According to a large randomized controlled trial (RCT) has highlighted that screening tests do not reduce mental disorders in soldiers returning back home, and are a complete waste of money. The current trial was the first of its kind to tackle this problem.
The study funded by US taxpayers cost £2m (€2.34m; $2.5m) and took place at King’s College Centre for Military Health Research, in London England. The study aimed to scrutinize the various mental health screening programs for army personnel available in many countries.
The study was possible to be carried out in the UK because unlike other countries such as Australia, United States, Netherlands and Canada, because UK has not setup any mental health screening programs.
King College’s Simon Wesley believed that it would have become difficult to test the effectiveness of mental health screening programs in a country where they have already been setup since almost everybody would have signed up for them and there would not have been any control population to compare the results with.
The researchers randomly divided the little above 10,000 military personnel returning from Afghanistan to receive either normal mental healthcare offered to everyone in the army, or to be given custom created mental health advice.
The first step in the study trials was to give the participants a short mental health assessment questionnaire which they had to solve on a computer. Platoons that made upto 15 to 35 people were grouped to either screening services or no screening services randomly.
Individuals in the platoon, which comprised of both men and women whose answers hinted towards signs of post-traumatic stress disorder (PTSD), anxiety or depression, signs of alcoholism were then given custom-made mental health advice depending on their self-assessment and the answers they gave as part of their assessment.
Whereas the control group received the normal health advice which is available to all army personnel. The overall results showed that both groups were at risk of a minimum of one of the three outcomes such as alcohol abuse, PTSD or anxiety/depression.
Both groups were then given more intense advice and follow-up care that lasted for 10 months to 2 years, to see whether the individuals given more intense advice would seek help.
Ultimately the difference between the two groups was negligible meaning that screening tests were ineffective.
The follow up questions also proved the initial theories of the scientists as 33% of the participants who were at risk of anxiety/depression or PTSD had gone on to seek mental healthcare, with little to no difference between control or screened groups.
The control group sought mental healthcare close to 36% whereas screened participants sought mental healthcare close to 33%.
The study concluded that post-deployment screening for mental disorders based on custom mental health advice did not increase frequency of individuals seeking help nor did it decrease prevalence of mental disorders in soldiers returning home.
One of the researchers, Neil Greenberg said,” Countries that have implemented screening should take notice and consider the implications of these findings.”
So what could be the solution if screening tests have been proven ineffective? According to Greenberg a period of decompression might do the job. You might ask what’s that? Well to put it simply, Greenberg suggests that military men and women discuss their issues with fellow army personnel to vent out and decompress similar to PTSD support groups.
But unfortunately as things stand there are no trials to suggest the efficacy of this technique. The researchers also mentioned that pre-deployment screening did not work as well. Communicating with soldiers before they were deployed to Iraq helped identify those who sought help but a large majority were still missed.
Even though mental disorders in war veterans is given more media attention, issues of anxiety or depression and PTSD were still as problematic in the general population, but alcohol misuse was more prevalent in war veterans compared to the general population.
A previous study looked at the causes of suicide in soldiers as suicide attempts are increasing annually and occurring at a faster rate than even the number one killer which is heart attack. Thus, a comprehensive study was needed to formulate target interventions and to come up with effective prevention methods.
Results of the study showed that soldiers who were in their second month of service and those who had never been previously deployed were at a higher suicidal risk compared to others. This might be due to the fact that the beginning of their training period is often the most difficult to get adjusted to.
Veterans need time to adjust back to civilian life when they return home. As they are not used to any other job apart from the military, they may find it hard to readjust and be a part of the normal society.
Veterans need to learn new skills and practices which are a prerequisite for the job. As the military provides them with the basic necessities getting reacquainted can be difficult which is why they can go into a phase of depression.