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Transcript of DISSERTATION FINAL SUBMITTED DRAFT
Work-based Research and Dissertation
MENTAL HEALTH SUPPORT FOR
PRIVATE MILITARY SECURITY COMPANIES
IN THE 21st CENTURY
A dissertat ion submitted to the faculty of
Buckinghamshire New Universi ty
Department of Securi ty and Resi l ience
Submitted by Student 21200319
March 2014
In part ial fulfi lment of the requirements for the degree of
MSc in Business Continuity, Securi ty and Emergency Management
Module Code: SF701
Supervisor Gail Rowntree
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Student 21200319 Page i
ABSTRACT
As global conflicts spread there has been a surge in demand for Private Military Security
Company’s (PMSCs) that are being deployed into hostile environments. In today’s
competitive market place where these PMSC’s chase lucrative contracts, often the last
priority for the owners is the psychological welfare of their workforce. This research
examines aspects of mental health issues surrounding operators in these roles, by assessing
the attitudes and varying contributing factors of all concerned.
An excellent response from members of the industry contained within the anonymous
feedback exposed several interesting trends and revealing data, which is verified and argued
during interviews with key figures in mental health care and PMSCs. The key study
outcomes were that 80% of operators believed that their positions would be at risk if their
employer knew that they were seeking mental health support. There were numerous
insightful comments regarding attitudes, especially around the stigma of mental health issues
being perceived a weakness in the industry remaining a significant barrier to change. Both
management and operators believed that more should be done towards mental health support,
but only 11% of companies had a full program while 22% had nothing at all. Accountability
amongst PMSCs is debatable with 51% not signatory to any best practice code of conduct.
The study analysed the level of care currently available, its suitability, what stressors are
unique to PMSCs and what the commonly used coping strategies and offers
recommendations on how mitigations, coping strategies, interventions and therapies could be
improved.
A thorough review of the contemporary literature into the subject matter highlighting gaps
and themes which were then used to formulate quantitative surveys distributed through social
media networks to both operators and management in PMSCs. The major implications for
this study is that the findings may be used by those keen within the industry to build
resilience and make improvements in Psychosocial Risk Management. This study has served
to build upon existing research in the specific subject area by providing deep insight of the
attitudes with PMSCs and an understanding of their unique stressors faced.
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ACKNOWLEDGEMENTS
I would like to express my gratitude and appreciation to the following that have all supported me
in this research. Firstly to my employer at the Government of Ras Al Khaimah and His Highness
Sheik Saud bin Saqr al Qasimi for support and authorsing financial funding for this course. The
mentoring and encouragement of my dissertation supervisor Gail Rowntree and all of the
Security and Resilience Department at Buckinghamshire New University under the leadership of
Philip Wood and ably supported by Richard Bingley and Gavin Butler. A special gratitude to the
enlightening interviewees who provided expert insight and to all of those management and
operators from the industry who took the time to complete the surveys and for revealing the depth
of feelings in the answers. To Peter Reynolds for encouraging me to attempt the course and for
his support throughout. And lastly a debt of gratitude to my parents Ron and Jenny Bomberg
who are celebrated their 50th wedding anniversary on the same day that this paper is submitted, a
true example of resilience.
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TABLE OF CONTENTS
ABSTRACT ...................................................................................................................................................................I
ACKNOWLEDGEMENTS ..................................................................................................................................... II
TABLE OF CONTENTS ......................................................................................................................................... III
LIST OF FIGURES AND TABLES .....................................................................................................................VI
ACRONYMS ........................................................................................................................................................... VIII
GLOSSARY ................................................................................................................................................................IX
INTRODUCTION .......................................................................................................................................................1
1.1 BACKGROUND ............................................................................................................................................. 1 1.2 THE AIM ....................................................................................................................................................... 2
1.3 RESEARCH OBJECTIVES ............................................................................................................................. 2
1.4 RESEARCH QUESTIONS............................................................................................................................... 3 1.5 SAMPLE GROUP OVERVIEW ...................................................................................................................... 3
1.6 SUB GROUPS ................................................................................................................................................ 4 1.7 OVERVIEW OF CHAPTERS .......................................................................................................................... 4
1.7.1 Literature Review Chapter...................................................................................................................4
1.7.2. Methodology Chapter ......................................................................................................................5 1.7.3. Findings Chapter ..............................................................................................................................5
1.7.4. Discussions Chapter ........................................................................................................................5
1.7.5 Conclusions and Recommendations Chapter ...................................................................................5 1.8 SUMMARY .................................................................................................................................................... 6
LITERATURE REVIEW..........................................................................................................................................7
2.1 INTRODUCTION............................................................................................................................................ 7 2.2 THE HUMAN ELEMENT OF BUSINESS CONTINUITY ............................................................................... 7
2.3 ATTITUDES TOWARDS MENTAL HEALTH CARE ..................................................................................... 8 2.4 GROWTH OF PRIVATE MILITARY SECURITY COMPANIES ..................................................................... 8
2.5 EXTERNAL INFLUENCES AND OPERATING ENVIRONMENTS OF PMSCS............................................. 8
2.6 ACCOUNTABILITY ..................................................................................................................................... 10 2.7 STRESS ........................................................................................................................................................ 11
2.8 RESILIENCE TO STRESS ............................................................................................................................ 12
2.9 EMOTIONAL INTELLIGENCE AND GENDER ............................................................................................ 13 2.10 EXPOSURE TO HOSTILE ENVIRONMENTS............................................................................................... 13
2.11 STRESSORS ................................................................................................................................................. 14 2.12 STRESS PHYSIOLOGY................................................................................................................................ 14
2.12.1 Cortisol........................................................................................................................................... 14
2.13 COPING STRATEGIES ................................................................................................................................ 15 2.13.1 Cognitive ......................................................................................................................................... 15
2.13.2 Social Support ................................................................................................................................ 15
2.13.3 Sense of Belonging ........................................................................................................................ 16 2.13.4 Humour............................................................................................................................................ 16
2.13.6 Relaxation ....................................................................................................................................... 16
2.13.7 Normalisation and Routine .......................................................................................................... 16 2.13.8 Holistic Approach.......................................................................................................................... 17
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2.13.9 Physical ........................................................................................................................................... 17
2.13.10 Improving Stress Coping Skills in PMSCs ................................................................................ 17 2.14 EXISTING STUDIES IN THE SUBJECT MATTER. ..................................................................................... 17
2.15 POST -TRAUMATIC STRESS DISORDER .................................................................................................. 18
2.15.1 Causes ............................................................................................................................................. 18 2.15.2 Symptoms ........................................................................................................................................ 18
2.15.3 Treatment ........................................................................................................................................ 19 2.16 POST -TRAUMATIC GROWTH AND RESILIENCE ..................................................................................... 19
2.17 TRAUMA RISK MANAGEMENT (TRIM) ................................................................................................. 19
2.18 PSYCHOSOCIAL RISK MANAGEMENT..................................................................................................... 20 2.19 TRAINING AND BRIEFINGS....................................................................................................................... 20
2.20 PSYCHOLOGICAL FIRST AID .................................................................................................................... 20
2.21 ADDITIONAL CONSIDERATIONS .............................................................................................................. 21 2.22 CONCLUSIONS OF LITERATURE REVIEW .............................................................................................. 21
METHODOLOGY ................................................................................................................................................... 22
3.1 INTRODUCTION.......................................................................................................................................... 22
3.2 ETHICAL CONSIDERATIONS ..................................................................................................................... 22
3.3 THEORY ...................................................................................................................................................... 23 3.4 APPROACH ................................................................................................................................................. 23
3.5 JUSTIFICATION........................................................................................................................................... 23
3.6 PILOT SURVEY........................................................................................................................................... 24 3.7 QUESTIONNAIRES...................................................................................................................................... 24
3.8 OPERATORS SURVEY RATIONALE .......................................................................................................... 24
3.9 COMPANY SURVEY RATIONALE ............................................................................................................. 29 3.10 INTERVIEWS ............................................................................................................................................... 33
3.11 SUMMARY .................................................................................................................................................. 34
FINDINGS .................................................................................................................................................................. 35
4.1 INTRODUCTION.......................................................................................................................................... 35
4.2 LIMITATIONS.............................................................................................................................................. 35 4.3 PRESENTATION OF SURVEY DATA.......................................................................................................... 36
Further information and comments supplied:.............................................................................................. 51
4.4 INTERVIEWS ............................................................................................................................................... 51 4.4.1 Interview with “A” ............................................................................................................................ 51
4.4.2 Interview with “B” ............................................................................................................................ 52 4.4.3 Interview with “C” ............................................................................................................................ 52
4.4.4 Interview with “D” ............................................................................................................................ 54
4.5. SUMMARY ....................................................................................................................................................... 54
DISCUSS IONS .......................................................................................................................................................... 56
5.1 INTRODUCTION.......................................................................................................................................... 56
5.2 REVIEW OF METHODOLOGY.................................................................................................................... 56 5.3 SUMMARY OF THE RESEARCH QUESTIONS AND OBJECTIVES ............................................................ 57
5.4 KEY FINDINGS OF THE STUDY RESULTS................................................................................................ 57
5.5 APPRAISAL OF THE SURVEY’S BACKGROUND DATA........................................................................... 58 5.6 DISCUSSIONS ON RESEARCH QUESTION ONE: ...................................................................................... 60
5.7 DISCUSSIONS ON RESEARCH QUESTION TWO: ..................................................................................... 63 5.8 DISCUSSIONS ON RESEARCH QUESTION THREE: .................................................................................. 67
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5.8.1 Accountability ..................................................................................................................................... 68
5.8.2 Training/Recruitment......................................................................................................................... 71 5.9 SUMMARY OF MAJOR FINDINGS ............................................................................................................. 71
CONCLUS IONS AND RECOMMENDATIONS............................................................................................ 72
6.1 INTRODUCTION.......................................................................................................................................... 72 6.3 MITIGATIONS ............................................................................................................................................. 73
6.3.1 Awareness ............................................................................................................................................ 73 6.3.2 Accountability ..................................................................................................................................... 73
6.3.3 Recruitment and Vetting .................................................................................................................... 74
6.3.4 Training/Briefing ................................................................................................................................ 74 6.3.5 Acclimatisation Stopover Prior to Deployment............................................................................. 75
6.5 COPING STRATEGIES ................................................................................................................................ 75
6.5.1 Teamwork............................................................................................................................................. 75 6.5.2 Manageable Rotations in Theatre ................................................................................................... 75
6.5.3 Life Support ......................................................................................................................................... 76 6.5.4 Communications ................................................................................................................................. 76
6.5.5 Self-Development................................................................................................................................ 76
6.5.6 Support Networks ............................................................................................................................... 76 6.5.7 Physical Exercise................................................................................................................................ 77
6.5.8 Routine and Normalisation ............................................................................................................... 77
6.5.9 Decompression Stopovers Leaving Theatre................................................................................... 77 6.6 SUPPORT ..................................................................................................................................................... 77
6.6.1 Post Traumatic Incident Support ..................................................................................................... 77
6.7 HORIZON SCANNING................................................................................................................................. 78 6.8 RECOMMENDATIONS FOR FURTHER RESEARCH................................................................................... 78
6.9 MATRIX ...................................................................................................................................................... 79 6.10 CONCLUSION ............................................................................................................................................. 81
REFERENCES .......................................................................................................................................................... 82
APPENDIX A: METHODOLOGY FLOW CHART .................................................................................................. A-2 APPENDIX B: RESEARCH ETHICS CHECKLIST – POSTGRADUATE STUDENTS ............................................ A-7
APPENDIX C: SCREENSHOT OF SURVEY AGREEMENTS................................................................................... A-8
APPENDIX D: EXAMPLE OF INTERVIEW CONSENT FORM ............................................................................... A-9 APPENDIX E: AUTHORS EXPERIENCE AND REFLECTIONS ON PMSCS AND MENTAL HEALTH CARE.... A-10
APPENDIX F: FURTHER COMMENTS SUBMITTED BY SURVEY RESPONDENTS ........................................... A-13 APPENDIX G: TRANSCRIPT WITH INTERVIEW “B” ......................................................................................... A-18
APPENDIX H: TRANSCRIPT WITH INTERVIEW “D”......................................................................................... A-24
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LIST OF FIGURES AND TABLES
FIGURE 2.1: MASLOW’S HIERARCHY OF NEEDS 20
FIGURE 2.2: YERKES-DODSON STRESS CURVE 23
FIGURE 2.3: THE EFFECTS OF STRESS ON THE HUMAN BODY 26
TABLE 3.A : CHART OF THE RESEARCH METHODOLOGY 37
TABLE 4.A : THE TOTAL NUMBERS SAMPLED 50
FIGURE 4.1: SURVEY ENTRANTS WORKING IN PMSCS 51
FIGURE 4.2: SECTORS OF THE PMSC INDUSTRY THAT OPERATORS WERE WORKING IN 52
FIGURE 4.3: NUMBER OF YEARS’ EXPERIENCE THAT OPERATORS HAD IN HOSTILE
ENVIRONMENTS 53
TABLE 4.B: OPERATORS W HO HAD PREVIOUSLY MILITARY EXPERIENCE 53
FIGURE 4.4: REGIONS THAT OPERATORS HAD WORKED IN 54
FIGURE 4.5: THE LEVEL OF IMPORTANCE THAT OPERATORS PUT ON MENTAL HEALTH 54
FIGURE 4.6: OPERATORS W HO HAD RECEIVED MENTAL HEALTH SUPPORT 55
FIGURE 4.7: OPERATORS WHO BELIEVED THAT THEIR POSITION WOULD BE AT RISK IF THEY
SOUGHT MENTAL HEALTH THERAPY 56
TABLE 4.C: COPING STRATEGIES THAT OPERATORS WOULD EMPLOY AFTER A TRAUMATIC
EXPERIENCE 56
FIGURE 4.8: OPERATOR’S PERCEPTION ON WHETHER THERE HAS BEEN AN IMPROVEMENT IN
MENTAL HEALTH 57
TABLE 4.D: OPERATORS PRIORITIES OF MENTAL HEALTH W ELL-BEING 57
FIGURE 4.9: OPERATORS WHO BELIEVED THAT COMPANIES SHOULD BE CONTRACTUALLY
OBLIGED TO PROVIDE MENTAL HEALTH SUPPORT 58
FIGURE 4.10: COMPANIES WITH EXPERIENCE OF OPERATING IN HIGH RISK AREAS/CONFLICT
ZONES/HOSTILE ENVIRONMENTS 59
TABLE 4.E: LENGTH OF TIME THAT COMPANIES HAVE BEEN ESTABLISHED 59
TABLE 4.F: NUMBER OF OPERATORS THAT COMPANIES HAVE 59
FIGURE 4.11: REGIONS THAT COMPANIES ARE OPERATING IN 60
TABLE 4.G: DOCUMENTS THAT COMPANIES ARE A SIGNATORY TO 61
FIGURE 4.12: COMPANY MANAGEMENT THAT THOUGHT THE APPROACH TO MENTAL HEALTH
CARE HAD IMPROVED IN THEIR INDUSTRY 62
TABLE 4.H: MENTAL HEALTH AND COPING STRATEGIES THAT COMPANIES HAVE IN PLACE WITH
REGARDS TO THEIR OPERATORS 62
TABLE 4.I: WHAT EMPHASIS COMPANY MANAGEMENT PLACE ON THE MENTAL WELL-BEING OF
THEIR OPERATORS 63
TABLE 4.J: COMPANY MANAGEMENT PRIORITIES OF MENTAL HEALTH SUPPORT 64
FIGURE 4.13: COMPANY MANAGEMENT OPINION ON WHETHER MORE SHOULD BE DONE TO
SUPPORT MENTAL HEALTH IN PMSCS 64
TABLE 4.K: MANAGEMENT OPINION ON WHETHER PMSCS SHOULD BE OBLIGED TO PROVIDE
PSYCHOLOGICAL SUPPORT 65
FIGURE 5.1: LENGTH OF TIME COMPANIES HAVE BEEN ESTABLISHED 69
FIGURE 5.2: NUMBER OF OPERATORS THAT COMPANIES HAD 70
FIGURE 5.3: ALL RESPONDENTS ON WHETHER MENTAL HEALTH CARE SHOULD BE A
CONTRACTUAL OBLIGATION 70
FIGURE 5.4: CURRENT PROCEDURES THAT PMSCS SURVEYED HAVE IN PLACE FOR MENTAL
HEALTH SUPPORT 71
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FIGURE 5.5: HOW IMPORTANT IS MENTAL HEALTH CARE IN THE ROLE (OPERATORS AND
MANAGERS RESULTS COMBINED) 72
TABLE 5.A: THE EMPHASIS THAT COMPANY MANAGEMENT SAID THAT THEY PLACED ON THE
MENTAL W ELL-BEING OF ITS OPERATORS 72
TABLE 5.B: THE PERCEPTION FROM OPERATORS ON WHETHER THEIR POSITIONS WOULD BE AT
RISK, IF THEY SOUGHT MENTAL HEA LTH SUPPORT 73
TABLE 5.C: PRIORITIES THAT OPERATORS DEEMED WERE IMPORTANT FOR MENTAL WELL-BEING
75
FIGURE 5.6: COPING STRATEGIES THAT OPERATORS WOULD EMPLOY AFTER A TRAUMATIC
EXPERIENCE AT WORK 76
FIGURE 5.7: SIGNATORY DOCUMENTS THAT COMPANIES ARE AFFILIATED TO 79
FIGURE 5.8: OPERATORS WHO PERCEIVED THAT THEIR POSITION WOULD BE AT RISK IF THEY
SOUGHT MENTAL HEALTH THERAPY 82
TABLE 5.D: THE NUMBER OF RESPONDING OPERATORS WHO STATED THAT THEY HAD RECEIVED
MENTAL HEALTH SUPPORT 83
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ACRONYMS
ASIS American Society for Industrial Security BCSEM Business Continuity, Security and Emergency Management
BSI British Standards Institute
CBT Cognitive Behavioral Therapy
CISM(U) Critical Incident Stress Management (Unit)
CPR Cardio-Pulmonary Resuscitation
CSR Corporate Social Responsibility
DALY Disability Adjusted Life Year
DFID Department For International Development DR Disaster Recovery
EI Emotional Intelligence (Also known as EQ)
EOD Explosive Ordinance Disposal
EMDR Eye Movement Desensitisation and Reprocessing
EU European Union
GP General Practitioner
HSE Health and Safety Executive HMF Her Majesty’s Forces
ICoC International Code of Conduct for Private Security Service Providers
ICO Independent Commissioners Office
ICRC International Committee of the Red Cross
IP Internet Protocol
IPCC Independent Police Complaints Commission
ISO International Standards Organisation IT Information Technology
MARSEC Maritime Security (Organisation)
NASA National Aeronautics and Space Administration
NGO Non-Governmental Organisation
NLP Neuro-Linguistic Programming
NoK Next of Kin
OPSEC Operational Security
ORM Operational Risk Management OSM Operational Stress Management
OSA Official Secrets Act
PAS Publically Available Specification
PRM Psychosocial Risk Management
PSC Private Security Company
PTG Post-Traumatic Growth
PTE Potentially Traumatic Event RAND Research and Development (Corporation)
RPO Recovery Point Objective
SAMI Security Association for the Maritime Industry
SCEG Security in Complex Environments Group
SRAD System Requirements Analysis Document
TA Territorial Army
TriM Trauma Risk Management
UN United Nations UNMAS United Nations Mine Action Service
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GLOSSARY
Coping Method; A constantly changing cognitive and behavioural efforts to manage external
and/or internal demands that are taxing the resources of the person (Lazarus & Folkman, 2005).
Management; PMSC owners, CEO’s, country managers and those in positions of influence or
decision makers.
Mental Health; Describes a level of psychological well-being, or an absence of a mental
disorder. Which includes an individual's ability to enjoy life, and create a balance between life
activities and efforts to achieve psychological resilience. It can also be defined as an expression
of emotions, and as signifying a successful adaptation to a range of demands (WHO, 2005).
Operators; Refers to those who are employed by PMSCs. Their roles include; it can include
diplomatic protection, convey safety, static site guarding, covert security, maritime anti-piracy
tasks, de-mining and explosives ordinance disposal.
PMSC; Private Military Security Company (PMSCs) are private business concerns that provide
military and/or security services, usually armed, and in post-conflict areas (ICRC, 2014).
PRM; Psychosocial Risk Management is a program that addresses the full mental health needs of
an organisation and mitigates risks associated with psychological issues (Leka, Cox & Zwetsloot,
2008).
PTSD; Posttraumatic stress disorder is an anxiety disorder that may develop after a person is
exposed to one or more traumatic events, such as military combat (Breslau, 2009).
Respondent M/012; Denotes comments entered by the twelfth respondent to the management
survey.
Respondent O/123; Denotes comments entered by the one hundred and twenty third respondent
to the operators’ survey.
Stressor; Physical, psychological, or social force that puts real or perceived demands on the body,
emotions, mind, or spirit of an individual (Lating, 2012).
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INTRODUCTION
1.1 Background
“Our people are our most important asset” (Stein & Book, 2009 p166)
This popular catchphrase is frequently used by organisational leaders, but rarely given full consideration.
Business Continuity, Security and Emergency Management (BCSEM) planning is often meticulous and
makes provision for all manner of contingencies, but seldom caters for the largest variable in the equation,
which is the human element and its bearing on performance when exposed to heightened levels of stress
and trauma (Puri, Khurana & Seth, 2010).
The purpose and focus of this research is to assess attitudes, approaches and levels of mental health care
currently provided to an industry that operates in a high risk/stress environments, namely Private Military
Security Companies (PMSCs). It will examine the external factors and stressors that have a bearing on
those individuals who routinely operate in hostile areas and may frequently be exposed to Potentially
Traumatic Events (PTEs) as part of their role (Dunigan, Farmer, Burns, Hawks & Setodji, 2013). The
study will seek to uncover the coping methods and strategies employed by operators within PMSCs and
will examine the widely varying levels of care and support mechanisms currently provided, which are
said to range from zero to well-structured programs (Buckman, Sundin, Greene, Fear, Dandeker,
Greenberg & Wessely, 2011). It will critically assess the issue of psychological care and stigma by
examining the varied approaches to a problem that is frequently regarded as taboo and is often suppressed
(Blais, Renshaw & Jakupcak, 2014). Finally it will seek to identify improvements for pathways to mental
health support and future care initiatives.
