UK serving and ex-Service personnel experiencing mental health problems such as Post-traumatic Stress Disorder, depression and anxiety disorders, and alcohol misuse need earlier identification and better support, according to a new review commissioned by the Forces in Mind Trust (FiMT) and conducted by the National Centre for Social Research (NatCen).

The study offers new insights into the prevalence of mental health problems, the experiences of serving and ex-Service personnel and their family members, and the effectiveness of current interventions. It brings together a review of 190 research studies and interviews with stakeholders from the Ministry of Defence, NHS England, military charities and academic institutions.

The findings reveal that deployment and combat are strong predictors of mental health problems, with common mental disorders such as anxiety and depression the most prevalent conditions for both serving and ex-Service personnel. For serving personnel, work culture, workload, and peer or leadership support are important determinants of mental health. For ex-Service personnel, the transition into civilian life can come with challenges such as isolation, feeling misunderstood and relationship problems.

Barriers to help-seeking for serving personnel include stigma and the fear of adverse impacts on their military career. Barriers for ex-Service personnel include not always being aware of the different treatment options available, and trying to cope with mental health challenges alone.

To better support the mental health of the Armed Forces community, the report recommends that there should be:

  • Earlier identification of ‘at risk individuals’ and early intervention to prevent escalation of mental health problems.
  • Improved awareness amongst healthcare professionals of the needs of ex-Service personnel and their entitlement to priority support.
  • Greater connectivity between Armed Forces and civilian services, to manage the transition to civilian life and ensure ex-Service personnel do not slip through the net.
  • Increased education on mental health and stigma for military personnel and their families, to support help seeking and address concerns around career impacts.

Ray Lock, Chief Executive at Forces in Mind Trust, says:“While just a small minority of serving and ex-Service personnel struggle with mental health challenges, our goal is for all ex-Service personnel and their families to be able to access good quality health and social care where and when they need it. This review brings together evidence to support FiMT’s wider Health Programme by collating existing research to provide us with an evidence base on the mental health needs of serving and ex-Service personnel that can be used by the whole sector to better support them.

“As we move forward, it is important that policy makers and service providers take account of the impact of Covid-19 too. This is already affecting the mental health of many in society, including serving and ex-Service personnel, some of whom are working on the frontline. This is an issue we will be looking at as we continue to develop our Health Programme.”

FIMT’s Policy Statement on Health, also published today, is available to read in full here.

Daniel Phillips, Head of Evaluation at The National Centre for Social Research, says: “This review offers important new insights into the mental health needs of military personnel and families. Deployment and combat are strong predictors of later mental health problems, while difficulties in the transition to civilian life also impact on the mental health of veterans and their close relations.

“While effective interventions are available, barriers such as perceived stigma can prevent personnel and their families from seeking help. More could also be done to ensure military personnel and their families are aware of the support available to them and feel confident about using it. We hope the recommendations in this research will help shape more proactive identification, intervention and support for serving and ex-Service personnel and their families.”

Andy Bell, Deputy Chief Executive at the Centre for Mental Health says: “This important study provides valuable insights into the mental health needs of Service and ex-Service personnel. It identifies not just the types of mental health difficulty people may experience during their transition to civilian life but also the groups with the highest risks. It also points out significant gaps in research that need to be addressed. We hope that this report will help to put resources where they are needed most and inform the next generation of research on this crucial topic.”