Army personnel who become ill during deployment are just as likely to develop mental health problems on their return to the UK, as personnel who are injured, according to new research from the King's Centre for Military Health Research (KCMHR) at King's College London, published in BioMed Central's open access journal BMC Psychiatry.
Dr Nicola Fear, from KCMHR at King's and lead author of the paper, says: 'On returning home to the UK, injured personnel receive assistance and support from the military, whereas those who come back as a result of illness enter the general medical system. We have identified a group of individuals who are possibly not receiving the help and support they need on their return from deployment.'
Dr Fear adds: 'We were really surprised by the results of the study. We found that the severity of the illness also impacts on post-deployment mental health – we found that the strongest link between illness and subsequent mental health problems was amongst those who were medically evacuated.'
The study sample was made up of 3,896 UK Army personnel who participated in the KCMHR military cohort study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 and 2009. Researchers analysed data on attendance to military field hospital for UK military personnel in Iraq and Afghanistan, and linked the data to the self-reported mental health outcomes (from the KCMHR military cohort) for UK Army personnel who were deployed to Iraq or Afghanistan.
Of this group, 6.8% (270/3896) had a record of attendance at the military field hospital for an illness during their deployment and 6.9% (261/3896) for injury. A total of 2.3% were medically evacuated back to the UK because of illness or injury.
Personnel who were admitted to a military field hospital for illness during deployment were 1.5 times (Adjusted OR 1.49) more likely to report having a common mental health problem post-deployment; and almost 3 times (Adjusted OR 2.79) more likely if they were medically evacuated due to illness. Common mental health problems included anxiety, depression and panic disorders.
Injured personnel were 1.5 times (Adjusted OR 1.52) more likely to report having a common mental health problem post-deployment if they were admitted to field hospital; and 1.5 times (Adjusted OR 1.51) more likely if they were medically evacuated. Personnel who were medically evacuated due to injury were over 4 times (Adjusted OR 4.27) more likely to report probable PTSD post-deployment. In contrast, personnel who were returned to their unit after attending a military hospital for illness or injury were not at an increased risk of mental health problems post deployment.
Dr Fear says: 'The link between physical illness and mental health disorders is seen in civilian population. However, for Army personnel, we need to identify whether there is anything specific about their experiences of returning home due to illness which might result in subsequent mental health problems.'
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Forbes, H.J et al. 'What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record study of UK Army personnel who have served in Iraq or Afghanistan' BMC Psychiatry. www.biomedcentral.com/bmcpsychiatry/