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Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq

King’s Centre for Military Health Research, King’s College London

NICOLA T. FEAR, DPhil

Academic Centre for Defence Mental Health, King’s College London

NEIL GREENBERG, MPCPsych, CLAIRE FRENCH, MSc, ROBERTO J. RONA, FFPH, SIMON WESSELY, FMedSci and MATTHEW HOTOPF, MRCPsych

King’s Centre for Military Health Research, King’s College London, London, UK

Correspondence: Professor Matthew Hotopf, King’s Centre for Military Health Research, Weston Education Centre, London SE5 9RJ, UK. Tel: +44 (0)20 7848 0435; fax: +44 (0)20 7848 5408; email: m.hotopf{at}iop.kcl.ac.uk

Declaration of interest None. N.G. is a full-time active service medical officer seconded to the King’s Centre for Military Health Research as a liaison officer, paid by the Ministry of Defence. S.W. is honorary civilian consultant advisor to the British Army. Other funding is detailed in Acknowledgements.

Background Deployment to the 2003 Iraq War was associated with ill health in reserve armed forces personnel.

Aims To investigate reasons for the excess of ill health in reservists.

Method UK personnel who were deployed to the 2003 Iraq War completed a health survey about experiences on deployment to Iraq. Health status was measured using self-report of common mental disorders, post-traumatic stress disorder (PTSD), fatigue, physical symptoms and well-being.

Results Reservists were older and of higher rank than the regular forces. They reported higher exposure to traumatic experiences, lower unit cohesion, more problems adjusting to homecoming and lower marital satisfaction. Most health outcomes could be explained by role, experience of traumatic events or unit cohesion in theatre. PTSD symptoms were the one exception and were paradoxically most powerfully affected by differences in problems at home rather than events in Iraq.

Conclusions The increased ill-health of reservists appears to be due to experiences on deployment and difficulties with homecoming.

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