but was not significantly different at the two follow-up points. Following adjustment for mental health confounders, there were no significant between-group differences in perceptions of leadership and cohesion and in ratings of six training outcomes at the two follow-up points.ConclusionsWe found no evidence that resilience-based training had any specific benefit to the health and well-being of UK military recruits.

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“…The UK Academic Centre for Defence Mental Health assessed whether TLD impacted upon both mental health and post-deployment readjustment. Jones et al 54 55 suggested that TLD had a positive impact upon mental health outcomes (PTSD and multiple physical symptoms) and levels of harmful alcohol use. However, when the samples were stratiﬁed by combat exposure, post-deployment readjustment was similar for all exposure levels, and personnel experiencing low and moderate levels of combat exposure experienced the greatest positive mental health effects.…”

Section: Can Military Leadership and Management-related Factors Incrementioning

confidence: 99%

The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity

et al. 2014

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The recent conflicts in Iraq and Afghanistan have attracted considerable political and media interest in the mental health of UK military personnel. As a result of the close operational collaboration between US and UK forces, there have inevitably been many comparisons drawn between the mental health status of the two forces. Considerable research activity suggests that the mental health of UK forces appear to have remained relatively resilient in spite of their considerable exposure to traumatic events; one stark exception to this is the high rates of alcohol misuse which seem to be related to deployment. This paper explores the recently published literature relating to UK military forces and attempts to draw conclusions about the reasons for the apparent resilience shown by the majority of the regular forces.

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Can mental health and readjustment be improved in UK military personnel by a brief period of structured postdeployment rest (third location decompression)?

Cited by 25 publications

References 29 publications

Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners

Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners

Resilience-based intervention for UK military recruits: a randomised controlled trial

The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity

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