‘Goodbye and good luck’: the mental health needs and treatment experiences of British ex-service personnel

Iversen, Amy; Dyson, Claire; Smith, Naomi; Greenberg, Neil; Walwyn, Rebecca; Unwin, Catherine; Hull, Lisa; Hotopf, Matthew; Dandeker, Christopher; Ross, John; Wessely, Simon

doi:10.1192/bjp.186.6.480

Cited by 128 publications

(113 citation statements)

References 22 publications

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“…A small cross-sectional study in the UK of Gulf, Bosnia and 'Era' (personnel who served in the military at the same time but were not deployed on these operations) veterans who had all left the military revealed the same findings (Iversen 2005b). This is mirrored in both the stillserving US military population (Riddle 2007) and in the UK general population (Jenkins 1997).…”

Section: Common Mental Health Problems In Veteransmentioning

confidence: 63%

“…A clear view that emerged from the stakeholders and veterans interviewed was that the mental health needs of veterans were not being met by existing National Health Service (NHS) provisions at that time. A more recent cross-sectional study examining health service utilisation in those who have left the British armed forces (Iversen 2005b) has confirmed the anecdotal impression. It found that only 58% of those who reported mental health problems were currently seeking help from any professional, and only 28% had sought help from a non-governmental organisation.…”

Section: Improving the Mental Health Of Ex-service Personnel And Resementioning

confidence: 74%

“…Riddle and colleagues (2007) examined the baseline prevalence of mental disorders in the US military in a cohort of 77 047 participants and found that certain military subpopulations, including female, younger, less educated, single, White, short-term service enlisted personnel, and army personnel, were more likely to have poor mental health. In the UK veteran population, a similar, although smaller (n = 496), study found that those who served in the army, were single, and were from lower ranks were most at risk of reporting mental health problems (Iversen 2005b). Studies from both the UK and the USA have shown that combatants who had preenlistment/childhood adversity were more likely to experience mental health problems on return from deployment (Cabrera 2007;Iversen 2007).…”

Section: Uk Reservists Deployed To Iraqmentioning

confidence: 81%

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Mental health of regular and reserve military veterans

Iversen

Greenberg²

2009

Adv. psychiatr. treat

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SummaryThe psychiatric problems of combat returnees are a topical and important issue given the ongoing conflicts in Iraq and Afghanistan. Despite the media prominence afforded to post-traumatic stress disorder, the most common disorders in the UK armed forces post-deployment are depression, alcohol misuse and anxiety disorders. Although the majority of service personnel do well after leaving military life, a minority who leave with psychiatric problems appear to be at risk of social exclusion and ongoing ill health. Reserve veterans are at greater risk as they do not have access to the usual support networks of the regular military. Steps to improve the knowledge and expertise of primary care services about veterans' mental health issues and increasing the availability of treatment options are important and are underway.

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Section: Common Mental Health Problems In Veteransmentioning

confidence: 63%

Section: Improving the Mental Health Of Ex-service Personnel And Resementioning

confidence: 74%

Section: Uk Reservists Deployed To Iraqmentioning

confidence: 81%

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Mental health of regular and reserve military veterans

Iversen

Greenberg²

2009

Adv. psychiatr. treat

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“…Research suggests that treatment offered by these services is likely to benefit a significant number of veterans were they to access the help (Kitchiner, Roberts, Wilcox, & Bisson, 2012). However, evidence suggests that UK veterans often under use these services (Greenberg, 2014), with only around 50% of veterans seeking help for mental health problems (Iversen et al, 2005). In addition, research indicates that veterans may experience mental health difficulties for as long as 12 years after leaving the Armed Forces (AF) before they seek professional help (Murphy, 2016).…”

mentioning

confidence: 99%

Pathways into mental health care for UK veterans: a qualitative study

Mellotte

Murphy

Rafferty

et al. 2017

European Journal of Psychotraumatology

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Background: It is well established that veterans suffering from mental health difficulties under use mental health services. Objective: This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans’ help-seeking and pathways to care. Method: The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results: Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans’ help-seeking in future; these focussed on enhancing both veterans and health professionals’ knowledge regarding mental health difficulties. Conclusions: This study identified a number of barriers and enablers that may impact a veteran’s journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

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“…It has been observed that ex-service personnel with untreated PTSD are at particular risk (Iversen et al, 2005) and that veterans who have been diagnosed with PTSD have poorer outcomes following treatment than non-military peers with PTSD (Watts, Schnurr, Mayo, Young-Xu, Weeks, & Friedman, 2013;Bradley, Greene, Russ, Dutra, & Weston, 2005).…”

mentioning

confidence: 99%

Exploring Outcome Predictors in UK Veterans Treated for PTSD

Murphy¹,

Busuttil²

2015

JPR

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Post traumatic stress disorder (PTSD) in ex-service personnel is associated with high levels of co-morbidity and significant functional impairment. This paper reports on predictors of treatment outcomes in UK veterans with PTSD. The sample for the study consisted of 244 participants who had received a standardised six week residential treatment programme for PTSD. The programme consisted of individual trauma-focused CBT and group therapy sessions. In this paper, evidence is presented that shows improvements in intrusive, avoidance and hyper-arousal PTSD symptoms six months after the end of treatment; with post-treatment avoidance PTSD symptoms showing the most improvements. The findings suggest that higher levels of baseline anxiety and dissociation are associated with worse post-treatment PTSD outcomes. This suggests the importance of treating these difficulties in UK veterans before intervening for symptoms of PTSD.

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‘Goodbye and good luck’: the mental health needs and treatment experiences of British ex-service personnel

Abstract: Depression is more common than post-traumatic stress disorder in UK ex-service personnel. Only about half of those who have a diagnosis are seeking help currently, and few see specialists.

Cited by 128 publications

References 22 publications

Mental health of regular and reserve military veterans

Mental health of regular and reserve military veterans

Pathways into mental health care for UK veterans: a qualitative study

Exploring Outcome Predictors in UK Veterans Treated for PTSD

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