The mixed methods research examined experiences of physical and mental healthcare during and after military service. It forms part of the ADVANCE (ArmeD SerVices TrAuma RehabilitatioN outComE) study, which researches the long-term consequences of sustaining a physical combat injury during deployment to Afghanistan.  ADVANCE is a collaboration between King’s College London, Imperial College London and the Ministry of Defence.

Key findings

Participants largely reported that physical healthcare after an injury was high quality.  However, the research found that:

  • some participants with limb loss expressed a need for more efficient prosthetics services after leaving the military
  • some participants injured without associated limb loss felt their injuries had not been thoroughly assessed, which delayed appropriate treatment and diminished their chances of receiving compensation
  • persistent pain affected some injured participants with and without limb loss, impacting on their wellbeing
  • participants perceived that differences in pain relief prescription approaches in military and civilian healthcare settings could create risks of misuse.

In addition, experiences of those who sought mental healthcare varied: some reported interrupted care, long waits or treatment that tended not to meet their needs, while others valued the support they received.

Recommendations

The report made nine recommendations to improve life after combat injury including:

  • Equity of healthcare – The Ministry of Defence should ensure that injuries are comprehensively assessed regardless of whether the person sustained limb loss or not.
  • Prosthetic services after the military – Ensure consistent referral to efficient prosthetic and mobility aid services during the transition to civilian life.
  • Pain relief – consider how to dovetail approaches to pain relief between military and civilian healthcare systems.
  • Mental health support – Review how military mental healthcare support services can best support those with physical combat injuries.

Read the full report for all recommendations and key findings.

Anna Verey, co-author, King’s College London, said:

“Many of the participants we spoke to felt that the physical healthcare they received post-injury was excellent.  However, they felt that more needed to be done to get the mental healthcare up to the same standard.

With regards to physical healthcare, some participants injured without limb loss felt that the treatment of their injuries had not been equivalent to those injured with limb loss, possibly because their injuries were less visible.  These participants felt their lives were challenging because they had to use tribunals to get the financial compensation they felt they were warranted and some of them were living with pain long after their injury, which could make their personal and professional lives difficult.  Participants who had been prescribed pain medication, told us that the different pain relief philosophies between military and civilian healthcare systems, could negatively affect them, creating risks of misuse, as they navigated starting a new life, post-discharge.”

 Michelle Alston, Chief Executive of Forces in Mind Trust, said:

“The way that we approach combat injuries – both at the point of delivery or years later – will be hugely important for former Service personnel’s experiences in civilian life. This research has highlighted some key strengths and success stories in recovery from those injuries. By building on that success, and collaborating across military and civilian healthcare, there is potential for significant benefits to those injured by combat and the wider community around them.”

The research draws on questionnaire data from 547 former Service personnel, including 396 injured during deployment to Afghanistan, and 28 in-depth interviews.

Read Combat injured veterans’ perceptions of their physical and mental healthcare: a short report from the ADVANCE-INVEST study.