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

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 pound. Service costs were slightly higher in the control group compared to the intervention group (1197 pound vs. 1147) pound which was not statistically significant (bootstrapped 95%CI, -363 pound to 434 pound. 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 post-deployment screening, the political cost of disinvestment needs careful consideration. Those who develop psychiatric morbidity have substantially higher care costs than those who do not.