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Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan

Published online by Cambridge University Press:  23 March 2020

N. Jones ,
N.T. Fear ,
S. Wessely ,
G. Thandi  and
N. Greenberg
N. Jones*
Affiliation:
Academic Department of Military Mental Health, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, United Kingdom
N.T. Fear
Affiliation:
Academic Department of Military Mental Health, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, United Kingdom
S. Wessely
Affiliation:
King's Centre for Military Health Research, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, United Kingdom
G. Thandi
Affiliation:
Academic Department of Military Mental Health, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, United Kingdom
N. Greenberg
Affiliation:
Academic Department of Military Mental Health, Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, United Kingdom
*
⁎Corresponding author. Tel.: +44 2078 485 428. E-mail address:norman.jones@kcl.ac.uk (N. Jones).
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Abstract

Background

This observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners.

Method

In-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses.

Results

Overall 74.8% (n = 729) of personnel RTD on completion of care. Of those that underwent evacuation home (n = 246), 69.1% (n = 170) returned by aeromedical evacuation; the remainder returned home using routine air transport. Predictors of evacuation included; inability to adjust to the operational environment, family psychiatric history, previously experiencing trauma and thinking about or carrying out acts of deliberate self-harm.

Conclusion

Deployed mental health practitioners helped to facilitate RTD for three quarters of mental health casualties who consulted with them during deployment; psychological rather than combat-related factors predicted evacuation home.

Keywords

MilitaryUnited KingdomForward psychiatryDeploymentOccupational
Type
Original article
Information
European Psychiatry , Volume 39 , January 2017 , pp. 66 - 72
Copyright
Copyright © Elsevier Masson SAS 2017

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