The research incorporates a wide range of sources, including contemporary literature, prevailing data,
surveys from within the industry, interviews and expert insight from therapists, company representatives
and individuals that are currently employed in these roles.
Cases in Post-Traumatic Stress Disorder (PTSD) of those returning from conflict zones and their severity
have rapidly increased in recent years (Gonzalez, 2011), in conjunction there has been a greater demand
for PMSCs with current estimates in Afghanistan alone, indicating that there are 18,000 operators
(Bloomfield, 2013). As demand for PMSCs rises globally, unless adequate support is provided there is an
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increased risk of an upturn in the number of PTSD cases (Isenberg, 2010). The subject of psychological
care can often be contentious (McNally, 2003), although recently aspects of mental health in the work
place have been attaining greater prominence there and in society generally it is slowly gaining
acceptance (Louis, Burke, Pham & Gridley, 2013). Concurrently the surge in the number of PMSCs is set
to continue due to a downsizing in many national militaries (Schreier & Caparini, 2005), with their future
deployments in post-conflict zones, maritime hot-spots and hostile regions of the world (Singer, 2006).
Life insurance and medical cover have now become common place for those operating in high-risk
environments, but this rarely covers psychological support (Dunigan, et al, 2013). Greater accountability
and Corporate Social Responsibility (CSR) is slowly gaining recognition and compliance for compulsory
psychological care programs may become mandatory in the future (Stinchcomb, 2011), an example of this
is PAS1010; Guidance on the Management of Psychosocial Risks in the Workplace, which is becoming a
widely used international standard (Gallagher & Underhill, 2012).
This research will be of interest to all quarters of the PMSC industry, contract donors, insurance
companies, policy makers, mental health charities and military veterans associations. It may also be of
benefit to traditional organisations and individuals who may find themselves dealing with a “Black Swan”
event (Taleb, 2010), which is an unexpected and unpredictable crisis, for example the aftermath of a
hostage situation or terrorist attack and the associated trauma.
1.2 The Aim
To identify the level of Psychosocial Risk Management (PRM) available within the industry, analyse the
root causes of stressors, the existing cultures of PMSCs, especially in their attitudes towards mental health
and to suggest improvements in providing psychological coping and support.
1.3 Research Objectives
The research objectives are to highlight the specific dimensions and issues surrounded this topic, which
primarily will be to:
Review the available relevant literature.
Assess attitudes, stress coping strategies within the industry by form of survey questionnaires.
Gain deeper understanding through interviews with key individuals.
Consider what is adequate and what is failing.
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Make recommendations built on the findings and outcomes.
1.4 Research Questions
The specific research questions that will be addressed to provide a clear focus for the study are:
Is the current level of mental health care adequate and what is the existing mindset towards it?
What are the unique stressors that PMSCs face in their operating environment and what are the
best coping strategies?
How could mitigations, coping strategies, interventions and therapies be enhanced?
1.5 Sample Group Overview
The sample group chosen for this research are personnel that operate in PMSCs. In recent years there has
been a dramatic rise in the numbers of PMSCs (Singer, 2006) with estimates that there are currently in the
region of 250,000 operating globally, chasing lucrative contracts and fulfilling roles that western
governments cannot do with their militaries alone (Gomez del Prada, 2006).
PMSCs operate in conflict zones and high-risk areas and often in a law and order vacuum. Recently there
has also been a surge in the number of maritime PMSCs, which have been created to counter the threat of
piracy towards merchant shipping, mainly off the Eastern coast of Africa (Liss, 2013a). PMSCs recruit
almost exclusively ex-military personnel and are male dominated (Jäger & Kümmel, 2009). However,
the industry also suffers from an image problem, with its operators often referred to as “mercenaries”
(Tonkin, 2011, p10). Numerous PMSCs are conceived in a short time-span and many of these immature
companies would appear to have low accountability, CSR or duty of care towards their operators,
especially in the areas of psychological support (Isenberg, 2010). Because almost all PMSC operators
have previously served in a national military force, the mental health care approach of serving personnel
and military veterans is additionally scrutinised for this research.
Following on from the Iraq and Afghanistan conflicts, PMSCs are now fulfilling roles regularly in
Yemen, Libya, Somalia and other conflict areas that fills gaps for foreign powers between military
capabilities and the commercial world (Gomez del Prada, 2006). However, their use can cause
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controversy as they frequently operate in lawless post-conflict zones. The growth of the industry,
including the recent boom in maritime anti-piracy companies, is now estimated to be worth £400 billion
in awarded contracts to PMSCs (Dutton, 2013).
1.6 Sub Groups
Within the sample group there are three distinct sub groups, which will be individually examined to
ascertain whether there are any differences in attitudes or levels of care.
Personnel Security Detail
This is identified as the main group within PMSCs. Typically their tasks involve the armed close
protection of government diplomats or company management that are conducting business in hostile areas
(Gomez del Prada, 2006).
Maritime Security
This section of the industry is relatively new and was created to counter the threat from maritime piracy.
Their role involves the protection of merchant vessels, where they often spend long transits with the
constant threat of pirate attack (Liss, 2013b).
Demining and Explosive Ordinance Disposal
These companies generally work in post conflict areas that are now considered stable enough for the start
of minefield and unexploded ordinance clearance activities. The bomb disposal technician’s role is
highly dangerous and often conducted in remote areas, with only basic life support (Habib, 2008).
1.7 Overview of Chapters
This following section serves to signpost the content of the research by providing an overview of the
chapters that follow this introduction chapter:
1.7.1 Literature Review Chapter
The scope of this appraisal is to draw from a comprehensive range of sources, assessing applicable
research material, with the purpose of critically analysing previous studies relating to the topic. It starts
by assessing the broader themes in the evolution of BCSEM and its human component, the use of PMSCs
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and current attitudes towards mental health care. It proceeds by narrowing to evaluate studies on the
causes of stress, an overview of the prevailing legislation and guidelines of psychological support. It
continues with the external factors that have a bearing on PMSCs, previous psychological research of
military personnel and existing levels of mental health care available. Finally it focusses on research
seeking to mitigate the risks of stress, coping strategies and future approaches.
1.7.2. Methodology Chapter
A wide array of methods are employed to conduct the research, which includes interviews with experts,
surveys that evaluate all factors regarding mental health and the culture and attitudes towards it. Much of
the research is of a qualitative nature, as unlike physical injuries following a disaster when the number of
fatalities, limbs lost or other injuries can be accurately documented, the presence of PTSD either
immediately after the event or presenting itself at a later stage can be difficult to quantify (Smith B,
Wong, Smith T, Boyko & Gackstetter, 2009). This Chapter covers a full explanation of the
questionnaires with their rationale and justification and all of the additional research methodology is
presented.
1.7.3. Findings Chapter
The presentation of results progress through the findings chapter in a logical manner, where graphs,
figures, tables and charts are used to establish understanding and interpretation of the primary data.
Poignant points from the interviews with their reflections on the survey findings are also presented.
1.7.4. Discussions Chapter
The significant points drawn from the findings are critically analysed and debated. Trends and patterns
highlighted from the surveys are compared with opinion from the interviews and conclusions of the
literature review. It refers to arguments presented in previous parts of the study and where variables exist
they are analysed for their meaning. It presents discussion of an evaluative nature that contributes
towards the outcomes which shape the research conclusions and recommendations.
1.7.5 Conclusions and Recommendations Chapter
This chapter draws from all of the main points emerging from the study, assessing their value and
considers scope for improvement. The conclusions seek to set down recommendations for change that are
likely to become evident during the research, especially with a view towards horizon scanning of what the
future may hold for the industry and its approach to PRM. The recommendations offered from this
research will be of benefit to the PMSC industry as a whole.
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1.8 Summary
The research centers on the human element of operators who are exposed to high stress levels as part of
their role and examines all aspects in regards to their mental health. PMSC operators are expected to
experience some of these external pressures and PTEs (Isenberg, 2010) and this research seeks to
understand, assess and provide guidance. This will be achieved by collating and interpreting opinions
from key industry figures and feedback from the specific focus group to ascertain the existing attitudes,
stressors, coping and available therapy. A thorough evaluation of the topic will include current
procedures, interventions and therapies. This will include review of all material relating to this topic,
which can be found in the following review of literature chapter.
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LITERATURE REVIEW
2.1 Introduction
The scope and purpose of this literature review is to assess the existing and pertinent research material on
the mental health care of operators working for PMSCs. A thorough search and evaluation of the
available literature in this subject area will also seek to identify any gaps in this field of research. The
review starts by assessing the broader themes, which are the evolution of BCSEM and the human element
within it, the use and growth of PMSCs and current attitudes towards mental health care in the work
place. It proceeds by narrowing to evaluate studies on the causes of stress, and includes an overview of
the prevailing legislation and the guidelines towards psychological support. It continues by examining
the working environment and external factors that have a bearing on PMSCs, plus previous psychological
research of military personnel and existing levels of mental health care available. Finally it focusses on
research to find ways to mitigate the risks of stress, PTSD, including coping strategies, prevention
programs and future approaches.
2.2 The Human Element of Business Continuity
Research by Crandall, Parnell & Spillan, (2013) highlights the advancement and evolution of BCSEM
after the terrorist attacks of 9/11 and the further prominence given to it following recent crises, including
the financial crash and other natural or man-made disasters. This has served to focus corporate minds to
the idea that catastrophes can strike anywhere, at any time and that they can have a significant detrimental
impact on business functionality (Kennedy, Perrottet & Thomas, 2003). According to Barnes &
Oloruntoba, (2005), comprehensive disaster recovery planning, contingency preparation, ensuring the
integrity of supply chains and downstream operations is now starting to become common place for most
credible companies, where resilience has become a part of business strategy.
Duffey & Saull, (2008) argue that the most important constituent in organisations is that of the human
element and that it can also be highly unpredictable during a disaster. Yet despite the corporate mantras
of “Our people are our most important asset” this key component is often overlooked or given low
priority in regards to BCSEM planning (Stein & Book, 2009 p166).
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2.3 Attitudes towards Mental Health Care
Angermeyer, (2006) highlights that attitudes towards mental health have improved in recent years.
However (Blais et al, 2014), state that a paradigm shift is required to remove existing stigmas, in a similar
vein that attitudes have changed in recent decades with regards to the acceptance that smoking cigarettes
damages health, gender equality, sexual orientation, or racial apartheid. This is essential so that the
subject is given the priority it deserves, especially for those who are exposed to high levels of stress as
part of their profession (Corrigan, 2004). Medical insurance cover for employees have now become fairly
commonplace and there has been an overall rise in health and safety standards and attitudes towards many
of these issues which are far advanced from where they were 50 years ago, but a further step change is
required (Mouan & Popovski, 2010).
2.4 Growth of Private Military Security Companies
In recent years there has been a dramatic rise in the numbers of PMSCs chasing lucrative contracts and
fulfilling roles that Western governments cannot with their militaries alone (Singer, 2006), with estimates
that there are currently in the region of 250,000 operators globally Gomez del Prada, (2010). They
operate in post-conflict zones and high-risk areas, often in a law and order vacuum. Recently there has
also been a surge in the number of maritime PMSCs, which have been created to counter the threat of
piracy towards merchant shipping, mainly off the Eastern Coast of Africa (Liss, 2009a). According to
Tonkin, (2011 p10) the industry recruits almost exclusively ex-military personnel and they are often
referred to as “mercenaries”. It is also claimed in by Isenberg, (2010) that many PMSCs are conceived at
short notice and these immature companies have low accountability, CSR or duty of care towards their
operators, especially in the areas of psychological support.
2.5 External Influences and Operating Environments of PMSCs
The RAND Corporation study on the health and well-being of PMSCs assessed the varying level of living
conditions and external factors and their bearing as stressors (Dunigan et al, 2013). This is compared
with Maslow’s long-standing theory of hierarchical needs, which is frequently applied in business
management to gauge well-being and for motivation of staff (Maslow, Stephens, Heil, & Bennis, 1998).
When this model is applied to PMSCs, it is apparent that many of the elements are either deficient or
difficult to achieve in their working environment.
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Figure 2.1: Maslow’s Hierarchy of Needs (Source: Russell-Walling, 2008)
The physiological stage of initial needs are the basic foundations of human instinct, once satisfied, the
greater desires take priority. At the base level is breathing and as highlighted by Smith, B et al (2009), in
their study of those deployed to Afghanistan, increased levels of respiratory problems were found, due to
the dusty conditions. Food can often be of poor quality in post-conflict zones, although as Dunigan et al,
(2013) point out many PMSCs do place emphasis on providing the best available. Water, sleep and living
conditions can be of poor quality in theatre, although as Cardinali, (2011) states, there have been great
advances in life support for contractors in recent years. Maslow’s next tier up is safety and security of the
body, which is an obvious risk when operating in war-zones, but as Isenberg, (2010) argues, security of
employment is also an added stressor for many contractors. Dunigan et al, (2013), highlight the
importance of medical insurance as a vital component and key factor in operators feeling valued.
However, as Miller, (2006) raises; US contractors’ dependents faced difficulties in receiving insurance
payments, when mental health or suicide was the stated in the claim. A sense of belonging and image are
strong values for many PMSC operators according to Poisuo, (2014) and the male-orientated industry has
many internet sites dominated by macho profiles of operators displaying an alpha-male image. Maslow’s
theory has many deficiencies if applied to PMSCs and some of these can be considered for improvement
to enhance operators’ well-being. Certain deficient elements can be compensated by “trade-offs”, for
example advances in technology and internet communications or by financial compensation, i.e. a higher
pay rate for dangerous work (Isenberg, 2010).
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2.6 Accountability
There are existing codes of conduct, best practices, agreements, guidelines and mandates that cover the
PMSC industry and although none of these are legally binding they are a positive step (Messenger et al,
2012). The International Code of Conduct for Private Security Service Providers has 708 signatory
companies as of 1st September 2013 (ICOC, 2013) and includes all associated members of The Security
in Complex Environments Group (SCEG). However, there is only a brief mention to duty of care in
respect of employee mental health in the document:
Section 6.2 states:
“Signatory Companies will ensure that reasonable precautions are taken to protect relevant
staff in high-risk or life-threatening operations. These will include: adopting policies which
support a safe and healthy working environment within the Company, such as policies which
address psychological health” (ICOC. 2013 p63).
According to Greenberg, (2013) in guidance drafted for Maritime PMSCs, it is envisaged that ISO:28007
will eventually contain Operational Stress Management (OSM) regulations that companies will soon be
obliged to demonstrate to shipping companies, flag States and marine insurers that they are compliant and
are providing reasonable psychological support for their operators. American National Standards
Institute of International Standards and Guidelines specify provision of; “medical and psychological
health awareness training, care and support” (ASIS. 2012 p24), which at least demonstrates a
recognition towards the topic. Although extremely comprehensive, The Montreux Document for Good
Practices of Private Military and Security Companies has no reference to mental health support
throughout and under welfare of operators only states: “Providing individuals injured by their conduct
with appropriate reparation, adopting operational safety and health policies” (ICRC 2013 p15). There is
no mention for the provision of psychological support in the Voluntary Principles for Security and
Human Rights, which only states that contracting PMSCs should recognised the rights of employees
under the International Labour Organisation’s (ILO’s) Declaration on Fundamental Principles at Work
(Voluntary Principles, 2014).
Accountability is extremely varied with PMSCs and many are willing to accept the risk of having little or
no systems in place to cater for psychological support with the view that operators are merely on short-
term contracts and they can easily be replaced if they are unable to fulfill their duties due to a stress-
related illness (Christian-Miller, 2010). By comparison, the United Nations (UN) is one body that is
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leading in approaches towards PRM and Critical Incident Stress Management (CISM). PowerPoint™
lectures presented by Reynolds, (2013), gains insight to the attitude taken by the UN in the support given
to its staff when deployed into hostile areas. Their resolutions and mandates include:
Assessment of staff members psychosocial needs and status, UN resolution (A/RES/55/238)
Coordination of Stress Management and training related activities, UN resolution
(A/RES/56/255)
Pre and Post-Deployment Training, UN resolution (A/RES/57/155)
Preventive and Critical Incident Stress Management, UN resolutions (A/RES/47/226)
UN Mandates created by Critical Incident Stress Management Unit (CISMU)
2.7 Stress
Stress is defined by Lazarus, (2006), as anything that poses a challenge or a threat to our well-being.
However, Yerkes & Dobson, (2007), recognise that certain levels of tolerable stress are not only
acceptable, but known to be beneficial and stress itself should not be confused with a normal workload
pressure argues Nordqvist, (2009). According to Bernstein, (2013) stress in the workplace is said to cost
businesses in the US between $150 to $300 billion annually, so from a business continuity perspective it
is a very important factor that is not given full priority (Wallace, 2009).
Figure 2.2: Yerkes-Dodson stress curve (Source: Cohen, 2011)
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Controllable amounts of stress can be healthy and productive as demonstrated with Yerkes-Dodson law
and stated by Staal, (2004), in the NASA research on stress, cognition, and human performance. Where
lower levels of stress result in under-stimulation, higher levels in stress responses and an acceptable
amount “Eustress” is found to be the optimum level.
Stress can also have an effect on critical decision making, for example in the case study of an over-
worked doctor in a hectic accident and emergency reception of a hospital, who under the stresses of the
job accidently misplaced the decimal point for an infant’s morphine dose, resulting in its death (King,
2006). The consequences of PMSC operators making mistakes under highly stressful situations could
also have fatal implications (Dunigan et al, 2013). An example of where mental well-being is given
significance is the Japanese approach where some companies participate in regular Tai-Chi or similar
exercises together as a measure to promote well-being, cohesion and improve productivity (Wilkinson,
2008). This is supported in a study by Donald, Taylor, Johnson, Cooper, Cartwright & Robertson,
(2005), that also linked shortened exposure to stressors to increased work performance.
2.8 Resilience to Stress
Human beings have a natural and inbuilt resilience to stress, even when faced with extremely difficult
circumstances (Bonanno, 2004). Having an optimistic personality is advantageous when people face
stress according to Freedman, (2006). Penninx, Beekman, Honig & Deeg, (2001), state that it may be
difficult to change perceptions, but perhaps recruitment for people who operate within PMSCs should
favour individuals who see a glass as being half full, rather than half empty. Pessimists tend to have
personality traits of emotion towards a problem, which can include avoidance or denial (Wallace, 2009).
Optimists take a challenge orientated, problem focused approach (Bosompra, Ashikaga, Worden & Flynn,
2001). Other personality traits have bearing and unsurprisingly people who are impulsive, are more likely
to use alcohol or other drugs after as a reaction to stress according to Hall & Johansson, (2003). Being as
physically healthy as possible is beneficial and the mind, body, spirit concept is nothing new, with many
ancient societies recognising the link between physical health and mental fortitude (Penedo & Dahn,
2005).
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2.9 Emotional Intelligence and Gender
Emotional Intelligence (EI), is also referred to as (EQ) and Slaski & Cartwright, (2003) argue its value as
a moderator to stress and also that gender is a key variable with females tending to have higher EQ’s and
that this can have a positive effect in countering stress. Hunt & Evans, (2004) claim the influence of EQ
on predicting reactions to traumatic stress and whether gender has is a key factor. As PMSCs are almost
exclusively male-orientated (Dunigan et al, 2013) the bearing this has, is echoed in research on
psychological mechanisms in acute response to trauma by McNally, (2003). Approaches towards stress
coping also vary between the sexes according to Griffin, (2006), which is fundamental in developing
potential solutions. Females tend to have a desire to help others and are stronger members of support
networks (Albrecht, Goldsmith & Thompson, 2003) and males have been known to show more anger
when faced with a stressful situation (Lonczak Neighbors & Donovan, 2007).
2.10 Exposure to Hostile Environments
In researching the root causes of stress Levine, (2006) concludes that males have a stronger “fight or
flight” instinct and stronger physical responses to stressful situations, such as higher heart rate and blood
pressure. It is not entirely known why this is, but is perhaps some form of primeval predisposition
(Trueblood, 2013). The presence of high adrenaline and being in a state of hyper-vigilance can have the
effect of being on edge constantly and being unable to unwind according to McEwen, (2005). Research
by Spierer, Griffiths & Sterland, (2009) into the PMSC sub group of bomb disposal technicians on the
human nerve system and heart rate variability, showed stress responses in tactical situations and
highlighted split second decisions under extreme pressures of those operating in high-pressure
environments, their decision making processes and the likelihood of stress induced mistakes. It
concluded that higher levels of fitness and cardiovascular capacity are greatly beneficial in this critical
decision making process and for reducing stress levels overall.
It is fairly predictable that PMSC operators may face Potentially Traumatic Events (PTEs) in their role
(Isenberg, 2010) and research has shown that training and preparing can enhance coping mechanisms
after the experience (Whealin, Ruzek & Southwick, 2008). Understanding the effects of stress and being
able to control the situation post-event has shown improvements of recovery to be an effective strategy
(Rentschler, 2007). Another resilience factor is having the funds to cope with a stressful situation and the
salaries of operators go some way to addressing that (Kempf, Ruenzi & Thiele, 2009).
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2.11 Stressors
The various classification of stressors are amplified while operating in high-risk areas (Dunigan et al,
2013). Stressors include; environmental, daily, life changing, employment, chemical, foreign
environment and external influences outside of the norm, such as the harsh conditions that PMSCs
operate in. LePine, (2005) argues that where possible stressors should be viewed as challenges and
although this cognitive approach will not eliminate the stressor, it can positively impact the way it is
perceived. Other stressors facing PMSCs include people wanting to cause them serious harm and/or kill
them and long periods away from loved ones (Heaney & Israel, 2002).
2.12 Stress Physiology
Figure 2.3: The effects of stress on the human body (Source: Positive Medicine, 2014)
An operator who is healthy and has a robust immune system
is more likely to cope with stress (Segerstrom & Miller,
2004). The link between how stress affects the body
physically is well-documented (Van der Kolk, McFarlane &
Weisaeth, 2012). The interaction highlighted by Ader &
Moynihan, (2001) between psychological stress and the
immune system’s capability to protect the body, known as
Psychoneuroimmunology and as Godin & Kittel, (2004)
conclude, from a business continuity stance, the less stress
people face in their lives, the less time off they are likely to
take for illness such as colds and flu. Research by Krantz &
McCeney, (2002) suggests that people exposed to prolonged
periods of stress may be more susceptible to certain illnesses
later in life, such as coronary diseases and heart attack.
2.12.1 Cortisol
Cortisol is a naturally occurring hormone released by the
adrenal gland into the blood at times of stress (Lupien, 2007).
