Military Mental Health Personnel Deployment Survey: A Secondary Analysis

Military mental health personnel (MMHP) have increasingly engaged in deployment-related roles in closer proximity to combat environments. Although studies examining deployment-related outcomes among military health care personnel have found combat exposure (CE) positively related to psychological problems, no studies of MMHP have investigated CE or its association with psychological outcomes. This study seeks to provide descriptive data on CE and perceived impacts associated with deployment, as well as explore how CE, perceptions of preparedness for deployment, difficulties during deployment (DDD), and meaningful work during deployment relate to appraisal of problems after deployment (ie, sleep problems, interpersonal withdrawal, depressive symptoms, and work problems).

Archival postdeployment survey data from 113 U.S. Air Force MMHP previously deployed to Iraq or Afghanistan were utilized to determine descriptive statistics on CE and other factors. Additionally, hierarchical linear regression was utilized to test relationships between CE, DDD, preparation for deployment, and meaningful work with reports of sleep problems, interpersonal withdrawal, work problems, and depression symptoms. The study was approved by the Institutional Review Board of the U.S. Air Force Academy.

MMHP reported an average of 1.58 (standard deviation = 1.03) combat-related events and DDD included: (1) being away from family/close friends (62%), (2) uncertain redeployment date (35%), (3) difficulty adapting to a new situation (35%), and (4) working long hours (31%), with 66% endorsing two or more areas of difficulty. Most MMHP reported feeling prepared for deployment both professionally (91%) and personally (87%), as well as that their family was prepared (83%). Additionally, nearly all reported at least one meaningful work experience while deployed (96%) with positive impacts on their clients, being the most frequent (89%). Furthermore, CE predicted both sleep difficulties and interpersonal withdrawal. MMHP who perceived their deployment experience as difficult also had higher rates of postdeployment difficulties. Finally, we found no relationship between perceived deployment preparation and postdeployment outcomes.

This is the first study of MMHP reporting CE rates and examining relationships between perceived outcomes and CE, deployment preparation, difficulties during deployment, and meaningful work. The vast majority of MMHP were exposed to more than one combat-related event; however, this rate of CE appears lower than what has been reported among a similar sample of military health care personnel. Although CE predicted difficulties, appraisals of difficulties during deployment experience predicted the highest rates of postdeployment difficulties, accounting for nearly a quarter or more of the outcome variance. The lack of relationship between deployment preparation and meaningful work is inconsistent with prior research and may be because of the limited response range in our sample. Additionally, other methodological limitations include: (1) cross-sectional study design, (2) lack of validated measures, and (3) the long-term retrospective nature of the assessment. Future research should incorporate more rigorous methodologies and assess constructs absent in this archival data set. Despite these limitations, this study provides important preliminary data to support future research development and funding. Additionally, the results may be used to normalize associated impacts and promote help seeking among MMHP.