Military veterans and civilians’ mental health diagnoses: an analysis of secondary mental health services

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 58; no. 7; pp. 1029 - 1037
• Main Authors: Williamson, Charlotte, Palmer, Laura, Leightley, Daniel, Pernet, David, Chandran, David, Leal, Ray, Murphy, Dominic, Fear, Nicola T., Stevelink, Sharon A. M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2023; Springer Nature B.V
• Subjects: Electronic health records; Epidemiology; Health services; Humans; Machine learning; Medical electronics; Medicine; Medicine & Public Health; Mental disorders; Mental Health; Mental health care; Mental Health Services; Military personnel; Military Personnel - psychology; Original Paper; Population-based studies; Psychiatry; Sociodemographics; State Medicine; Veterans - psychology; United Kingdom > UK; Civilian; Secondary healthcare; Armed forces; Veteran; Mental health; Military
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-022-02411-x

Purpose
Healthcare provision in the United Kingdom (UK) falls primarily to the National Health Service (NHS) which is free at the point of access. In the UK, there is currently no national marker to identify military veterans in electronic health records, nor a requirement to record it. This study aimed to compare the sociodemographic characteristics and recorded mental health diagnoses of a sample of veterans and civilians accessing secondary mental health services.
Methods
The Military Service Identification Tool, a machine learning computer tool, was employed to identify veterans and civilians from electronic health records. This study compared the sociodemographic characteristics and recorded mental health diagnoses of veterans and civilians accessing secondary mental health care from South London and Maudsley NHS Foundation Trust, UK. Data from 2,576 patients were analysed; 1288 civilians and 1288 veterans matched on age and gender.
Results
Depressive disorder was the most prevalent across both groups in the sample (26.2% veterans, 15.5% civilians). The present sample of veterans accessing support for mental health conditions were significantly more likely to have diagnoses of anxiety, depressive, psychosis, personality, and stress disorders (AORs ranging 1.41–2.84) but less likely to have a drug disorder (AOR = 0.51) than age- and gender-matched civilians.
Conclusion
Veterans accessing secondary mental health services in South London had higher risks for many mental health problems than civilians accessing the same services. Findings suggest that military career history is a key consideration for probable prognosis and treatment, but this needs corroborating in other geographical areas including national population-based studies in the UK.