PMSCs are exposed to prolonged periods in hostile
environments, which as Wang, (2007) highlights can cause residual fatigue due to increased levels of
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Cortisol, this is echoed in Raison & Miller’s, (2003) research, that prolonged high levels of cortisol can
have side adverse effects in the human body, which include decreased antibody production and the body’s
ability to fight ailments, leading to a condition known as “burn-out”.
2.13 Coping Strategies
2.13.1 Cognitive
Having cognitive approaches that mitigate or handle the stresses that an operator is likely to face is
advantageous (Limbert, 2004). For some people this can be a deeply religious belief, to help them cope,
for example in the Middle East, where deeply religious Zaka volunteers assist to recover body parts in the
aftermath of terrorist incidents, this gruesome task is undertaken because of their deeply religious values
(Solomon & Berger, 2005). A cognitive approach to coping with stress and rationalising may be a way to
counter the “catastrophising” of thoughts, as Martin & Dahlen, (2005) highlight and give the example that
many people have a fear of flying, but statistically are more likely to be involved in a fatal car accident.
In a similar fashion operators may have a fear of being involved in an insurgent attack, kidnapping or
road-side bombing, but as Christian-Miller, (2010) states that statistically the odds of this happening are
fairly small, so the fear of it is the actual stress driver.
2.13.2 Social Support
The element of social support is a key coping factor according to Ben-Shalom, Lehrer & Ben-Ari, (2005).
A good culture of camaraderie can be forged when working closely together in a challenging environment
and the military offers individuals a close network of friends (Messenger et al, 2012). However, PMSC
operators who have now left the military and may find themselves having to deal with symptoms of stress
in civilian life without being surrounded by colleagues can find it difficult (Faber, 2008). Advances in
electronic communications and social media have been a great advantage in this area, not only are
operators able to talk to friends and family instantly via a webcam, there also exists many support
websites (Preece & Shneiderman, 2009). Studies have shown that people belonging to strong social
support networks have been known to recover from injury and illness earlier (Wills & Ainette, 2012).
This has been a great advantage to those such as PMSC operators who spend long periods away from
home (Leung, 2007). There is however, also a theory put forward by Cohen, (1998) that in some cases
too much social support can have a negative effect, whereby for example an individual becomes overly
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reliant on a support network rather than moving on and helping themselves to advance and shake off the
condition and that some support networks do not promote better health and may in fact have a negative
impact.
2.13.3 Sense of Belonging
Feeling inclusive of a team, a “we’re all in this together” ethos and membership to a social support
network is an important emotional coping approach. Teamwork and a sense of belonging are important
and this is highly regarded in the military, where units have strong identities (Greenberg, 2013). However
problems can arise in transition back into civilian life, as Van Staden, Fear, Iversen, French, Dandeker &
Wessely, (2007) claim in their study, when issues occur as stress symptoms take hold and these are not
readily available. A sense of belonging can be something as small as being part of a lottery syndicate
with fellow work colleagues (Ben-Shalom et al, 2005). This basic human desire links back to one of
Maslow’s hierarchical needs covered earlier in this chapter (Maslow et al, 1998).
2.13.4 Humour
The military where the vast majority of PMSC operators have served (Greenberg, 2013) is known for
high levels of humour and is recognised as being key to maintaining moral in the face of adversity (De-
Gruyter, 2010). This coping skill is developed by those who routinely face stressful experiences for
example, morgue workers who are renowned for their dark sense of humour (Malinowski, 2009).
2.13.5 Relaxation
Relaxation as a coping resource is recognised by Van der Klink, Blonk, Schene & Van Dijk (2001) to
ease the symptoms of stress and for PMSCs operators in a prolonged high-risk environment, an effective
strategy of a period of relaxation each day, if only for a short time is highly beneficial (Messenger et al,
2012).
2.13.6 Normalisation and Routine
Normalisation and keeping to a routine is highlighted to by Lapp, Taft, Tollefson, Hoepner, Moore &
Divyak (2010), such as having the same routine on a base in Iraq, as if an operator were at home can have
an effect of stabilising a potentially stressful environment.
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2.13.7 Holistic Approach
A multi-layered and holistic approach is preferable for stress management, according to Taormina & Law,
(2000), who state that there is no single solution and instead a menu of coping resources should be
applied to suit each unique individual and the differing circumstances they are operating in.
2.13.8 Physical
A physical coping strategy for operators often includes some form of physical training or sports (Peluso
& Andrade, 2005). Unfortunately in this alpha-male dominated industry many have been known to abuse
anabolic steroids (Storm, 2008) and this can lead to a psychological problem known as “roid rage” (Riem
& Hursey 1995 p255). There are many other methods for coping physically which include breathing
techniques or stress balls which are squeezed in the hand at time of tension. Physical activity such as
running releases endorphins, known as “runner’s high”, and Scully, Kremer, Meade, Graham, &
Dudgeon, (1998) also highlight using sports to effectively counter stress. This can include boxing
training and striking a punch bag, which Scully et al, (1998) claim offloads the feeling of stress and anger.
2.13.9 Improving Stress Coping Skills in PMSCs
It is important to realise that perhaps the primary stressor facing PMSCs is that they may be operating in
an environment where people want to kill, or do harm to them. This would have to be recognised as an
unchangeable stressor (Gore–Felton, 2005) and the only method of countering this would be less
exposure to the risk, which would mean less time in theatre i.e. shorter rotations with longer breaks. This
is recognised by most operators but runs counter to a desire for financial gain and increased travel and
manpower expenses for PMSCs (Messenger et al, 2012). Gore–Felton, (2005) realises that energy should
not be wasted on unchangeable stressors, and the focus should be on dealing with changeable stressors
where mitigations can be of value.
2.14 Existing Studies in the Subject Matter.
There are very few existing studies that focus on the issue of the mental well-being of PMSCs, which
further highlights the justification for this paper. A recent UK study of post-deployed troops found links
between exposure to military combat and violent offending associated in part due to alcohol abuse and a
pre-existing risk towards mental health problems (MacManus et al, 2013). Christian-Miller, (2010)
highlights the lack (or unwillingness) of insurance companies to recognise mental illness, in a refusal to
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pay out life insurance on a contractor suicide, said to be brought on by PTSD (Christian-Miller, 2010).
He goes on to highlight and praise one large US contractor which created its own psychological support
program, through the company’s insurance health plan. It included a 24-hour hotline and psychologists
that debriefed contractors immediately returning from theatre and again six months later. Isenberg’s,
(2010) article is also a rare example, but his observations are often emotional “…often they do have one
thing in common with regular military personnel, namely, they frequently get screwed over” (Isenberg
2012 p3). He also makes points about accountability, duty of care and that they can be seen as a cheap
alternative despite ethical shortfalls. Both Isenberg, (2010) and Christian-Miller, (2010) highlight the vast
differences in psychological support, which is on a company by company basis and varies between
comprehensive and developed programs to none at all. A perceived lack of support is an added stressor
that operators face is and “ambiguity in their employment status at the end of contract” (Messenger et al,
2012 p864) it is argued contributes to an increased risk of mental health difficulties (Messenger et al,
2012).
2.15 Post-Traumatic Stress Disorder
2.15.1 Causes
PTSD can develop at any time after a significant act of trauma. The trigger could be sex abuse, an
accident such as a car crash, a natural disaster, or being victim of a criminal act, or military combat
(Andreasen, 2011). With PMSCs it is highly likely that operators will have experienced military combat,
either previously during military service or in contact with insurgents while working as PMSCs (Clancy,
Graybeal, Tompson, Badgett, Feldman, Calhoun & Beckham, 2006). However, it could be that they have
experienced a significant act of trauma in earlier life and exposure to military combat has been enough to
trigger PTSD (Vogt, King D & King L, 2007).
2.15.2 Symptoms
There are many symptoms which can include a combination of the following: Re-experiencing the event,
avoidance, anxiety, emotional arousal, intrusive memories, flashbacks, nightmares, intense distress,
physical reactions of pounding heart, rapid breathing, nausea, muscle tension, sweating, apathy, feeling
detached from others, despair of the future, sleep issues, irritability, difficulty concentrating, hyper-
vigilance, anger, guilt, alcohol or drug abuse, feelings of mistrust, betrayal depression, suicidal thoughts
and feeling alienated (Shipherd, Stafford & Tanner, 2005).
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2.15.3 Treatment
Early intervention for PTSD is advantageous (Litz, 2004). There are a wide range of therapies and
interventions available all claiming success rates, including CBT, NLP, Hypnosis, and their effectiveness
varies depending on the individual and severity of their trauma (Foa, Keane, Friedman & Cohen, 2008).
2.16 Post-Traumatic Growth and Resilience
It should be noted that there is not always a negative outcome to experiencing a traumatic event (Tedeschi
& Calhoun, 2004). However, there is still a lot of research required to understand why individuals who
have all had the same negative experienced, could either develop PTSD, while others retain a stable
equilibrium and some even experience Post-Traumatic Growth (PTG), by improving themselves, either
through a form of spiritual awaking, a deeper appreciation for life and relating to others, or greater
personal strength and pursuing new opportunities (Nelson, 2011). PTG should not be confused with the
natural resilience of a person to withstand an act(s) of trauma and remain largely unaffected mentally
(Levine, Laufer, Stein, Hamama‐Raz & Solomon, 2009). This resilience is thought to be formed by a
combination of cognitive characteristics which include; hardiness, optimism, self-enhancement,
repressive coping, positive effect and a sense of coherence (Bonanno, 2004).
2.17 Trauma Risk Management (TRiM)
A study by Frappell-Cook, (2010) asks “Does trauma risk management reduce psychological distress in
deployed troops?” The research looked specifically at the approach of TRiM in two separate groups of
servicemen. TRiM is described as:
“A proactive peer group model of psychological risk assessment that has been used since 2010.
It aims to promote recognition of psychological illness and keep personnel functioning after
traumatic events by enhancing the understanding and acceptance of stress reactions within an
appropriate environment” (National Institute for Health and Clinical Excellence, 2010).
During the research one of the groups was TRiM experienced and other TRiM naïve, in order to highlight
any improvements in resilience to battlefield stresses with the use of a TRiM program. Whilst the key
findings of this report were that social support, and especially within the military where the regimental
system is key to providing this; it also recognised that enhancing social support of any kind is beneficial.
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However, this raises questions about PMSCs, who have similar experience of being party to, or affected
by, aggressive enemy acts; but as they are on contract work this type of comprehensive regimental
support network is no longer available to them (Messenger et al, 2012).
2.18 Psychosocial Risk Management
PRM is a program that addresses the full mental health needs of an organisation and mitigates risks
associated with psychological issues. To an extent the stresses faced by PMSCs are predictable and some
mitigation can be put in place to lessen their impact. Differing coping mechanisms will support operators
in varying ways and will mean different things to each personality type; this could be something as simple
as having a soothing cup of tea, or for someone else a cigarette (Cummings, 2004).
2.19 Training and Briefings
There must be a balance with the realisation that it can be a dangerous task against a risk of over
catastrophising, as discussed in the role of catastrophising (Carty, O'Donnell, Evans, Kazantzis &
Creamer, 2011). It is important during pre-deployment that next of kin (NoK) are identified; families are
a good source of support, also a friend/work colleague who may have to inform the family of injury or
death. Thought should be given to training on this and any potential mental health impact on the
messenger (Faust, 2006).
2.20 Psychological First Aid
In the immediate aftermath of an incident, a peer led support system is highly advantageous according to
Messenger et al, (2012), however as (Johnson cited in Hiles, 2011) states; timing is everything and
forcing counselors onto individuals in the immediate aftermath of an incident may have an adverse effect.
Human instinct is to look for leadership in these situations and “defusing” by a pre-identified company
member stating to operators that the organisation is going to attend to the immediate practical needs, for
example the repatriation of a deceased team member, a considerate message of care with information on
what has happened and what is going to happen (Johnson cited in Hiles, 2011).
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2.21 Additional Considerations
‘Burnout” is the development of a mental distress where prolonged exposure to multiple stressors result in
a tipping point that leads to a breakdown (Maslach, 2008). This is another business continuity issue, as
not only can key individuals be lost for periods of sick leave, but it also figures as a major legal claim
against employers, costing industry billions (Gabriel, 2000).
There is known to be a strong alcohol culture within military service (Jacobson, Ryan, Hooper, Smith,
Amoroso, Boyko & Bell, 2008) and alcohol can become a crutch for many as a coping method and
referred to as “Self-medication” (Connor-Smith & Flachsbart, 2007). Operators have also come from a
background of risk taking and people in this category are more likely to experiment with illicit drugs, as a
maladjusted coping strategy (Zuckerman, 2000).
2.22 Conclusions of Literature Review
This literature review has examined existing theories that contribute to the aspects of PMSCs and their
mental health care, including previous employment history of operators, mindsets, their working
environment, stressors, coping strategies, social support and the latest approaches to the issue. With a
lack of comprehensive material available on this subject in relation to PMSCs it is important that these
issues are given priority and weighted accordingly during this research. The scope and purpose of which
is to highlight and present existing gaps in this subject area and recommend methods that will improve the
approach of psychological support to PMSCs.
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METHODOLOGY
3.1 Introduction
This chapter outlines the rationale and research methodology applied during this study; it explains the
frameworks that have been used with the aim of investigating the relationship between mental health and
PMSCs. The research incorporates questionnaires for PMSC operators and company management,
interviews with industry front-liners plus views from experts within the mental health practitioner’s arena.
It includes an explanation of the ethical considerations, the sample group’s recruitment and
characteristics, a description of the research settings, data collection methods, analysis procedures,
interview selection methods and techniques. A flow chart of the methodology applied to this study is in
Appendix A.
3.2 Ethical Considerations
Consideration for the highest standards of ethical researching and data protection protocols were given to
this study. The research ethics checklist is in Appendix B. Permission was initially sought and granted
from the site hosts of the social media groups for the surveys to be posted within them. The
questionnaires introductions all had an opt-out and permission granted option, which is shown in
Appendix C. Any “No” responses resulted in those entries being treated as null and void. The final page
of both surveys included a thank you statement and a link to an ex-servicemen’s mental health charity,
should any surveyed individual be in need of further support. This research has been carried out with a
strict confidentiality policy. No company or individual is named herein, as the results in some cases
contain deeply personal material. Information will be held securely and destroyed once the research
process has been formally completed in accordance with Independent Commissioners Office (ICO Data
Protection Rules, 2013). Each interviewee was sent an explanation of the research, interview outline and
a consent form, which was signed prior to each interview being conducted. They were informed that if
they were uncomfortable with any of the questions that they were not obliged to answer them; that they
could stop and withdraw their permission at any time during the interview and up to two weeks beyond.
An example of an interviewee consent form can be found in Appendix D.
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3.3 Theory
The theory applied to this research initially used an interpretivism approach by the examining the
perception of mental health within PMSCs and continued rationally by testing whether the current care
levels were felt to be adequate. The study as a whole was of a phenomenological nature in that all of the
participants had spent time in hostile environments; therefore the research took an inductive theoretical
line. The author to this research has experience in the fields of working in PMSCs and mental health
care; therefore this research was written from an insider viewpoint, whilst remaining professional,
independent and open minded at all times to other views. The author’s experiences are covered in
Appendix E.
3.4 Approach
Deductive research of social based reasoning was applied to this study, starting with the theories and
generalisations, before narrowing to discussions, and finally analysing them to form the conclusions. A
mixed methods approach was adopted by using a survey for operators within PMSCs and an additional
one for company management, primarily gathering the above information, the questions were then
formulated for the interviews with professionals in mental health care; and this in turn was compared to
existing studies and the Literature Review. This methodology allowed for extraction of data which was
endorsed for critically analyses of the cause and not solely the effect, by examining the history of
operators and assessing their existing mindset and attitudes towards mental health.
3.5 Methodology Justification
The increasing popularity of social media has been taken advantage of in this research, enabling the target
audience to be reached instantly and comprehensively for the survey distribution. A further advantage of
using social media sites is the existence of a perceived stigma and reluctance to discuss mental health
problems (Mittal, 2013). Therefore the justification for selecting this type of survey and distribution
method is that it could be undertaken anonymously, which was key to allowing participants to complete it
honestly and without any fear of stigma or embarrassment.
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3.6 Pilot Survey
A pilot questionnaire was initially conducted and sent to four key individuals with experience in mental
health and PMSCs. The outcome resulted in several questions being adjusted and certain ambiguities
rectified. However, the main conclusion was that an additional survey needed to be formulated and
directed at PMSC management, in order to draw comparisons or any contradictions that may be presented
from trends and patterns in the operator’s data. The pilot survey process added to the validity of this part
of the research.
3.7 Questionnaires
Questionnaires formulated on SurveyMonkey™ were distributed through the social media websites and
ran for a period of three calendar months, closing on 10th December 2013. The questions were designed
to deduce themes and common threads from which conclusions could be drawn and the research
questions addressed satisfactorily. As the PMSC operators population was estimated to have peaked in
2008 at 250,000 according to Gómez del Prado, (2012) and due to the distribution methodology, there
was a reasonably high confidence in the error margins that the responses would be genuine. Therefore a
sample size from which useful data could be deemed worthwhile was put at a total of 250 for both
surveys, as this would reflect at least 0.1% of this sample group population and thought to be a size of
value. However, a potentially low percentage take up could have indicated a culture of avoidance
towards the subject matter. The length of “soak period” and variety of networking sites that the surveys
were posted on, allowed for contingency, should any participants have withdrawn permission for
whatever reason, then a realistic sample size could still be obtained. Several measures were included in
the survey design that minimised contamination and no incentives were offered for participation in these
surveys.
3.8 Operators Survey Rationale
The questions are listed below in the order which they appeared in the surveys, with the rationale and
parameters for each one written below it in italics. All questions required an answer, unless stated.
Question One
Are you working in a high-risk area/conflict zone/hostile environment?
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Yes Previously Never have
Any “Never have” responses were directed to the survey end page, with those entries null and void,
meaning that only those who answered “Yes” or “Previously” (for ex -operators) participated in the
survey.
Question Two
What sector do you work in?
Mine clearance
Close protection
Maritime
Static site guard
Low profile security
Mobile security detail
Other (please specify)
This question was designed to ascertain what areas of the industry individuals had operated in and would
seek to find if variations exist in the levels of care between sub groups.
Question Three
How many years’ experience do you have in high-risk areas/conflict zones/hostile environments?
Under 1 year
1 to 2 years
2 to 4 years
4 to 8 years
8 to 15 years
Over 15 years
This viewed the level of experience that operators had.
Question Four
Prior to becoming a Private Security Contractor did you serve in the military?
Yes If No, please state
To confirm, or otherwise that the industry is almost exclusively dominated by ex -military personnel.
“No” answers required an entry to clarify where operators had gained their experience.
Question Five
What regions have you operated in as a PMSC operator?
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Maritime
Afghanistan
Iraq
Yemen
Somalia
Nigeria
Central America
Latin America
Russia/ex-Soviet States
Eastern Europe
Southern Africa
Asia
Other (please specify)
This will identify which areas operators have worked in. Multiple answers were permitted.
Question Six
How do you rate mental health care in your role?
Not at all Somewhat Moderately Important Very Important
This question is designed to identify how operators feel mental health care is perceived within the
industry. This was the first question in the survey that addressed mental health and the drop -out rate at
this point was analysed to see if avoidance of the subject was a contributing factor.
Question Seven
Have you ever received mental health support?
Yes No
If Yes - Please specify
Will seek to determine what percentage of operators have received mental health support and if so, what
type and level.
Question Eight
If you sought mental health therapy would your position be at risk?
Very likely Likely Not sure Unlikely Very unlikely
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This question is posed to discover operator’s perception of whether their position would be at risk if they
sought mental health therapy.
Question Nine
If you experienced a traumatic event, what would you do to cope? (Choose as many answers as you
like)
Prayer or religious act
Try to keep my routine
Spend time alone in reflection
Speak to a therapist
Drink alcohol
Speak to a mate about it
Watch TV
Do some sport
Speak to a loved one
Read a book
Nothing, I could handle the
trauma
Other (please specify)
The choices were randomised for each participant so that the answers were displayed in a different order
and were intended to attain the coping strategies that individual operators employ. It had multi-choice
answers and an “Other” box for additional coping methods used.
Question Ten
Has the approach to mental health care improved in your profession?
No Not sure Yes
This ascertained operator’s perception as to whether there has been an improvement is mental health
care within the industry. It provided further insight of attitudes towards the topic.
Question Eleven
What do you think is priority for mental health well-being?
Please rank in order from 1 (highest) to 8 (lowest)
A long term support network
De-compression stopover leaving theatre
1
2
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Post incident psychological debriefing
On task support
Shorter rotations in theatre
Decent life support/Living conditions
Training to recognise symptoms in yourself and others
Internet communications (Skype™/Facebook™) with friends and family
This question was randomised for each participant. It was designed to ascertain the priorities of mental
health coping mechanisms. Each answer had to be ranked in order from one (highest) to eight (lowest).
Question Twelve
Should companies be contractually obliged to provide mental health support?
Yes, definitely Yes Maybe Not really No, not at all
This took the operators perspective of whether companies should be more accountable on mental health
care.
Question Thirteen
Do you have any further information that can help with this research?
The last question was designed to capture any further information that an operator felt might be of use or
wished to make a statement. Unlike all of the other questions it did not require a compulsory reply.
3
4
5
6
7
8
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3.9 Company Survey Rationale
This questionnaire is for company management and those in positions of authority or influence.
Question One
Does your company operate in high-risk areas/conflict zones/hostile environments?
Yes No Previously
Any “No” responses were directed to the survey end page and those entries were deemed null and void.
Question Two
How many operators does your company routinely have in high-risk areas/conflict zones/hostile
environments?
Under 5
6 to 10
11 to 20
21 to 40
41 to 80
81 to 150
151 to 300
301 to 500
Over 500
This identified the size of companies and sought to obtain accountability or test the theory that many are
small “start-up” companies and whether larger companies have greater accountability in regards to
mental health.
Question Three
How long has your company been established?
Under 2 years
2 to 5 years
5 to 10 years
10 to 20 years
20 to 40 years
Over 40 years
Along with question two this will identify the typical profile of PMSCs to look into the theory that many
are young companies.
Question Four
What regions is your company operating in?
