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Life in and after the Armed Forces: social networks and mental health in the UK military

Hatch, Stephani L., Harvey, Samuel B., Dandeker, Christopher, Burdett, Howard, Greenberg, Neil, Fear, Nicola T., Wessely, Simon·2013·Sociology of Health & Illness

DOI 10.1111/1467-9566.12022

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Abstract

This study focuses on the influence of structural aspects of social integration (social networks and social participation outside work) on mental health (common mental disorders (CMD), that is, depression and anxiety symptoms, post‐traumatic stress disorder (PTSD) symptoms and alcohol misuse). This study examines differences in levels of social integration and associations between social integration and mental health among service leavers and personnel still in service. Data were collected from regular serving personnel (n = 6511) and regular service leavers (n = 1753), from a representative cohort study of the Armed Forces in the UK. We found that service leavers reported less social participation outside work and a general disengagement with military social contacts in comparison to serving personnel. Service leavers were more likely to report CMD and PTSD symptoms. The increased risk of CMD but not PTSD symptoms, was partially accounted for by the reduced levels of social integration among the service leavers. Maintaining social networks in which most members are still in the military is associated with alcohol misuse for both groups, but it is related to CMD and PTSD symptoms for service leavers only.

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Childhood determinants of past-year anxiety and depression in recently transitioned military personnel
Sheriff, R. S., Hooff, M. V., Malhi, G. S., Grace, B. S., & McFARLANE, A. C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.04.053 · Cited by 6
Rejection Sensitivity Mediates the Relationship Between Social-Interpersonal Stressors and Depressive Symptoms in Military Context
Jia, W., Cheng, X., Xu, K., Xu, H., Wang, H., & Feng, Z. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00447 · Cited by 7
Health and Wellbeing Cohort Study of Serving and Ex-Serving UK Armed Forces Personnel: Phase 4 ProtocolPreprint
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“4 combat experiences (16), a military culture of alcohol use (17), and difficulties experienced during and after transition to civilian life, such as a poor integration into civilian life and limited social support (18).”
BackgroundSelf-citation
The Military to Civilian Transition: Exploring Experiences of Transitions to ‘Civvy Street’ and Implications for the Self
Morris, J., & Hanna, P. (2023) · Journal of Veterans Studies · doi:10.21061/jvs.v9i3.458 · Cited by 6
The challenges of leaving: Reintegration difficulties and negative mental health outcomes in UK Armed Forces Veterans residing in Northern Ireland
McGlinchey, E., Spikol, E., Robinson, M., Ross, J., & Armour, C. (2024) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh-2023-0066 · Cited by 8
The association between perceived social support and mental health in combat-injured and uninjured male UK (ex-)military personnel: A cross-sectional study
Grover, L. E., Schofield, S. J., Burdett, H. J., Palmer, L., Bennett, A. N., Bull, A. M. J., Boos, C. J., Cullinan, P., Fear, N. T., Kaya-Barge, M., et al. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.09.017 · Cited by 6
Self-citation
The prison as a postmilitary landscape
Moran, D., & Turner, J. (2021) · Social & Cultural Geography · doi:10.1080/14649365.2021.1983860 · Cited by 5
“…and spatial changes’ (Herman & Yarwood, 2014, pp. 41–2, 49), with some facing feelings of abandonment and dislocation, and sometimes mental health and physical health problems (see Brewin et al., 2011; Buckman et al., 2012; Hatch et al., 2013; Iversen & Greenberg, 2009; Iversen et al., 2007).”
Background
Development and psychometric evaluation of the mental readiness for military transition scale (MT-Ready)
Romaniuk, M., Fisher, G., Sunderland, M., & Batterham, P. J. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05032-z · Cited by 5
“Similar findings have also been reported in studies from the US and UK, indicating that as service members separate from the military, the rates of mental disorder and suicide sharply increase [18, 20, 23].”
