WAF0049

 

 

Written evidence from King’s Centre for Military Health Research and

Academic Department for Military Mental Health, King’s College London

 

Defence Committee - Women in the Armed Forces: From Recruitment to Civilian Life

 

We thank the Defence Committee for the opportunity to respond to the inquiry, Women in the Armed Forces: From Recruitment to Civilian Life (January 2021). We have research evidence from the King’s Centre of Military Health Research (KCMHR) and the Academic Department of Military Mental Health (ADMMH), both based at King’s College London (KCL). Our research evidence helps to inform approaches to the mental health and wellbeing of female service personnel and veterans. We provide evidence in the areas of, ‘Mental health and wellbeing ‘(including common mental health disorders (CMD), Posttraumatic stress disorder (PTSD) and alcohol misuse), ‘Posttraumatic growth’, ‘Intimate Partner Violence, ‘Retention’ and ‘Future Research Needs and Gaps’. We summarise this research, providing implications and recommendations. Links to KCMHR key papers are integrated in the text, with full references in Appendix 1.

 

King’s Centre for Military Health Research

KCMHR is the leading independent civilian UK centre of excellence for military health research. KCMHR was established in 1996 as a joint initiative between the Institute of Psychiatry, Psychology & Neuroscience and the Department of War Studies, King’s College London. KCMHR draws upon the experience of a multi-disciplinary team and is led by Professor Sir Simon Wessely and Professor Nicola Fear. Our flagship cohort study of 20,000 UK Armed Forces - ‘The Health and Wellbeing of the UK Armed Forces’, has followed those who served in Iraq and Afghanistan since 2003 and now provides longitudinal data on their health outcomes, spanning over 17 years. Data from our studies have been used to analyse various military issues, and papers have been published in peer reviewed, scientific journals. Our findings are regularly reported in the press and help shape government policy towards military personnel and other occupational groups, with our research published in high impact journals such as the British Medical Journal and The Lancet.

 

Academic Department of Military Mental Health

ADMMH is funded by the MoD and collaborates closely with KCMHR. ADMMH aims to provide the highest quality research, and academic advice to the MoD both during peacetime and on operations on the mental health of the Armed Forces. ADMMH's mission is to act as the uniformed focus for military mental health research for the UK Armed Forces. The department aims to gather, assess and report on information that will enhance the health and operational effectiveness of the UK Armed Forces. ADMMH staff work to support the research efforts of the Defence Medical Services and other organisations or institutions that work to better understand and improve the health of serving personnel.

 

Mental Health and Wellbeing - Women in the Armed Forces

Background

KCMHR Research

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/E77CCC4B6D0B2A3B6A481C0980D29E93/S0007125018001757a.pdf/mental_health_outcomes_at_the_end_of_the_british_involvement_in_the_iraq_and_afghanistan_conflicts_a_cohort_study.pdf

Women in Ground Close Combat (WGCC)

During the pre-implementation evaluation phase of the Women in Ground Close Combat (WGCC) project by the MoD, secondary data analysis conducted by ADMMH/KCMHR which included assessments of the potential mental health impact of combat exposure, levels of work strain and the possible impact on help-seeking should the WGCC policy be implemented. Three analyses were carried out by ADMMH/KCMHR.

 

  1. Data from phase 2 of the KCMHR cohort study assessed levels of work strain and mental health outcomes on return from deployment using self-report survey data obtained from 8799 men (88%) and 1185 women (12%). 

https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2020/jones-et-al-2020-military-women-and-help-seeking.pdf

 

  1. Data was analysed from a structured telephone interview study of individuals recruited from phase 3 of the KCMHR cohort study who reported that they had experienced a, ‘mental health, stress or emotional problem in the past three years’. This study comprised of 219 women from a total of 1448 participants (Stevelink et al., 2019).

 

  1. In an ADMMH Operational Mental Health Needs Evaluation, ‘OMHNE’ study, the mental health impact of combat exposure upon military women was explored.  When assessed in an operational theatre, 4% of currently deployed women and 4% of currently deployed men had symptoms indicative of PTSD.

 

Intimate Partner Violence

 

Post Traumatic Growth

 

Retention

 

Future Research Needs and Gaps

 

Implications and Recommendations

 

If the committee would like to discuss any of these aspects further, please get in touch with KCMHR and ADMMH.

With best wishes,

Professor Nicola Fear/Professor Sir Simon Wessely

 

2 February 2021                           

 

King’s Centre for Military Health Research

King’s College London

Weston Education Centre

Cutcombe Road

London SE5 9RJ

 

Telephone:              020 7848 5351

Fax:              020 7848 5397

Email:              kcmhr@kcl.ac.uk

Website:              www.kcl.ac.uk/kcmhr

 


                                          WAF0049

 

 

Appendix 1- References

 

BARTLETT, B. A. & MITCHELL, K. S. 2015. Eating disorders in military and veteran men and women: A systematic review. International Journal of Eating Disorders, 48, 1057-1069.

