Military Mental Health: SelfSelected,MissionRelated or Selection Biased

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Military Mental Health Self-Selected,Mission-Rela
ted or Selection Biased?

• Symposium of the 46th Annual Conference of the
  International Military Testing Association
• Marten Meijer Ph.D.
• Centre for Research and Expertise of the Veterans
  Institute in Doorn, The Netherlands
• Victor F. Nederhof MSc
• Centre for Assessment and Selection of the
  Netherlands Armed Forces
• Mark Zamorski, MD, MHSA
• Directorate of Medical Policy of the
• Canadian Armed Forces

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CONTENTS

• INTRODUCTION
• 1. SYMPOSIUM, QUESTIONS
• 2. CAF DATA, MARK
• 3. DUTCH SELECTION, FRANS
• 4. NAF DATA, MARTEN
• 5. CHALLENGES IN RESEARCH
• 6. CONCLUSIONS
• 7. DIRECTIONS FOR FUTURE WORK
• 8. M. Meijer_at_veteraneninstituut.nl

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4. DATA OF THE NETHERLANDS ARMED FORCES
DERAILMENTS

• MAJORITY KEEPS TRACK
• MINORITY IS IN DANGER
• ARMED FORCES PRODUCE MASSIVE VIOLENCE
• SOCIETY IS AT RISK
• VETERANS ARE AT RISK
• SELFHARM AND SUICIDE
• VIOLENCE, DOMESTIC VIOLENCE
• TABOOS
• REGISTRATIONS ARE UNDERESTIMATES

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4. NAF SUICIDE (1)

• INDIVIDUALLYVERSUS EPIDEMIOLOGICALLY
• HOPELESSNESS, MULTIPELE MALAISE
• COMPLEXE GRIEVE
• PAY RESPECT TO THE DEAD

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4. NAF SUICIDE (2)

• EPIDEMIOLOGICALLY
• MORE THAN 1500 SUICIDES EACH YEAR ON 16 MILLION
  PEOPLE IN THE NETHERLANDS
• TABOOS
• WORK OF A PIONEER
• MENTAL HEALTH RESERACH BY SHARON GALOR
• IN 45 OF THE SUICIDES IN THE USA THERE HAS BEEN
  A CONTACT WITH A PCP lt 1 MONTH BEFORE THE SUICIDE
  
• MORE THAN TWICE AS MUCH AMONG ASYLUMSEEKERS IN
  THE NETHERLANDS

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4. NAF YOUNG VETERANS (1) NUMBERS
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4. NAF YOUNG VETERANS (2) NUMBERS IN SEP 2003
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4. NAF YOUNG VETERANS (4)

• UNTAC IN CAMBODIA 1992-1993
• HELPING A VICTIM OF A MINE EXPLOSION
• SUCCESFUL PERFORMANCE RECORD
• NO RECORD OF MENTAL HEALTH PROBLEMS
• NON - RESPONSE
• MARITAL CRISIS
• SUICIDE

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4. NAF YOUNG VETERANS (4)
Centre for War and Service Victims
Veterans Institute with Central Registration Desk
and Centre for Research and Expertise
Platform of 39 Veterans Unions
Association of Dutch Military War and Service
Victims BNMO
Department of Defence
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5. CHALLENGES IN RESEARCH (1)
PERCENTAGES OF NATURAL DEATH, VIOLENT DEATH AND
SUICIDE AMONG THE NORWEGIAN AND NETHERLANDS
POPULATION, NORWEGIAN UNIFIL VETERANS,
NETHERLANDS ARMY PERSONNEL AND MILITARY POLICE.
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5. CHALLENGES IN RESEARCH (2)
NUMBER OF SUICIDES PER 100.000 PER YEAR OF MALES
AND FEMALES AGED 15-24 IN 3 COUNTRIES Source
WHO 1998.
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5. CHALLENGES IN RESEARCH (3)
MORTALITY IN THE RNL NAVY AND RNL MARINE
CORPS1996-2002 PER 100.000 PER YEAR
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MORTALITY AMONG RNL ARMY FIXED TERM CONTRACTS
AND LONG STAY
5. CHALLENGES IN RESEARCH (4)
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MORTALITY NETHERLANDS MALES AND ROYAL
NETHERLANDS ARMY FIXED TERM CONTRACTS 1996-2002
PER 100.000 PER YEAR
5. CHALLENGES IN RESEARCH (5)
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6. CONCLUSIONS

• SOME VETERANS NEED HELP TO STOP THEIR WARS
• SEEKING HELP IS UNCOMMON TO THE DOMINANT MILITARY
  CULTURE
• HEALTHY SOLDIER/DEPLOYER
• CAF AND USA AIRFORCE PERSONNEL
• UK ARMY 20 YEARS AND YOUNGER
• NAF ARMY FIXED TERM CONTRACT IS VULNERABLE GROUP

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7. DIRECTIONS FOR FUTURE WORK

• ANALYSIS OF NON-RESPONSE
• OBLIGATORY HEALTH MONITORING
• ENHANCE EARLY INTERVENTIONS AND HELP
• USE CONRASTS IN PHYSICAL HEALTH AND MENTAL HEALTH
• TAKE CARE OF GROUPS AT RISK
• LIST EMAIL ADRESSES AS A COWORKER IN IMMHC AND
  NATO HFM