Do medical service personnel who deployed to Iraq war have worse mental health than other deployed personnel?

King's Centre for Military Health Research, Institute of Psychiatry, King's College London, London, UK.
The European Journal of Public Health (Impact Factor: 2.59). 09/2008; 18(4):422-7. DOI: 10.1093/eurpub/ckn031
Source: PubMed


There is evidence of increased health care utilization by medical personnel (medics) compared to other trades in the UK Armed Forces. The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war.
Participants' main duty during deployment was identified from responses to a questionnaire and verified from Service databases. Psychological health outcomes included psychological distress, post-traumatic stress disorder, multiple physical symptoms, fatigue and heavy drinking.
A total of 479 out of 5824 participants had a medical role. Medics were more likely to report psychological distress (OR 1.30, 95% CI 1.00-1.70), multiple physical symptoms (OR 1.65, 95% CI 1.20-2.27) and, if men, fatigue (1.38, 95% CI 1.05-1.81) than other personnel. Female medics were less likely to report fatigue (0.57 95% CI 0.35-0.92). Neither post-traumatic stress disorder nor heavy drinking symptoms were associated with a medical role. Traumatic medical experiences, lower group cohesion and preparedness, and post-deployment experiences explained the positive associations with psychological ill health. Medics made greater use of medical facilities than other trades.
There is a small excess of psychological ill health in medics, which can be explained by poorer group cohesion, traumatic medical and post-deployment experiences. The association of mental ill health with a medical role was not the consequence of a larger proportion of reservists in this group.

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    • "All service members, regardless of occupation, are exposed to a similar set of values that include obedience; service; mission first; and never failing, quitting , or leaving another service member behind (Defense Health Board, 2015; Rondeau, 2011). Military health-care providers experience psychological problems similar to those seen in combat troops where stress, emotional instability, and family conflict are prominent upon return home (Jones et al., 2008; Kolkow, Spira, Morse, & Grieger, 2007; Milliken, Auchterlonie, & Hoge, 2007; Seal et al., 2009; Smith et al., 2008, Thomas et al., 2010). Even though over 75% of combat veterans recognize these problems, only 40% are interested in receiving help (Brown, Creel, Engel, Herrell, & Hoge, 2011). "
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    ABSTRACT: Our past lessons from war trauma have taught us that mental health-care stigma and other issues surrounding mental health–seeking behaviors can negatively impact the healing trajectory and long-term function for service members and their families. It can take years to decades before a service member seeks professional help for psychological distress, if he or she seeks it at all. Unfortunately, signs of personal and family problems can be subtle, and consequences, such as suicide, tragic. In this chapter, we consider the story one military health-care provider submitted in response to a study solicitation that read: Please provide your personal story telling me about any psychological distress you may have experienced after returning from deployment and your personal challenges accessing care and/or remaining in treatment. This story is analyzed to explore the moral implications of his experience for the military and for other service members. The main points to be highlighted are that altruism can leave altruists more vulnerable, military mental health stigma may exacerbate this risk, and military families may profoundly be affected.
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    • "Perhaps good preparation as well as unit cohesion has resulted in low incidence of combat stress-related disorders. Research demonstrated that medical personnel in military units are highly vulnerable to PTSD, and also that protective effects of unit cohesion increases as warzone stress exposure intensifies [20]. Contrary to what has been found in other studies psychological health outcomes beyond PTSD, such as psychological distress, multiple physical symptoms, fatigue, and heavy drinking were not found in this study [21]. "
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    ABSTRACT: Introduction: Care for battle casualties demands special skills from medics, nurses, and tactical commanders. To date, no inventory has been performed evaluating the first responders (medics, nurses and tactical commanders) around battle casualties. Method: This observational cohort study was conducted amongst the first responders (n=195) who were deployed to Southern Afghanistan (2009-2010) in three Marine companies. The survey focused on four main topics: (1) participants general background, (2) exposure to combat (casualty) situations, (3) self-perceived quality of care (1 [low]-10 [high]) in the pre-hospital phase, and (4) the effects of combat stressors on professional skills and social environment using the Post Deployment Reintegration Scale (PDRS) and the Impact of Event Scale-Revised (IES-R). Results: 71% of the eligible Dutch tactical commanders, medics, and nurses participated in this survey. Most (14/16) medics and nurses scored their pre-deployment training as sufficient The overall self-perceived quality of care score was above average (7.8). Most (80%) of the participants were exposed to battle casualties. There were no significant differences regarding rank, gender, age and military task using the impact of event scale and PDRS, except for a worse score on the work negative, family positive and personal positive subscales (p<0.05) in the PDRS for the first responders in comparison to the armed forces norm score. Conclusion: The quality of care in the pre-hospital phase was considered adequate, symptoms of post-traumatic stress in this group was low. Active involvement of co-combatants and the social support network are essential in adaption after exposure to combat events. Further research is necessary to identity predisposing preventable high stress factors, and to compose a "waterproof" aftercare programme.
    Full-text · Article · Dec 2014 · Injury
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    • "Given the potential of providing aid to be a positive experience, the finding that it is associated with increased post-traumatic stress in medics is surprising. This finding is in contrast to previous research where providing aid was found to decrease psychological distress in medical personnel , including doctors, nurses, and medical assistants (Jones et al., 2008). This finding is likely due to differences in the environments in which medics and other medical personnel provide aid. "
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    ABSTRACT: U.S. Army combat medics who were three months postdeployment reported higher prevalence of post-traumatic stress disorder (PTSD) and aggressive behaviors than did medics who had never been deployed to a combat zone. Combat experiences were then separated into six categories: killing, fighting, threat to oneself, death and injury of others, providing aid to the wounded, and saving a life. After controlling for socially desirable response bias, providing aid and threat to oneself predicted post-traumatic stress; providing aid predicted depression; and reports of killing predicted aggressive behaviors in postdeployed medics. Despite their noncombatant status and primary role as health care providers, medics report behavioral health symptoms in association with combat experiences.
    Full-text · Article · Oct 2014
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