Executive Summary
This report charts the impact of their early enlistment on mental health, with a focus on suicide in male personnel and veterans. (The few reliable statistics for females show a similar pattern.)
Early enlistment is associated with an increased risk of suicide.
The suicide rate among soldiers aged 16–19 is substantially higher than that of their civilian peers:- Over the last two decades, the suicide risk among male soldiers aged 16–19 has been one-third higher than that of their civilian peers 4 and three times the armed forces average. 5
- This risk is concentrated in the infantry (Figure 2), where child recruits are over-represented. 6 More than half of infanteers who died by suicide in the last two decades had joined up as children (Figure 3); 7 infanteers who had signed up under the age of 18 have had double the odds of ending their lives while still in service compared with those who joined as adults. 8
- Rates of anxiety, depression, and PTSD are also elevated in young personnel, at approximately double those found in civilians of the same age (Figure 11). 9, 10
Suicide risk increases after personnel leave ('veterans'). Again, veterans who had signed up as children suffer worse outcomes than those who had joined as adults (Figure 5): 11, 12
- Over the last two decades, veterans aged 16–19 have been three times as likely as civilians of the same age to end their lives (Figure 4). 13 A 2009 study found that the risk had been highest of all in army veterans who had joined up at 16. 14
- Over approximately the last 25 years, veterans who had enlisted as children have also had double the odds of alcohol misuse and double the odds of reporting self-harm when compared to veterans who had joined up as adults (Figure 7). 15
Young recruits’ high rate of suicide is not explained by childhood background alone
A troubled background is common among child recruits. But while adversity in childhood is known to contribute to mental ill-health in adolescence and adulthood, this alone does not account for the elevated rate of suicide in this group:
- Over the last 25 years or so, veterans who joined up as children have had between two and three times the odds of long-term PTSD compared to civilians of the same age and similar childhood background (Figure 7). 16
- Over a similar period, their rate of suicide has been three times that of the most disadvantaged civilians of the same age (Figure 6).17
Military suicide is most common among those who have never seen war
Contrary to a common assumption that the main cause of military suicide is traumatic war experiences, the risk tends to be highest among those who have never been deployed.18 Three factors help to explain why this is so in young personnel and veterans in particular:
- The heightened vulnerability of the adolescent brain to stress, particularly in recruits with a background of adverse childhood experiences;
- The impact of early military experiences, particularly the stressful conditions of initial training; and
- Difficulties readjusting to civilian life after discharge.
These risk factors tend to accumulate along the typical career pathway of a child recruit:
A. Pre-military factors heighten vulnerability. A background of adverse childhood experiences amplifies the adolescent brain’s reactivity to stressors. 19
B. Military factors apply stress:
- Initial training is an intensive resocialisation process – a ‘pressure cooker’ – which makes routine use of sustained stress. Restrictions on external communications20 and the right to leave21 add to the load, as do common experiences of peer bullying,22 sexual harassment,23, 24 and abuse by staff.25 The British army’s own research found in 2022 that child trainees, particularly girls, experienced an ‘erosion of resilience’ (Figure 8).26
- Daily stress during initial training divides trainees into a majority ‘in-group’ who adapt to its demands and an ‘out-group’ who do not. 27 Young veterans and their parents report that out-group recruits are commonly bullied by peers and instructors, leading to low self-worth, emotional numbing, and depression. 28
C. Post-military factors compound impact. Immediately out of work and education, young veterans are socio-economically highly vulnerable. Few have professional mental health support. 29
Conclusion: Early enlistment aggravates the risk of suicide and mental ill-health
This report finds a high rate of suicide
and associated mental health problems in
those who join the British armed forces at
a young age, particularly those who enlist
under the age of 18. This is best explained
by a combination of factors: the impact
of childhood stress, stressful military
experiences (mostly before personnel are
sent to war), and the stresses of transition
to civilian life following early discharge.
It is sometimes suggested that, had child
recruits not joined up, they would be out
of work and education and so suffer still
poorer mental health. But today, four in
five 16-year-olds living in deprivation –
the army’s main recruitment pool – now
continue in full-time education30 and
most of the remainder are in work.31
Among the voices calling for this
change are those of the United Nations
Committee on the Rights of the Child,34
the Children’s Commissioners for each
UK nation,35 health experts36 and children’s
rights organisations,37 and the families
harmed by the policy of child enlistment.38
Polling indicates clear support in the
British public for raising the minimum
enlistment age to 18.39
On the evidence, the change would
also mean that fewer young people end
their lives.
Introduction
While most states worldwide have made the transition to all-adult armed forces, the UK is unusual in enlisting adolescent children from age 16 and unique in relying so heavily on the age group.40
A quarter of new soldier recruits are aged under 18,41 drawn mostly from deprived neighbourhoods.42
The effect of early enlistment on mental health has not been well understood. This report draws on official sources and peer-reviewed research to show that the policy of recruiting from age 16 contributes to a heavy mental health burden on child recruits.
We focus on suicidality. While suicide itself is a rare event, elevated suicide rates are also a barometer for stress-related mental health problems, particularly anxiety, depression, and posttraumatic stress disorder (PTSD).43
We show for the first time that early military experiences, before recruits are sent to war, have a deep and disproportionate impact on the mental health of the youngest personnel and veterans.
The United Nations (UN) Convention on the Rights of the Child requires that, in all actions that concern children, their best interests must be made a ‘primary consideration’.44 They have a legal right to be fully safeguarded from any undue harm that may arise from their enlistment for military purposes.
We hope that this report will support that aim.
