ABSTRACT
There is an urgent need to provide evidence-based well-being and mental health support for front-line clinical staff managing the COVID-19 pandemic who are at risk of moral injury and mental illness. We describe the evidence base for a tiered model of care, and practical steps on its implementation.
Subject(s)
Coronavirus Infections , Health Personnel/psychology , Mental Health/standards , Occupational Stress , Pandemics , Pneumonia, Viral , Preventive Psychiatry/methods , Psychosocial Support Systems , Stress Disorders, Post-Traumatic , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/therapy , Humans , Mental Health Services/organization & administration , Mental Health Services/standards , Occupational Health/standards , Occupational Stress/etiology , Occupational Stress/prevention & control , Occupational Stress/psychology , Occupational Stress/therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Pneumonia, Viral/therapy , Quality Improvement , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Suicide/psychology , Suicide PreventionABSTRACT
This article reviews the use of psychological decompression as applied to troops returning from active service in operational theaters. Definitions of the term are considered and a brief history is given. Current policies and practices are described and the question of mandatory decompression is considered. Finally, the evidence base for the efficacy of decompression is examined and some conclusions are drawn. This article highlights variations in the definition and practice of decompression and its use. Although there is, as yet, no evidence that decompression works, there is also no evidence to the contrary. Given the lack of knowledge as to the balance of risks and benefits of decompression and the absence of any definitive evidence that decompression is associated with improved mental health outcomes or that lack of decompression is associated with the reverse, it is argued that the use of decompression should remain a matter for discretion.
Subject(s)
Adaptation, Psychological , Mental Health , Military Personnel/psychology , Psychology, Military/methods , Rest , Evidence-Based Medicine , Humans , Mandatory Programs , United KingdomABSTRACT
We carried out a brief longitudinal mental health screen of 254 members of the UK's Air Assault Brigade before and after deployment to Iraq last year. Analysis of General Health Questionnaire (GHQ-28) scores before and after deployment revealed a lower score after deployment (mean difference=0.93, 95% CI 0.35-1.52). This indicated a highly significant relative improvement in mental health (P < 0.005). Moreover, only 9 of a larger sample of 421 (2%) exceeded cut-off criteria on the Trauma Screening Questionnaire. These findings suggest that war is not necessarily bad for psychological health.
