Screening soldiers for mental health problems doesn't work

Do we need to look back from the beginning, before someone joins, their early life, research more of that, family history?
I doubt that records exist even for relatively new recruits never mind old farts like myself. My hearing loss was repeatedly glossed over by the MOD and the NHS, never mind my poor susceptibility to other mental health issues due, primarily, to my divorce rather than service issues.
 
I cant comment on what else can be done but I think then any surveys are swayed by answers - most surveyed wont tell the truth. I was told by aMO that when they asked the question about an individuals alcohol intake, no matter what they 'admitted too' they doubled it.
You're not supposed to use 'gut feeling' though, are you? The idea of any project of this type is to use raw, primary data. And it says what it says. Gut feeling means "I don't believe it"
 
The challenges that a person goes through when leaving the army (or any form of institution) can be tracked. There is a well trodden path - its not that narrow though. We have 'what a lot of people do' - which is common - and then some that are out of that control area.
  • It depends on what you're like when you join
  • Why you join - ambition, peer pressure, nothing else to do
  • What you are sold, or told it's going to be like
  • What you actually get
  • What happens to you
  • How long you're there for and how institutionalized you become.
When I was in, we had 18 year old's on P wing, suicides, awol, stress, depression - and I left in 1991.

Then, when you leave, you are thrown into an alien world called 'civvy street' and the old rules don't apply. Nobody wants to see your medals or hear your stories. You can't get a job or somewhere to live because your qualifications aren't recognized and support can be rated as little to none. And when that happens, society gets a label with 'problem' written on it and sticks it on you.

And the excuse of "You knew what you were getting into" is completely invalid because the experience each individual goes through is unique.

So until this situation is correctly addressed, you will always have this problem. I now work with 16 and 17 year old civilian kids and they pretty much go through the same thing. The mental health issues in this age bracket are staggering - lack of meaningful friendships, no visible future, self harm, abuse, drugs, depression, suicide, no role models, poor standards and values. In essence, we're talking about the same thing.
 
You're not supposed to use 'gut feeling' though, are you? The idea of any project of this type is to use raw, primary data. And it says what it says. Gut feeling means "I don't believe it"
True, but there must be an area where experience counts. Also, body language can give an indication if the individual is 'uncomfortable' with the answer they give.
 
There is the concept of 'quick kill'. You've seen it before and already know what the solution is and you don't have to reinvent the wheel. And if someone is uncomfortable with what they are saying then it's false data. There are ways and means of getting a more honest answer out of someone, and i'm not talking about waterboarding!
 
I'm on Sertraline...... I hope the side effects are worth it.
 
That's an SSRI type of anti depressant, Mick. Can I encourage you to go and see your doctor? Known side effects and there are better things to be on - it's an old drug with side effects. PM me if you want to.
 
I'm on Sertraline...... I hope the side effects are worth it.
That's an issue for you to resolve with your doctor, and nothing to do with the topic of this thread. There is a mental health/depression thread elsewhere for that sort of discussion. Please keep this thread on topic.
 
Someone above mentioned that some people may actually be suffering adjustment problems making the transition from military to civvy life. The phenomena has been known for a very long time, have a read at:Poetry Lovers' Page - Rudyard Kipling: Chant-Pagan
I think this is a very important point. Indeed, I'd go so far as to opine that one of the greatest tragedies is that quite a few people suddenly find themselves in an environment that lacks the structure, cameraderie and sense of purpose that being in the forces gave them. I can't say what happens now, but back in the late 90s when I left, there was no structural support for 'weaning' people off the forces and back into being a civilian. I felt a little bit "lost", even thought I had plenty to do when I left, but I know some people who really found it quite difficult and somewhat of a culture shock. I sometimes thought it would have been nice to have some kind of ongoing mess membership (eg, stuff like Mess Nights, Ladies Evenings (or whatever they're called these days), or Burns' Nights), but, then again, who wants a bunch of old farts hanging around endlessly discussing THAT rifle, or the finer points of Clansman and the Chieftain tank, or close air support with Westland Wapitis?

Another thing that struck me. I'm surprised, indeed quite shocked, to see some of the names that appear in this and other mental health related threads. I simply wouldn't have guessed that some of the really witty and intelligent (seeming!) members of ARRSE could have such severe problems.
 
I think this is a very important point. Indeed, I'd go so far as to opine that one of the greatest tragedies is that quite a few people suddenly find themselves in an environment that lacks the structure, cameraderie and sense of purpose that being in the forces gave them. I can't say what happens now, but back in the late 90s when I left, there was no structural support for 'weaning' people off the forces and back into being a civilian. I felt a little bit "lost", even thought I had plenty to do when I left, but I know some people who really found it quite difficult and somewhat of a culture shock. I sometimes thought it would have been nice to have some kind of ongoing mess membership (eg, stuff like Mess Nights, Ladies Evenings (or whatever they're called these days), or Burns' Nights), but, then again, who wants a bunch of old farts hanging around endlessly discussing THAT rifle, or the finer points of Clansman and the Chieftain tank, or close air support with Westland Wapitis?