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Maritime
Afghanistan
Iraq
Yemen
Somalia
Nigeria
Central America
Latin America
Russia/ex-Soviet States
Eastern Europe
Southern Africa
Asia
Other (please specify)
Will identify which areas of the world PMSCs are involved in. Multiple were answers permitted.
Question Five
Is your company signatory to any of the following?
None
International Code of Conduct for Private Security Service Providers
The Montreux Document for Good Practices of Private Military and Security Companies
ISO 28007 for Maritime Security
ASIS International Standards and Guidelines
Other (please specify)
This was designed to measure accountability within the industry and through the “Other” entry identify
any further signatory documents that companies were associated with.
Question Six
Do you think that the approach to mental health care has improved in the private military security
industry?
Yes Maybe No
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This judged managerial perceptions on mental health and was compared with the same question posed to
operators to identify any disparity.
Question Seven
What does your company have in place with regards to mental health and well-being? (Choose as
many answers as applicable)
Nothing at all
Training to recognise symptoms of stress
Decompression stopover leaving theatre
Good life support & living conditions
Acclimatisation stopover entering theatre
Mental health screening/Vetting
A company appointed therapist
A full psychological support program
Other (please specify)
This question was randomised for each participant. It sought to identify what level of mental health
support exists with PMSCs.
Question Eight
What emphasis does your company place on the mental well-being of its operators?
None really Somewhat Moderately Important V. important
This question was compared with the same in the operator’s survey to highlight any changes in
perception between the groups.
Question Nine
What do you think is priority for the mental health well-being of your company's employees?
Please rank in order from 1 (highest) to 8 (lowest)
Post incident psychological debriefing
Decent life support/Living conditions
1
2
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De-compression when leaving theatre
Long term support network
Shorter rotations in theatre
On task support
Good communications (Skype™ or Facebook™) with friends and family
Training to recognise symptoms in themselves and others
This question was randomised for each participant. It identified what priority companies put on the
various coping methods and was compared the operator’s choices.
Question Ten
Should more be done to support mental health within the security industry?
Yes Maybe No
If Yes - Any suggestions?
This assessed attitudes from management towards mental health care and was compared to the
operator’s answers.
Question Eleven
Should companies be contractually obliged to provide psychological support?
Yes, definitely Yes Maybe Not really No, not at all
This examined whether management believed there should be greater accountability and was compared
to the operator’s views.
3
4
5
6
7
8
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Question Twelve
Do you have any further information that can help with this research?
This gives opportunity for PMSC management to add their views or any additional information.
3.10 Interviews
The primary data collated from the surveys was tested and raised in interviews with key personnel from
the industry and mental health care. These comparisons were conducted at the conclusion of the surveys,
allowing for the interview questions to be formulated from the responses, to confirm trends and add depth
to the survey findings. The interviewees were selected as individuals who were identified that could help
build a picture of the issues prevalent, discuss the current approaches and provide insight for potential
improvements. They had all previously served in government-backed military and all had experience of
PMSCs, however, each one brought a unique perspective to the study. They were probed on their views
to the survey’s significant findings, the research questions to this study, their expert opinion of
experiences of the topic area and possible future solutions. These first-hand accounts were extremely
valuable in understanding the subject area from differing perspectives and for providing possible
resolutions. The interviewees were as follows:
Interviewee “A” An operator who suffered PTSD symptoms and sought therapy outside
of his companies framework due to fear of losing his job.
He had not received any support from his company in the aftermath of a traumatic event and therefore
kept his issues to himself fearful of losing employment if admitting to a mental health problem.
Interviewee “B” Former UN Agency Chief of Security
He provided insight to the approach taken by the UN in the support given to its staff when deployed to
hostile areas in comparison to that of PMSCs.
Interviewee “C” Founder of an ex-servicemen’s mental health charity who had
previously served with Britain’s Special Forces
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He provides knowledgeable insight to the pressures of working in high-risk environments and the
founding of the charity.
Interviewee “D” Director of a mental health charity and former Armed Forces
psychiatrist
After a military career that specialised in mental health care, he now specialises in clinical psychiatry, has
Doctorate in mental health and advises on policy concerning PMSCs.
3.11 Summary
This research used social media as an efficient means to distribute surveys and reach the focus group
effectively. It allowed feedback to be drawn from all areas of the industry providing a broad depth of data
and feedback. Additionally it obtained the opinions from subject matter experts in mental health and
PMSCs for their expertise. The information gathered throughout the survey and interview stages has been
compared with existing works on the subject, which are covered in the Literature Review. The highest
ethical standards were applied throughout, and full duty of care has been taken with this sensitive subject.
The results of all the gathered data, evidence and statistics are laid out and presented in the following
Findings Chapter.
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FINDINGS
4.1 Introduction
The results from the comprehensive questionnaires are presented throughout this chapter in chronological
order. The findings are displayed using graphs, figures and charts to aid in their interpretation and
understanding. The key points drawn from the interviews with experts offering in-depth knowledge of
the PMSC industry and mental health care are highlighted, especially where they endorse the survey data,
or help explain the trends that are derived from it.
4.2 Limitations
The social media sites used for the purpose of this study were all found to have large memberships;
however, it was clear that there is considerable duplication as the sample population subscribed to
multiple sites. Internet access was a requirement to participate, which can be an issue for certain
operators in remote areas or those on maritime tasks who would not necessarily have access while away
on ships convoy protection duties. To counter this the survey was made available for three months, as
anti-piracy convoy duties or rotations in hostile environments are never usually longer than this period
(Murphy, 2013). The questionnaires were only posted onto English speaking sites and although there
were found to be a few non-English speaking groups, it was clear that the sites used catered for the
majority of PMSC operators and offered a good representation of the industry. Consideration was given
to using the option of only allowing one entry per I.P address, but this was deemed unsuitable, as it may
have blocked entries from an overseas base with several potential participants. Because of this some
managerial data duplication may have occurred, i.e. more than one representative from a PMSC entering
data on the survey from the same company. There was also no way to stop operators who could have
entered data several times, although there is no real evidence of this or considered motivation to do so.
Other approaches that were considered but deemed unsuitable was distribution of the questionnaire by E-
mail to potential participants, as this would have compromised anonymity. None of the limitations
mentioned here are thought to have had any significant impact on the value and integrity of the data that
was gathered.
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4.3 Presentation of Survey Data
A total of 30 LinkedIn™ and 19 Facebook™ well-supported networking groups were targeted for the
survey. Due to the confidential nature of the PMSC industry, these sites presented higher levels of
security than others did. For these “closed sites”, all potential associates are invite only and verified prior
to membership, therefore the sample group was deemed pure from contamination from any outsiders. All
of the groups had connections to the PMSC industry, including the sub groups, which all contributed to
receiving as wide a range of feedback as possible. The groups varied in their characteristics and ranged
from “The International Mercenary Association” to a group dedicated to raising standards in the industry;
“The Professional Security Group”. The two surveys were attempted by 459 potential participants;
however there was a high dropout rate, where many may have just been curious or realised that the survey
did not apply to them, resulting in a final total of 264 completed questionnaires.
Table 4.A: The total numbers sampled.
Survey Attempts Incomplete Completed
Operators 350 138 212
Company 109 57 52
Total responses 459 195 264
These totals are considered to be a satisfactory sample size, from which opinions on the subject of
psychosocial risk issues are considered to be a reasonable representation from within PMSC industry.
For the presentation of data shown at Figure 4.1 the full results are displayed regardless of whether the
questionnaire was completed. Only the raw data is presented throughout this chapter, all results and
significant findings are critically analysed in detail in the Discussions Chapter.
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Figure 4.1: Survey entrants working in PMSCs.
The first question was designed so that the 39 “Never have” responses shown at Figure 4.1 to having
experience of working in PMSCs were directed to the final page and omitted from the study, enhancing
the integrity of the survey. The remaining 311 responses from those currently deployed amounted to
51.1%, with 48.9% having previous relevant experience.
Figure 4.2: Sectors of the PMSC industry that operators were working in.
179
132
39
0%
10%
20%
30%
40%
50%
60%
Yes Previously Never
Total responses 350
15.8%
42.7%
18.6%
5.7%
8.6%
8.6%
Total responses 279Mine clearance 44
Close protection 119
Maritime 52
Static site guard 16
Low profile security 24
Mobile security detail 24
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Figure 4.2 shows the spread of main roles annotated within the questionnaires. 38 “Other role” entries
were received, of which four stated they were Explosive Ordinance Disposal (EOD) and these have been
clustered into the aligned mine clearance sub group. The remaining included; Police training/mentoring x
3, Non-Governmental Organisation (NGO), corporate security, liaison, transport, strategic advice, due
diligence, aid delivery and refugee security.
Figure 4.3: Number of years’ experience that operators had in hostile environments.
Figure 4.3 above shows that over 60% of operators have less than eight years’ experience, but a high
volume of 21.8% claimed to have over 15 years’ in the industry.
Table 4A: Operators who had previously military experience.
Answer Percentage Operators
Yes 89.4% 219
No 10.6% 26
Total responses 245
As part of the research centred on comparisons with PMSC and military service, this question ascertained
these levels, the results are shown at Table 4A. The “No” responses entered the following data; four had
served in a police force; one was a paramedic, and only ten stated that they had not served in any military
prior to joining a PMSC. This is in line with other research and was an expected response.
1924
54
67
48
59
0%
5%
10%
15%
20%
25%
30%
Under 1year
1 to 2years
2 to 4years
4 to 8years
8 to 15years
Over 15years
Total responses 271
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Figure 4.4: Regions that operators had worked in. (Excluding military service)
Details of the global spread are shown in Figure 4.4. Further “Other” entries included; Sudan x10, Libya
x9, Lebanon x5, North Africa x3. These were expected results and reflect the typical world wide
deployment of PMSCs.
Figure 4.5: The level of importance that operators put on mental health care.
27.0%
43.4%
55.9%
12.1%13.7%
12.1%
9.4%
8.6%
6.6%
24.2%
20.3%
19.1%
Total responses 256 (multiple answers permitted ) Maritime 69
Afghanistan 111
Iraq 143
Yemen 31
Somalia 35
Nigeria 31
Central America 24
Latin America 22
Russia/ex Soviet States 17
Eastern Europe 62
Southern Africa 52
Asia 49
1822
26
79
105
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Not at all Somewhat Moderately Important Veryimportant
Total responses 250
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Figure 4.5 shows that three quarters of the operators believe strongly that their mental health care is either
“Important” or “Very Important. However 18 deemed it was “Not at all” important.
Figure 4.6: Operators who had received mental health support.
“Yes” responses were encouraged to clarify what mental health support they had received: Counseling x5,
PTSD x4, depression x3, Combat Stress (Referring to the ex-services mental health charity) x2. Others
single answers were, Eye Movement Desensitisation and Reprocessing (EMDR), TRiM, Talking2Minds
training (a veterans mental health charity), anti-depressants, psychotherapy, NLP (Neuro-Linguistic
Programming), Bi-polar, counseling, life coaching, acceptance and commitment therapy, mindfulness
training, end of tour debrief, assessment on discharge from the Military.
Other entries of note were:
Respondent O/026;
“Debriefs after serious incidents in Northern Ireland”
Respondent O/071;
“UNMAS counseling after colleague was blown up and killed”
41
209
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Yes No
Total responses 250
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Figure 4.7: Operators who believed that their position would be at risk if the y sought mental health
therapy.
Figure 4.7 covers a significant finding of this study and demonstrates the perception that at best operators
are “Not Sure” and over half believed it to be “(Very) Likely” that they would lose their job, if they
sought mental health support
Table 4B: Coping strategies that operators would employ after a traumatic experience at work.
(Multiple answers permitted)
Rank Coping Method Percentage Operators
1 Speak to a mate about it 57.2% 139
2 Try to keep my routine 53.1% 129
3 Spend time alone in reflection 41.6% 101
4 Do some sport 39.5% 96
5 Speak to a loved one 39.1% 95
6 Drink alcohol 25.1% 61
7 Nothing, I could handle the trauma 20.2% 49
8 Speak to a therapist 15.6% 38
9 Read a book 14.4% 35
10 Watch TV 9.9% 24
11 Prayer or religious act 9.1% 22
Total responses 243
7971
65
18 17
0%
5%
10%
15%
20%
25%
30%
35%
Very likely Likely Not sure Unlikely Veryunlikely
Total responses 250
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The most common responses in regards to coping strategies are found at Table 4B. Of note is the top
response which is to “Speak to a mate about it”. This and a full assessment of the entries are assessed in
Discussions at Chapter 5. Additional coping strategies that operators included were:
Respondent O/160;
“Listen to music and meditate”
Respondent O/169;
“Pursue prostitutes”
Respondent O/214;
“Remain active, dwelling on past will eventually lead to some form of depression”
Respondent O/242;
“Martial arts practice have been very helpful for me personally”
Respondent O/273;
“Holiday to Bora Bora”
Respondent O/326;
“Play XBOX”
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Figure 4.9: Operator’s perception on whether there has been an improvement in mental health care
in PMSCs.
A consideration was required in the perceptions of responders if they felt the approach to mental health in
PMSC’s was improving. Figure 4.9 shows that “No” replies accounted for 30.5%, “Not sure” 47.7% and
“Yes” responses 21.8%
Table 4C: Operator’s priorities of mental health well-being.
Rank Answer option Score 1
Internet communications with family and friends 5.42 2 Shorter rotations in theatre 5.14
3 Decent life support/Living conditions 4.55
4 Training to recognise symptoms in yourself and others 4.54
5 De-compression stopover leaving theatre 4.25
6 A long term support network 4.07
7 Post incident psychological debriefing 4.04
8 On task support 3.99
Total responses 227
Personal comments in regards to the responder’s priority scale on what they considered would allow a
healthier mental state was scored and results are shown above at Table 4C. Communicating with
somebody close rates highest, shorter rotations is a surprisingly high score, as it runs counter to financial
74
116
53
0%
10%
20%
30%
40%
50%
60%
No Not sure Yes
Total responses 243
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gain. Decent living conditions are recognised as being advantageous; however there is poor support for
structured mental health support.
Figure 4.10: Operators who believed that companies should be contractually obliged to provide
mental health support.
There is a strong indication that operators believe support should be offered from their organisation,
results shown at Figure 4.10 support this case and supports other answers that this topic is of high
significance to them.
Figure 4.11: Companies with experience of operating in high-risk areas/conflict zones/hostile
environments.
80
67
42
17
9
0%
5%
10%
15%
20%
25%
30%
35%
40%
Yes,definitely
Yes Maybe Not really No, not at all
Total responses 215
72
26
11
0%
10%
20%
30%
40%
50%
60%
70%
Currently Never Previously
Total responses 109
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“Never” responses shown at Figure 4.11 were directed to the survey final page and removed from future
results in order as not to contaminate the data.
Table 4D: Length of time that companies have been established.
Duration Percentage Companies
Under 2 years 6.8% 5
2 to 5 years 23.0% 17
5 to 10 years 37.8% 28
10 to 20 years 17.6% 13
20 to 40 years 6.8% 5
Over 40 years 8.1% 6
Total responses 74
The research established statistics around company history and time length for a variety of reasons around
support structure capability. Table 4D’s results are in-line with expectations and reflect the post Iraq and
Afghanistan “boom years” for company incorporation.
Table 4E: Number of operators that companies have.
Company size Percentage Company’s
Under 5 18.2% 14
6 to 10 16.9% 13
11 to 20 23.4% 18
21 to 40 7.8% 6
41 to 80 6.5% 5
81 to 150 11.7% 9
151 to 300 5.2% 4
301 to 500 1.3% 1
Over 500 9.1% 7
Total responses 77
The data shown in Table 4E denotes that many PMSCs in the survey are fairly small companies. This
and the results in Table 4D are commented on further in Discussions at Chapter 5.6.
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Figure 4.12: Regions that companies are operating in.
A wide area of operations are shown in Figure 4.12. A further total of 13 “Other” entries included: North
Africa x2, Libya, Sudan x2, Caribbean, Tanzania, Ghana, Middle East, Sudan, Papua New Guinea, West
Africa, Mali, Ghana, Ivory Coast, Saudi Arabia, Israel and Kurdistan. The results are in-line with the
operators’ responses and highlights PMSCs global spread.
Table 4F: Documents that companies are a signatory to.
Document Percentage Companies
None 50.7% 35
International Code of Conduct for Private Security
Service Providers 43.5% 30
ISO:28007 for Maritime Security 24.6% 17
The Montreux Document for Good Practices of Private
Military and Security Companies 20.3% 14
ASIS International Standards and Guidelines 15.9% 11
Total responses (Multiple answers permitted) 107
46%
37%
43%
14%27%
34%
24%
23%
19%
26%
37%
38%
Total responses 284 (multiple answers permitted) Maritime 34
Afghanistan 27
Iraq 32
Yemen 10
Somalia 20
Nigeria 25
Central America 18
Latin America 17
Russia/ex Soviet States 14
Eastern Europe 19
Southern Africa 27
Asia 28
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The topic of accountability is discussed in-depth in Chapter 5.9.1. The feedback at Table 4F reveals that
over half of company management respondents stated that their companies were not signatory to any of
the above documents. There were three other entries:
Respondent M/037;
“Voluntary Principles for Security and Human Rights”
Respondent M/046;
“UN has its own standards”
Respondent M/082;
SAMI (Security Association for the Maritime Industry)
Figure 4.13: Company management that thought the approach to mental health care had improved
in their industry.
Results at Figure 4.13 shows perception from PMSC Management that only 24.6% believe there has been
an improvement and 34.8% were not sure, while 40.6% believed that there had not.
17
24
28
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Yes Maybe No
Total responses 69
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Table 4G: Mental health and coping strategies that companies have in place with regards to their
operators well-being? (Listed in order of ranking)
Rank Answer option Percentage Companies
1 Good life support & living conditions 48.4% 31
2 Training to recognise symptoms of stress 46.9% 30
3 Mental health screening/Vetting 46.9% 30
4 Nothing at all 21.9% 14
5 A company appointed therapist 21.9% 14
6 Decompression stopover leaving theatre 18.8% 12
7 Acclimatisation stopover entering theatre 18.8% 12
8 A full psychological support program 10.9% 7
Total responses (Multiple answers permitted) 151
The results from Table 4G are commented on in greater detail in Discussions at Chapter 5.9.
“Other” responses included:
Respondent M/037;
“Critical incident debriefing and treatment”
Respondent M/075;
“March on stress and GP declaration”
Respondent M/097;
“Occupational health nurse and Dr trained in PTSD councilling (sic) and mental health offering
cognitive therapy”
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Table 4H: What emphasis company management place on the mental well-being of their operators.
Opinion Percentage Companies
None really 13.3% 8
Somewhat 15.0% 9
Moderately 20.0% 12
Important 25.0% 15
Very important 26.7% 16
Total responses 60 60
Table 4H statistics shows a strong emphasis that company management respondents have weighted on the
mental health of their employees. For at least one company this survey seems to have raised awareness as
stated by Respondent M/042;
“This survey has certainly been a timely reminder and something that I will be taking up with
senior management”
Table 4I: Company management priorities of mental health support. (In order of choice)
Rank Answer options Score
1 De-compression when leaving theatre 5.55
2 Shorter rotations in theatre 5.13
3 Good communications (Skype™ or Facebook™) with friends
and family 4.61
4 Long term support network 4.59
5 Post incident psychological debriefing 4.52
6 On task support 4.00
7 Training to recognise symptoms in themselves and others 3.88
8 Decent life support/Living conditions 3.73
Total responses 64
To compare PMSC operatives with their company’s the same questions were asked in regards to mental
health support albeit with a different accentuation. As with the operator’s responses, mental health
training or support did not rate highly as shown in Table 4I. Decent life support was one of the top
operator’s choices as opposed to the lowest of managerial priorities.
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Figure 4.14: Company management opinion on whether more should be done to support mental
health in PMSCs.
An emphatic answer to this question with only a single “No” response, with 16 (29%) “Maybe” and a
high majority of 38 (69%) stating “Yes” as shown above in Figure 4.14. “Yes” responses were
encouraged to state what should be done and those entries can be found in Appendix F.
Table 4J: Management opinion on whether PMSCs should be obliged to provide psychological
support.
Opinion Percentage Companies
Yes, definitely 25.5% 14
Yes 34.5% 19
Maybe 21.8% 12
Not really 10.9% 6
No, not at all 7.3% 4
Total responses 55
Management thoughts on obligatory requirements for psychological support were surveyed and the
answers at Table 4J support a strong “Yes” and “Yes definitely” score which is encouraging. The “Not
really” scores of 6 (10.9%) or and “No, not at all” 4 (7.3%) are of a concern to this study.
38
16
1
0%
10%
20%
30%
40%
50%
60%
70%
80%
Yes Maybe No
Total responses 55
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Further information and comments supplied:
Numerous additional comments were entered which provided deep insight on attitudes towards the topic.
The majority are listed in Appendix F with the more significant points that warranted additional analysis
and discussion in Chapter 5, where they are used to highlight key points and support or debate the
arguments.
4.4 Interviews
The four interviewees used for a further qualitative survey were asked their opinions on the research
questions shown above, the key findings from the surveys and then asked to give opinions to the survey
questions where applicable. Pertinent points from their interviews are entered below, with the other
poignant points located throughout the Discussions Chapter where they are used to validate key points.
Transcripts to the two interviews which were of greatest interest to the research are in Appendices G and
H.
4.4.1 Interview with “A”
‘A’ was questioned about his experiences as an operator and how he sought mental health therapy outside
of his company’s knowledge due to fear that he would lose his job. He was asked about his experiences
and what, in his opinion, could be done to improve the care. The key points noted were that, in his
opinion, many of his colleagues had some form of mental health issue, but simply refused to admit it
openly. On coping methods, he believed it was the little things that make the difference, leading as
normal a life as possible in a war zone helped, for example watching a hometown news channel or sitting
down with colleagues for a Sunday dinner together. His stated regular internet communications with
family at home had the effect of keeping him “grounded”. After privately undertaking therapy, he felt he
had the coping tools to continue working successfully within PMSCs with a more forward thinking
approach. He feels that the support was extremely beneficial, and may have led to a degree of PTG. On
long rotations in theatre, he mentioned some operators clearly push the limits to earn the extra daily rate
and stay away too long in hostile environments, when they should be taking regular breaks. He used the
analogy that coping techniques acted like “shock absorbers” on a car; therefore, if an operator was
exposed to stress or a traumatic event, the many coping methods would lessen their impact. He added
that he once tried to give up smoking in a hostile environment, which may not have been the best
opportunity to do so. His therapy with the charity had taught him not to be so hard on himself.
