The purpose of this document is to explore all Combat Stress research over the past decade, which has as its focal point understanding the needs of the veteran community affected by mental health difficulties. This dissemination of study findings has been broadly categorised into individual but overlapping areas of investigation. One line of research describes the demographic profile, referral patterns and health profile of the veterans treated by Combat Stress. Themes also explore the needs of minority veteran groups and women veterans more closely. Studies investigating the nature of difficulties veterans may face are described, such as PTSD, alcohol misuse, physical health problems, complex PTSD (CPTSD), moral injury and military sexual trauma. Another line of research explores Combat Stress treatment outcomes and the interventions that the department has been involved in developing to treat veterans for these difficulties, such as the Residential Treatment Programme offered by the charity service, the Together Programme (an intervention developed to support military partners), remote access therapy, an anger management programme, and art therapy. Clinical trials investigating novel treatments the department has been involved in developing are also described, including treatments for CPTSD and moral injury.
Abstract: BACKGROUND: Military populations are known to have higher prevalence and heavier alcohol use compared to the general population globally. This has serious negative implications to the military. The objective of this study was to describe the prevalence, patterns and associated factors of binge drinking among male military personnel in the Sri Lanka Army. METHODS: A cross sectional study was conducted among 1337 male Army personnel in active service using multistage sampling. A self-administered questionnaire and the interviewer-administered Alcohol Use Disorders Identification Test which is a 10-item screening tool were used. Prevalence of binge drinking was summarised as a proportion with 95% Confidence Intervals (CI). Age specific prevalence rates and the age standardized prevalence rate of binge drinking were calculated. The standard measure of one unit of alcohol being equivalent to 10 g of pure alcohol was used as a reference to calculate the units of alcohol consumption. Binary logistic regression analysis was used to determine the factors associated with binge drinking. RESULTS: The overall prevalence of binge drinking was 51.2% (95% CI 48.5%-54.0%). The age standardized prevalence of binge drinking was 28.3%. The majority binge drank once a month (50.4%). Those engaged in binge drinking used 5.6 median units of alcohol on a typical day, 84% consumed arrack, 69.3% have ever thought or attempted to quit and median age of first alcohol consumption was 18 years. When controlled for confounding, those who had mental distress (AOR 2.46, 95% CI=1.72-3.53), had sex with a commercial sex worker (AOR 1.92, 95% CI=1.21-3.06), ever smoking (AOR 1.69, 95% CI=1.27-2.25), had serious consequences (AOR 1.58, 95% CI=1.13-2.20), currently used cannabis (AOR 1.39, 95% CI=1.02-1.89) and had combat exposure (AOR 1.37, 95% CI 1.00-1.87) had a higher likelihood of binge drinking. CONCLUSIONS: The high prevalence of binge drinking warrants immediate advocacy to the highest level of command of the Sri Lanka Army for support to implement sustainable evidence-based alcohol prevention programmes.