Service evaluation of a Human Givens Therapy service for veterans
Burdett, H. J., & Greenberg, N. L. (2019) · Occupational Medicine · doi:10.1093/occmed/kqz045 · Cited by 5
“This finding is very much in keeping with previous research showing that good social networks are protective of mental health in veterans [17].”
ResultSelf-citation
Suicidal ideation in male UK military personnel who sustained a physical combat injury in Afghanistan and the mediating role of leaving service: The ADVANCE cohort study
Dyball, D. M., Williamson, C., Bennett, A. N., Schofield, S. J., Boos, C. J., Bull, A. M. J., Cullinan, P., & Fear, N. T. (2024) · International Journal of Social Psychiatry · doi:10.1177/00207640241264195 · Cited by 4
“However, it is noted that involvement in the military community (Vogt et al., 2022) or social participation outside of employment (Hatch et al., 2013) I n j u r e d ( n = 576 ) A m pu t a t i o n i n j u r y s ub g r o up ( n = 160 ) N o n - a m pu t a t i o n i n j u r y s ub g r o up ( n = 416 )…”
BackgroundSelf-citation
Barriers and Facilitators to Successful Transition to Civilian Life for Ex‐Servicewomen: The Perspective of Service Providers and Policymakers
Croak, B., Rafferty, L., Sharp, M., Smith, A. C., Khan, R., Langston, V., Greenberg, N. L., Fear, N. T., & Stevelink, S. A. M. (2025) · Health & Social Care in the Community · doi:10.1155/hsc/2327743 · Cited by 4
“Lower levels of social integration in ex-service personnel have been associated with common mental disorders (CMD) such as anxiety and depression [6].”
Self-citation
Health needs of ex-military personnel in the UK: a systematic review and qualitative synthesis
Senior, S. L. (2018) · Journal of the Royal Army Medical Corps · doi:10.1136/jramc-2018-001101 · Cited by 4
“The loss of social networks in the transition from military to civilian life may also contribute to risk of mental illness (study 19).(23)”
Background
The effect of traumatic-like stress exposure on alterations in the temporal social behavior of a rodent population
Han, M., Luo, H., Bai, Y., Zheng, S., Li, F., Fu, J., Jiang, S., Liu, Z., & Zheng, X. (2019) · Stress · doi:10.1080/10253890.2019.1702642 · Cited by 4
Reservists and Veterans: Viewed from Within and Without
Griffith, J. E., Connelly, V. J., Catignani, S., & Johansson, E. (2020) · Springer eBooks · doi:10.1007/978-3-030-02866-4_34-1 · Cited by 4
Preliminary Exploration of the Relationship between Veteran Family Membership, School Climate, and Adverse Outcomes among School-Aged Youth
Sullivan, K. S., Dodge, J., Williamson, V., Alves-Costa, F., Barr, N., Kintzle, S. M., Fear, N. T., & Castro, C. C. (2021) · Education and Urban Society · doi:10.1177/00131245211027363 · Cited by 4
“Mental ill health can develop or become more severe on leaving military service due to a loss of social support and difficulties transitioning (Diehle et al., 2019; Hatch et al., 2013).”
BackgroundSelf-citation
Effects of Social Network Characteristics on Mental Health Outcomes Among United States Army Reserve and National Guard Soldiers
Vest, B. M., Goodell, E. M. A., Homish, D. L., & Homish, G. G. (2022) · Community Mental Health Journal · doi:10.1007/s10597-021-00935-1 · Cited by 4
“Among UK military members, having a network of mostly other military members was related to greater alcohol misuse, and increased odds of common mental disorders and PTSD among former soldiers (Hatch et al., 2013).”
BackgroundResultInfluential
Identifying Service-Related Predictors of Community Reintegration Difficulties in Northern Irish Military Veterans
Spikol, E., Ross, J., McGlinchey, E., & Armour, C. (2022) · Armed Forces & Society · doi:10.1177/0095327x221112963 · Cited by 10
“…al., 2019) but such endemic social support is not present in NI (Armour et al., 2018) As veterans may withdrawal from social contact after service (Hatch et al., 2013), feeling a shift in identity outside the military “bubble” (Gordon et al., 2020), lack of perceived support may negatively affect…”
Background
‘Applied Social Prescribing Practice: A Focused Arts Based Participatory Action Research Study of Military Veteran Transition Into Civilian Life’
Graham, Y., Plouviez, A., Clelland, A., Fox, A., Fowler, G., SARGENT, J. R., & Hayes, C. (2022) · Journal of Participatory Research Methods · doi:10.35844/001c.37612 · Cited by 4