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4.4.2 Interview with “B”
“B” was interviewed around experiences delivering Critical Incident Stress Management (CISM) training
to the UN and his long exposure of working with PMSCs and any differences of attitude from them. He
stated that the UN approach was advanced and delivered good pre and post-deployment training, assessed
its staff’s psychological needs, coordinated stress management training and offered comprehensive
support to its employees. However, he was keen to stress that the UN are well resourced and most
PMSCs simply do not have the financial depth to fund PRM programs. He believed economic pressure to
be a major factor, where small companies bidding for a contract had to cut costs and would not have
appetite or foresight to have a PRM program. Secondly, once a contract is awarded there is normally a
rush to fill up to 100 positions where doing any form of vetting or mental health awareness training would
be highly unlikely. Yet, he felt that there are many small measures which can be employed that will
improve mental health of operators. When asked his opinion on whether technologic advances could
replace face to face therapy or enhance it, he said that personal contact is always best, but in today’s ever
connected world and with the youth of today growing up and developing their communication
personalities through social media, it should certainly be researched. He mentioned the benefit of salaried
staff rather than daily pay rate limiting temptation to over stretch the length of rotations in high-risk areas,
and that Governments issuing contracts should ensure that those they hire are taking adequate duty of care
towards their operators’ mental health, and that this could be done through an audit process. He valued
teamwork highly as a coping strategy and strong bonds with colleagues were essential, this was also key
with social support networks, for example the British Legion. He had also seen good advances in
approaches towards the topic within the military, where 30 years ago it would have been swept under the
carpet.
4.4.3 Interview with “C”
“C” was questioned in his capacity as the founder of an ex-servicemen’s mental health charity, about his
experiences within PMSCs and further background of working within the British military. On
recruitment he pointed to the distinct “tier structure” within the industry with good quality and resilient
operators getting the best paid jobs where word of mouth vetting was commonplace. He felt this had
advantages, but that due to financial cuts, less qualified and often less psychologically resilient
individuals were finding their way into positions that they were not suited for. He said that military skills
were essential for PMSC operators, but that the culture towards mental health in the military carried
stigma, in that it was seen as a weakness and serviceman would commonly abstain from discussing
anything resembling emotional content. He said that there had been very little positive changes towards
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this subject in the industry, and even the changes seen were done merely so companies could mitigate the
risk of being sued rather than duty of care towards their operators. He had seen certain companies turn
their backs after a serious traumatic incident, leaving the operators to fend for themselves
psychologically. Personally in the aftermath of any PTE he tries to maintain routine and focus on the
future as his coping method. Further conversation led to his covering typical ways that many seasoned
operators cope with such events, in drinking alcohol excessively to “get it out of their system” as a typical
ex-military approach. Decompression periods were felt important, so operators did not bring certain
stresses back into their family home life. There was a factor that some people stayed in high pressure jobs
longer than they should due to a desire to earn money and this was extremely detrimental to the
psychological well-being. He felt that self-development such as learning a new language or skill was a
great way to combat boredom which in itself could be a stressor or lead to having time to develop
negative thoughts, plus the effect of empowering the individual in being future focused. While employed
as a PMSC operator he developed PTSD, sought treatment outside of his company’s knowledge and later
went onto found a mental health charity. He stated that his charity had been contacted by numerous
PMSC operators who were seeking therapy outside of their company’s knowledge due to stigma and a
fear of losing employment. The interventions used by the charity adopt a holistic approach using a
combination of NLP, Timeline therapy and hypnosis, focusing on everything that is not the trauma. The
situation has got better with regards to accountability, but a PMSC can be started up easily by a couple of
mates in the bar of a special forces garrison town and next thing you know, they’re deploying dozens of
guys into harm’s way with little regard to the psychological well-being. He rated acclimatisation
stopovers prior to going into a hostile environment as a good place for training and where operators could
prepare themselves psychologically for any challenges that lay ahead. Steroid abuse he felt was a
problem and that he did not see a large issue with drug taking in theatre. He knew that some service
members lied on their mental health assessments due to a fear of being stigmatised. He said that a PTE
could trigger negative emotions that have been locked up since early childhood, when typically memories
are locked in what is known as childhood amnesia, these can develop into PTSD and these exaggerated
emotions drive the symptoms in some cases. His charity’s interventions work to neutralise these
memories by changing the perspectives on how they are viewed and dispelling these unwanted negative
emotions. These types of therapy he thought could be used to build resilience by them being delivered to
operators before they are exposed to PTEs and has also lead to people experiencing PTG in his opinion.
He felt psychological problems could surface later as many operators migrate back into a civilian
lifestyle.
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4.4.4 Interview with “D”
”D” was questioned in his capacity as a leading military psychiatrist who now works with PMSCs having
written many papers on mental health care in relation to these areas. Some operators join PMSCs, as
links to military service are strong and they enjoy that lifestyle as it is familiar to them, to some they are
doing this as opposed to establishing a civilian life. These people are high risk in developing mental
health issues. However, he felt it must be stated strongly that most in the industry are doing it for the
right reason, but a minority can have a disproportionate effect on the image of the industry. Although the
salaries are good, it can be unhealthy in some circumstances if this becomes the main driver, ignoring the
risks totally instead of building a stable civilian life. He also highlighted that PMSC levels of care were
completely random, in that some pay lip service to it, and operators potentially find themselves in the
aftermath of a PTE without the same support that was on offer in the military. On accountability he is
involved in drafting guidelines for organisations that place people in harm’s way which recommends
basic screening and vetting, early detection, peer support and team leaders that are trained to spot warning
signs. Fast track treatment is imperative to the few that need it. He felt that companies should re-employ
operators after therapy as PTSD or other mental issues can be treated and they can return to a normal
working life. For psychological first aid, he thought it very important that early peer led support
immediately after and social support were available. There were some differences between the sub
groups with maritime seeking boredom avoidance and a good team spirit, seen as very important.
Training for good individual residence and a well-led team that are trauma aware was key. On
acclimatisation stopover, he thought they were good for forging a cohesive team and receiving important
briefings, but not as important as decompression stopovers exiting theatre. He feels operators should not
go straight back to family, and a stopover of 24hrs for a few beers or other relaxation is a good thing. On
routine he talks about the importance of individuals finding their own body rhythm as an important
coping mechanism which is the best way to switch the mind away from the daily stresses. There was a
definite need for better due diligence through risk assessing and vetting in order to stop a tragic event
such as an unstable operator being allowed into a hostile environment with access to weapons, especially
where alcohol was freely available.
4.5 Summary
The surveys have been well supported by members of the PMSC industry and the data returned has
revealed findings that give added substance to some of the current theories researched and being used for
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discussion and analysis. These findings were further debated during the informative qualitative
interviews with nominated key industry figures. The results in some cases are emphatic and demonstrate
the importance of this subject and its bearing on individuals operating in hostile environments. The
revealing data confirms, but also reveal many interesting trends, these along with the key points drawn
from the interviews are critically analysed in the following Discussions section at Chapter 5.
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DISCUSSIONS
5.1 Introduction
This chapter builds on the data drawn together throughout this research. It critically analyses the findings
from qualitative and quantitative surveys, offers observations on what has been learnt based on the
research undertaken. The Discussions are presented in a cohesive narrative that provides context to the
study by linking the various threads and considering their value. Using the primary data of the surveys it
initially provides an interpretation of the answers using statistical data presented to highlight the key
points. The chapter then continues to offer explanation on what the significant and memorable findings
are and discusses what is believed to account for these outcomes, why they are important and the
implications for the future use in improving the approach to mental health within PMSCs. Additionally it
will review any perceived negatives from the research outcomes, where the results were not in line with
anticipated answers.
5.2 Review of Methodology
Limited previous research into the specific study area meant that material surrounding the topic was
explored in-depth for the Literature Review which provided sound background material into some of the
broader themes. The study set out to gather feedback and data that could be utilised to gauge the level of
the care available and its effectiveness. Initially it examined the stressors faced by PMSCs, collated their
most commonly used coping measures and evaluated them. The approach of using social media in
reaching out to the target audience proved to be an effective platform for distribution of the surveys.
Overall from the 459 that started the surveys 42.5% dropped out. There were drop outs at each question,
with a higher rate for the questions that took more thought and time. There were no significant dropouts
when the survey questions started enquiring about mental health, this was anticipated but did not
materialise. The interviews proved extremely useful in confirming, adding detail and clarification on
several points.
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5.3 Summary of the Research Questions and Objectives
The fundamental questions raised for the purpose of this research which are critically analysed in this
chapter are:
What level of care is currently available in this employment arena, and is it adequate?
What are the unique stressors that PMSCs face in their operating environment and what are the
best coping strategies?
How could mitigation, coping strategies, interventions and therapies be improved?
5.4 Key Findings of the Study Results
The main findings from the research undertaken revealed:
The importance of a requirement for mental health support was highly recognised in the survey
feedback with 71.6% of operators stating that it was a (very) important issue. However a
noticeably lower amount 51.7% of management stated that it was.
There was found to be wide discrepancy among the responding companies for the provision of
mental health care provision, with 22% of them having “nothing at all”, the same percentage
having a “Company appointed therapist”, and only 11% having “a full psychological support
program”.
The issue of the topic being stigmatised still exists. Tellingly the majority 80% were either not
sure, or felt it (very) likely, that their positions would be at risk if their employer knew they
required some form of mental health therapy.
Peer support is highly regarded by operators with 57.2% stating that they would wish to “Speak
to a mate about it” in the aftermath of a traumatic event. However 20.2% claimed they would do
nothing as “They could handle the trauma”, with only 15.6% stating they would consider
speaking to a therapist.
Internet communications, shorter rotations and decent living standards in theatre were ranked by
operators as the highest priority to counter stress. Long term support networks, post incident
psychological de-briefing and on task support regarded as the lowest according to survey
responses.
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Over half of the companies surveyed (51%) were not a signatory to any code of conduct or best
practice, which has raised the question of accountability for their employees’ issues.
There were many revealing and informative comments submitted by members of the PMSC
industry which have contributed towards this research. An example of the mindset that exists,
which is a barrier to seeking therapy is offered by Respondent O/287;
“The macho culture found in these environments deters people from speaking out about mental
health issues. We've all seen people who are clearly suffering mental anguish, yet they are
allowed to continue operating”
The major findings are assessed in greater detail throughout this chapter together with all of the other
significance points.
5.5 Appraisal of the Survey’s Background Data
In the following section the findings are analysed and discussed in the order that the questions were
posed. The volume of operators having less than eight years’ experience (60.5%) most likely reflects the
industry “boom” years where both Afghanistan and Iraq post-conflict related security tasks were at their
height. Alternately it could indicate that levels of burn-out are high, and working in these environments is
time-limited and potentially has a “shelf-life”. It should be also noted here that some previous operators
will have moved into management roles within PMSCs (Interviewee C). The percentage of operators that
had previously served in the military was very high (89.4%) and confirmed previous expectations. The
transition to civilian life can be difficult for some ex-servicemen (Interviewee D). However, many
operators feel comfortable taking up a PMSC role after leaving the military, as it is where their skills and
backgrounds are recognised among their peers, where a similar culture, mindset and language exist
(Dunigan et al, 2013).
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Figure 5.1: Length of time companies have been established.
As discussed, the majority of companies surveyed and shown in Figure 5.1 were found to be relatively
young which seems to coincide with a peak of the post-conflict Iraq war era.
Figure 5.2: Number of operators that each company had.
The data displayed in Figure 5.1 denotes that half of the companies had fewer than 20 operators. This
combined with the information from Figure 5.2 shows that many were also small organisations; perhaps
meaning that they would not have necessarily invested in a PRM strategy. This point was also stressed in
Interviews B and C.
Figure 5.3: All respondents on whether mental health care should be a contractual obligation.
5
17
28
13
5 6
0%
5%
10%
15%
20%
25%
30%
35%
40%
Under 2years
2 to 5years
5 to 10years
10 to 20years
20 to 40years
Over 40years
Total responses 74
1413
18
65
9
4
1
7
0%
5%
10%
15%
20%
25%
Under5
6 to 10 11 to20
21 to40
41 to80
81 to150
151 to300
301 to500
Over500
Total responses 74
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Operators and management have similar thoughts as to whether PMSCs should be contractually obliged
to provide mental health support. This is raised by Respondent O/214;
“Changes in contracts would help, as every day demands all have varying degrees of stress
levels - which contribute to anxiety, depression and loneliness.
5.6 Discussions on Research Question One:
Is the current level of mental health care adequate and what is the existing mindset towards
it?
Observations on attitudes towards mental health care are that in recent years there has been a greater
societal acceptance of the issues (Angermeyer, 2006). This has filtered through to the military who are
now implementing PRM programs (Interviewee D), but as the survey data reveals, levels of care in
PMSCs remain inconsistent at this stage. Sizeable differences exist with 21.9% of companies having
“Nothing at All” which is twice as many of those who had “A full psychological support program”; that
said, 21.9% also had a “A company appointed therapist”. Only seven (10.9%) of companies surveyed
have a full support program, this highlights the industry’s deficiency in this area and lack of consistency
and was also raised on by Interviewee B. Interviewee A makes the observation that social media sites
reveal a “Mindset” and “Group think” that is still to fully and openly embrace mental health care without
fear of embarrassment or associated stigma. This is reinforced through comments offered throughout the
survey.
26%
35%
22%
11%
7%
37%
31%
20%
8%
4%
0%
10%
20%
30%
40%
Yes,definitely
Yes Maybe Not Really No, Not atall
Total Responses 270
Management
Operators
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Respondent O/169 uses many expletives to reinforce his opinions, which are as valid as the others.
“There is no info that can help the layman work out which headshrinkers are gen (sic) and which ones
are bluffing/useless/wankers/eejits (sic). Fucking lunacy”
Figure 5.4: Current procedures that PMSCs surveyed have in place for mental health support.
A linguistic text analysis of all of the responses from both surveys produced key words that would be
expected to be prominent in discussions on mental health, but two words that stood out as being
repeatedly used were “Support” and “Value”. The significance of this can be interpreted that operators
value support highly. An example from Respondent O/232;
“Solid team support”
21.9%
46.9%
18.8%
48.4%
18.8%
46.9%
21.9%
10.9%Total responses 64 Nothing at all 14
Training to recognise symptoms ofstress 30
Decompression stopover leaving theatre12
Good life support & living conditions31
Acclimatisation stopover enteringtheatre 12
Mental health screening/Vetting 30
A company appointed therapist 14
A full psychological support program 7
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Figure 5.5: How importantly PMSCs rate mental health care in the role.
There was very little difference between the operators and management response in data presented in
Figure 5.5 showing that three quarters of responders believe strongly that mental health care is either
“Important” or “Very Important” which is fairly emphatic. However, 7.2% of operators and 13.3% of
management replied “Not at all”, which again reflects the negative approach towards mental health from
some quarters of the industry. The graph at Figure 5.5 shows data clearly weighted towards claims from
company management on the emphasis they put on the mental health of their employees. This is not
really backed up by investment or positive actions, as demonstrated in Figure 5.4 and points made
strongly in all of the feedback.
Table 5.A: Operators’ perception on whether there has been an improvement in mental health care
within PMSCs.
Opinion Percentage Operators
No 30.5% 74
Not sure 47.7% 116
Yes 21.8% 53
Total responses 243
The answers in Table 5.A are inconclusive and show that the perceptions remain mixed and at best are
unclear.
8%10%
12%
30%
39%
13%15%
20%
25%27%
0%
10%
20%
30%
40%
50%
Not at all Somewhat Moderately Important V. Important
Total responses 310
Operators
Management
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Table 5.B: The perception from operators on whether their positions would be at risk, if they
sought mental health support.
Opinion Percentage Operators
Very likely 31.6% 79
Likely 28.4% 71
Not sure 26.0% 65
Unlikely 7.2% 18
Very unlikely 6.8% 17
Total responses 250
The results from this question shown at Table 5.B. are remarkable, revealing the level of work that is
required for operators to have confidence in asking for support without a fear of losing their position.
This was also a major issue raised by all Interviewee’s, that the current mindset is a significant barrier for
improving the level of mental health care within the industry. It is reinforced in comments posted in the
survey; a lack of CSR from PMSCs is raised by Respondent O/116;
“I think that the concept of contract working is the key problem. Drop anything about mental
health and you are on your own. There is no responsibility from the org/comp to care for ex -
employees. In and out policy, human merchandise”
Respondent O/250;
“As a result of a bombing I have occasional nightmares. Alas I cannot go to the Dr as
it would affect my employability, so like everyone else we soldier on”
5.7 Discussions on Research Question Two:
What are the unique stressors that PMSCs face in their operating environment and what are
the best coping strategies?
As concluded in the Literature Review, Maslow’s theory highlights that many of the basic human needs
are not met or satisfied while operating in a hostile environment and these added stressors could have an
effect on PMSCs mental health (Maslow et al 1998). This was commented on by Interviewee A, who
stated;
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“Even the smallest issue can be amplified when working in a war-zone”.
The theme is also raised by Respondent O/294, who points to the welfare of maritime operators;
“Diet and nutrition contribute to and mental well-being - my experience working in maritime
security has been that dietary considerations are not covered in contracts and food on ships is
often lacking serious nutritional value. Protein levels especially, help to maintain good levels of
mental and physical awareness; this leaves operators at risk of losing focus and ability to
function properly in high-stress situations”
Table 5C: Priorities that operators deemed were important for mental well-being.
Rank Answer option Score
1 Internet communications (Skype™/Facebook™) with
friends and family 5.42
2 Shorter rotations in theatre 5.14
3 Decent life support/Living conditions 4.55
4 Training to recognise symptoms in yourself and others 4.54
5 De-compression stopover leaving theatre 4.25
6 A long term support network 4.07
7 Post incident psychological debriefing 4.04
8 On task support 3.99
Total responses 227
On the question of ranking the eight choices in order of priority to personal mental health well-being
Table 5.C shows an interesting first was “Internet communications (Skype™/Facebook™) with friends
and family”. This highlights the importance for communications, either to loved ones at home, with
friends or groups of like-minded individuals to those working in the industry. Social media has been a
great advance for operators within PMSCs, as it offers instant communication, a sense of belonging and a
comfort zone where operators can freely air their views with peers; forming an effective social support
network. However, what happens if individuals become overly reliant on it, could they suffer withdrawal
symptoms? For example, a maritime operator may often find him/herself on a convoy in the Indian
Ocean for several weeks without an internet connection, whereas, before he/she had been in constant
communications with their support network several times a day. The effects of this would vary
depending on the individual, but are an unknown quantity that may warrant further study. The second
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placed result of “Shorter Rotations in Theatre” which as Interviewee C stated should be top based purely
on the high risk of working in this industry, as less time exposed to dangers diminishes the risk, and
therefore the stressor. However this would be opposed to an operators desire to earn money. Decent life
support and living conditions were the third choice. When operating in hostile environments these can
make the task more manageable from a stress level point of view according to Interviewee B. The
remaining answers ranked as expected.
Figure 5.6: Operators most commonly used coping methods following a PTE.
1) The highest answer of “Speak to a mate about it” (57.2%) was significant as it highlights the key
requirement of the “rapport” that is needed when individuals are discussing their own personal
matters. Interviewee C rates rapport as being a major factor for his charity’s interventions to be
effective.
2) “Try to keep to my routine” was second (53.1%) and was echoed by Interviewee A who repeated
that post incident he would try to “crack on as normal” meaning sticking to a routine as a way of
coping and maintaining a sense of normality.
3) A high number (41.6%) entered “Spend time alone in reflection”. This is widely recognised by
mental health professionals Whealin et al, (2008) and commented on by Interviewee C that it is
beneficial to have issues brought out in any way possible rather than being bottled up.
25.1%
39.5%
9.1%
39.1%
9.9%
14.4%57.2%15.6%
53.1%
41.6%
20.2%
Total responses 243 (multiple answers permitted) Drink alcohol 61
Do some sport 96
Prayer or religious act 22
Speak to a loved one 95
Watch TV 24
Read a book 35
Speak to a mate about it 139
Speak to a therapist 38
Try to keep my routine 129
Spend time alone in reflection101Nothing, I could handle thetrauma 49
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4) Engaging in physical activity was also rated highly (39.5%). The benefits of this to counter stress
are well known (Scully et al, 1998), but with caution on operators who maybe prone to steroid
abuse and the phenomenon known as “roid rage” where steroid abusers have been known to
display signs of aggression. This issue was also highlighted as a problem by in interviews A, B
and D.
5) “Speak to a loved one about it” (39.1%) reinforces the advantages of social media and recent
year’s technological advances such as Skype™; again it promotes communicating with someone
with whom the operator already has a rapport.
6) Drinking alcohol (25.1%) was a high percentage and a figure that was expected, as most
operators come from the military which has a culture of drinking (Interviewee A). This in itself is
not necessarily a maladjusted coping strategy, and can be viewed positively as a way of
unwinding and relieving tension unless done repeatedly and excessively.
7) A larger than expected (20.2%) replied that they “could handle the trauma”. This is a significant
and interesting outcome. It would warrant further enquiry should an individual answer this on a
pre-employment questionnaire for example.
8) Only 15.6% said they would consider speaking to a therapist, which shows the level of reluctance
towards seeking mental health care that exists.
9) Reading a book was not a surprisingly high choice at 14.4%.
10) Watching TV was a low response at 9.9%. This and playing video games of an evening is
probably considered as a routine stress coping/boredom relieving strategy, more than a reaction to
a traumatic experience.
11) Prayer or other religious act was a slightly higher figure than anticipated at 9.1%.
The 14 “Other” entries ranged from practicing martial arts to pursuing prostitutes; this is a known
maladjusted coping strategy. None of the respondents entered drug use during the survey, which
was surprising as Interviewees A and C claimed that a number of operators used recreational
drugs as a coping strategy while on leave. Many PMSCs on US contracts have to conduct
mandatory drug testing; this is not the case on other tasks (Interviewee B). Maladjusted coping
was raised in Interview C “Living on the edge and being addicted to adrenaline, some guys’ need
fixes, which leads to risk taking and this had become their new norm”
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5.8 Discussions on Research Question Three:
How could mitigations, coping strategies, interventions and therapies be enhanced?
