Hypothesis
1 No hypothesis
2 A) Those who deployed in a combat role and left service will be at greater risk of poor mental health outcomes (compared to those who are still in service and other combat roles) B) No hypothesis (currently, though this may change as I familiarise myself with the literature). C) Different eras will have different risk of reporting probable mental disorder depending on operational tempo.
3 A) No hypothesis (not enough research on UK data). B) No hypothesis (not enough research on UK data). C) Mental health and quality of life will mediate the relationship between combat injury and suicidal ideation.
4 A) No hypothesis (not enough research). B) No hypothesis (currently, though this may change as I familiarise myself with the literature).
Summary
1
1 No hypothesis
2 A) Those who deployed in a combat role and left service will be at greater risk of poor mental health outcomes (compared to those who are still in service and other combat roles) B) No hypothesis (currently, though this may change as I familiarise myself with the literature). C) Different eras will have different risk of reporting probable mental disorder depending on operational tempo.
3 A) No hypothesis (not enough research on UK data). B) No hypothesis (not enough research on UK data). C) Mental health and quality of life will mediate the relationship between combat injury and suicidal ideation.
4 A) No hypothesis (not enough research). B) No hypothesis (currently, though this may change as I familiarise myself with the literature).
2
Title: Deployment-era, combat role and combat injury: A comparison of mental health outcomes across HERRICK
Background: Previous research has identified that UK military personnel who deploy to Afghanistan a) in a combat role and b) sustain a combat injury are both associated with greater rates of mental illness. Few studies have investigated the distinctness of deploying to particular eras of the Afghanistan deployment, and whether certain eras with higher/lower operational tempo might be associated with greater/lower relative risk of poor mental health outcomes. Additionally assessing whether rates of mental illness differ depending on combat role would be beneficial to understanding the exposures that likely increase risk for mental illness. By investigating the ADVANCE cohort alongside the KCMHR military cohort, we will have a suitable large sample size of military personnel who deployed to each era of HERRICK and also be able to compare to personnel who did not deploy to HERRICK at all.
3 Title: Suicidal ideation and combat injury
Background: Suicide in the Armed Forces is a rare but potentially preventable outcome. An investigation into a cohort of regular UK armed forces who left services between 1996 and 2008 found that overall suicide rates among veterans was similar to that of the UK general population (SMR 94 (95%CI 88, 99)), however an increased risk was noted among veterans under the age of 25 years old (age-specific mortality ratio [95% CI] of 160 [136-187] in those aged 20-24 year). During the UK military deployments to Afghanistan (2002-2014, operation HERRICK) young male Armed Forces personnel sustained severe combat injuries which often resulted in medical discharge. In the US, combat injury has been found to be associated with suicide attempts, however no known research has investigated this in the UK. Investigating suicidal ideation in a cohort of military personnel who sustained combat injuries could help identify those potentially at risk and help guide future policy/intervention to helping those individuals.
4
Title: Illicit drug use in UK combat injured Armed Forces personnel
Background: Severe combat injury can result in patients self-medicating due to chronic pain or mental illness. It is important to understand whether personnel with certain types of injuries are using illicit drugs and whether this is for self-medicating reasons or other factors are involved (e.g. sports performance enhancement). By garnering this understanding, we can inform upon policy and clinical intervention to steer current and future personnel to safer practices and reductions in dangerous drug use. Little research has investigated the rates of illicit drug use in UK Armed Forces personnel who sustain a combat injury. (Such as required for: student project / particular report or paper / exploratory analysis (not for publication/external dissemination).
Keywords
Post-Traumatic Growth, Mental Health, Suicidal Ideation, Drug Use