UK troops mentally healthier than US peers, research finds

UK troops are mentally healthier and more resilient than their US counterparts, but those involved in combat and reservists have a higher risk of developing mental health problems, according to research.

The findings of the study by the King’s Centre for Military Health Research at King’s College London provide early evidence that intervention strategies introduced by the UK Armed Forces have helped mitigate the impact of trauma, the authors say.

However, they add that those deployed in a combat role and reservists are at greater risk of mental health problems and warn that alcohol misuse and violence remain areas of concern.

The researchers reviewed 34 published studies, some going back 15 years, on the psychological impact of deployment to Iraq and Afghanistan on the UK Armed Forces. Where possible, they compared the research findings with those published on the mental health of US military personnel. The study is published in the Journal of the Royal Army Medical Corps.

PTSD more likely in US troops
It found that among regular troops, rates of post-traumatic stress disorder (PTSD) are similar to that of the general population – ranging from 1.3 to 4.8% for troops and 3% across the population.

Rates of common mental health disorders such as anxiety and depression were also comparable to the general public.
But rates of PTSD among troops involved in direct combat are higher, at around 7%. Reservists are also more than twice as likely to report common mental health disorders and PTSD if they had been deployed to Iraq or Afghanistan than if they had not.

Nevertheless, rates of PTSD are significantly lower for UK troops compared to their US peers, where recent studies have reported rates ranging from 21 to 29%. The authors say this could be down to US personnel tending to be younger, from lower socio-economic backgrounds and undertaking longer tours – 12 months compared to 6 in the UK.

Furthermore the US military deploys more reservists than the UK, and US troops don’t have access to the same level of healthcare. Meanwhile, harmful drinking continues to give cause for concern, affecting up to 1 in 5 regular soldiers, while aggressive and violent behaviour is also more likely among those returning from deployment, particularly soldiers in combat roles who are experiencing mental health problems. UK troops are more likely to report problem drinking that their US military colleagues.

Finally, rates of suicide and self-harm among UK military personnel are lower than they are among the general population, except for army recruits under the age of 20. In the US, despite preventative efforts, suicide has become one of the leading causes of death in the US military in recent years.

Professor Neil Greenberg, from King’s and senior author of the study, said: “Not since the Vietnam War has there been so much research directed towards the mental health of service personnel. It remains to be seen what the longer-term psychological impact of serving in Iraq or Afghanistan will be, and what social and healthcare services might be required for this small, but important group of veterans who are at highest risk of mental health problems.”

Dr Deirdre MacManus, lead author of the study from King’s, added: “Overall, UK military personnel have remained relatively resilient in spite of the stresses endured in Iraq and Afghanistan. The UK Armed Forces have made considerable efforts to improve access for deployed personnel to high quality mental health services and implement a number of evidence-based mitigation measures. These include ‘Third Location Decompression’ and ‘Trauma Risk Management, which are evidence-based interventions routinely used in the UK Armed Forces, but not in the US.”