The Australian Defence Force Mental Health Prevalence and Wellbeing Study: design and methods

Abstract

BackgroundThe Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population.ObjectiveThe MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods, and identify specific occupational factors that influence mental health. This paper describes the design, sampling strategies, and methodology used in this study.MethodAt Phase 1, approximately half of all regular Navy, Army, and Air Force personnel (n=24,481) completed self-report questionnaires. At Phase 2, a stratified sub-sample (n=1,798) completed a structured diagnostic interview to detect mental disorder. Based on data from non-responders, data were weighted to represent the entire ADF population (n=50,049).ResultsOne in five ADF members met criteria for a 12-month mental disorder (22%). The most common disorder category was anxiety disorders (14.8%), followed by affective (9.5%) and alcohol disorders (5.2%). At risk ADF sub-groups were Army personnel, and those in the lower ranks. Deployment status did not have an impact on mental disorder rates.ConclusionThis study has important implications for mental health service delivery for Australian and international military personnel as well as contemporary veterans.

Associations Among Childhood Trauma, Childhood Mental Disorders, and Past‐Year Posttraumatic Stress Disorder in Military and Civilian Men

“…The 2010 ADF Mental Health Prevalence and Wellbeing Study (MHPWS) employed a two‐phase design to estimate the prevalence of mental disorders, per criteria in the 10th revision of the International Classification of Diseases ( ICD‐10 ), across all currently serving regular ADF personnel (Van Hooff et al., ). This two‐phase design is well accepted in the investigation of mental disorder prevalence (Dunn, Pickles, Tansella, & Vazquez‐Barquero, ).…”

“…For the ADF sample, detailed descriptions of stratification procedures and weighting are available elsewhere (Hodson, McFarlane, Van Hooff, & Davies, ; Van Hooff et al., ). In brief, mental disorder prevalence estimates were derived using a robust two‐stage weighting process, which attenuated the impact of low response rates as well as any selection and responder bias.…”

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

“…A significant amount of these methods require that the individual completes a questionnaire. In relation to military and seafaring populations, questionnaires include: the Primary care evaluation of mental disorders patient health questionnaire (PHQ) [214, 245, 246], the Kessler psychological distress scale [247, 248], the post-traumatic stress disorder checklist-civilian version (PLC-C) [213, 248–250] and the General Health Questionnaire (GHQ-12) [213, 229, 251, 252]. …”

“…Research found that the GHQ-12, which is the twelve item version, is just as reliable and valid as the longer version and takes less time to complete [255]. This questionnaire has been used in several military [213, 248, 252] and in particular naval service populations [229, 256], which indicates its value for providing knowledge about these populations.…”

“…In contrast to the high levels found in the U.K. and U.S., research on the Australian Armed Forces found that the prevalence for alcohol abuse was lower for the armed forces compared to the general population [344]. Additional research on the Australian Defence Forces found that alcohol disorders were the most prevalent in the navy [248], which indicates that this population may be at a higher risk. However, there is a distinction between alcohol disorders and alcohol consumption.…”