Introduction In the UK military, suicide is infrequent and studies of self‐harm behavior in this population are rare. Objectives To compare lifetime self‐harm rates estimated on three occasions between 2004 and 2016 and to explore the associates of lifetime self‐harm. Method Three phases of a UK AF cohort study (n = 10,272, 9,990, and 8,581, respectively) provided data. Telephone interviews assessed associates of self‐harm among cohort members who reported subjective mental health problems in the past 3 years (n = 1,448). Validated measures of mental health and related stigmatization, social support, and help‐seeking were obtained. Results Lifetime self‐harm increased significantly (p < .001) from 1.8% among serving personnel and 3.8% among veterans in 2004/06 to 1.9% and 4.5% in 2007/09 and to 4.2% and 6.6% in 2014/16 in the two groups, respectively. Veterans were consistently significantly more likely to report lifetime self‐harm than serving personnel. Significant determinants of lifetime self‐harm included current mental disorder symptoms, stigmatization, poor social support, suicidal ideation, and seeking help from formal medical sources. Conclusion Self‐harm has increased over time in the UK serving and veteran community. Suicide prevention should focus on ameliorating mental disorder by encouraging engagement with health care, reducing negative views of mental illness, and fostering social support.

Background Internationally, women are about to undertake combat duties alongside their male colleagues. The psychological effect of this policy change is largely unknown. Aims To explore the mental health impact of combat exposure among military women. Methods Self-report, between-subjects survey data were collected in Iraq and Afghanistan on four occasions between 2009 and 2014 (n = 4139). Differences in mental health, stigmatization, deployment experiences, intimate relationship impact, perception of family support levels, unit cohesion, leadership and help-seeking were compared between deployed men and women. Comparisons were repeated with the study sample stratified by level of combat exposure. Outcomes were examined using logistic regression adjusted for socio-demographic, mental health and military factors. Results Overall, 4.1% of women and 4.3% of men reported post-traumatic stress disorder (PTSD) (odds ratio (OR) 1.31, 95% confidence interval (95% CI) 0.70–2.46); 22% of women and 16% of men reported symptoms of common mental disorder (CMD) (OR 1.52, 95% CI 1.11–2.08). Women were less likely to report mental health-related stigmatization (OR 0.68, 95% CI 0.53–0.87), negative relationship impact from deployment (OR 0.69, 95% CI 0.49–0.98) and subjective unit cohesion (OR 0.69, 95% CI 0.53–0.90). Help-seeking for emotional problems was similar by gender (OR 1.22, 95% CI 0.84–1.77). Overall, outcomes were minimally impacted by level of combat exposure. Conclusion Although women experienced more CMD symptoms, PTSD symptoms were similar by gender. Subject to confirmation of the study findings, women may not require enhanced mental healthcare during deployment for exposure-based conditions such as PTSD when undertaking the ground close combat role.

Background Recently, the UK Armed Forces have revised the ground close combat role to include women. Aims To assess the potential mental health impact of this initiative we examined gender differences in deployment patterns, work strain, occupational factors, mental health, alcohol use and help-seeking following operational deployment. Methods The study was a secondary analysis of self-report survey data; 8799 men (88%) and 1185 women (12%) provided data. A sub-sample (47%, n = 4659) provided data concerning post-deployment help-seeking. The latter consisted of 408 women (8.8%) and 4251 men (91%). Results With the exception of alcohol misuse, which was significantly lower for women, women reported significantly more common mental disorder symptoms, subjective depression and self-harm. Women were significantly more likely to seek help from healthcare providers. Men were significantly more likely to have deployed operationally and for longer cumulative periods. Subjective work strain, but not job control, was significantly lower for women whose military careers were significantly shorter. Post-traumatic stress disorder (PTSD) symptom intensity was similar to men. Conclusions With the exception of PTSD and alcohol misuse, UK military women experience more mental health-related problems than military men. This finding was not related to the more arduous aspects of military service as women served for shorter times, deployed less and for shorter cumulative periods and were less likely to report work-related stress.

Background: Little is known about gender differences in mental health, related help-seeking behavior and social support in UK military personnel. Methods: 1714 UK military serving personnel and ex-service veterans were randomly selected if, in a cohort study, they endorsed experiencing a subjective stress, emotional, alcohol or mental health problem in the previous three years. Following exclusions, the final sample size was 1448 (participation rate 84.5%; women n = 219). Structured telephone interviews assessed anxiety, depression, PTSD symptoms, alcohol use, help-seeking and social support occurring both currently and in the past three years. Outcomes were assessed using weighted unadjusted and adjusted logistic regression analyses. Results: Mental health problems assessed at interview were broadly similar for men and women; for both genders, levels of social support were high. One-fifth of respondents screened positive for probable mental disorder or alcohol misuse; although rates of mental disorder symptoms did not differ by gender, women were significantly less likely than men to report alcohol misuse. Women were significantly more likely to have sought help from formal medical sources but significantly less likely to access informal support such as friends, family or unit welfare sources; reasons for seeking formal medical support were similar for men and women except for problem recognition and acting on advice from others, which were both significantly more common among women. Conclusion: For military personnel with a history of mental ill-health, women should make greater use of informal support networks while for men, engagement with formal medical help sources should be encouraged.The United Kingdom Armed Forces (UK AF) have contributed substantial numbers of personnel to combat and peacekeeping operations including medium-scale missions in Bosnia Herzegovina, Kosovo, countries in Africa (Curran & Williams, 2017

Background Although there is currently little research data to support the contention, concerns have been raised about possible traumatic stressors inherent to Remotely Piloted Aircraft System (RPAS) operator roles. Factors such as exposure to visually traumatic events compounded by long working hours and blurred boundaries between military and civilian life have been cited as potential stressors. Robust research into the well-being of RPAS operators is scarce and mostly samples US personnel. Aims To provide mental health and well-being data relating to UK RPAS operators. Methods UK RPAS operators completed mental health questionnaires to assess levels of post-traumatic stress disorder (PTSD), anxiety and depression symptoms, alcohol use and occupational functioning. Respondents were also asked about work patterns. Results Forty-one per cent of the sample reported potentially hazardous alcohol use. Ten per cent met psychiatric symptom criteria for moderate or severe anxiety, and 20% for moderate depressive symptoms. While there were no cases of probable PTSD, 30% of the sample reported sub-clinical PTSD symptoms likely to impair occupational functioning. Overall, 70% of the sample reported that psychological symptoms significantly impaired their functioning. Conclusions Compared to UK military sub-groups, RPAS operators were not at increased risk of mental health problems. However, a high proportion of the sample reported significant functional impairment, which has not been explored in other comparable studies. The most frequently highlighted work-related stressors were timing of RPAS work and operator shift patterns.