BURDETT, H., STEVELINK, S. A., JONES, N., HULL, L., WESSELY, S. & RONA, R. 2020. Pre-service military-related and mental disorder factors associated with leaving the UK armed forces. Psychiatry, 1-16.

CAWKILL, P., ROGERS, A., KNIGHT, S. & SPEAR, L. 2009. Women in ground close combat roles: The experiences of other nations and a review of the academic literature. Defense Science and Technology Labroratory, Porton Down.

DYBALL, D., TAYLOR-BEIRNE, S., GREENBERG, N., STEVELINK, S. A. M. & FEAR, N. T. 2021. Deployment-related Post-Traumatic Growth in Iraq/Afghanistan Deployed Veterans/Serving Personnel: Sociodemographic, Health and Deployment-related Factors associated with Post-Traumatic Growth (Manuscript in preparation).

GODIER, L. R. & FOSSEY, M. 2018. Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces. British Medical Journal Publishing Group.

JONES, N., GREENBERG, N., PHILLIPS, A., SIMMS, A. & WESSELY, S. 2019a. British military women: combat exposure, deployment and mental health. Occupational Medicine, 69, 549-558.

JONES, N., GREENBERG, N., PHILLIPS, A., SIMMS, A. & WESSELY, S. 2019b. Mental Health, Help-Seeking Behaviour and Social Support in the UK Armed Forces by Gender. Psychiatry, 82, 256-271.

JONES, N., JONES, M., GREENBERG, N., PHILLIPS, A., SIMMS, A. & WESSELY, S. 2020. UK military women: mental health, military service and occupational adjustment. Occupational medicine.

KWAN, J., SPARROW, K., FACER-IRWIN, E., THANDI, G., FEAR, N. & MACMANUS, D. 2020. Prevalence of intimate partner violence perpetration among military populations: A systematic review and meta-analysis. Aggression and violent behavior, 101419.

MCGRAW, K., KOEHLMOOS, T. P. & RITCHIE, E. C. 2016. Women in combat: framing the issues of health and health research for America's servicewomen. Military medicine, 181, 7-11.

RONA, R. J., FEAR, N. T., HULL, L. & WESSELY, S. 2007. Women in novel occupational roles: mental health trends in the UK Armed Forces. International journal of epidemiology, 36, 319-326.

ROSEBROCK, L. & CARROLL, R. 2017. Sexual function in female veterans: A review. Journal of Sex & Marital Therapy, 43, 228-245.

SOUTHWELL, K. H. & MACDERMID WADSWORTH, S. M. 2016. The many faces of military families: Unique features of the lives of female service members. Military Medicine, 181, 70-79.

SPARROW, K., DICKSON, H., KWAN, J., HOWARD, L., FEAR, N. & MACMANUS, D. 2020. Prevalence of self-reported intimate partner violence victimization among military personnel: a systematic review and meta-analysis. Trauma, Violence, & Abuse, 21, 586-609.

SPARROW, K., KWAN, J., HOWARD, L., FEAR, N. & MACMANUS, D. 2017. Systematic review of mental health disorders and intimate partner violence victimisation among military populations. Social psychiatry and psychiatric epidemiology, 52, 1059-1080.

STEVELINK, S. A., JONES, M., HULL, L., PERNET, D., MACCRIMMON, S., GOODWIN, L., MACMANUS, D., MURPHY, D., JONES, N. & GREENBERG, N. 2018. Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study. The British Journal of Psychiatry, 213, 690-697.

STEVELINK, S. A., JONES, N., JONES, M., DYBALL, D., KHERA, C. K., PERNET, D., MACCRIMMON, S., MURPHY, D., HULL, L. & GREENBERG, N. 2019. Do serving and ex-serving personnel of the UK armed forces seek help for perceived stress, emotional or mental health problems? European journal of psychotraumatology, 10, 1556552.

UNWIN, C., HOTOPF, M., HULL, L., ISMAIL, K., DAVID, A. & WESSELY, S. 2002. Women in the Persian Gulf: lack of gender differences in long-term health effects of service in United Kingdom Armed Forces in the 1991 Persian Gulf War. Military Medicine, 167, 406-413.

WOODHEAD, C., WESSELY, S., JONES, N., FEAR, N. & HATCH, S. 2012. Impact of exposure to combat during deployment to Iraq and Afghanistan on mental health by gender. Psychological Medicine, 42, 1985.

 

King’s Centre for Military Health Research

King’s College London

Weston Education Centre

Cutcombe Road

London SE5 9RJ

 

Telephone:              020 7848 5351

Fax:              020 7848 5397

Email:              kcmhr@kcl.ac.uk

Website:              www.kcl.ac.uk/kcmhr