Inclusive management of ex-servicemen in India: Satisfaction of air force veterans from resettlement facilities with special reference to Tamil Nadu
Maharajan, K., & Krishnaveni, R. (2016) · IIMB Management Review · doi:10.1016/j.iimb.2016.11.001 · Cited by 4
The mental health of military veterans in the UK
Burdett, H. J., Greenberg, N. L., Fear, N. T., & Jones, N. (2014) · International Psychiatry · doi:10.1192/s1749367600004665 · Cited by 4
“As in other settings, reporting poor social networks is linked to poor mental health (Hatch et al, 2013).”
BackgroundSelf-citation
Mental health in the UK Armed Forces
Nicholson, P. J., & McLoughlin, D. C. (2019) · Occupational Medicine · doi:10.1093/occmed/kqz129 · Cited by 4
Current perspectives on the mental health of UK military personnel and veterans
Juškaitė, S., Stone, J., Greenberg, N. L., Dyball, D. M., & Fear, N. T. (2025) · British Medical Bulletin · doi:10.1093/bmb/ldaf003 · Cited by 3
“For veterans, maintaining social contacts with actively serving personnel was associated with greater odds of reporting both probable CMD and PTSD compared to personnel still in service [36].”
Self-citation
Adverse mental health outcomes and alcohol misuse among UK Armed Forces personnel: fourth phase of a 20-year cohort study of military personnel who served during the Iraq and Afghanistan conflicts
Sharp, M., Jones, M., Franchini, S., Leal, R., Hull, L., Molloy, N., Burdett, H. J., Leightley, D., Simms, A., Stone, J., et al. (2026) · Occupational and Environmental Medicine · doi:10.1136/oemed-2025-110647 · Cited by 3
Self-citation
Military Veterans’ Psychological Health and Physical Activity After Separation From Service
Waldhauser, K. J., Hives, B. A., Liu, Y., Puterman, E. M., Sharifian, N., Castañeda, S. F., Carey, F. R., Rull, R. P., & Beauchamp, M. R. (2025) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2025.04.012 · Cited by 4
Average Military Service Length and Soldiers’ General Health
Taghva, A., Azizi, M., Rajabian, M. H., Khademi, M., Omid, A., Donyavi, V., & Rohani, S. M. (2014) · Journal of Archives in Military Medicine · doi:10.5812/jamm.20604 · Cited by 3
Self-assessment of need for assistance with military-to-civilian transition
Thompson, J. M., Dursun, S., Lee, J. E. C., Skomorovsky, A., Lockhart, W., & MacLean, M. B. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815312-3.00005-x · Cited by 3
Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness
Geuzinge, R., Visse, M. A., Vermetten, E. H. G. J. M., & Duyndam, J. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2306792 · Cited by 3
“However, several scholars of the military argue that military communities have similar basic social arrangements across cultures and throughout modern history (Braswell & Kushner, 2012), and, as shown in the discussion, other research ﬁ ndings from countries across the globe showed many similarities to our ﬁ ndings.”
Holding and rupture: Describing post-traumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan
Palmer, L., Busuttil, W., Simms, A., Fear, N. T., & Stevelink, S. A. M. (2024) · PLoS ONE · doi:10.1371/journal.pone.0308101 · Cited by 3
“Indeed, comradeship has been consistently identified as supportive of wellbeing and protecting against the development of mental health problems [54, 55].”
BackgroundSelf-citation
The return of the traumatized army veteran: a qualitative study of UK ex-servicemen in the aftermath of war, 1945 to 2000
Jones, E., Bhui, K. S., & Engelbrecht, A. (2019) · International Review of Psychiatry · doi:10.1080/09540261.2019.1585767 · Cited by 4
“The issue of reintegration was explored in relation to 1753 UK service leavers who were compared with regular serving personnel (Hatch et al., 2013).”
BackgroundInfluential
Stepped-down intervention programs to promote self-managed physical activity in military service veterans: A systematic review of randomised controlled trials
Gilson, N. D., Papinczak, Z. E., Mielke, G. I., Haslam, C., McKenna, J., & Brown, W. J. (2021) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2021.06.008 · Cited by 3
Mental Health, Sexual Orientation, and Perceived Social Network Support in Relation to Hazardous Alcohol Consumption Among Active Duty Military Men
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“This finding is consistent with research demonstrating that maintaining largely military social networks is associated with increased alcohol consumption among veterans (Hatch et al., 2013).”
