The long term occupational fitness of UK military personnel following community mental health care

Abstract

Background: Fitness to undertake operational deployment is a key requirement of military service.

Aim: To assess individual deployment fitness at a single point from one month to eight years following discharge from mental healthcare.

Method: Survival analyses assessed levels of deployability; the predictive effects of key covariates upon time to being classified as non-deployable were examined using univariate and multivariate Cox proportional hazards regression procedures.

Results: A total of 1405 individuals provided study data. 437 individuals (31.1%) were non-deployable or discharged from service during follow-up. 17.2% were non-deployable in the first year following mental healthcare; the proportion did not rise above this level until year seven when it was 19.1% and then 30.6% in year eight. Risk factors for being classified as non-deployable were female sex, receipt of intermediate duration therapy, management by the multidisciplinary team and previous referral to mental health services. Previous deployment was significantly associated with reduced risk. Overall, the levels of non-deployability appeared to be no higher than those found among the wider military services.

Conclusion: Non-deployable status among mental healthcare recipients was broadly similar to that found among the wider UK military; risk factors for non-deployability could be amenable to targeted relapse prevention measures.

Keywords:

• Occupational
• military
• deployment
• mental healthcare

Acknowledgements

We are grateful to the men and women of the UK Armed Forces who contributed data to this study. We are also grateful to Defence Statistics for performing the data linkage.

Declaration of interest

Norman Jones is a serving member of the British Army. Nicola Fear, Gursimran Thandi and Neil Greenberg are researchers employed under the terms of a contract by the UK Ministry of Defence. Sir Simon Wessely is the Director of the King’s Centre for Military Health Research which receives funding from the Ministry of Defence. No direction was taken from the funding agency in the delivery of the research project and the presentation of the study outcomes. The UK Ministry of Defence funded this study. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.