An evaluation of stress education in the Royal Navy

Psychoeducational programmes aim to reduce the morbidity associated with exposure to stressful events. Although they are widely used, there are conflicting views as to how or why they might be effective.

To examine exposure to 'stress' education within the Royal Navy (RN) and ascertain any links between stress education and mental health status.

In all, 1559 RN personnel were surveyed using a study questionnaire which asked about exposure to and quality of any stress education provided during service. Participants also completed two measures of psychological health, the General Health Questionnaire (GHQ)-12 item and the Post-Traumatic Stress Disorder Checklist. Odds ratios (ORs) were calculated and 95% confidence intervals were computed using multivariable logistic regression adjusting for socio-demographic variables.

The response rate was 70%; 47% of the sample reported having received a stress brief during service. Those who reported having received a brief had better general mental health (measured by the GHQ) than those who had not [adjusted, OR = 0.76 (0.59-0.98)]. When brief quality was taken into account, only those who received a brief and considered it 'useful' were significantly less distressed [adjusted, OR = 0.65 (0.49-0.86)]. Poor-quality briefs were no better than having had no brief at all [adjusted, OR = 1.04 (0.74-1.47)].

Our data indicate that only educational stress briefs which are relevant for the target audience may be beneficial. Simply providing stress briefings, without thought to their quality, may constitute a waste of resources.