First major study of mental health of UK armed forces in Iraq

Professor Neil Greenberg and colleagues from the Academic Centre for Defence Mental Health conducted the study in Iraq in January and February 2009. 611 armed forces personnel, who were based in eight locations across Iraq, completed a questionnaire about their deployment experiences and health. This number represents about 15% of the UK personnel deployed in Iraq at the time.

The majority of the personnel (92.6%) rated their overall health as good, very good or excellent. Personnel were more likely to report good health if they were of officer rank, if they felt their unit was very cohesive and had supportive leadership, and if they had taken a period of rest and recuperation in an area outside the operational theatre.

Of the 611 personnel, 20.5% showed signs of experiencing symptoms of psychological distress and 3.4% had probable post-traumatic stress disorder (PTSD). These rates are similar to those that have been found among service personnel who are not on deployment. They are also lower than in other high-stress occupations such as police officers, doctors in emergency departments and disaster workers.

The researchers found that psychological distress was more common among personnel who were young, female, in the army, and of junior rank. PTSD was more common among personnel of junior rank, among those who reported feeling in danger of being killed, and who had higher combat exposure. Personnel who reported sick for any reason during their deployment were also more likely to have symptoms of psychological distress.

At the end of the questionnaire, 11% of the personnel said they would be interested in receiving help for a stress, emotional or family problem. These personnel were more likely to be in the junior ranks.

Professor Greenberg said: “Most research on the mental health of UK armed forces personnel has been conducted either before or after deployment – we know very little about their mental health while they are deployed on operations.

“Our study suggested little overall effect of deployment on mental health. Interestingly, those who told us they remembered having a pre-deployment stress briefing reported significantly better mental health than those who did not. Although there is a policy that requires personnel to be given a pre-deployment brief, our study suggested this policy needs to be more rigorously enforced. In addition, although most units have some in-unit medical support, the training for medical staff has only recently begun to be standardised to ensure it covers mental health disorders. Improving training, as well as raising awareness among staff of the link between personnel reporting sick and having poorer mental health, may help identify those in most need of psychological help.”

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Mulligan K, Jones N, Woodhead C, Davies M, Wessely S and Greenberg N (2010) Mental health of UK military personnel while on deployment in Iraq, British Journal of Psychiatry, 197: 405-410