The Stigma of Weakness

The head of the Army’s mental health engagement team has called on the chain of command to better recognise that “vulnerability is not a failure”.

Colonel Tim Boughton said more should be done to tackle the stigma that admitting to difficulties is to show weakness. rguing that physical fitness is indivisible from mental fitness, the officer urged commanders to continue to drive the change in culture.

“Authentic leadership acknowledges that failure is progress if you learn from it,” he said. “Our darkest moments often lead to periods of greatest strength. “As a commander you have a legal and moral duty of care for your subordinates. Think from the perspective of a soldier or junior officer – it can be a lonely place and they may rely on you for confidential advice within the regiment.”

Describing how he believes organisational change can be achieved, Colonel Boughton emphasised that leaders at all levels should allow others to make mistakes and improve, be aware of the emotional environment in their unit and establish shared values by encouraging honest conversations on mental health.

He added: “Resilience starts with a choice – to give in or move forward and become stronger. Self awareness gives you the tools to influence your situation and control it.”

Reference

Soldier. (2020) Strength from Failure. Soldier. November 2020, pp. 10.

What is the Value of Mental Health First Aid for the UK Armed Forces?

Research Paper Title

Mental health first aid for the UK Armed Forces.

Background

Education programmes in mental health literacy can address stigma and misunderstanding of mental health.

This study investigated self-rated differences in knowledge, attitudes and confidence around mental health issues following participation in a bespoke Mental Health First Aid (MHFA) training course for the Armed Forces.

Methods

The mixed methods approach comprised quantitative surveys and qualitative interviews.

A survey, administered immediately post-training (n = 602) and again at 10-months post-attendance (n = 120), asked participants to rate their knowledge, attitudes and confidence around mental health issues pre- and post-training.

Results

Quantitative findings revealed a significant increase in knowledge, positive attitudes and confidence from the post-training survey which was sustained at 10-months follow-up.

Semi-structured telephone interviews (n = 13) were conducted at follow-up, 6-months post-attendance.

Qualitative findings revealed that participation facilitated an ‘ambassador’ type role for participants.

Conclusions

This study is the first to have investigated the effect of MHFA in an Armed Forces community.

Findings show participants perceived the training to increase knowledge regarding mental health and to enhance confidence and aptitude for identifying and supporting people with mental health problems.

Results suggest that such an intervention can provide support for personnel, veterans and their families, regarding mental health in Armed Forces communities.

Reference

Crone, D.M., Sarkar, M., Curran, T., Baker, C.M., Hill, D., Loughren, E.A., Dickson, T. & Parker, A. (2020) Mental health first aid for the UK Armed Forces. Health Promotion International. 35(1), pp.132-139. doi: 10.1093/heapro/day112.

Are Pre-service Military-related & Mental Disorder Factors Associated with Leaving the UK Armed Forces?

Research Paper Title

Pre-service Military-related and Mental Disorder Factors Associated with Leaving the UK Armed Forces.

Background

The UK Armed Forces (UKAF) have a substantial manning deficit as more personnel leave than join.

This article identified pre-service, military, and mental health factors giving rise to leaving the UKAF and estimated the contributions to leaving of those factors which are potentially amenable to modification.

Methods

This study utilised data from a three-phase cohort study (2004-2006, 2007-2009 and 2014-2016), commencing while respondents were serving in the UKAF (n = 10,836; 6,046 (55.8%) had left service).

Associations between leaving the services and socio-demographics, military career and experiences, and mental health were determined using Cox regression.

Contribution to leaving was based on population attributable fractions (PAF) from Cox regression.

Analyses were stratified by rank due to the different career structures of Commissioned Officers and enlisted personnel.

Results

Leaving the UKAF was associated with joining when older, being a woman with a child/children, Army service, combat role, lower education level, and poor mental health.

Factors contributing a significant proportion of leaving among enlisted personnel were joining over the age of 17, history of externalising behaviour, being female, common mental disorders, and alcohol misuse.

Among Commissioned Officers only age at joining and sex contributed significant proportions to leaving.

Conclusions

The key factors for leaving are education and higher age at recruitment.

These are not amenable to intervention, for policy, equity, and legal reasons.

Heavy drinking and common mental disorder symptoms may be more amenable to modification and hence reduce rates of leaving the UKAF.

Women are more likely to leave due to childbearing.

Reference

Burdett, H., Stevelink, S.A.M., 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. doi: 10.1080/00332747.2020.1729063. [Epub ahead of print].