Another thing that struck me. I'm surprised, indeed quite shocked, to see some of the names that appear in this and other mental health related threads. I simply wouldn't have guessed that some of the really witty and intelligent (seeming!) members of ARRSE could have such severe problems.
Arrse is a cornucopia, a vivid cross section of the military (and civilian) population. However, government policy is, instead of helping people, ti restrict the number of people getting help to the absolute minimum.

IIRC theres a clue in a statement made by a govt minister .... last year I think .... who said, when questioned why it took five years for servicemen and women to be "processed" for injury related pensions and the like, responded: ""well thats normal".

It isn't normal, its diabolical.
 
So what is it about Professor Sir Simon Wessely, Professor of psychological medicine at the Institute of Psychiatry, Kings College, London, and head of its department of psychological medicine, vice dean for academic psychiatry, teaching and training at the Institute of Psychiatry, Director of the King's Centre for Military Health Research, honorary consultant psychiatrist at KCH and the Maudsley, civilian consultant advisor in psychiatry to the Army, and President of the Royal College of Psychiatrists that is lacking, in your view?
Does he actually see any patients? My bad he's history-the chap without the quals that is..
 
Does he actually see any patients? My bad he's history-the chap without the quals that is..
Most senior academics in medical specialities don’t see many if any patients any more. That in no way means that they aren’t experts in the conditions or ways to treat or ameliorate the symptoms of them. He’ll have seen thousands of patients in his time and it’s this that informs his research.
 
Well, Jarrod, you are the site expert on mental stuff you tell us.

What I can tell you is that a few years ago blokes wouldn't report "funny turns" due to not wanting to be labelled a "loony" and marital violence was just shrugged off as "marital" stuff.

When I had my pre bugger off from the army medical in 1990, the hearing test was a joke and the medical wasn't as thorough as the one if had prior to joining in 1968.

There was no mention of mental health probs and anyway it's doubtful if anyone would admit to it in those days.

What could have revealed some blokes probs would have been blood tests - liver function etc - and a well designed psych questionnaire.

But again accuracy of results would to a large extent depend on the willingness of the subjects to be honest in their replies.
The Army doesn’t want to find any problems with you when you are leaving.
 
Most senior academics in medical specialities don’t see many if any patients any more. That in no way means that they aren’t experts in the conditions or ways to treat or ameliorate the symptoms of them. He’ll have seen thousands of patients in his time and it’s this that informs his research.

Not to mention there are many experts in medicine who are not clinicians and have never treated a patient.
 
Getting back to the original topic of screening, and leaving pre-screening of potential recruits aside, I was surprised at the complacency to the acknowledgment that this process can be harmful. It has been something that bothers me that, in the wake of any tragic event in our schools, it appears to be a default setting for "trained counsellors" to be unleashed on every pupil, and I can envisage many children being more traumatised by the process of being "counselled" than by the original event, particularly if they weren't directly involved.
 
It has been something that bothers me that, in the wake of any tragic event in our schools, it appears to be a default setting for "trained counsellors" to be unleashed on every pupil, and I can envisage many children being more traumatised by the process of being "counselled" than by the original event, particularly if they weren't directly involved.
I'd be very surprised if an intervention such as this - pre-emptive counselling after trauma - wasn't evidence-based/evidence-led.

Edit: Is there a link somewhere describing where this is happening?
 
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How do they gather the evidence?
Many ways - randomised control trials - compare future outcomes for those who get counselling after a traumatic incident vs those who didn't; measure changes in prevalence rates of individuals who go on to develop issues after counselling, compared to known age/gender/socio-economic matched baselines (e.g. prevalence rate/percentage of people who go on to develop mental health issues after experiencing a traumatic incident). And outcomes can be measured in terms of those who go on to develop full blown mental health problems and get a diagnosis, or you can use 'subclinical; and measure level of adverse symptoms; or even cognitive tests with simple things like how long do people spending fixating on a happy vs sad face. The list goes on and on, and is generally the same format to investigate the efficacy of any type of medical intervention.
 
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Many ways - randomised control trials - compare future outcomes for those who get counselling after a traumatic incident vs those who didn't; measure changes in prevalence rates of individuals who go on to develop issues after counselling, compared to known age/gender/socio-economic matched baselines (e.g. prevalence rate/percentage of people who go on to develop mental health issues after experiencing a traumatic incident). And outcomes can be measured in terms of those who go on to develop full blown mental health problems and get a diagnosis, or you can use 'subclinical; and measure level of adverse symptoms. The list goes on and on, and is generally the same format to investigate the efficacy of any type of medical intervention.
Yet (based on the assumption that for maximum efficacy of the horde of counsellors involved, a screening process forms the initial stage of the counselling) Prof Wessely's remarks in the article linked in the original post don't support that.
New Scientist said:
Because screening brings no benefits, it is likely to do harm overall, says Simon Wessely of King’s College London. One risk comes from classifying people as having a mental health problem when they do not have one, or would have recovered from it anyway if left alone. “If we label normal emotional reactions as problems it can become self-perpetuating,” he says.
Screening soldiers doesn’t protect them from mental illness
 

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