Introduction Predeployment stress management/mental health training is routinely delivered in an effort to mitigate potential adverse psychological effects. Little is known about the effectiveness of such interventions.
Methods A systematic literature review explored research outcomes related to this subject, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. An electronic database search using key terms identified studies published between January 2007 and March 2019. Comprehensive inclusion/exclusion criteria were applied and study quality was appraised by two reviewers using 12 criteria adapted from the Critical Appraisal Skills Programme (CASP) checklist. Papers were excluded if they were allocated CASP scores ≤10 out of 24.
Results 2003 references were identified; 15 papers fulfilled inclusion criteria and quality threshold requirements. Included studies were randomised controlled trial design (n=8), quasi-experimental (n=5), case report (n=1) and cross-sectional (n=1). Duration of follow-up assessment varied from immediately postintervention to 24 months. The included studies were heterogeneous so clear recommendations relating to predeployment training for military personnel could not be made. Although somewhat disparate, predeployment interventions shared the aim of promoting prior to, during and after deployment health and well-being. Social benefits such as improved cohesion and improved stress management skills were identified in some studies, although substantial mental health and well-being benefits were not found.
Conclusions Evidence for the effectiveness of predeployment psychological interventions is scant. Every attempt should be made to use methods and measures to facilitate comparisons across studies, to attempt a longer follow-up timescale and to clarify key trainer characteristics.
- mental health
- stress management
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Contributors LH and NJ were responsible for writing the manuscript. LH identified search terms, conducted search and extracted articles. LH and CW reviewed the articles and carried out quality appraisal. AP conducted the search again. NG and AS edited the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the Ministry of Defence, the National Health Service, the National Institute for Health Research, the Department of Health or Public Health England.
Competing interests NJ is a full-time reserve member of the British Army currently seconded to King’s College London. AS is a full-time member of the British Army similarly seconded. NG is the Royal College of Psychiatrists Lead for Military and Veterans Health and trustee with two military charities; however, he was not directed by these organisations in any way in relation to his contribution to this paper. He is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. AP, CW and LH received funding from the Ministry of Defence for the duration of the study but were not instructed in any way in the production of this manuscript.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement This manuscript is a systematic review and therefore existing studies were studied and summarised.