Mental Health Status of Sri Lanka Navy Personnel Three Years after End of Combat Operations: A Follow Up Study

Abstract

The main aim of this study was to assess the mental health status of the Navy Special Forces and regular forces three and a half years after the end of combat operations in mid 2009, and compare it with the findings in 2009. This cross sectional study was carried out in the Sri Lanka Navy (SLN), three and a half years after the end of combat operations. Representative samples of SLN Special Forces and regular forces deployed in combat areas were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to the end of combat operations were included in the study. The sample consisted of 220 Special Forces and 275 regular forces personnel. Compared to regular forces a significantly higher number of Special Forces personnel had experienced potentially traumatic events. Compared to the period immediately after end of combat operations, in the Special Forces, prevalence of psychological distress and fatigue showed a marginal increase while hazardous drinking and multiple physical symptoms showed a marginal decrease. In the regular forces, the prevalence of psychological distress, fatigue and multiple somatic symptoms declined and prevalence of hazardous drinking increased from 16.5% to 25.7%. During the same period prevalence of smoking doubled in both Special Forces and regular forces. Prevalence of PTSD reduced from 1.9% in Special Forces to 0.9% and in the regular forces from 2.07% to 1.1%. Three and a half years after the end of combat operations mental health problems have declined among SLN regular forces while there was no significant change among Special Forces. Hazardous drinking among regular forces and smoking among both Special Forces and regular forces have increased.

Prevalence and correlates of alcohol use in a military setting in Sri Lanka

“…Information on the mental health correlates of HRD and BD were collected with locally validated screening tools, namely, 9-Item Patient Health Questionnaire (PHQ-9) for depression (caseness was defined with a score ≥ 10) [30], PTSD Checklist Military Version (PCL-M) for post-traumatic stress disorder (PTSD) (caseness was defined with a score ≥ 45.5) [28], and 13 items Chalder Fatigue Scale for fatigue (caseness was defined with a score ≥ 4) [29]. In addition, standard questions were used to ascertain the degree of unit cohesion, aggression, cigarette smoking, cannabis use, family history of psychiatric disorders and exposure to childhood abuse [31,32,33,34]. As done with a previous military study, psychosocial functioning was assessed with the tenth question of the PHQ-9 [5].…”

Changes in the Psychophysiological State of Servicemen After a Long Stay in the Combat Zone

“…Сучасні публікації в основному відмічають наявність негативних зрушень в психологічному і психофізіологічному статусах у військовослужбовців, які тривалий час перебували в зоні бойових дій [4,14]. Потрібно констатувати, якщо безпосереднє дослідження фізіологічних трансформацій організму в умовах бойових дій істотно ускладнене, а часом просто неможливе, то вивчення психофізіологічних ефектів чинників бойового середовища допустиме після ви ходу військовослужбовців з цієї зони.…”

A review of the physiological and psychological health and wellbeing of naval service personnel and the modalities used for monitoring

“…This relationship also increased over time and was particularly high in those who thought they might have been killed or had experienced hostility during combat deployment [337]. Similarly, a three and a half year follow-up study on individuals in the Sri Lankan Navy who had served in combat areas found that after three and a half years post combat, levels of hazardous drinking increased amongst regular forces [339]. …”

“…One reason is the effect of deployment in combat zones [359]. Research on the Sri Lankan Navy found that although the prevalence of PTSD was reduced three and a half years after combat, there were increases in rates of smoking among both regular and special forces [339]. This study could indicate that although PTSD symptoms could be reduced after this period of time, other underlying mental issues may remain and individuals may cope with these issues by using alcohol and tobacco.…”