Protecting the wellbeing of UK armed forces
King's College London
|Type of research
Our research into the mental health consequences of deployment
helped secure a pay increase for members of the UK’s armed forces
and influenced a top-level military decision not to extend the
length of operational tours.
The UK military’s Harmony Guidelines stipulate the duration of
tours of duty. They differ for each of the armed services, and are
designed to safeguard against excessive deployments and
For the army, the guidelines state that a tour should last for
six months and be followed by a 24-month break. Therefore, if the
guideline is followed, a unit should not be deployed for more than
12 months within a three- year period.
Research led by Professor Roberto Rona at King’s Centre for
Military Health Research (KCMHR), showed that when servicemen and
women had been deployed for more than 13 months within three years,
they were more likely to report mental ill health as well as
symptoms of physical ill health and problems at home.
Unforeseen increases in the length of a tour were especially
detrimental: if the tour of duty was longer than anticipated,
servicemen and women were much more likely to report symptoms of
post-traumatic stress disorder (PTSD) afterwards.
The number of tours, however, made no difference to people’s
psychological wellbeing. ‘The length of each tour and the
“down-time” in between was more important than the actual number of
deployments,’ says Professor Sir Simon Wessely, co-director of
‘Our research highlighted the importance of adherence to the
Harmony Guidelines covering tour length,’ he says. ‘The guidelines
weren’t often broken, but if they were, there was an effect on
people’s mental health.’
The research team also showed that whilst ‘Regulars’ were not at
increased risk of mental health problems following deployment, the
‘Reserve’ personnel were. This led to a specific programme of
mental health support within the NHS for Reserves.
Our research was cited in the 2008 Armed Forces’ Pay Review Body
report that recommended a one per cent increase to service wages.
The risk of developing mental health problems – particularly when
the Harmony Guidelines are breached – was one of the reasons for
In 2011, the UK Armed Forces were asked to review their policy
on tour length, partly for financial reasons. The Chief of the
Defence Staff and Chief of the General Staff set up a committee to
consider proposals for increasing tour length from six to nine
‘We gave evidence to the committee, as our work was the only
source of UK data on the impact of tour length on mental health. We
later learned that one reason the committee did not recommend a
change of policy on tour length was because it accepted our views
that increasing the tour length might have a negative impact on
mental health,’ says Professor Wessely.
KCMHR figures suggest that, for each year of continued
operations in Iraq and Afghanistan, adherence to the Harmony
Guidelines prevents an additional 7.1 per cent of common mental
illnesses and post-traumatic stress disorder, and 7.7 per cent of
The research was carried out as part of an ongoing ‘Health and
Wellbeing of UK Armed Forces’ study at KCMHR, which been running
since 2003, and includes approximately 16,000 service men and