Abstract
Aims and methodTo describe an interim service set up to examine the breadth of UK ex-service personnel's concerns in relation to their mental health and military service and provide a record of the first 150 individuals assessed following conformation of military service and examination of all available military and civilian medical records.ResultsThe majority of attendees were White male ex-soldiers. Average age, service and time to assessment were 44.5, 15.8 and 11.7 years respectively. Two-thirds were receiving help from the National Health Service and ex-service nongovernmental organisations. Rates of post-traumatic stress disorder were similar to previous UK studies. Obsessional symptoms were of relevance to the clinical presentation in a third. Fabrication and/or exaggeration occurred in about 10%.Clinical implicationsThe spread of diagnoses and delay in help-seeking are similar to civilians. The link between mental disorders and military service is seldom straightforward and fabrication or exaggeration is difficult for civilians to recognise. Verification and contextualisation of service using contemporaneous service medical records is important given the possible occupational origin of mental health conditions.
Highlights
Enquiries and advice were sought by ex-service person/personnel (ESP), their friends and families, general practitioner (GP), mental health professionals, researchers and non-governmental organisations (NGOs)
When individuals were contacted by letter and invited to update the Medical Assessment Programme (MAP) about their situation 6 months after attendance, the response rate was in the order of 15%, which was still better than an earlier response rate from GPs for information on attendees’ progress (10%)
The individuals seen did not require extensive telephone contact with GP or other agencies, which may relate to the time taken to identify their concerns and the provision of a formulation for both ESP and GP
Summary
Telephone and email contact with the service increased 95% over the period of 18 months, unrelated to the 150 cases. As individuals came from across the UK, the average consultation lasted 2.9 h, attempted in one setting. Each consultation required an average administration time of 3.7 h (total 6.6 h). The individuals seen did not require extensive telephone contact with GP or other agencies, which may relate to the time taken to identify their concerns and the provision of a formulation for both ESP and GP. The majority (65%) had received two or more psychiatric diagnoses, of which 42% were unrelated to service; in only 20% was the link unequivocal. About one in five individuals had unequivocal record of involvement with military mental health services before discharge, of whom 67% had received NHS follow-up
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