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Overstretch by the armed forces increases mental health risk

AUGUST 03, 2007

Researchers in the King’s Centre for Military Health Research (KCMHR) have found evidence that the amount of time Armed Forces personnel spend on military operations, above current guidelines, increases the risk of common mental illness, including post traumatic stress disorder.
A new paper entitled ‘Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study’ has been published on the BMJ on-line looking at the possible effects of operational ‘overstretch’ in the services given current commitments. (2nd August 2007)
The Armed Forces guidelines provide thresholds regarding the length of operational deployments that reflect the need to balance rest and recuperation with deployment. These are known as the harmony guidelines and are useful in monitoring overstretch as a measure of over-commitment. 
The study assessed information on 5,547 regular UK military personnel with at least one operational deployment in the last three years. 21.8% reported to have been deployed in total for at least 13 months in the last three years. Thus, this level of deployment is above the recommendations in the Armed Forces Harmony guidelines.
Research demonstrated a consistent pattern of excess symptoms of post-traumatic stress disorder, psychological distress, multiple physical symptoms and severe alcohol problems in those deployed for 13 months or over in comparison to those deployed for a shorter period of time in the last three years. This excess could be explained in part by role in theatre and problems at home.
The study has also shown that uncertainty over the period of time Service personnel will spend on a single deployment may increase the risk of post traumatic stress symptoms.
All analyses were adjusted for factors such as age, gender, rank, marital status and Service. Further adjustments were made for role in theatre (combat or support), type of deployment (war or peace enforcement operations) and time spent in a forward area in close contact with the enemy. 

Professor Roberto Rona, one of the principal investigators at King’s, commented, “It is important that every effort is made to keep the amount of time Service personnel spend on deployments within current guidelines. Failure to do so has some tangible effects on mental health and family wellbeing.”

Professor Simon Wessely, director of the King’s Centre for Military Health Research added, “The effect of prolonged deployment on most psychological symptoms is relatively low unless it is unexpected.This must be continually monitored.”
These results suggest that deployment above the recommended limit in the UK armed forces is associated with poor mental health and problems at home, according to these researchers.  This may be more apparent in those with direct combat exposure.

The study team call for a clear and explicit policy on the duration of each deployment to help reduce the risk of post traumatic stress disorder.
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