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

January, 2017

This article considers how deployed mental health practitioners facilitated a return to the deployed operational unit for around three quarters of personnel who consulted with them in Afghanistan, thus opening up an avenue for early intervention and preventative activities.


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.

Full Reference

Jones, N., Fear, N. T., Wessely, S., Thandi, G., Greenberg, N. (2017). Forward psychiatry: early intervention for mental health problems among UK armed forces in Afghanistan. European Psychiatry, 39, 66-72.

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