title: Systematic review: deployment length and the mental health of diplomats.
abstract: BACKGROUND
  While there has been considerable research into the psychosocial consequences of tour length for military personnel, this subject has not been studied in other occupational groups who also deploy staff to high-threat areas.
  
  
  OBJECTIVE
  To carry out a comprehensive review of relevant published literature to inform diplomatic organizations that deploy staff in high-threat postings (HTPs).
  
  
  METHODS
  We searched appropriate scientific databases for studies relevant to deployment length, mental health and well-being for diplomats. A systematic review related to military personnel was found and used as the foundation for the literature review. Other relevant papers identified by the search have also been included.
  
  
  RESULTS
  The majority of identified papers had examined military personnel. Results suggested that longer deployments were associated with poorer mental health including post-traumatic stress disorder, depression and alcohol problems and this was most likely to be a function of increased exposure to potentially traumatic events. Exceeding a threshold of 6-12 months within a 3 year period, for military personnel, appeared to elevate the risk of psychosocial problems. Furthermore, diplomats deploying on their first HTP, and those whose tour length is altered after deployment, could be especially vulnerable.
  
  
  CONCLUSIONS
  While further research of this topic is required, this review provides an evidence-based insight into the increased risks of developing mental health problems when deployed to HTPs. This information is relevant to generating policies, which may reduce the impacts of adverse psychosocial effects on diplomatic staff and their families.
authors.affiliation: King's Centre for Military Mental Health, King's College London, Weston Education Centre, London SE5 9RJ, UK, rebecca.r.dunn@kcl.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Dunn
authors.affiliation: Welsh Institute of Health and Social Care, University of South Wales, Pontypridd CF37 1DL, UK.
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.affiliation: Health Planning Ltd, Reading, Berkshire, RG6 1QB, UK.
authors.forename: V
authors.initials: V
authors.lastname: Kemp
authors.affiliation: Foreign and Commonwealth Office, London SW1A 2AH, UK.
authors.forename: D
authors.initials: D
authors.lastname: Patel
authors.affiliation: King's College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Greenberg
mesh_terms: D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology; D000067551:Diplomacy; D006801:Humans; D008603:Mental Health / Q000592:standards*; D016272:Occupational Health / Q000639:trends; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000209:etiology / Q000523:psychology
keywords: Deployment length; diplomats; mental health; military; occupational exposure.