Respondent O/024 believes that recruitment issues increase PMSCs risk;
“Risk mitigation in recruitment for task by companies needs to be better”
Discrete counseling is put forward by Respondent O/031;
”Guys need to know that they can go for mental health support and that no one knows that have
done this”
Respondent O/094 also provides opinion of what is required;
“Recommend approach based on life coaching and mindfulness training modalities, which
focus on present and future (rather than past) and avoid mental health treatment stigma”
Respondent O/118 highlights the need for a strong rapport with those who are offering therapy;
“Get GP’s and phyciatist (sic) to have a better understanding of ex-military and the issues they
have encountered and are suffering”
Respondent O/132 mentions the need for operators to have a certain level of resilience, but also
recognises a need for appropriate levels of care;
“This industry is operated and supported by risk takers. If too much emphasis is placed on
feelings and well-being, the atmosphere will change. We are here because we choose to be and
many of us feel as though we belong here. I feel that being rough and tough is better than being
psychologically coddled. With that said, if someone needs help, it should be quickly identified
by one's self and his team mates and assistance rendered ASAP”
Confidential support is also highlighted by Respondent O/284;
“Mental healthcare would be more warmly considered by people in this industry if the
services offered were discrete and undocumented or anonymous”
Respondent O/291 points to better recognition to mental health issues;
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“Lack of training in combat stress by medical staff, needs to be rectified”
There should also be realisation that this is a risky task, without over traumatisation. Interviewee C
recalls;
“That a proposed contractor pulled out at the joining phase when asked to provide DNA,
proof of life questions and next of kin details which is routine in case of death or being taken
hostage. This is a form of natural selection and for those who withdrew the task was not for
them”
5.8.1 Accountability
CSR obligations for those companies that employ operators in hostile environments should have greater
gravity according to Interviewee B and Respondent O/214;
“Companies have an obligation to monitor the welfare of their work-force and not just take it for
granted, that all ex-military are robots”
Figure 5.7: Signatory documents that companies are affiliated to. (Multiple responses permitted,
except the “None” option)
The survey statistics shown at Figure 5.7 reveal that over half the management responders stated that their
companies were not signatory to any of the above documents and this raises questions of accountability.
If companies were signatory, as is mandatory for PMSCs wishing to tender for contracts with the US
Government for example (Interviewee A) they are then eligible to be audited and to demonstrate
35
30
1417
11
0%
10%
20%
30%
40%
50%
60%
None ICoC Code TheMontreuxDocument
ISO:28007Maritime
ASISStandard
Total responses 69
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compliancy in all areas, including the provision for mental health well-being. Interviewee D is involved
with drafting mental health advice for the next version of ISO:28007. Awareness of the issues is raised
by Respondent M/033 who states;
“This topic and survey is necessary to share with international organisations that work in the
same area”
Interviewee A makes the claim that;
“Some companies pay lip service to these standards and merely see them as adding a kite mark
of credibility in order to strengthen their corporate image”
As covered in the Literature Review the above agreements can also be strengthened with regard to mental
health care provision.
Figure 5.8: Operators who perceived that their position would be at risk if they sought mental
health therapy.
This statistic strongly reinforces the theory that operators seeking mental health support are in real fear of
losing their employment by admitting perceived weaknesses. The current situation serves to drive the
problem underground where individuals will refuse to admit a problem. Companies must be persuaded
that seeking therapy should not jeopardise an employee’s position, rather a way of avoiding future risk.
So although as highlighted in Figure 5.1 there is recognition by all in the industry that mental health is of
79
7165
18 17
0%
5%
10%
15%
20%
25%
30%
35%
Very likely Likely Not sure Unlikely Veryunlikely
Total responses 250
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importance, there is an anomaly with the data displayed, that at best operators who sought therapy would
be “Not Sure” or feel “(very) likely” that they would lose their position of employment.
Table 5.D: The number of responding operators who stated that they had received mental health
support.
Answer Percentage Operators
Yes 16.4% 41
No 84.0% 210
Total responses 251
A slightly higher than expected proportion of operators (16.4%) said that they had received mental health
support. It is not known if this figure is inflated by those who had suffered issues being drawn to the
survey which was entitled “Psychosocial Risk Management and the PMSC Industry”, equally, however, a
number could have ignored the survey and avoided the subject. Of the 41 that replied “Yes”, 31 entered
data in the text box, which asked them to state what type of care they had received. Of note was
Respondent O/124, who claimed he was obligated to receive treatment after an incident, indicating that
he felt he didn’t need it, perhaps touching on the associated stigma;
“Was compulsory, didn't ask for it”.
Respondent O/159 alludes to seeking support of his own accord;
“My own therapist”
Also does Respondent, O/212;
“Privately secured psychoanalysis”
And Respondent O/284;
“Discrete counseling services”
It is not stated exactly why the above respondents sought treatment in this way, but “Interviewee D”
stated that his charity regularly treats PMSC operators discretely without the knowledge of their
employers for fear of embarrassment or losing their position.
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5.8.2 Training/Recruitment
These mitigating actions are all areas for improvements that can be made as was commented on in survey
feedback. The opinion of Respondent M/014 is;
“Some people that are supposedly trained to assess people are questionable. I have found
from experience and this part of the process needs stronger critical analysis”
Respondent O/079 highlights this requirement;
“There should definitely be more than a short power point on stress management at induction!!!”
5.9 Summary of Major Findings
This research used Skype™ effectively to conduct the interviews, which due to geographical locations of
interviewees was a practical and workable solution. Recent news reports point to trials that are being
under taken using that method for some Doctors appointments (Sky News, 2014) and there already exists
smart phone apps for mental health interventions and therapies (National Clinical Director of Mental
Health, 2014). Today’s younger generation are developing their cognitive behaviour and communication
skills through social media, although research suggests that human rapport and interaction are a preferred
option. Does the future lie here? For example, would it be suitable to provide an operator with therapy
using this method, especially if he were in a remote or hostile area of the world. The overriding factors
that are highlighted in the research are stigma, accountability and fiscal constraints, which are covered in
the following Conclusions and Recommendations Chapter.
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CONCLUSIONS AND RECOMMENDATIONS
6.1 Introduction
This final chapter incorporates the key findings identified within this study and presents the
conclusions and recommendations to it. Interpretation of the accumulated evidence is offered in all of
the research areas. The conclusions reflect all of the key points that were raised from the literature
review, the survey data and feedback and the interviews from key individuals. They focus on the
prime aim of the research which was to identify the level of mental health care available within the
industry, the existing mindset towards it and to make suggestions for consideration based on the
outcomes.
The conclusions initially comment on mitigations that could be implemented to negate or reduce the
risk of mental health issues to PMSC operators. Following this it proceeds to highlight coping
strategies and measures that can be employed to lessen the impact of stressors. Finally it will
comment on interventions and engagements that can be initiated as response to a PTE. Some of the
recommendations offered may take a lengthy timescale and require fiscal commitment; others require
no financing and can be implanted swiftly. Recommendations for improvement are made throughout
this chapter and are presented in a matrix at the end which takes into account resources required such
as costs, timeframes, responsibilities for adaptation and their likely effect.
6.2 Comparative Analysis of Existing Studies
The relatively few studies and available theories into this specific subject area have all highlighted the
issue of stigma as being a significant barrier to receiving mental health support. They all centred on
military combat and its effects on mental health, as the vast majority of operators have previous
experience there. These analyse the possible numbers of those likely to be effected by PTSD and its
bearing towards PMSCs (Christian-Miller, 2010) (Greenberg, 2012), (Isenberg, 2012), (Dunigan et al,
2013). This study differs in that it takes a deeper assessment of the cause rather than the effect of the
key issues, analysing a deeper understanding of the attitudes that are held by members of the industry
towards the subject. It has examined the key overriding factors that have a bearing on this subject
matter which are; stigma, fiscal considerations, and accountability. It has also served to provide a
deeper understanding of the attitudes that are held within PMSCs towards mental health which is key
to providing future solutions to the issue.
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6.3 Mitigations
These are all actions that can be considered by organisations, companies and operators prior to any
deployment to negate or lessen the impact of stressors or potential trauma. These numerous
mitigations can reduce the risk of stress, should all be considered on merit and incorporated into a
PMSC’s risk assessment. Many of these mitigating actions echo the adage that “prevention is the best
cure”.
6.3.1 Awareness
Societal attitudes towards mental health have improved in recent years and the anonymous survey
carried out for this study reveals that the majority of operators and companies within the PMSC
industry hold it in high regard. However, it will take some time before greater understanding and a
full acceptance of its importance and the role it plays in organisational resilience is fully appreciated.
Learning how to recognise potential stressors, the symptoms of mental health issues, how to develop
effective coping strategies and where to find support if required, should all be promoted by industry
led initiators. The culture, mindset and “Group think” that exist within certain areas of the industry
are still strong barriers to seeking care and warrant further efforts to educate and make operators
aware. For example, a worrying 20% of operators claimed they “could handle the trauma” after an
incident. Much more is required to educate and overcome the stigma or embarrassment that plagues
the issue of mental health care.
6.3.2 Accountability
A PMSC can be started easily, that said some of these companies have gone on to be established and
reputable organisations. This research revealed that many of these companies are young and
relatively small, and in addition to this, over half of the companies were not signatory to any form of
guidelines or best practice mandates. They had little or no accountability and scant incentive to cater
for mental health care, as they compete with rival companies for lucrative contracts. Greater
accountability by PMSCs would help to advance levels of care; these improvements should be driven
by greater accountability by those clients issuing the contracts to PMSCs. Contracting Governments
have a responsibility when issuing contracts and a duty to the psychological care of operators that
they deploy to hostile environments. Auditing by the vendors who award contracts to PMSCs in the
conflict zones, should confirm that they are providing appropriate levels of mental health support to
their staff. Stronger emphasis should be given to support in all of the commonly subscribed best
practice guidelines and mandates. Companies should state to their operators, that if seeking help they
would not be in jeopardy of losing their position and offer a route to counseling and therapy even if
done discretely, without the company’s knowledge if desired. It should be a contractual commitment
that any contractor asking or receiving psychological support would not have their employment
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terminated. The duty of care should also be extended for a reasonable length of time into the future
and offer a route to counseling or therapy which again could be received without the company’s
knowledge if required. It is easy to see that accountability and PRM programs are low priority for
PMSCs as they chase contracts, therefore as mentioned, those issuing the contracts are key to the
solution in regards to accountability. Insurance companies could also improve their CSR by
providing more comprehensive cover for mental health and offering incentives and better premiums to
companies that have full PRM programs.
6.3.3 Recruitment and Vetting
The role of a PMSC operator can be an arduous and fraught with challenging circumstances, but is
offset by financial compensation, which can be lucrative. There is a distinctive tier structure based on
the quality of operator which has a direct link to the quality of person and pay scales. As budgets
become more competitive with many companies in the market place vying for contracts, so pressure is
put on the standard of recruitment. With 90% of operators having previously served with a military,
there is also a high chance many will already have experienced combat and been exposed to PTEs,
therefore some operators may already present symptoms of PTSD or other mental health issues.
Operators have to be fit for purpose to conduct the task at hand and vetting is often conducted through
word of mouth with a management member either personally knowing the operator from their ex-
military unit or speaking to a friend that has. This can have its advantages, but serious consideration
should also be given to a more formal procedure to cover criminal record checks and a higher level of
due diligence. Even the larger companies treat vetting and background checks as a very low priority,
especially when in a rush to recruit and mobilise a large volume of operators in a compressed time
frame to satisfy contractual obligations. Some form of screening on attitudes towards mental health
and coping strategies should be sought during any recruitment for PMSC work. For example the 20%
of responders that answered “Nothing, I could handle the trauma” would warrant further scrutiny as to
their suitability to operate in a hostile environment. Another observation was that operators fall into a
category of being risk takers, they are fairly well paid and do a high-pressure job and would therefore
it could be argued fall into a category of being more susceptible to recreational drug abuse.
6.3.4 Training/Briefing
Many of the survey responses on training pointed to a requirement for improvement in these areas.
Ideally the minimum baseline that PMSC should implement is a lecture on recognising the symptoms
of stress, how to develop coping strategies and routes to where further care could be found if required.
At the very least, a hand out or email sent to operators with this basic information at time of
mobilisation is desirable. Further training should also be considered for those who have been
identified to inform NoK of bereavement of a team member, as the stressors placed on these would be
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greater. It is critical that it is made clear, that independent and wholly confidential treatment
pathways on any mental care concerns should be made available to operators to ensure that they are
not dissuaded from requesting help. This can be conducted in conjunction with an acclimatisation
stop over prior to deployment.
6.3.5 Acclimatisation Stopover
Preparing one’s self mentally prior to deploying into a hostile environment gives an operator time to
focus, for PMSCs that are well-structured and have their own facilities this can be the place where
PRM briefing and training takes place prior to deployment. These periods are advantageous in
gearing up and preparing an operator mentally prior to deployment. It can be an important
psychological stepping-stone prior to entering the hostile environment, in a similar fashion that first
responders to tragic incidents steel and prepare themselves to a PTE.
6.4 Coping Strategies
These are measures that will either improve quality of life while deployed, lessen the effect of daily
stressors, counter “burn out” symptoms, or act as a “shock absorber” to a PTE. This study has
highlighted that coping strategies are uniquely individual, personally chosen by each operator. They
must want to engage with these strategies in the same way that therapy cannot be imposed on
operators or they may simply reject it. The coping strategies vary widely from meditation, artwork
and yoga to the maladjusted coping strategies of pursuing prostitutes, excessive alcoholic drinking or
even narcotics abuse. Maladjusted coping/reactions to stress maybe difficult to police, except in the
case of drug and alcohol testing, but at least education should be available on their negative effects
and to where support can be found on these addictions.
6.4.1 Teamwork
A sense of belonging is a basic human need which can be more acute while in a hostile environment,
as survey feedback identifies a sense of belonging are high on many operators priority, it is important
as a coping mechanism and PMSCs should promote an “Esprit De Corps”. There are many small and
inexpensive or free steps that PMSCs can do to give their operators a sense of belonging, for example
a lottery syndicate or a regular team sport.
6.4.2 Manageable Rotations in Theatre
There is a juxtapose position between a desire for financial gain for operators and exposure to the risk.
This is recognised by companies and operators alike, those on flat salaries throughout a calendar year
do not have the temptation for unreasonable long periods in hostile environments. Salaried rather
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than a daily rate of pay would take away the temptation of operators to spend longer in theatre for
financial gain. This may be controversial and difficult to facilitate, but should be considered by all
PMSCs and policy makers. In a similar fashion that it is important for operators to relax and de-stress
on a daily basis, prolonged periods exposed to the stresses of a hostile environment may ultimately
lead to burn out or other psychological issues.
6.4.3 Life Support
Good living conditions and support including food, sleeping and washing facilities are important in
hostile environments. This is a controllable anti-stressor that can be achieved with some thought and
moderate costs to PMSCs. By providing the best living conditions and food available this can soften
the impact of other uncontrollable stressors. It would also have the effect of operators feeling valued
by their employer, which is another key point for improving morale and well-being overall.
6.4.4 Communications
It is clear that communicating as a coping strategy and or after a PTE is key. Good communications
with friends and family should be maintained during rotations in order to keep operators “grounded”.
Access to internet communications is an important means for operators to communicate and be
involved in much needed support networks.
6.4.5 Self-Development
This coping mechanism can take the form of learning a foreign language, undertaking an academic
program or learning a new skill. As well as being an effective boredom countermeasure, it has the
effect of empowering the operator by focusing on the future.
6.4.6 Support Networks
The revolution in social media has meant that support networks are readily available to operators who
have internet access, which is now becoming more available even to some of the remotest corners of
the globe. It can offer instant connection to like-minded people, a sense of belonging and camaraderie
which is key to many as a human instinct. However, a small minority of the internet groups observed
had a maladjusted mindset and septic environment where any form of mental health support was
deemed a weakness. Facebook™ and LinkedIn™ sites should be engaged with, as they are often
where new employment opportunities are advertised and are very well subscribed to.
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6.4.7 Physical Exercise
The use of sports as a coping strategy is a good way for operators to fill time. The promotion of a
healthy body and mind should be promoted and PMSCs should make every effort to provide facility
for this. As part of a daily routine operators should engage in a form of physical training.
6.4.8 Routine and Normalisation
Keeping to a routine is something that many operators subscribed to and is endorsed. This included
simple things, such as sitting down to a Sunday dinner together, watching a home town local daily
news broadcast. Many of these small steps seem to contribute to improving quality of life and state of
mind while in a hostile environment and make an operator feel normal. Finding a body rhythm that
works for each individual is key as a coping strategy.
6.4.9 Decompression Stopovers Leaving Theatre
These pauses before heading onward, often to family at home can have a beneficial effect of
unwinding for an operator, rather than arriving back home to family in a hyper-vigilant state, which
can cause friction in those relationships.
6.5 Support
The following section addresses actions post event, either after a PTE, or on the presentation of PTSD
or other mental health symptoms.
6.5.1 Post Traumatic Incident Support
It is recognised that early interventions are advantageous; however, offering support during the
immediate aftermath of an incident can be overwhelming. This cannot be forced upon operators as it
may have the opposite effect and they may reject it. The provision of adequate mental health support
should be made available by PMSCs post incident to ensure that contractors and their family’s needs
in this area are met. Operators indicated that “Speaking to a mate” was highly rated in the aftermath
of a PTE. This type of rapport is key to any intervention and PMSCs should consider training up
operators so that they can be effectively delivered in theatre. This peer-led support system, where
those receiving the initial help and have a strong rapport is highly advantageous. Confidentiality was
also shown to be important to many operators, as barriers to care of embarrassment and related stigma
are still evident, discrete support services may be the best approach to use in these situations.
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6.6 Horizon Scanning
The world 50 years ago had far different attitudes and fortunately there have been advances in how
health safety and CSR is applied in the work place, but there still requires a paradigm shift to allow all
barriers to mental health care to be removed and a greater acceptance of psychological support
without stigma. Looking into the future it is difficult to predict how technological advances may
affect the approach to mental health care, but today’s younger generations are growing up and
developing much of their cognitive behaviour and communications skills through social media.
Therefore it does follow that coping advice, interventions, counseling and therapies could be delivered
through this media. There already exists mobile phone apps that claim to aid in applying mental
health therapy and interventions; further research is required in their effectiveness and their
development. Mental health professionals should look into developing therapies that can be delivered
through these mediums.
Other recent technological advances of note that could have future bearing on PMSCs are recent
recommendations for UK Police Firearms Officers to deploy with body-worn video cameras for
accountability and evidence collection. It may be a while before this is made compulsory for all
PMSC operators, but future developments and calls for this type of accountability may introduce new
stressors for operators. Whilst already under extreme pressure and under certain life threatening
scenarios, they may now also find themselves with the added pressure that any recorded mistake
could end in a prison sentence in a far flung part of the globe.
6.7 Recommendations for Further Research
The use of social media as a support network for PMSCs.
The existence of mental health Apps for smart phones has come with the recent explosion of in the
use of social media (National Clinical Director of Mental Health, 2014). A worthwhile study would
be on its use a coping strategy, its influence and bearing on those that join groups. What happens if
people become overly reliant on it and cannot connect for a period of time?
The transition from PMSC contractor to civilian life.
There are numerous studies on the transition from the military into civilian life (Van Staden et al,
2007). (Frapwell-Cooke, 2010), (Buckman et al, 2011) (Blais et al, 2014). However, when
individuals migrate from the military to a PMSC they are in effect still in a military culture. Research
is required to study the effects after leaving a PMSC and moving into civilian life?
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6.8 Matrix
The actions and initiatives shown in the matrix start with mitigations (green), coping strategies
(amber), followed by post PTE actions (red). In each of these sections, they are ranked in hierarchical
order taken from the outcomes and findings from this research. The responsibility, likely costs and
time to implement are all displayed, but naturally there a many variables in these factors. It is
important to bear in mind that each circumstance is unique and these points should be taken and
considered on a case-by-case basis, as each situation and coping strategies is very individualised.
Key:
M = PMSC Management $ = Negligible T = Immediate
O = Operator $,$ = Moderate T,T = Mid term
1 = Signatory Documents $,$,$ = Expensive T,T,T = Long term
2 = Contract Vendors
3 = Policy Makers Mitigations
4 = Mental Health Charities Coping Strategies
5 = Industry Organisations Post PTE Actions
6 = Insurance Companies
Example:
A decompression stopover ranks sixth as a coping strategy (Amber) that would be implemented by
PMSC management, (M) it would take minimal time to arrange (T), but would be costly ($,$,$).
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Action Jurisdiction Costs Timeframe
A Full PRM Program M,2,6 $,$,$ T,T
Awareness M,1,2,3,4,5,6 $,$ T,T,T
Accountability M,2 $,$ T,T,T
Internet Communications M, $,$ T
Good Living Conditions M $,$,$ T,T
Training M,5 $ T,T
Contractual Changes M,2,6 $,$,$ T,T
Adequate Insurance M,2,3,6 $,$,$ T,T
Vetting M,2,5 $,$ T,T
Acclimatisation Stopover M,O $,$ T
NoK Bereavement Training M,O,4 $,$ T,T
Auditing M,1,2,3,5,6 $,$,$ T,T,T
Addiction Advice M,4,5 $ T
Narcotics Testing M,2,4 $,$,$ T,T
Social Support Groups M,O,4,5 $ T
Shorter Rotations M,O,1,2,3,5,6 $,$,$ T,T
Decent Life Support M,2 $,$,$ T,T
Physical Training O $ T
Good Food M,O $,$ T
Decompression Stopover M $,$,$ T
Routine and Normalisation O $ T
Esprit De Corps M,O,4,5 $ T,T
Daily Relaxation Period O $ T
Self-Development O $,$ T,T
Discrete Counselling Service M,4,5 $,$ T,T
Psychological First Aid M,O $,$ T,T
Incident Support M,O,2 $,$,$ T,T,T
24-Hour Help Line M, $,$ T,T,T
Psychological Follow Up M,2,3,6 $,$,$ T,T,T
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6.9 Conclusion
This study has taken a broad look at the wider issues surrounding PMSCs and the psychological well-
being of its operators. The conclusions and recommendations are all inclusive and many may seem
obvious, common sense and may be already be in place. The human element is key to the success of
all organisation, these are put under the microscope for individuals in hostile environments due to the
role being undertaken. The wide use PMSCs is likely to continue, as more and more we see those
performing demanding roles that Governments cannot fulfill with their military’s alone. They are
likely to be under greater pressure to operate in more remote and seemingly lawless areas of the
world, often with broken infrastructure that occurs post-conflict. Ex-military personnel that dominate
these PMSCs bring skills such as; discipline, fitness and training, conveying many good qualities that
are conducive for operating in complex environments. However, this can be offset by a “Bravado”
culture, where asking for help in mental health matters is regarded as a weakness. There is no doubt
that the role can be tough, demanding and the industry must recruit operators that are resilient and fit
for purpose. Most operators can be open to long exposure to the risk, the associated stress and may
even experience traumatic incidents and continue to function perfectly well, leading a normal life.
