Leading civilian UK centre of excellence for military health research

After a year of intensive work, The King’s Centre for Military Health Research (KCMHR) can publish the headline findings of their study Veterans-CHECK, funded by the Office for Veterans' Affairs, which assessed the impact of the COVID-19 pandemic on the health and wellbeing of the veteran community.

Compared to before the pandemic, levels of common mental health problems (for example, depression and anxiety) among veterans, remained stable while hazardous drinking (patterns of drinking that risks individuals’ health) reduced during the pandemic.

There are no longer any descriptions that don’t sound like cliché’s for how strange and difficult the last 18 months have been. We have all experienced the pandemic in different ways and have no doubt had huge pressures put upon our physical and mental health.

However, at the beginning of the pandemic in March 2020, we were not sure how the pandemic would affect the veteran community. As a group who have researched the health of the Armed Forces community for 25 years and made vital contributions to evidence for the Government and healthcare services, this was a crucial question we wanted to be able to answer.

There was research to suggest that veterans might be at more risk of negative outcomes from the pandemic due to a proportion of veterans experiencing mental health problems and drinking high levels of alcohol. There was also research to suggest that the particular experience of loneliness could be worsened by the social isolation COVID-19 would bring. However, we also knew that veterans have been trained in-service to adapt and to deploy to difficult and often threatening environments and so, may also be just the population well placed to handle a ‘COVID-19’ deployment.

We rapidly got in touch with veterans who had taken part in the third phase of our KCMHR cohort study and over June-September 2020 asked them how they were doing with their health and how they had been experiencing the pandemic. We then compared this back to what those veterans had told us in 2014-2016 to see if there were potential impacts from their covid experiences.

What did we find?

Veterans told us they were drinking less alcohol during the first phase of the pandemic, reducing their hazardous drinking down from 49% to 28%. Common mental health problems in veterans remained stable from pre-pandemic levels of 25% to 26%. Out of the total sample, 27% of veterans reported feelings of loneliness and we found that individuals were more likely to report loneliness if they knew someone who died from COVID-19, were a health and social care key worker, lived alone, and had children or caring responsibilities.

The most frequently reported COVID-19 stressors were boredom (25%), having to change or delay major plans (24%) and difficulties with family/other social relationships (20%). Many in the veteran group were key workers (46%) and just under half with children reported they had to change childcare arrangements because of the pandemic (48%), with nearly half of those (45%) reporting a negative impact on their life from those changes. 18% reported extra or new caring responsibilities because of the pandemic. Veterans who reported the COVID-19 stressors of difficulties with family or social relationships, boredom, and difficulties with health, were more likely to report common mental health problems, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use, suggesting a COVID-19 impact.

What does this all mean and how do veterans compare to the UK general population?

Despite reductions in hazardous drinking, veterans are still using alcohol at higher rates than the general population, hence it is still an area where veterans need targeted intervention and support. Rates of common mental health problems are similar to general population levels seen during the pandemic. The absence of an increase in levels may indicate resilient responses from the veteran community, however there are still a proportion of veterans who will need access to services and mental health support.

Veterans’ levels of loneliness were lower than some UK general population levels which may be from protective factors such as the majority of the veteran sample being in a relationship. The study builds a picture of particular mental health pressures experienced in veteran families, on their relationships and especially by those who have children or caring responsibilities, or by those who are health and social care key workers. All of these groups of veterans may need particular targeted supported as we emerge from the pandemic.

What are the limitations of this study?

The study is only generalisable to veterans who were in the UK military during the recent conflicts in Iraq and Afghanistan, and it is limited to the context of the initial phase of the COVID-19 pandemic in the UK, June-September 2020.

What next?

We are aware that there are many factors that might impact veterans’ health into the future. Events such as the recent withdrawal of the UK military presence from Afghanistan or continued impacts of the pandemic or veterans simply getting older and having different needs, may all impact veterans differently. We therefore plan to follow up this veteran group to see what happens to their health and wellbeing in the future and where support can be best targeted.

We have been following the health and wellbeing of approximately 18,000 military personnel since 2003 and will be conducting a fourth wave of data collection in late 2021 which will run for two years. The longitudinal data will be used to provide evidence to the Government and other stakeholders as to the health and wellbeing of these veterans and will be able to monitor any changes and trends.

If you took part in phase three of the KCMHR health and wellbeing cohort in 2014-2016, please look out for study invites in the future as this information is vital to continue to be able to bust any myths about Armed Forces health and to target support where it is needed.

To read a summary of the findings, please read our Veterans-CHECK Summary Sheet.

To read the full academic paper please follow this link.

Please follow @kcmhr on twitter for all our Armed Forces research study news

For information on mental health support services for veterans please see NHS Op COURAGE , Combat Stress, Help for Heroes, and for broader support needs and signposting Veterans’ Gateway

Photo Credit: Sergeant Ian Forsyth RLC, Defence Imagery (www.defenceimagery.co.uk)

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