Employment and mental health among UK ex-service personnel during the initial period of the COVID-19 pandemic

Introduction: The COVID-19 pandemic has interrupted participation in the labour force and may have affected mental health, both directly through the effects of illness and isolation and indirectly through negative effects on employment. Former military personnel may be at particular risk as a result of both additional exposure to risk factors for poor mental health and barriers to labour market participation raised by the transition from military to civilian working environments. This article examines furlough and unemployment as a result of the COVID-19 pandemic among UK working-age ex-service personnel and its associations with poor mental health. Methods: Participants from an existing cohort study of Iraq- and Afghanistan-era UK Armed Forces personnel were invited to provide information on employment before the COVID-19 pandemic and how it has changed since the pandemic. Mental health was measured using the General Health Questionnaire and compared with data collected pre-pandemic. Results: Although Veteran unemployment is not higher than civilian unemployment (4.7% and 4.8%, respectively, in September 2020), it rose during the pandemic from a lower level (1.3%). Part-time and self-employed Veterans were more likely than full-time employees to experience furlough or unemployment. A negative impact on employment was associated with the onset of new mental ill health. Discussion: Employment of ex-service personnel was more negatively affected by the COVID-19 pandemic, possibly because ex-service personnel are mostly men, and men were more affected in the UK general population. This employment instability has negative consequences for mental health that are not mitigated by furlough. LAY SUMMARYThis article examines how employment status changed for working-age UK ex-military personnel in the early period of the COVID-19 pandemic and how this relates to their mental health. Overall, the unemployment rate among ex-military personnel was not worse than that in the general population;however, because ex-military personnel generally have a lower unemployment rate than the general population, this suggests they were worse hit by the pandemic. Part-time and self-employed personnel were more likely to experience negative changes to their employment situation. Both becoming unemployed and being furloughed were correlated with negative changes in mental health. However, it should be noted that the mental health data used for this comparison predate the onset of the pandemic;hence, other factors related to both change in employment status and change in mental health could be the cause of this apparent relationship.

Volunteering behaviours among UK military Veterans during the COVID-19 pandemic and associations with health and well-being

LAY SUMMARYThe COVID-19 pandemic influenced ways in which individuals volunteered and created barriers for participation because of differing restrictions. The research assessing how Veterans volunteer is limited, but there may be aspects of military culture that encourage service to others. The authors investigated volunteering among UK Veterans during the COVID-19 pandemic and what factors made Veterans more or less likely to volunteer. The study found that 60% of Veterans had volunteered in the past 12 months, a level similar to that among the UK general population. Overall, Veterans volunteered more often through formal organizations rather than on an informal basis, such as helping individuals such as neighbours. However, in relative terms, levels of formal volunteering decreased and levels of informal volunteering increased during the pandemic. Veterans were more likely to volunteer if they were officers or to increase volunteering if they felt lonely. Veterans who reduced volunteering were more likely to have mental health problems. Understanding volunteering among Veterans may open up more opportunities for participation. Introduction: The COVID-19 pandemic facilitated new methods of and motivations for volunteering and created barriers to participation through social restrictions and lockdowns. The research assessing the volunteering behaviours of ex-service personnel (Veterans) is limited;however, as a group they may be more likely to volunteer because of aspects of military culture that encourage pro-social behaviours. The authors investigated levels of formal and informal volunteering among UK Veterans during the pandemic, factors associated with volunteering, and whether the pandemic affected Veterans' volunteering behaviours. Methods: An additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces through an online survey conducted from June to September 2020. Participants were included if they had left the armed forces after regular service and were living in the United Kingdom. Invitation emails were sent to 3,547 Veterans, with a 44% response rate (N = 1,562). Results: Overall, 60% of Veterans reported volunteering in the past 12 months. Of those who volunteered, 41% reported formal volunteering, and 44% reported informal volunteering. Veterans reported reducing formal volunteering because of the pandemic (45%), but they also reported increasing informal volunteering (66%). Discussion: During the pandemic, UK Veterans volunteered at a level similar to the UK general population. They reported higher levels of formal volunteering and lower levels of informal volunteering compared with the UK general population. Understanding who among Veterans is likely to engage in volunteering could support future strategies to engage volunteers and open more opportunities for participation.