Some will even experience Post-Traumatic Growth, but provision must be made for those who are in
need of psychological support. A key finding in this study was that a staggering proportion of
operators fear they would lose their position if they sought mental health therapy, yet both operators
and management recognise that this is a very important part of their role. The significant findings
from this study will contribute towards improved “Mental Health Support for PMSCs in the 21st
Century”.
Dissertation word count: 21,981
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Student 21200319 Page 82
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APPENDICES
Appendix A: Methodology Flow Chart
Interview questions formulated
Interview A
conducted
Pilot survey
conducted
Survey questions formulated
Interview B
conducted
Literature review conducted
Discussions raised
Conclusions drawn
Recommendations formulated
Findings analyses
Management
survey added
Both Surveys conducted
Interview C
conducted
Interview B
conducted
Work-based Research and Dissertation
Student 21200319 A - 3
A checklist should be completed for every research project which is used to identify whether a full application for
ethics approval needs to be submitted to your Faculty Ethics Committee.
1 Applicant details
Name of Researcher (applicant): Tim Bomberg 21200319
Module name and number: Work-based Research and dissertation – SF701
Name of Module Leader: Gavin BUTLER
Course: MSc in Business Continuity, Security and Emergency Management
2 Project details
Project title:
“Mental Health Support for Private Military Security Companies in the 21st Century”
Please provide a brief description of the project:
I will post some questions on some of these internet forums (stating exactly who I am and the research
reasons) to see if there is a willingness to discuss the topic of mental health, which can be associated with a
perceived stigma.
No individual or company names will be mentioned.
3 Research checklist (to check if more than minimal risk)
Appendix B: Research Ethics Checklist – Postgraduate Students
Work-based Research and Dissertation
Student 21200319 A - 4
Please answer each question by checking the appropriate box:
YES NO
1. Does the study involve students within the University? X
2. Does the study involve employees of the University? X
3. Does the study involve participants who are particularly vulnerable or unable to give
informed consent: children, those with cognitive impairment?
X
4. Will the study require the co-operation of a gatekeeper for initial access to the
groups or individuals to be recruited? (e.g. students at school, members of self-help
group, residents of nursing home)
X
5. Will it be necessary for participants to take part in the study without their knowledge
and consent at the time? (e.g. covert observation of people in non-public places)
X
6. Will the study involve discussion of sensitive topics or illegal activity (e.g. sexual
activity, drug use)?
X
7. Are drugs, placebos or other substances (e.g. food substances, vitamins) to be
administered to the study participants or will the study involve invasive, intrusive or
potentially harmful procedures of any kind?
X
8. Will tissue samples (including blood) be obtained from participants? X
9. Is pain or more than mild discomfort likely to result from the study? X
10. Could the study induce psychological stress or anxiety or cause harm or negative
consequences beyond the risks encountered in normal life?
X
11. Will the study involve prolonged or repetitive testing? X
12. Will the research involve administrative or secure data that requires permission from
the appropriate authorities before use?
X
13. Is there a possibility that the safety of the researcher may be in question (e.g. in
international research: locally employed research assistants)?
X
14. Does the research involve members of the public in a research capacity (participant
research)
X
15. Will any of the research take place outside the UK? X
16. Will the research involve respondents to the internet or other visual/vocal methods
where respondents may be identified?
X
17. Will research involve the sharing of data or confidential information beyond the
initial consent given?
X
18. Will financial inducements (other than reasonable expenses and compensation for
time) be offered to participants?
X
Work-based Research and Dissertation
Student 21200319 A - 5
Research that may need to be reviewed by NHS NRES Committee or an external
Ethics Committee
NA
19. Will the study involve recruitment of patients or staff through the NHS or the use of
NHS data or premises and/or equipment?
X
20. Does the study involve participants age 16 or over who are unable to give informed
consent? (E.g. people with learning disabilities: see Mental Capacity Act 2005). All
research that falls under the auspices of the MCA must be reviewed by NHS
NRES
X
If any item is checked then an application to your Faculty Research Ethics Committee is required.
Applicant:
Name (please print): Tim Bomberg
Signed:
Date:16th August 2013
Module Leader: Please check the appropriate boxes. Even if the student has answered ‘no’ to all questions in
Section 3, the study should not begin until all boxes have been checked and the form counter-signed.
The student has been made aware of the University’s Code of Good Research Practice and relevant
professional codes of conduct
The topic merits further research
The student has the skills to carry out the research
The participant information sheet or leaflet is appropriate (where applicable)
The procedures for recruitment and obtaining informed consent are appropriate (where applicable)
Comments from Module Leader: Gail Rowntree
I am happy to support Tim Bomberg in his research.
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Gail A. Rowntree
Module Leader:
I confirm that work as described will be carried out in full conformity to all ethical standards and any
additional professional requirements.
Name (please print): Gavin BUTLER
Signed: [email protected]
Date: Dec, 2013
Module Leader to send completed form to the Research Unit ([email protected])
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Appendix C: Screenshot of Survey Agreements
Operators Questionnaire Agreement
Management Questionnaire Agreement
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Appendix D: Example of Interview Consent Form
Tim Bomberg
Saqr Port Authority
Government of Ras Al Khaimah
United Arab Emirates
PO Box 5130
Informed Consent Form
Title of Work: Mental Health Support for Private Military Companies in the 21st Century Name of Researcher: Tim Bomberg
1. I have read and understood the attached information sheet giving me the details of the study to be undertaken by Tim Bomberg
2. I have had the opportunity to ask Tim Bomberg any questions that I had about the research and my involvement in it, and I understand my role as a participant
3. My decision to take part (consent) is entirely voluntary and I understand that I am free to
withdraw at any time until 21st March 2014 without giving a reason or being penalised 4. I understand that data gathered in this study may form the basis of a report or other form
of publication or presentation in the future 5. I understand that my name will not be used in any subsequent literature, publication or
presentation, and that every effort will be made to protect my anonymity
Participant’s name (In Capitals ): Participant’s signature:
Name: Tim Bomberg Researcher’s signature:
Date: 1st March 2014
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Appendix E: Authors Previous Experience and Reflections on PMSCs and
Mental Health Care
The author previously served in the British Army for fifteen years and subsequently went onto work
inside PMSCs in the position of a team leader with an armed mobile security team and later low profile
(covert) close protection duties. He also undertook a role as a United Nations Field Officer for the Iraqi
Referendum and Elections in a violent period of Iraq’s post-conflict era. He has trained as a master
practitioner with a UK mental health charity, which specialises in delivering interventions and therapy to
ex-service personnel and emergency first responders. His reflections are that he found the transition from
military to civilian life challenging at times and can see how some ex-servicemen find a cultural “comfort
zone” inside of PMSCs. Attitudes towards mental health in the military have changed for the better in
recent years, but this has yet to migrate into the commercial sector, namely PMSCs. The vast majority of
operators are professional and resilient and most recognise that spending too long in high-risk areas has a
detrimental effect on psychological well-being. He noted that coping strategies or boredom counter
measures were uniquely individual and that de-compression stopovers were highly recommended to stop
operators returning to families while still in a heightened state of vigilance or hyper-tension. On work
undertaken with the charity he noted that a key element to therapy being successful was for those seeking
it to have a strong rapport with those delivering it.
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Appendix F: Further Comments Submitted by Survey Respondents
Management on what improvements can be made in the approach towards mental health with the
industry.
Respondent M/005;
Greater awareness
Respondent M/011;
“There is a lack of knowledge within the industry, therefore awareness and pre-employment
screening”
Respondent M/019;
“Yoga”
Respondent M/028;
“Monitoring and councilling (sic)”
Respondent M/029;
“It should be compulsory for extensive background checks, instead of using contractor supplied
referees. Often the symptoms of stress are undetectable with a test, and will only manifest in the
field”
Respondent M/037;
“Stronger vetting procedures”
Respondent M/039;
“Better pre and post-deployment screening, reference checking etc”
Respondent M/044;
“A company mental health chapter to be included in health and safety guidelines”
Respondent M/056;
“Training, increase awareness and access to counsellors”
Respondent M/069;
“The labour laws of countries individuals are contracted under need to be taken into
consideration when looking at this aspect”
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Respondent M/080;
“International guidelines to support menthal (sic) health in risk works”
Respondent M/089;
“Pro-actively adressing (sic) the subject; most employees don't want to accept or recognize the
effect of their work on their mental health”
Respondent M/102;
“Support groups operated by people who have been there”
Respondent M/107;
“Proper assessments before starting work”
Additional Comments supplied at the end of the PMSC Surveys
Respondent O/322;
“Proper training prior to going to the high risk zones, people see £££ signs and go. You have
to think it through as it is enjoyable if you have a good team”
Respondent O/297;
We don't choose to be affected by trauma. It becomes part of us.
Respondent O/181;
“Many will not seek support for fear of being labelled (sic) and restricted from further
deployments. It's easier to 'suffer' alone if you want a career
Respondent O/160;
“PTSD happens to everyone in combat, time and distance help with most if not all the
symptoms”
Respondent O/152;
“Note the huge difference in aid between returning within a regiment structure, with mates and
shared experience and as an individual, with companies or TA returning alone.
The following was entered by Respondent O/005;
“Contracting companies should be made aware that this is a problem and that to simply replace
the contractor as you would a faulty piece on a car is not a solution”
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Respondent M/079;
“On recruitment, the problem is most companies need to just fill posts, i.e. bums on seats and
vetting is done by word of mouth usually.
Respondent M/037;
“Medical insurance provided by companies to operators traditionally ceases when the operator
stops working for the company. Unfortunately symptoms of mental illness can appear after
employment ceases and the operator has no cover. Looking at this aspect would be of benefit
for operators, company reputations and society at large”
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Appendix G: Transcript to Interview “B”
Interviewee B
Interviewer identified as R.
R & B - Ethics protocol and pre-amble…
R – I would like to interview you specifically with your views coming from a background of delivering training to
the United Nations on psychosocial risk management, their approach to it and how that differs with private military
security companies in your view. Okay?
B – Okay
R – I will start by asking you the questions to my research, which are general questions here. Is the current level of
healthcare adequate and what is the existing mind-set towards it and I am talking about private military security
companies rather than the UN there.
B – Okay if I can just start by telling you what I think was in place when I was Head of Security for the UN and then
compare it with what I believe was in place with both large and small security companies as of today. For example,
within the UN there is a Critical Incident Stress Management Unit. It was created in the year 2000 and the mandate
to that particular unit and its staff were given it by the UN resolutions, which addres s things like preventative and
critical incident stress management, the assessment of staff psychosocial needs and status, coordination with stress
management and training related activities and pre and post deployment training which are all part of UN
resolutions. You can look them up under the numbers if I can send them to you separately if you want, which are
quite formal mandate that the UN placed on this unit to look after the care and welfare of its staff and you can see it
covers quite a lot of things. The difficulty I think both medium and small private security companies have is they do
not have the assets in place. One: because they are quite costly, two: because it would have taken their eyes of what
the actual the contract they are trying to win and thus you end up with small teams and people who are probably not
as well supported from the psychosocial aspect as people who work for this really large organization with its world
wide deployment.
R – Okay so funding you think is a major. Funding and accountability you rather brushed on that as well.
B – One of the problems small companies have is they bid for a contract they don’t necessarily have the assets in
place to actually fulfil that contract until they are told yes it’s a go, this contract is a go and then they have two
weeks to get a bunch of guys together, guys and girls together to go and deploy them and to carry out the tasks.
That doesn’t allow those people gel into the teams that perhaps you and I were used to in the military i.e. you ’ve had
years of getting to know who you could trust and you can’t trust and that team building which is one of the
fundamental things of military uniform units and even to some extent in the UN where a lot of people know each
other over years, you’ve got a short notice getting together periods and thus there is probably more stress on the
individuals in those ad hoc teams that a company puts together than there is you know its maybe slightly different in
the larger companies who would tend to retain people longer and aren’t just doing it for the one contract, although
you and I both know that that is not necessarily the case that people are just thrown together for a six month
contract. That is one thing and the small companies just do not have the outle ts or the cash to be able to run, you
know a full time psychologist to do the interviews or to get the people in place. Those who are suffering from PTSD
and who have been screened and assessed.
R – Yes and but what about the people who are issuing the con tracts, does the solution or some of the answers lie
with them that they should be insisting that they’re getting the correct PRM in place?
B – The government organisations tend to take it slightly more seriously although even in the duty of care
documents that are issued by for example DFID (Department for International Development) it says nothing about
you know, the companies responsibility as of yet that I’m aware of, as of yet that you know, they have to have
certain things in place. Perhaps more pres sure should be put on donors, governments, UN for example itself. UN
issues contracts just for companies to do certain things in the security sector, when the elections come around
because they need to ramp up a hell of a lot of security people over a very short term.
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R – Okay, interesting. Okay I’ll move on to the next question, and again your sort of views broadly on this and more
to do with private security companies in the UN. This is part of the research question. What are the unique stresses
that private military security companies’ face in their operating environment and what are the best coping strategies?
B – What I’ve learnt is, I’ve already alluded to in the first questions in that, you can deal with most things if you are
surrounded by a bunch of people on a daily basis that you know extremely well, that you know their families so that,
in companies it is isn’t like that. You arrive in your team from all parts of the world, you have no idea of the
backgrounds of the other people, and thus you are more inward looking rather than outward looking when you
actually go out and do a job and that places more stress on you, mentally, physically sometimes because you don’t
know whether you can rely on other members of the team. That changes over time of course but by that stage you
have been stressed to such an extent you may actually make duff decisions, because you are not quite sure what
everybody else in the team is going to do. That is a unique stressor I think, in private military security companies
and there is no large organization in some cases, to back you if something goes wrong. If you’re out in a fo ur man
team in a warehouse or somewhere or wherever it is, that’s it until you know, three four hours later if your company
comes and sends someone to get you out of there if your company once you come under attack. That must make a
difference. One of the best coping strategies, the best coping strategy I would suggest is that, there needs to be a
period of training, assessment to put the right teams together to put the right guys working with each other, to be
able to face up to those challenges.
R – Okay, very interesting. You are talking to us from Libya there, what are your sort of coping, I see you like to
watch the rugby, you like to fill the time. In some of these places, I guess boredom can be a stressor in itself, or
filling the time, or not taking your mind off external pressures.
B – Particularly at times when it is not advisable to go for a ride around time, we are certainly not capable of
walking the streets and things like that, we used to, but now people are being picked up at gunpoint alon g the street
fifty yards from our villa here. So you do tend to get cabin fever after a while and you know, twice a week you say
‘I have to get out of here, I have to go and do something’ and I totally agree with and I’ve, happily I’ve seen some of
the answers in the Libya survey is you need some sort of support externally and that includes the Skype, that
includes the communications with friends and family to those in place if only to vent at someone and then you can
know the shitty-ness of the weather or whatever it is or its either your partner, it’s your wife, it’s your girlfriend or
whatever and you need some sort of venting mechanism inside as well, but in very very small teams you really don’t
want to upset the balance and it’s all very well talking to a mate but he’s got to be a real mate.
R – Very interesting. The next research question which you probably answered most of it already, is how could
mitigations, coping strategies, interventions and therapies be enhanced?
B – The difficulty is, interventions have to be delivered by someone you trust. You have to have some sort of
training to recognize the signs. Now most of the guys and girls will recognize the signs of stress in each other and
as you well know in the uniform service people will rib each other mercilessly, endlessly in things like that and in
most cases that works. In some cases, it does not and in some cases the guy or girl really goes off the rail and he
goes tilt. The difficulty with small companies operating in these sort of environments when you’re in an oil field
300 miles off the coast, when you’re in an airplane once a week maybe, it’s quite hard to be able to intervene if
you’ve got someone who has gone tilt and your surrounded by three brigades of militias who prevent all mo vement,
what do you do in those cases? Very difficult problem.
R – Ok great. I am going to go on to some of the key findings from the research now, which I have shared with you
and get your views on them. The issue of stigma surrounding the topic still exists and tellingly, the majority of 80%
of operators were either not sure or found it very likely that their positions would be at risk if their employer knew
that they were seeking mental health therapy. That is quite a strong statistic there.
B – Which is why the work you are doing is really really important. The more that we talk about it, the more that
we force employers to consider it, the more that they’d understand that actually knowing you’ve got a problem is
80% of the solution, the easier it will be to address this problem and better the fears of the individuals who worry for
their jobs will be allayed, because if a guy recognizes he’s got a problem and needs to talk to someone about it, well
he’ll get bonus points for that. Even if he is not available for a month or so to do whatever it is that he needs to have
done, because he is actually seeking active treatment and treatment will make him a better person and operator at the
end.
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R – Excellent, Okay. You’ve mentioned about teamwork and speaking to mates or people that you have got a bond
with or rapport and this reflected highly in the survey responses where peer support, the highest was 57% stating
that they speak to a mate about it after a traumatic event, however 20% said they do nothing as they could handle the
trauma, or they felt they could and only 15% said that they would consider speaking to a therapist.
B – I am actually quite surprised that 20% claim they would do nothing as they could handle the trauma that is quite
a high percentage. One of the fundamental reasons, well one of the big reasons that we have things like in the UK
like the British Legion is ‘cos the old bods from WW2, the Korean war, whatever it is, get together and share the
experience of those days, because it tends to make you feel better. Because you have a shared experience, you have
seen the dead bodies; you have seen say, sort of traumatic incidents and you are not on your own. That 20% could
do, say that they could do, you know, solve this for themselves I find quite surprising!
R – Okay, that is interesting, well you have brushed there on that social support and that social support is key and
shared experiences and bonds is also very important. Okay, what else, internet communications, shorter rotations in
theatre, decent living conditions they were all ranked high which is unsurprisingly, well surprisingly; shorter
rotations for some runs counter with the desire for financial gain. However, obviously the shorter that you are
exposed to the risk, the less chance there is of a problem. So that is a bit of a conundrum.
B – I totally agree and the individual operators that are working under private industries are under competing
pressures. One is they’ve got you know, a serious mortgage to pay off in the UK, which forces them down the road
of going to slightly longer rotation perhaps they only get, in most cases they only get paid for the time in the area of
operations or whatever it is and don’t get paid while they’re out, so they’re competing with each other , actually
forcing them down the road of taking more long term engagements and longer rotations which actually may not be
that good for their mental health. Having said that, when people join the military and things like that, we used to,
they go on exercise and after a week after two weeks in the field you’ve won the war and you go home back to your
barracks and clean up. Real operations as everybody has found out, in Afghanistan, Iraq or wherever it is go on for
months and months and months and months and months and you know, years in some cases. Therefore, you are in
or out.
R – Okay interesting. Another point from a survey we brushed on accountability is 51% of companies’ survey, or
over half, were not signatory to any codes of practice or codes of conduct or best practice.
B – I find that quite surprising. I would have thought that in those, those placing the contract actually it would be in
their interest if the companies they hire to do this stuff has actually signed up, has a proven record of t raining, and
has a proven record of being signatories to something or other to best practice if nothing else.
R – Best practices themselves don’t actually mention much about mental health care within them and it’s been said
by others and I’ve got your opinion, do some companies sign up to these papers, or best codes of practice or what
have you, to just add a mark of respectability to their company anyway, pay lip service to it.
B – Well you could question the whole thing, I just do not know, the whole ISO system as well is a topic is it not?
You know, people who if you pay enough money you can get yourself signed up to it, as long as your procedures are
in place that fine, it’s a respectability, the pressure has got to be on to get those companies to actu ally look after their
staff, both pre and post engagement. Trouble is if you are in the commercial sector, there is no encouragement for
you to do so. Once the jobs done after four months or the contracts over and finished, that is it you are looking for
new work, you are looking for other things but the guys who have actually been used are back on their own.
R – Interesting. Okay, I have to go on to a few more points here. Generally, do you see any differences in
approaches between the subgroups? By the subgroups you know we have maritime, static guarding, mobile
security, mobile security being overt or low profile, you know like different personality profiles being chosen for
low profile than static guard, is there a better sort of resilience? Is there a better emotional intelligence?
B – Well there would be if you say anything about the companies, because some tasks are a damn sight harder than
others and those who are doing mobiles and they’re driving for hours of the day and are at risk and may be attacked
at any time, one would expect them to be better trained, more capable of making rational and correct decisions and
things like that. It must be quite, it is a quite specialized job. Static guarding is not so specialised. In maritime
sector you have to have a particular personality at the end of the day, because being on lock down on the ship for
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whatever it is, it could be two months, it could be three months, whatever it is you know, living, sitting in a tin box
takes a particular mindset. Personally, I could not do it but you know, especially because you do not have any
choice, you are totally reliant on your two or three teammates.
R – That’s interesting, that’s quite interesting and you know, it goes on to sort of, not part of the survey but research
for submariners and working in confined spaces and isolation for long periods of time and how that affects stress
that’s very interesting.
B – And that requires a serious psychological assessment before you do it, unless you want to have problems like,
you know for example, the XXXX incident, not that long ago.
R – Okay very interesting. Okay, moving on; your views of the future in regards to private military security
companies and mental health. I’m talking about perhaps delivery of therapy via social media, Skype or so on and so
on, body worn technology, what about things like for example the IPCC in UK recommending looking at police
officers, armed police officers and where video cameras going into instances. I know it is a bit removed from
private military security companies, but is it. You know, five or ten years’ time are we going to see that private
military security companies have to deploy with video cameras, which could be accountable?
B – I am loathe to give an opinion at the moment because I don’t know what the particular stresses on those, well I
know what the particular stress on our anyone who’s armed in the service is, but having, would you be able to forget
about having a camera and being even more accountable for every one of your actions? These days if you shoot
someone I presume in the police your still, immediately in suspicion until the enquiry is over, until the independent
police authority, the police authority has done its investigation and things like that. Will the camera aid or assist?
The camera gives a single viewpoint. It does not give the background of what is happening behind your back and all
the other things. I mean there are all sorts of arguments for and against. I am not sure it adds anything to the
equation.
