title: Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England.
abstract: BACKGROUND
  There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces.
  
  
  METHODS
  Data from a cross-sectional, nationally representative sample were used to compare health outcomes and treatment seeking among 257 post-national service veterans aged 16-64 years and 504 age and sex frequency-matched non-veterans living in the community in England. Early leavers (<4 years service) were compared with longer serving veterans.
  
  
  RESULTS
  Male veterans reported more childhood adversity and were more likely to have experienced a major trauma in adulthood than non-veterans. There was no association between any measure of mental health and veteran status in males, except reporting more violent behaviours [adjusted odds ratio (aOR) 1.44, 95% confidence interval (CI) 1.01-2.06]. In females, a significant association was found between veteran status and ever having suicidal thoughts (aOR 2.82, 95% CI 1.13-7.03). No differences in treatment-seeking behaviour were identified between veterans and non-veterans with any mental disorder. Early service leavers were more likely to be heavy drinkers (aOR 4.16, 95% CI 1.08-16.00), to have had suicidal thoughts (aOR 2.37, 95% CI 1.21-4.66) and to have self-harmed (aOR 12.36, 95% CI 1.61-94.68) than longer serving veterans.
  
  
  CONCLUSIONS
  The findings of this study do not suggest that being a veteran is associated with adversity in terms of mental health, social disadvantage or reluctance to seek treatment compared with the general population. Some evidence implies that early service leavers may experience more mental health problems than longer-serving veterans.
authors.affiliation: Academic Centre for Defence Mental Health, King's College London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Woodhead
authors.forename: R J
authors.initials: RJ
authors.lastname: Rona
authors.forename: A
authors.initials: A
authors.lastname: Iversen
authors.forename: D
authors.initials: D
authors.lastname: MacManus
authors.forename: M
authors.initials: M
authors.lastname: Hotopf
authors.forename: K
authors.initials: K
authors.lastname: Dean
authors.forename: S
authors.initials: S
authors.lastname: McManus
authors.forename: H
authors.initials: H
authors.lastname: Meltzer
authors.forename: T
authors.initials: T
authors.lastname: Brugha
authors.forename: R
authors.initials: R
authors.lastname: Jenkins
authors.forename: S
authors.initials: S
authors.lastname: Wessely
authors.forename: N T
authors.initials: NT
authors.lastname: Fear
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*