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UK troops mentally resilient and 'faring better' than US peers

Despite 10 years of conflict in Iraq and Afghanistan, UK troops remain mentally healthy and more resilient than their US peers, according to a study published today by the King’s Centre for Military Health Research (KCMHR) at King’s College London.


The findings provide early evidence that intervention strategies introduced by the UK Armed Forces have helped mitigate the impact of trauma.  

However, the authors highlight particular groups who are at greater risk of mental health problems – namely those deployed in a combat role, and Reservists – 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.

Rates of post-traumatic stress disorder (PTSD) among UK Regulars range from 1.30 to 4.8 percent - this is similar to the UK general population, at 3 percent. Rates of common mental disorders (such as anxiety, depression) amongst UK military personnel (which range from 16.7 to 19.6 percent) were also similar to those in the UK general population.

However, 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 deployed to Iraq or Afghanistan than if they had not. 

Rates of PTSD remain significantly lower for UK troops compared to their US peers, where recent studies have reported rates of PTSD range from 21 to 29 percent. US personnel tend to be younger, from lower socio-economic background and undertake 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 – the authors highlight that these factors may contribute to the different rates. 

Mild traumatic brain injury (mTBI) has also remained rare, at round 4.4 percent for UK Regular troops who have been deployed. However, rates increased to 9.5 percent for those deployed in a combat role. Rates of mTBI remain consistently lower than among US troops, where mTBI has been described as a ‘signature injury’ affecting 12 to 23 percent of deployed troops. 

Harmful drinking, however, continues to give cause for concern, affecting up to one in five 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, says: “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, says: “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 (TRiM) which are evidence-based interventions routinely used in the UK Armed Forces, but not in the US.”

Paper reference: MacManus, D. et al. ‘The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity’ published in the Journal of the Royal Army Medical Corps doi:10.1136/jramc-2013-000213

For further information, please contact Seil Collins, Press Officer, Institute of Psychiatry, King’s College London – / (+44) 0207 848 5377