Serving in Bosnia Made Me Appreciate Living in Bristol: Stressful Experiences, Attitudes, and Psychological Needs of Members of the United Kingdom Armed Forces

Military Medicine, May 2006 by Thomas, Samantha, Dandeker, Christopher, Greenberg, Neil, Kelly, Vikki, Wessely, Simon

Peacekeeping operations form an increasing part of the role of the U.K. Armed Forces. This study identified perceived needs for training before such operations, experiences of stress during deployments, beliefs and attitudes regarding psychological support and debriefing on return, general attitudes toward peacekeeping duties, and positive aspects of the peacekeeping role. Although nearly all peacekeepers were exposed to a variety of experiences, most perceived stress came from professional difficulties and frustrations with the occupational role of being a peacekeeper, rather than from dangerous situations. The exception was a significant fear of land mines. For many, peacekeeping had a positive impact on soldiers' lives, most commonly an appreciation of "things back home." Respondents' opinions about the peacekeeping experience vary greatly. Additional training addressing and exploring potential conflicts between the traditional role of the soldier and the role of the peacekeeper may be useful.

Introduction

Since 1948, there have been 59 U.N. peacekeeping operations throughout the world, with 16 current operations in 2005.1 As the number of peacekeeping operations has increased, so has their importance at social, political, and media levels. Peacekeeping operations may present particular challenges for some nations whose military personnel are trained solely for conventional war roles. Although U.K. military personnel are trained for both conventional war roles and peacekeeping, the nature of peacekeeping itself is also evolving, from the traditional neutral presence to oversee peace accords to dealing with new, complex, and potentially more dangerous kinds of peacekeeping.2,3

Previous research examined some of the health-related difficulties experienced by peacekeepers both during and after return from operations, but with very different estimates of prevalence rates.4-8 Limited information exists about strategies, training, debriefing, and social learning theory and modeling that may help prepare and support peacekeepers regarding the broad spectrum of issues they face, both in the field and on their return home. Political conflict resolution training has been introduced in some settings, but it is only sporadically used among peacekeepers before deployment. Psychological debriefing in military settings has a long history and, as far as the United Kingdom is concerned, has come and gone. Formal debriefing within the U.K. military ceased in 2000, because evidence suggested that single-session psychological debriefing was ineffective.9,10 However, there is still considerable debate about what, if anything, should be done for peacekeepers when they return from operations.

There is limited knowledge of peacekeepers' perceptions of what types of support they would find useful before, during, and on return from operations. This article presents narrative responses from 342 peacekeepers about future training, psychological debriefings, peacekeeping duties, and experience during and on return from deployment.

Methods

A questionnaire inquiring about peacekeeping operations was sent to 3,322 service personnel along with other questionnaires that were part of a series of follow-up studies of the King's U.K. military cohort. This included three random samples of U.K. military personnel, covering those who had taken part in the 1991 Persian Gulf War, those deployed to former Yugoslavia (FY) beginning in 1992, and those in the Armed Forces in 1992 who had not deployed on either operation. Details of the original study can be found elsewhere.11 The peacekeeping questionnaire asked questions about (1) training for those being deployed on future missions, (2) whether formal psychological briefing following return from peacekeeping operations was necessary, (3) whether peacekeeping experiences had changed the soldier, and (4) whether peacekeeping experiences had changed attitudes about the future in the military.

The overall response rate was 71%, and 1,202 (51%) reported being deployed on one or more peacekeeping operations. Details of this group are reported elsewhere.12 From this group of 1,202, we randomly selected 342 questionnaires to explore the qualitative findings of the study.

Data were grouped and analyzed thematically by using a model of cross-case text analysis. A constant comparative method allowed us to continually compare responses within the data in terms of similarities and differences. Categories emerged throughout the analysis process. Researchers then considered possible meanings and how these fit with developing themes. Where differences existed, consensus agreements were achieved between the researchers.

Results

General Characteristics

The general characteristics of the cohort are presented in Table I. The majority of peacekeepers were male (249 respondents, 86%), with a mean age of 38 years (SD, 6.8 years; range, 27-60 years). The majority (287 respondents, 84%) had undertaken at least two peacekeeping operations during the study period, with a total of 586 peacekeeping operations overall. The vast majority of peacekeeping operations were to FY (471 operations, 80%).