Tiered restrictions for COVID-19 in England: knowledge, motivation and self-reported behaviour.

OBJECTIVES: To test whether public knowledge and confidence in one's understanding of the local restrictions, motivation to adhere to local restrictions, and self-reported behaviour (going out for exercise, to work, socially) differed according to tier level. STUDY DESIGN: Cross-sectional, nationally representative, online survey of 1728 participants living in England (data collection: 26 to 28 October 2020). METHODS: We conducted logistic regression analyses to investigate whether knowledge of restrictions, confidence in knowledge of restrictions, motivation to adhere to restrictions, and self-reported behaviour were associated with personal characteristics and tier. RESULTS: Between 81% (tier 2) and 89% (tier 3) of participants correctly identified which tier they lived in. Knowledge of specific restrictions was variable. 73% were confident that they understood which tier was in place in their local area, whereas 71% were confident they understood the guidance in their local area. Confidence was associated with being older and living in a less deprived area. 73% were motivated to adhere to restrictions in their local area. Motivation was associated with being female and older. People living in tiers with greater restrictions were less likely to report going out to meet people from another household socially; reported rates of going out for exercise and for work did not differ. CONCLUSIONS: Although recognition of local tier level was high, knowledge of specific guidance for tiers was variable. There was some indication that nuanced guidance (e.g. behaviour allowed in some settings but not others) was more poorly understood than guidance which was absolute (i.e. behaviour is either allowed or not allowed).

Do members of the public think they should use lateral flow tests (LFT) or polymerase chain reaction (PCR) tests when they have COVID-19-like symptoms? The COVID-19 Rapid Survey of Adherence to Interventions and Responses study.

OBJECTIVES: This study aimed to investigate public use of lateral flow tests (LFT) and polymerase chain reaction (PCR) tests when experiencing key COVID-19 symptoms. STUDY DESIGN: In this study, data from two waves of a cross-sectional nationally representative online survey (data collected 1 and 2 June, and 14 and 15 June 2021; n = 3665 adults aged ≥18 years living in England or Scotland) were used. METHODS: We report data investigating which type of test, if any, the public think Government guidance asks people to use if they have COVID-19 symptoms. In people with key COVID-19 symptoms (high temperature / fever; new, continuous cough; loss of sense of smell; loss of taste), we also describe the uptake of testing, if any. RESULTS: Ten percent of respondents thought Government guidance stated that they should take an LFT if symptomatic, whereas 18% of people thought that they should take a PCR test; 60% of people thought they should take both types of test (12% did not select either option). In people who were symptomatic, 32% reported taking a test to confirm whether they had COVID-19. Of these, 53% reported taking a PCR test and 44% reported taking an LFT. CONCLUSIONS: Despite Government guidance stating that anyone with key COVID-19 symptoms should complete a PCR test, a significant percentage of the population use LFT tests when symptomatic. Communications should emphasise the superiority of, and need for, PCR tests in people with symptoms.

Factors associated with non-essential workplace attendance during the COVID-19 pandemic in the UK in early 2021: evidence from cross-sectional surveys.

