DMS CHECK: a cross-sectional study of the mental health of the UK defence medical services, focusing on factors associated with probable common mental disorder

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INTRODUCTION: During the COVID-19 pandemic, adverse mental health indicators were widely reported among healthcare workers, but evidence relating specifically to UK Defence Medical Services (DMS) personnel is limited. DMS personnel work across military and civilian healthcare settings and supported the UK pandemic response while maintaining operational commitments. This study examined the prevalence of adverse mental health indicators among DMS personnel and factors associated with probable common mental disorder (CMD). METHODS: An anonymous cross-sectional survey was distributed to DMS personnel between October 2021 and February 2022. The questionnaire assessed probable CMD, probable post-traumatic stress disorder (PTSD), alcohol misuse and suicidal ideation using validated measures, together with perceptions of morale, leadership and cohesion. Factors associated with probable CMD were examined using logistic regression. RESULTS: Of approximately 5000 accessible personnel, 1531 responded (estimated response rate: 30.6%); 1276 contributed to the primary fully adjusted model. Probable CMD was identified in 43.6% of respondents, probable PTSD in 12.1%, alcohol misuse in 16.9% and suicidal ideation within the previous 2 months in 8.9%. After full adjustment, personnel under 40 had higher odds of probable CMD than those aged 40 or over. Nurses and medics/paramedics had higher odds than non-clinical personnel. Less favourable perceptions of morale, leadership and cohesion showed the strongest associations with probable CMD. Alcohol misuse was also associated with higher odds of probable CMD. CONCLUSIONS: Although probable CMD and probable PTSD were less prevalent than reported in the initial UK National Health Service (NHS) CHECK study, a substantial proportion of DMS respondents screened positive for adverse mental health indicators. Probable CMD was associated with younger age, selected clinical roles, alcohol misuse and less favourable perceptions of morale, leadership and cohesion. These findings support continued DMS mental health surveillance and greater attention to organisational factors alongside individual support and clinical care.

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