12 October 2020

A new report released today found that veterans who served in recent conflicts are more likely to suffer from certain mental health conditions and alcohol misuse than the general public.

The mental health and treatment needs of UK ex-military personnel, by Dr Laura Goodwin (University of Liverpool) and Dr Deirdre MacManus (King’s College London) and funded by Forces in Mind Trust (FiMT), assessed UK veterans who served during military operations in Iraq and Afghanistan. It also examined current support available through NHS Improving Access to Psychological Therapies (IAPT) services which provide psychological therapies to patients with mild to moderate mental health disorders.

Although most ex-Service personnel adapt well when transitioning to civilian life, the research found that overall, veterans were more likely to report common mental disorders such as anxiety and depression, as well as Post Traumatic Stress Disorder (PTSD) and alcohol misuse, than non-veterans. Male veterans seem to be worse affected and were more likely to experience mental health issues than male non-veterans, whilst there was no significant difference for female veterans as compared to female non-veterans. Male veterans were also more likely to report problematic drinking behaviours (such as symptoms of dependence) than non-veterans, and both male and female veterans were more likely to report drinking at a hazardous level than non-veterans.

Additionally, the research supports evidence that employment is a key factor in successful transition from military to civilian life. Mental health problems were found to be more likely for both veterans and non-veterans who were unable to work due to illness or disability.

In addition to reporting the mental health issues faced by some veterans, the research assessed their response to psychological therapy through IAPT services. The results suggested that veterans were more likely to be screened for PTSD and meet criteria, although rates for anxiety and depression were similar in both groups. Veterans were found to both adhere and respond to psychological therapies for mild to moderate anxiety, depression and PTSD equally well as non-veterans using IAPT services. As such, the report recommends that veterans should be signposted to and encouraged to use the IAPT initiative.

The report also recommends increasing awareness of and education around both mental health and alcohol misuse problems within the armed forces community, better data sharing in the NHS, and more joined up working between mental health, alcohol misuse and welfare services.

Ray Lock, Chief Executive of Forces in Mind Trust, said: “The majority of those who serve in the Armed Forces are able to successfully transition to civilian life. However, this research highlights the mental health and alcohol misuse issues which are more prevalent amongst ex-Service personnel who served in recent conflicts. This is important to understand, so that better and more complete treatment options can be made available. It’s encouraging to see the positive response to IAPT services, and we support the recommendations for better signposting and awareness to ensure that those who need these services can reach them.

“Consistently, reports through FiMT’s Health programme recommend a more holistic approach to support for ex-Service personnel. This research too suggests that services could better work together, where individuals are likely to have both mental health and alcohol misuse issues. We hope to see policymakers and service providers taking forward these recommendations to ensure those who have served this country can get the support they need to successfully transition to civilian life.”

Dr Laura Goodwin said:

“The majority of military veterans respond well to civilian life, yet there appears to be a higher prevalence of mental health problems in male veterans compared to males in the general population and therefore an increased need for mental health support. An obvious difference between those who have served in the UK military and those employed in other occupations is the experience of operational deployment. Interestingly, whilst our work suggests that deployment may partly explain the increased level of PTSD in veterans, it did not explain the increased prevalence of CMD or alcohol misuse.

“Male and female veterans are also drinking more than individuals of a similar age from the general population. It is crucial that there is better promotion of safer alcohol use within the UK Armed Forces, greater efforts to identify and manage problematic drinking, and that support for alcohol misuse is integrated with mental health services where needed.”

Dr Deirdre MacManus said:

“Veterans using IAPT services were found to adhere and respond to psychological therapies for mild to moderate anxiety, depression and PTSD similarly to non-veterans. This provides support for the referral of veterans to these services and indicates the need for greater promotion of IAPT services within the veteran community and the services they present to, i.e. GP practices and military charities. It is also crucial that staff at IAPT services are trained in veteran sensitive practice.

“This study did not include those with more severe or complex mental health problems who would surpass the criteria for IAPT services. We are therefore not suggesting that IAPT services should replace Specialist NHS veteran mental health services, rather that they can be effectively utilised as part of a wider pathway of veteran mental health care.”

Download the full report and executive summary.


Notes to editors

About Forces in Mind Trust:

Forces in Mind Trust was founded in November 2011 by a £35 million endowment from the Big Lottery Fund (now The National Lottery Community Fund).  As a member of Cobseo – the Confederation of Service Charities and a permanent member of its Executive Committee, the Trust works within the Armed Forces charities sector, and much more widely, to support the UK’s Armed Forces Community.

The mission of FiMT is to enable ex-Service personnel and their families to make a successful and sustainable transition to civilian life. FiMT delivers this mission by generating an evidence base that influences and underpins policy making and service delivery, and by strengthening the Armed Forces charities sector through collaboration and leadership, and by building its capacity.

FiMT’s grants and commissions are designed to generate sustained change that improves the lives of ex-Service personnel and their families. FiMT awards grants to support its Change Model based on seven outcomes: Housing; Employment; Health; Finance; Criminal Justice System; Relationships; and its Enabler programme.