R – They are also talking about putting police officers after a shooting incident, in 36 hours isolation, where they
have to give their statements, which in the 36 hours after an incident is where they need the social support the most,
where they need to communicate.
B – Absolutely.
R - So there is a difference of opinion there between the evidence gathering and a recognition that social support is
vital in those 36 hours after an incident.
B – I reckon we and I mean in an ideal world there should be a heck of a lot more professionals who’ve had the
mental health training to be able to assist guys and girls to get through a trauma incident. That needs to start early
after an incident. Now whether a camera will help or hinder an investigation that is up to the government. I am not
sure, I am not sure.
R – I think there is actually research that suggests a sort of a goldilocks approach to when the therapy should be
delivered. It should be offered too soon after the event, immediately after; it should not be too late, but at a specific
timing point, which is goldilocks just right. Okay I will move on to, I mean we have mentioned sort of social
support and social media and you have mentioned things like you know, associations, shared and common values.
You know this week; the internet in its entirety is only 25 years old. So you know, where are we going to be in
another 25 years when it comes to social media and social support.
B – Perhaps therapies will be able to be instantly delivered to the watch on your wrist in full HDMI wherever you
are in the world.
R – Well exactly, so I mean, so should people be starting to develop therapies and interventions that can be
delivered via those means?
B – You should discount nothing, until we have tried it, tested it and actually seen the results out of it. Hey, how do
humans learn? They try, they test, they fail, they improve, whatever. It should not be discounted, especially
because we are working more and more remote areas and you need to have the access.
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R – Yeah, I think your view on this, with today’s younger generations, being brought up in a social media bubble
perhaps and it’s the way they’re developing their communication skills and it’s th e way they’re developing their
cognitive behaviour and relationships, does you know, does the future lie with delivering therapy through that
media?
B – The problem is I come from the old school, I want to see the look in the guys or girls eyes when I’m ta lking to
them, but if I feel I’m not getting some sort of feedback that makes me feel better. If I am not getting the personal,
because it is all about personal relationships at the end.
R - And rapport. But I mean, you know if that person is in a remote and hostile part of the world and it meant that
you going.
B – Hey if that is the best you can do then that is what you have to do.
R – Okay, very interesting, thanks for that. Okay teamwork we have covered, a few points here, which have come
up: humour, we have mentioned humour as a coping strategy and we have mentioned about the military before and
how that is forged.
B – The difficulty with the humour bit is it is not actually politically correct or whatever, but I do not discount it
because at the end of the day if it stops you going off the deep end it’s done its job.
R – Brilliant. Okay your views on acclimatisation stopovers going into theatre, decompression stopovers coming
out of theatre.
B – Acclimatisation what does that actually mean? Does that mean stopping somewhere halfway and getting some
cultural background.
R – Yeah maybe, a place where 24-hour, that sort of stopover perhaps where in an ideal world training could be
delivered, or if you’re going into a particularly hostile area you’re s tarting to gear up and getting your mind focused
on the job.
B – Sometimes you get more anxious hanging about rather than getting in there and getting it done. I am not sure. I
am not against it.
R – Okay what about coming out, you know rather than going straight back to your family.
B – Coming out? I think it is seriously required. One: to just detune. I can I mean, leave this in or take it out, my
first tour to xxxx as a twenty-two year old where having being spat at by women and shot at and all th e rest of it,
coming out and having time to decompress before going back to loved one’s was essential.
R – Okay, thanks very, very much for that it was extremely interesting.
B – You are most welcome.
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Appendix H: Transcript with Interview “D”
Interviewee D
Interviewer identified as R.
R & B - Ethics protocol and pre-amble…
R – Okay XXXX thanks very much for joining me. I will kick off and go straight into the research questions that I
have posed for the research paper and that is, the first question is:
R – Is the current level of mental healthcare adequate and what is the existing mindset towards it?
D – And you are talking about people in the PMSCs ?
R – Yes private military security companies .
D – Across the board?
R – Yeah
D – Okay so, in my view there are a couple of challenges you see. The challenges are is, are people who go into the
industry go into the industry because they’ve left the service, they liked it, they see its good money in security
industry or do they do it because they don’t feel they fit too well in the rest of society, they try to fit in. And we
have very limited data don’t we of that available. I think probably the latest data that we have available is the
RAND report, which I am sure you have read. It’s probably the most important clearly in those who have not made
the transition from military to civilian life well are going into PMSCs and suggests that actually its more likely to be
the latter definition which is there not fitting in well. Because they are not well. Most of t hem still are obviously
but some of them go into it because they do not fit in well elsewhere, which therefore means that they are at risky if
not more risky than people in the military.
R – Okay very interesting, very interesting.
D – And that is kind of why they do it. Is the level of support enough? My view is it varies hugely amongst the
industry because some companies have put a lot of time and money into it and others have absolutely nothing at all
and pay lip service to it.
R – Okay, that is very interesting. Okay I’ll move onto question number two and that is: what are the unique
stressors that private military security companies’ face in their environment and what are the best coping strategies?
These are general questions for the industry as a whole.
D – Are you talking about the companies basically or the individuals?
R – The individuals, individuals but then, yeah let us stick with individuals at the moment yeah.
D – Okay cos I think actually one of the things I will say is, have you read our paper Messenger et al, because one of
the things that came from that is the financial draw, although it is a small sample that gives quite an insight into
exactly this question. So I think there is the, there is the lure of the money, which is a good thing but also it is not
always a healthy thing. There is a distrust of locals
R – Why isn’t it healthy XXXX?
D – What in terms of the money thing?
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R – Yeah
D – Because it basically means that people may put aside some concerns they have on one side becau se, well what
they should be concerned about is the money over complex concerns, they’re real concerns. On the other hand,
what they might get working in XXXX (a supermarket) or as a plumber or as a someone involved in a regular
civilian job.
R – Which is safer and doesn’t have the same stresses or risks?
D – And have more opportunity to establish themselves in civilian life don’t they? One of the most challenging
things for military is transitioning into military life. Being a private military security contractor kind of delays or
stops that transition.
R – Do you think the high money and the high risk is there a predisposition to sort of maladjusted coping strategies?
Maladjusted behaviour?
D – Maladjusted people more like, I need to be really careful here because I think it’s important to say that most that
are going into the industry are sane, they may be reasonably adjusted but the majority are absolutely doing it for the
right reasons.
R – Quite resilient, good set of people and doing it for the right reasons.
D – But there’s an important minority that could have a disproportionately large effect on their company and also on
the industry as a whole because the XXXX incident the contractor who was reportedly hired by XXXX despite
warnings on hid mental health condition and shot and killed two colleagues and the XXXX incident when they
opened fire at XXXX, killing civilians, these have huge ramifications.
R – Yeah absolutely.
D – And an important minority who don’t cope well and who’ll be trying to take military coping strategies of talking
to your buddies, which doesn’t always work you know the whole Iraq thing has gone quite quickly, you know, your
buddies who are locally employed, three westerners employed with twenty local people working for you, y ou don’t
get the choice of who you speak to. Your back up, god forbid if you’re involved in an insurgent attack on convoy
duties, no one comes to rescue you in the same way. So I think, I think the challenges are similar but they are
different and I think most people take the military approach to it and try to but it doesn’t always work directly.
R – I have had some very interesting feedback about support within a military structure and then that not being
available inside the PMSC. Okay I will move on its how could mitigations, coping strategies, interventions and
therapies be enhanced. The whole lot in there and that includes companies and individuals.
D - One of the things I am doing is I am the President Elect of the XXXX and we are drafting up a guidelines for
organisational stress management. Now this is for all organisations that particularly/predictably place people in
harms’ way, and clearly including security companies. So I think in terms of that, the prevention key mus t be, that
initially the company have to have a policy or guideline that addresses it, they have to train their managers a little bit
about it. They have to make sure they take on the right sorts of people, and also that’s screening but then there is
some basic things you should be doing. They need to make sure that the medical certificates they get are not just
from a GP who thinks that this person works in a supermarket. Then they need to make sure that when people are
going to develop problems, which they will, that their own protection systems in place, they need to have peer
support, they need to have managers, you know, team leaders and in -country managers who are aware of mental
health issues and they need to have a monitoring type process in place to make sure that people’s health, cos people
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aren’t really honest with their companies sometimes because they’re getting paid and either they’re contracting you
are is as good as your current job.
R – I think the feedback we have is that they are not going to be honest with their companies because a lot of them
are fearful of losing their position if they admit to an issue.
D – Yip and that is frankly true isn’t it? They have no contract, they have no protection. So I mean there are early
protection systems that lead to good peer support and early intervention and on the treatment side if they do get
treatment, which is pretty unlikely as you said, they get through to a fast track evidence based treatment for
whatever they’ve got going and I don’t believe the companies could hold their job open but the companies should
not be averse to taking people back on if they have received care and are better.
R – Okay that is great. Now you’ve kind of moved me on to the next point which are your views on the research
key findings and that’s: The importance of mental health care was highly recognised by the survey, with 71% of
operators saying it was very important and 51% of management which was a little b it lower but the main point is the
issue of stigma surrounding the topic and tellingly 80% of operators said that they felt it would be likely or very
likely that they would lose their position if their employer found out they were seeking therapy. What a re your
views on that? I mean it sort of barriers the pathways to care and stuff, the stigma. What can be done there about
breaking down the stigma?
D – First it is important to say that when we look at stigma in the British military and when we looked at stigma in
the civilian population, you are still looking at 70% to 75% of people with mental health problems not getting help.
So you’ve got to take into background that most people whether they’re security contractor or not, don’t like getting
help but in this industry where you don’t get help and you’ve got a problem, you’ve got a XXXX incident or a
XXXX incident so you’ve got to fit in and you got the best team possible that are mentally fit for purpose or this will
have consequences because you’re not concentrating. I think security companies, to perform to a higher standard for
their customers, need to make sure that their people have the best mental health. And if you really believe the
RAND report that 12% of ex-British security contractors have PTSD and that means they’re going to be functionally
impaired, if I’m going to Iraq or Afghanistan I want someone who hasn’t got a mental health problem, will be
mentally stable and alert and able to conduct their task.
R – Yeah well in general, well someone who’s been and sorted it out and is back and back on their feet?
D – Oh that’s absolutely fine, I don’t care what they had in the past, as long as they’re well now that’s absolutely
fine.
R – Okay I am going to skip through these quickly. We have brushed, we have touched on accountability and to a
signatory document and I know that you are doing work there, can we just sort of, I mean is that where part of the
answer lies? Is it accountability for companies that are being awarded the contracts by th e British government, the
US government, that they are all legit? That they have good PRM in place.
D – There’s a couple of questions, one is that if you’re a company that employs security contractors you need to be
interested in making sure that the people that are protecting you have the highest state of mental health they can.
That is not because you’re nice, that’s because you want them to do a good job. So there’s that point, so as a
company that employs security companies, you should be demanding a high level of mental health and if you’re a
security company as well because you want people to have a good customer focus and to perform well because
that’s good for your business, again you want to make sure that you look after your people and also the last thing if
you want to recruit the best people to your organisation you want to make sure that your providing them with a
package that makes them want to come to you and not to someone else next door. Like you said already a lot of
security contractors think it’s important.
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R – Yeah that is good, so it is not just corporate social responsibility it is more.
D – It is the company and it is the companies that use security companies.
R – Okay very interesting great, ah I’m going to flick through these ques tions now. Do you see any differences in
approaches between the subgroups? By subgroups, I mean static guards, maritime security, demining, mobile
security, low profile, high profile; do you see any difference in approaches?
D – Yeah I do because; well if you’re on convoy duty and if you’re in Afghanistan the risk of traumatic exposure are
pretty high. If you happen to be in maritime security duties you know, going through the Arabian Gulf, your risk of
sunburn is pretty high. There is nothing wrong with that but the boredom factor can take over.
R – There are other stresses involved that are unique to this sub section of PMSCs in your view then?
D –In maritime security, although everyone needs to take trauma seriously, I think where you are isolated from the
usual social networks; I think the boredom factor is really important. We just did a study looking at remote area
medics, nothing to do with security industry and it is quite important in Iraq in the oil fields, one western medic and
of course they are not traumatised but they are depressed due to the isolation.
R – This all adds in XXXX and then the depression could link to something or if th ey were to experience a
potentially traumatic event in that state then they are less resilient perhaps.
D – If you happen to be on a maritime security team on a vessel in the Arabian Gulf and you’ve got to spend hours
looking out for possible attacks and pirates, you want the person to be switched on, whether they’ve got you know,
if they’ve got depression or PTSD neither are very good for functionality.
R – Okay great. Okay your views on the future in regards to private military security companies and mental health?
I’m talking about things like therapy via Skype, I’m talking about body warn technology, you know we’ve seen
things in the media recently about body warn technology, it detects insulin levels regularly, you know like heart rate
monitors and things like that but it causes our levels perhaps, ah also the body warn technology I’m thinking about
the IPCC the police report on head worn cameras for firearms policemen, is that going to be coming to private
military security companies in the near future and the added stressor of you know, if you make a mistake. There is a
lot there so what do you, where’s the future?
D – So I think the future hazards on the mental health side, rather than in, in that, as time goes on the ISO:28007, the
developing ISO:28007 will set in hopefully a guide saying, not that you have to do one thing but you have to have
support principles of protecting, preventing and treating and that, therefore if you are in deep trouble in a company
you could exercise your duty towards your contractors by following the guideline. So companies who don’t do that
are going to not basically get business and that will be good for everybody I think. In terms of the stressors I think
boredom is a key factor in terms of remote services there’s really good evidence that instant messaging, that Skype
that even text messaging self-help, that those sort of things make a difference and so if you’ve got people who are
static environments with no threat then actually if they start to develop problems t hey get to intervene early rather
than waiting until their next period of leave.
R – Yeah or it’s a hostile environment and the therapies can’t perhaps get there and so yeah technological advances
are great you know bearing in mind this is a available.
D – Yeah but I still go back to the fact that although you can deliver good therapy advice with things like Skype, the
bigger things people aren’t going to come and ask for it unless you’ve got an environment in which they can put
their hands up and which their peers can go ‘come on mate you need to get yourself up and’
R – Get yourself better?
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D –Yes and ask for help and in terms of the stressors yeah we’ve got a bit of work next week actually about the
IPCC thing about the fact that if you isolate police officers after they’ve shot you know, after 36 hours, what we
know is that, for PTSD that social support in the early environment is a key factor for whether people do well or not.
Now if you remove them from social support, preventing them from gaining an u nderstanding then you are going to
potentially cause problems.
R – Okay and talking about that sort of psychological first aid, when is the best time, is there a goldilocks sort of,
you know, is it too soon then its rejected, too late it not effective, or a just right time?
D – If you are talking about what should be done early on, then I think it is not mental health care because that is not
what, it is about buddy and leader support, because in the early days people had a good strong leader or peer. Good
leaders, really brilliant leaders and I mean, ideally good families, you when they’re back at home, who understand.
If they go on, the people who are not doing well, well then people like me become useful. But early on it’s about
provisions and good leadership and good social support, that’s vital.
R – Okay brilliant. I’m just going to go through my headings here, most of them we’ve mentioned, recruitment,
training, briefing, I’m talking about briefing and sort of without, you know over-traumatisation there has to be like a
realisation and people do they realize that they’re going into a hostile job which could, things could present
themselves and what about with packages for companies and I know some policeman have spoken about it, they
know they’re going to go and experience a particularly nasty scene or railway workers that do this and they kind of
steel themselves you know, they go somewhere and they hang their hat somewhere and they’re like ‘ok this is going
to be a bit, you know, but we’re going to get on with it.’ Can we, as obviously that is trainable?
D - You can train both individuals resilience and into companies and more importantly you can train good practices.
And the answer is that resilience mostly lies between individuals rather than in individuals. So actually if you’ve
got a well led team who are trauma aware, who know about social support, who can chat to each othe r because
they’ve practiced it and they’ve trained together so they’ve supported back in the military days, that team, is really
supporting, you know it helps each other. Individually you can train them, basically because we’ve got data from
when our troops first went to Iraq, showing that troops who have stress education debriefings do better than troops
who don’t. You can both train the group and the individual…
R – Great and as I said 90% of private security companies come from a military background so taking the best
things from that background, perhaps leaving the not so best things behind is good. Okay we have mentioned
teamwork; I am going to skip through these now. In my coping strategies I have researched humour, which again I
think is a great thing that has come from the military and is classic in some people who have worked in some testing
environments. Your views on acclimatisation stopovers going in to theatre and decompressions coming out?
D – Going in I think, going in is more about gearing up for the task ahead, the team, so if you’re going in as a single
operator, I’m not sure stopping over is necessary but I don’t think there’s much to it, other than getting a good
briefing so you can begin to acclimatise.
R – Gear up, okay.
D – Yeah gear up. I think the decompres sion thing done in the right place I think it is really important and I don’t
think it has to be 36 hours in a 5 star hotel but I don’t think you should be flying back from just out of an incident to
arrive back at home 14 hours later.
R – To bring that to your family perhaps arriving back in a heightened state of hypertension is not a good thing.
D – Yeah so it doesn’t have to be a five day stopover, but 24 hours teams tracking through, a couple of beers I think
is decidedly a good idea.
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R - Right okay, I’m just racking through these other coping strategies, so sort things like self-development,
normalization and routine people have spoken about, you know again maybe it’s a boredom thing but taking their
mind off being in a hostile environment, learning a language or doing a degree course is a good coping strategy. I
see you nodding there so that is in agreement?
D – Yeah in avoiding boredom.
R – Yeah okay. We have spoken about transition from military to private companies and then onwards to civvy
street, there’s not really been any research out there going forward from the next leap is there, which would be one
of my sort of recommendations for future research.
D – Have you spoken to XXXX?
R – Yeah great I have spoken to XXXX, really good, really useful, probably where I got that idea from. Okay,
attitudes, awareness, you know I am talking about sort of improvements now. I guess it’s all about awareness, I
mean I’m looking at society how it was 50 years ago with attitudes towards females in the work place, sexual
equality, racial equality you know, health and safety in the workplace. We have come a hell of a long way; it just
needs that sort of paradigm shift again.
D – It’s also equally about managers being aware of what to look for and they have to be overly tested. If someone
comes back and having been in a war zone for six weeks in the first few weeks of their job when they hit the floor in
XXXX (A Supermarket) it should not be funny, it should be a sign that they need to go see a doctor. If it happens
six months later by all means they need to go to a doctor, that’s it.
R – Okay that is quite a good; I like that because that is quite a good, its normal you know, it is interesting, very
interesting.
D – Very, that is sort of behaviour is typical and a perfectly normal reaction to military combat.
R – Great okay, approaches to change and I’m talking about the military and generally.
D – I don’t know how, I think we’ve shown evidence of the military over the last ten years, the thing that hasn’t
gone away, but it has crept down but the danger really is people have become overly concerned, the parents have
become overly concerned, it’s about getting that balance really.
R – Okay interesting I like that, not being overly concerned about it and again most guys that worked in this industry
and I’ve worked in the industry, are resilient you know, can get on with it, are quite mature and what have you.
Okay I am going to rattle through these now: relaxation as a coping strategy I mean, things like Tai Chi, yoga you
know it’s not everybody’s cup of tea.
D – My point is that there was a paper of research on the US marine corps, basically showing that in the US marine
corps combat team, the combat team sort of went out there prepared with stress management were better having
gone through a the operational tour than those who hadn’t. But of course, it might just work and for some people, it
mightn’t. If you do not do Tai Chi well you can try. Give it a go, if it does not work then maybe it is not for you.
R – I mean my view, obviously I am after your view, is that coping strategies are completely unique. You know if it
is listening to music in the evening or playing war games or doing Tai Chi or doing yoga or doing art, you know
coping strategies are completely unique.
D – I am not sure they are unique. In general if you can find ways to do some exercise that gets your body in a
rhythm that’s going to be good for you, whether that Tai Chi or running or swimming or exercise bike that must be
it, but actually in general if you take exercise, you’re probably going to do better than those who don’t, but again if
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you can find time for watching some television, just something to switch your mind off, that’s probably going to be
of more use to you than not doing it.
R – Yeah okay. I used to watch the travel channel in Baghdad, in the red zone, in the villa and I was there. I was in
the Seychelles or wherever the travel channel was that evening, pure escapism. Okay we have spoken about
maladjusted coping. Physical training as a coping strategy we know is good, but then I want to talk about steroid
abuse and I have seen a culture of that and I’ve brushed on a culture of that and something called ‘roid rage’ you
know, is this something you’ve come across? In the military and in PMSCs.
D – Well the military there’ve been challenges because it’s more difficult for drug testing, although it does go on
and there are companies that are on the border of being druggy and not druggy, but yeah absolutely the steroid craze
is not just in the security contractors, you know bodybuilders there’s lot of evidence that for that group of people it’s
clearly not the best thing to have.
R – Yeah okay, good stuff and then going on I’ve just heard lots of things about support and life support in country
you know food, sleeping you know, for the companies just the little things, how that sort of aids coping. It might
just be the little things that all add up to a contractor.
D – I think, I think you’re right. All the little things do add up but I think there’s probably a threshold where you
know, once you’ve got a reasonable place to have some down time and you’ve got a room and a television you
know when you relax. There are certain points where having luxuries are not necess ary but the basic level, I think is
important.
R – Okay that’s great. Why is it that many guys will experience the same PTE in companies with some developing
PTSD you know, why some and not others? Why is it that sort of eight guys can experience an event and two of
them, six of them being totally okay, one of them present the symptoms fairly soon after and one six months down
the line. Your views on that? I mean if you have the answers to that, you would be a millionaire I guess?
D – Yes it is very individual, but that important you have mental analysis of risk factors and there, that gives you
some clues. There are predisposing factors in your childhood proven and proven experiences and what the nature of
the event do you see it being challenging or exciting or is it something that you think you can’t cope with and there’s
what happens to you after, you know are you the sort of person who isolates yourself anyway or are you going to get
down the bar, have a couple of drinks and talk it through.
R – Okay there is a lot of stuff, that is very interesting and then the last couple of points: psychological first aid we
have spoken about and then yeah training, that is it XXXX those are all my questions. Do you have anything sort of
further there to add or?
D – No thank you very much I’ve got to disappear, thanks for that and I will have a look at what you’ve sent me and
when you have finished your report I’d really be interested in it.
R – Yeah great. Have a look at what I sent you last night and any comments you have on it, anything you want to
add that would be really useful. Brilliant. Thanks very much XXXX really appreciate it.