OBJECTIVES: Working from home where possible is important in reducing the spread of COVID-19. In early 2021, a quarter of people in England who believed they could work entirely from home reported attending their workplace. To inform interventions to reduce this, this study examined associated factors. STUDY DESIGN: Data from the ongoing COVID-19 Rapid Survey of Adherence to Interventions and Responses survey series of nationally representative samples of people in the UK aged 16+ years in January-February 2021 were used. METHODS: The study sample was 1422 respondents who reported that they could work completely from home. The outcome measure was self-reported workplace attendance at least once during the preceding week. Factors of interest were analysed in three blocks: 1) sociodemographic variables, 2) variables relating to respondents' circumstances and 3) psychological variables. RESULTS: 26.8% (95% confidence interval [CI] = 24.5%-29.1%) of respondents reported having attended their workplace at least once in the preceding week. Sociodemographic variables and living circumstances significantly independently predicted non-essential workplace attendance: male gender (odds ratio [OR] = 1.85, 95% CI = 1.33-2.58); dependent children in the household (OR = 1.65, 95% CI = 1.17-2.32); financial hardship (OR = 1.14, 95% CI = 1.08-1.21); lower socio-economic grade (C2DE; OR = 1.65, 95% CI = 1.19-2.53); working in sectors such as health or social care (OR = 4.18, 95% CI = 2.56-6.81), education and childcare (OR = 2.45, 95% CI = 1.45-4.14) and key public service (OR = 3.78, 95% CI = 1.83-7.81) and having been vaccinated (OR = 2.08, 95% CI = 1.33-3.24). CONCLUSIONS: Non-essential workplace attendance in the UK in early 2021 during the COVID-19 pandemic was significantly independently associated with a range of sociodemographic variables and personal circumstances. Having been vaccinated, financial hardship, socio-economic grade C2DE, having a dependent child at home and working in certain key sectors were associated with higher likelihood of workplace attendance.

Living a life less ordinary: what can the families of essential workers responding to covid-19 learn from uk military families?

Occupational stressors raised by the COVID-19 pandemic may negatively impact on the short and long-term mental health of essential workers as well as that of their family members. Given the lack of research in this area, refl ecting on similarities in the experiences of military families could help identify ways to help support the families of COVID-19 essential workers. This article presents an overview of United Kingdom research on the experiences of military families during separations and the corresponding impacts on their mental health, psychological well-being, and relationships. It considers what helps military families cope during challenging times and discusses lessons that could be adapted from the military community and applied to COVID-19 workers to support families of other occupational groups during times of increased stress and pressure. Lessons learned are applicable not only to those responding to the COVID-19 pandemic but also to similar future events. © Her Majesty the Queen in Right of Canada, as represented by Journal of Military, Veteran and Family Health 27 the Minister of National Defence, 2020.

Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties.

INTRODUCTION: Data are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic. METHODS: Data were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions-Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity. RESULTS: It was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties. CONCLUSIONS: Our findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

The impact of having inadequate safety equipment on mental health.

BACKGROUND: Concerns are being raised about the impact of inadequate safety equipment on the mental health of healthcare workers during the COVID-19 medical response. AIMS: To assess the impact of inadequate safety equipment on the mental health of service personnel deployed on operations in order to better understand the impact on those working under the similarly demanding conditions of the COVID-19 medical response. METHODS: Self-report surveys were conducted in four operational environments with 3435 personnel providing data. Surveys recorded data on socio-demographic, military and operational characteristics, mental health measures and specific occupational stressors. Analysis through logistic regression explored the association between inadequate equipment and all other factors. RESULTS: A total of 3401 personnel provided data on their perceptions of the adequacy of their equipment, of which 532 (15%) stated that they had a lot of concerns that they did not have the right equipment in working order. Analysis found significantly greater odds of reporting symptoms of common mental health disorders (CMD), 2.49 (2.03-3.06), post-traumatic stress disorder (PTSD), 2.99 (2.11-4.24), poorer global health 2.09 (1.62-2.70) and emotional problems 1.69 (1.38-2.06) when individuals reported working with inadequate equipment. Analyses remained significant when adjusted for confounding factors such as rank, sex and operational environment. CONCLUSIONS: An individual's perception of having inadequate equipment is significantly associated with symptoms of CMD, probable PTSD, poorer global health and increased reporting of emotional problems. This in turn may impact on their ability to safely carry out their duties and may have longer-term mental health consequences.