Future scenarios for mental health support within the UK Armed Forces community
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What is the issue?
The UK Armed Forces charities sector supports a sizeable community of UK Armed Forces personnel, veterans and families who can face unique risks and challenges to their mental health. As a result of trends such as the changing character of warfare, evolving societal attitudes towards mental health, and innovation in mental health interventions, the Armed Forces community is facing a dynamic mental health landscape that necessitates forward-looking strategic responses. To effectively plan for the future, the Armed Forces charities sector requires a better understanding of what the future landscape of military mental health may look like. This includes understanding how the demand and need for mental health services among the Armed Forces community may evolve, but also how mental health treatments may develop.
How did we help?
The RAND Europe Centre for Futures and Foresight Studies worked in collaboration with leading veterans' mental health charity Combat Stress to identify future trends out to 2045 which may affect mental health support for the UK Armed Forces community and develop scenarios to understand the evolving demand for and nature of mental health services. The research, funded by the Forces in Mind Trust, explored the following questions:
What future trends and developments are anticipated to impact provision and demand for mental health services among the UK Armed Forces community out to 2045?
Which of these trends are most likely to impact future mental health support for the Armed Forces community?
What are the implications for Combat Stress and the wider Armed Forces charities sector?
The research employed a structured, participatory scenario planning methodology. In the first phase, horizon scanning was conducted to identify key future trends and developments, drawing on a review of open-source data, literature, and interviews with subject matter experts. In the second phase, the research team developed a range of future scenarios for UK Armed Forces community mental health support, charting out alternative future outcomes for critical factors shaping the mental health landscape.
What did we find?
The future of mental health in the UK Armed Forces community is shaped by several trends that cut across UK society as well as trends that are unique to the military context.
Important society-wide trends include increasing demand for mental health support, particularly among children and young people, and potential impacts of climate change, political polarisation and economic disruption.
Within the Armed Forces community, there are significant concerns about the implications of geopolitical uncertainty and the potential UK involvement in future large-scale conflicts. These trends may amplify stressors placed on personnel and families, including level of operational tempo, exposure to combat and the complexity of military operations.
Important transformations are taking place in the way mental health care is delivered in the UK. This includes structural reforms in mental health care delivery, increasing adoption of technologies, and changing healthcare practices.
The research identified five scenarios that capture varied Defence and societal contexts which would exert different pressures on the Armed Forces mental health sector. The scenarios reflect on trends which may be highly impactful but are also highly uncertain.
Table 1: Overview of Scenarios
The figure is a five-column comparison of future scenarios and their likely implications for mental health-related conditions, priorities, and interventions. Each scenario includes a short narrative description followed by factors with arrows indicating whether each factor is expected to be much higher, higher, about the same, or lower than today.
Scenario 1: Mobilising at scale
A NATO-Russia conflict in Eastern Europe requires large-scale mobilisation of Regular and Reserve personnel, with economical fall-out shaping the UK social context.
Operational tempo: Very high or significantly higher than today
Combat: High or higher than today
Workforce shortages: High or higher than today
Spending on mental health: Low or lower than today
Technology in mental health care: High or higher than today
Scenario 2: The home front
An attack against mainland UK triggers full-scale mobilisation and volunteer conscription. Adversarial disruption requires low-tech, localised care delivery.
Operational tempo: Very high or significantly higher than today
Combat: Very high or significantly higher than today
Workforce shortages: Very high or significantly higher than today
Spending on mental health: Low or lower than today
Technology in mental health care: Low or lower than today
Scenario 3: A climate of crisis
Unmitigated climate change has led to recurrent public health crises. Military roles shift to humanitarian assistance and disaster relief. Health care delivery is technology centric.
Operational tempo: High or higher than today
Combat: High or higher than today
Public health crises: Very high or significantly higher than today
Spending on mental health: High or higher than today
Technology in mental health care: Very high or significantly higher than today
Scenario 4: Systemic fragmentation
The Armed Forces operate at high levels of readiness to manage tensions in the Indo-Pacific. Political change has led to backsliding in public attitudes and funding for mental health.
Operational tempo: High or higher than today
Entry standards: High or higher than today
Spending on mental health: Low or lower than today
Public perceptions: Low or lower than today
Social interventions: Low or lower than today
Scenario 5: Building social foundations
Geopolitical stability and sustained economic growth enable substantial investment in mental health. Social determinants are at the core of support provision.
Combat: Low or lower than today
Entry standards: Low or lower than today
Spending on mental health: Very high or significantly higher than today
Public perceptions: Low or lower than today
Social interventions: Very high or significantly higher than today
What can be done?
Stakeholders should consider how aspects of the scenarios may co-occur, to recognise how various pressure points on mental health services could be layered on top of each other. Although the scenarios present distinct dynamics, they are not mutually exclusive.
Service providers should keep abreast of high-impact trends which are not captured in the scenarios due to their higher level of certainty. This includes population ageing and the increasing prevalence of poor mental health across UK society, particularly among children and young people.
The sector should continue leveraging futures and foresight methods to help future-proof support strategies.
