Psychological Medicine, King's College London, London, UK
Academic Department for Military Mental Health, King's College London, London, UK.
BMJ Mil Health. 2023 Jun;169(3):218-224. doi: 10.1136/bmjmilitary-2021-001787. Epub 2021 Apr 20.
The UK is the only permanent member of the UN Security Council that has a policy of recruiting 16 and 17 year old individuals into its regular Armed Forces. Little is known about the consequences of enlisting as a Junior Entrant (JE), although concerns have been expressed. We compare the mental health, deployment history, and pre-enlistment and post-enlistment experiences of personnel who had enlisted as JEs with personnel who joined as Standard Entrants (SEs).
Participants from a large UK military cohort study completed a self-report questionnaire between 2014 and 2016 that included symptoms of probable post-traumatic stress disorder (PTSD), common mental disorders, alcohol consumption, physical symptoms and lifetime self-harm. Data from regular non-officer participants (n=4447) from all service branches were used in the analysis. JEs were defined as having enlisted before the age of 17.5 years. A subgroup analysis of participants who had joined or commenced adult service after April 2003 was carried out.
JEs were not more likely to deploy to Iraq or Afghanistan but were more likely to hold a combat role when they did (OR 1.25, 95% CI 1.00 to 1.56). There was no evidence of an increase in symptoms of common mental disorders, PTSD, multiple somatic symptoms (MSS), alcohol misuse or self-harm in JEs in the full sample, but there was an increase in alcohol misuse (OR 1.84, 95% CI 1.18 to 2.87), MSS (OR 1.51, 95% CI 1.04 to 2.20) and self-harm (OR 2.13, 95% CI 1.15 to 3.95) in JEs who had commenced adult service after April 2003. JEs remain in adult service for longer and do not have more difficulties when they leave service.
JEs do not have worse mental health than SEs, but there is uncertainty in relation to alcohol misuse, MSS and self-harm in more recent joiners. Monitoring these concerns is advisable.
英国是联合国安理会唯一的常任理事国，其政策是招募 16 至 17 岁的个人加入其正规武装部队。对于作为初级入伍者（JE）入伍的后果知之甚少，尽管已经表达了一些担忧。我们将作为初级入伍者（JE）入伍的人员与作为标准入伍者（SE）入伍的人员的心理健康、部署历史以及入伍前和入伍后的经历进行了比较。
参加英国一项大型军事队列研究的参与者在 2014 年至 2016 年间完成了一份自我报告问卷，其中包括可能的创伤后应激障碍（PTSD）、常见精神障碍、酒精摄入、身体症状和终生自残的症状。分析中使用了来自所有军种的常规非军官参与者（n=4447）的数据。JE 定义为在 17.5 岁之前入伍。对 2003 年 4 月后入伍或开始服成人役的参与者进行了亚组分析。
JE 不太可能被部署到伊拉克或阿富汗，但当他们被部署时，他们更有可能担任战斗角色（OR 1.25，95%CI 1.00 至 1.56）。在整个样本中，JE 入伍者没有出现常见精神障碍、PTSD、多种躯体症状（MSS）、酒精滥用或自残症状增加的证据，但在 2003 年 4 月后开始服成人役的 JE 入伍者中，酒精滥用（OR 1.84，95%CI 1.18 至 2.87）、MSS（OR 1.51，95%CI 1.04 至 2.20）和自残（OR 2.13，95%CI 1.15 至 3.95）有所增加。JE 继续在成人役中服役更长时间，并且在离开服役时没有更多困难。
JE 的心理健康状况并不比 SE 差，但最近入伍者的酒精滥用、MSS 和自残问题存在不确定性。建议对这些问题进行监测。
