PT - JOURNAL ARTICLE AU - Sharp, Marie-Louise AU - Serfioti, Danai AU - Jones, Margaret AU - Burdett, Howard AU - Pernet, David AU - Hull, Lisa AU - Murphy, Dominic AU - Wessely, Simon AU - Fear, Nicola T TI - UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study AID - 10.1136/bmjopen-2021-049815 DP - 2021 Aug 01 TA - BMJ Open PG - e049815 VI - 11 IP - 8 4099 - http://bmjopen.bmj.com/content/11/8/e049815.short 4100 - http://bmjopen.bmj.com/content/11/8/e049815.full SO - BMJ Open2021 Aug 01; 11 AB - Objective To investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness.Design An additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces.Setting Online survey June–September 2020.Participants Cohort members were included if they had completed a questionnaire at phase 3 of the King’s Centre for Military Health Research health and well-being study (2014–2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562).Primary outcome measures Common mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items—cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items—cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale— 3 items-cut-off ≥6).Results Veterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use.Conclusions Our study suggests a COVID-19 impact on veterans’ mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.Data are available upon reasonable request. Data will be processed in accordance with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018. We will not make any record-level data publicly accessible because we need to protect the confidentiality and security of the individual cohort members. You are welcome to contact us with proposals for collaborative research, which the investigators will consider on a case-by-case basis, and which will only occur as part of a legal collaborative agreement and after the collaborator has put in place the relevant research ethics, data protection and data access approvals.