Result
Understanding the Needs of Veterans with PTSD
Murphy, D., Busuttil, W., & Turgoose, D. (2018) · Healthcare · doi:10.3390/healthcare6030100 · Cited by 3
“After leaving the military, a lack of social support, taking longer to seeking help, unemployment and relationship difficulties have also been reported as risk factors for experiencing mental health difficulties [13].”
Background
Military healthcare professionals’ experience of transitioning into civilian employment: A heuristic inquiry
Whybrow, D., & Milligan, C. (2023) · Work · doi:10.3233/wor-220317 · Cited by 2
“Not all service leavers experience a smooth transition, with those leaving the military more prone to mental health problems than those currently serving [9].”
The Role of Group Formation and Interpersonal Connections in Support: A Qualitative Analysis of Social Structures in Emergency Services Organizations and Hospital-Based Emergency Settings
Geuzinge, R., Visse, M. A., Duyndam, J., & Vermetten, E. H. G. J. M. (2024) · SAGE Open · doi:10.1177/21582440241297958 · Cited by 2
“Service leavers may try to maintain these ties afterwards through reunions, commemorations, regimental associations, and close friendships (Hatch et al., 2013).”
Structural and functional social support in UK military veterans during the COVID-19 pandemic and associations with mental health and wellbeing: a cross-sectional study
Grover, L. E., Sharp, M., Jones, M., Burdett, H. J., & Fear, N. T. (2025) · BMC Public Health · doi:10.1186/s12889-024-21083-7 · Cited by 4
“Research has shown that veterans reported less social participation and were more likely to experience symptoms of anxiety, depression and post-traumatic stress disorder than those still serving in the military [10].”
Self-citation
A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team personnel
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The mental health and substance misuse needs of male ex-armed forces personnel in prison
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“Hatch et al. (2013) found that service leavers reported more social isolation than serving personnel and that less social activity and smaller social networks, were associated with symptoms of common mental disorder and PTSD.”
BackgroundResultInfluential
Development of a Medical Release Transition Framework
Lee, J. E. C., Watkins, K., & Dursun, S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815312-3.00007-3 · Cited by 2
Mental health of Canadian Armed Forces Veterans: Review of population studies
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Authors: Hatch, S. L., Harvey, S. B., Dandeker, C., Burdett, H., Greenberg, N., Fear, N. T., & Wessely, S.
Affiliations: King's College London (GB)
ORCID: Hatch, Stephani L.
Harvey, Samuel B.
Burdett, Howard
Greenberg, Neil
Fear, Nicola T.
Wessely, Simon
Venue: Sociology of Health & Illness
Publisher: Wiley
Published: 2013-01-29
Volume: 35
Issue: 7
Pages: 1045-1064
ISSN: 0141-9889 (ISSN-L)
1467-9566
DOI: 10.1111/1467-9566.12022
OpenAlex: W2148988246
Cited by: 132
References: 62
Citations by year: 2026: 6 · 2025: 7 · 2024: 11 · 2023: 9 · 2022: 9 · 2021: 15 · 2020: 18 · 2019: 18 · 2018: 11 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 5 · 2013: 1
FWCI: 32.13
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Sociology of Health & Illness (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
National Institute for Health and Care Research (NF-SI-0512-10003)
National Institutes of Health
National Institute of Mental Health
Topics: Social Sciences › Education › Education and Military Integration
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: military personnel, social integration, social networks, social participation (health and rehabilitation), common mental disorders, depression, anxiety, post-traumatic stress disorder, alcohol abuse, British armed forces
MeSH terms: Adult, Alcoholism, Anxiety Disorders, Depression, Female, United Kingdom, Humans, Male, Mental Health, Military Personnel, Surveys and Questionnaires, Risk Factors, Social Support, Stress Disorders, Post-Traumatic, Veterans

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Life in and after the Armed Forces: social networks and mental health in the UK military

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