Alan FINNEGAN Trinity College Dublin 7/8 Nov 12

Military Mental Health

What is Depression?

Aim To evaluate and provide a critical analysis of the predisposing factors leading to depression in the British Army. To develop a theoretical model outlining the factors leading to depression, and the appropriate patient’s clinical pathway. Provide detail from a GP validation exercise looking at the transferability of the findings to civilian healthcare

Methodology & Method Two surveys 0f MMH hospital admissions and DCMH referrals. A grounded theory qualitative study. GP validation exercise.

Predisposing Factors Multi factorial factors and symptoms. Majority had relationship problems, family issues occupational stressors. Wanting to leave the Army = 20% of all hospital admissions and 25% accessing a DCMH. Gender, Age & Rank Gender, Age & Rank

Predisposing Factors Leading to Depression in the British Army Personality Medical Services Unhappy Soldier Relationships Military Depression Army Social Views & Media Macho Image Social Class Stigma Physical Problems Isolation Symptoms Alcohol Bullying & Harassmen t Team Building DCMHs Rank Operations Control & Perceptions Benefits of Army Life Help Seeking Behaviour Cultural Issues Family Issues Situational Stressors Age Gender

Depression in the British Army Precipitating / Maintaining Factors Previous Trauma Childhood Trauma Physical Problems Past Family History Relationship Problems Family Issues Occupational Stress Bullying Unhappy Soldier Financial or Disciplinary Problems Secondary Coping Mechanisms Alcohol Abuse Substance Abuse Isolation Help Seeking Behaviour Personality Macho Image Age & Gender Social Class Cultural Factors Stigma Societal & Media Views Situational Stressors Contextual – Peacetime or Operations Environmental Support – The Army, AMS and DCMHs

Military Depression Unique Definition. Private Soldiers aged 18 to 22 years old. Non Commissioned Officers & Senior NCOs aged late 20’s to early 30’s. Soldiers nearing the end of their career and aged late 30s onwards. Women.

Validation Exercise Are the results a true reflection of the presentation of depression in the British Army? Should the model be introduced into GP training? Are findings transferable to civilian practice?

Implications Lessons learnt have been incorporated into a theoretical model indicating the factors leading to depression, and the patient’s clinical pathway. Has the potential to improve the operational capability of the Army. Utility – Army, and potentially transferable to other Armed Forces and young men’s MH.

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