Cost of post-deployment screening for mental illness in the UK military: findings from a cluster randomised controlled trial

ABSTRACT
Background: Little is known about the economic impact of military mental health screening.
Aims: To investigate (a) whether post-deployment screening of military personnel affects use and cost
of services and (b) the impact of psychiatric morbidity on costs.
Methods: Participants were recruited from UK Royal Marine and Army platoons and randomised to an
intervention group (which received tailored advice predicated upon mental health status) or a control
group (which received general advice following assessment of mental health status). The intervention
costs were calculated while service use and associated costs were assessed at 12-month follow-up.
Results: Data were available for 6323 participants. Mean screening cost was £34. Service costs were
slightly higher in the control group compared to the intervention group (£1197 vs. £1147) which was
not statistically significant (bootstrapped 95%CI, £363 to £434. In both groups, screening and control,
costs were significantly higher for those who screened positive for mental health problems.
Conclusions: Costs were not affected by screening. In countries that have already implemented postdeployment
screening, the political cost of disinvestment needs careful consideration. Those who
develop psychiatric morbidity have substantially higher care costs than those who do not.