***
Footnotes
1 For example, between 2017–18 and 2021–22, 27% of the army’s enlisted intake was aged under 18. *MoD, UK armed forces biannual diversity statistics: April 2022* (Data tables), 2022a, https://www.gov.uk/government//statistics/uk-armed-forces-biannual-diversity-statistics-april-2022, Table 9.
2 C Cooper, D Gee, ‘Youngest British army recruits come disproportionately from England’s most deprived constituencies’, 2019, read here; Oxford Economics, The wider value of the British army, 2021, p. 36, read here.
3 The policy prohibits UN staff from having any sexual relations with pIn the five-year period between 2016–17 and 2020–21, 10,140 army enlistees were aged under 18, of whom 3,898 (38%) were in the infantry, and 29,160 enlistees were aged 18 and above, of whom 8,710 (30%) were in the infantry. Calculated from information obtained under the Freedom of Information Act, 22 September 2021, ref. FOI2021/10665, read here, and MoD, UK armed forces biannual diversity statistics: April 2021 (Data tables), 2021, read here, Table 9A.
4 Between 2001 and 2020, the suicide rate in army personnel aged 16–19 was 31% higher than that found in the same-age general population. MoD, ‘UK armed forces suicides: 1984 to 2021 data tables’, 2022b, read here.
5 Between 2002 and 2021, the standardised mortality ratio for suicide among soldiers aged 16–19 in the UK was 131 (i.e. a 31% increased risk relative to the same-age general population) and 43 in the armed forces as a whole (i.e. a 57% reduced risk relative to the same-age general population), a threefold difference. Ibid., see Additional Table 4.
6 See endnote 3.
7 Information obtained under the Freedom of Information Act, ref. ArmyPolSec/D/N/FOI2022/12210, 14 November 2022, read here.
8 See Table 2 in Appendix B: Data tables for figures and sources.
9 Anxiety/depression in personnel under age 25 and same-age working civilians: 22% vs. 11%. L Goodwin, S Wessely, M Hotopf, et al., ‘Are common mental disorders more prevalent in the UK serving military compared to the general working population?’ Psychol Med, 2015, 45(9), pp. 1881-91. doi:10.1017/S0033291714002980.
10 PTSD in personnel under age 25 vs. same-age general population: 7% vs. 4%. S A M Stevelink, M Jones, L Hull, et al., ‘Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study’ (Supplementary Table 2), Br J Psychiatry, 2018, 213(6), pp. 690–697, doi:10.1192/bjp.2018.175 ; S McManus, P Bebbington, R Jenkins, and T Brugha (eds.), Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014, Leeds: NHS Digital, read here.
11 Australian Institute of Health and Welfare, ‘Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 2001 to 2019’, 2021, read here, Table 5; Department of National Defence (Canada), ‘2021 Report on Suicide Mortality in the Canadian Armed Forces (1995 to 2020)’, 2022, read here, Figure 1; Department of Defense (Defense Suicide Prevention Office, US), Annual suicide report, 2020, read here, Table 2; Centers for Disease Control and Prevention, ‘Changes in suicide rate: United States, 2019 and 2020’, 2022, read here, Table 1.
12 In the US, for example, the suicide rate for active personnel aged 17–19 in 2020 was 36% higher than that found in a similar age group in the general population. Specifically, the suicide rate among US active-component (cf. ‘regulars’ in UK) personnel aged 17–19 was 30 per 100,000 and the rate in the male general population aged 15–24 was 22 per 100,000. Department of Defense, 2020, op cit., Table 2; Centers for Disease Control and Prevention, op cit., Table 1.
13 C Rodway, S Ibrahim, J Westhead, et al., ‘Suicide after leaving the UK Armed Forces 1996-2018: a cohort study’ [pre-print], 2022, Table 1, doi:10.1101/2022.12.12.22283340.
14 N Kapur, D While, N Blatchley, et al., ‘Suicide after leaving the UK armed forces —A cohort study’, PLOS Medicine, 2009, 6(3), 2009, doi:10.1371/journal.pmed.1000026.
15 M Jones, N Jones, H Burdett, et al., ‘Do Junior Entrants to the UK Armed Forces have worse outcomes than Standard Entrants?’, BMJ Military Health, 2021, read here.
16 B P Bergman, D F Mackay, N T Fear, and J P Pell, ‘Age at entry to UK military service and long-term mental health’, BMJ Military Health, 2021, read here.
17 See Figure 6 for sources.
18 Department of National Defence (Canada), ‘2021 Report on Suicide Mortality in the Canadian Armed Forces (1995 to 2020)’, 2022, read here; Mia S Vedtofte, Andreas F Elrond, Annette Erlangsen, et al., ‘Combat exposure and risk of suicide attempt among Danish army military personnel’, 2021, The Journal of Clinical Psychiatry, 82(6), doi:10.4088/JCP.20m13251; Richard J Pinder, Amy C Iversen, Nav Kapur, et al., ‘Self-harm and attempted suicide among UK Armed Forces personnel: Results of a cross-sectional survey’, 2012, International Journal of Social Psychiatry, 58(4), 433–439, doi:10.1177/0020764011408534; Armed Forces Health Surveillance Center (US), ‘Deaths by suicide while on active duty, active and reserve components, U.S. Armed Forces, 1998-2011’, 2012, read here; Mark A Reger, Raymond P Tucker, Sarah P Carter, and Brooke A Ammerman, ‘Military Deployments and Suicide: A Critical Examination’, 2018, Perspectives on Psychological Science, 13(6), 688–699, doi:10.1177/1745691618785366; J Holmes, N T Fear, K Harrison, et al, ‘Suicide among Falkland war veterans’, 2013, BMJ, 346, doi:10.1136/bmj.f3204.
19 K Campbell, ‘The neurobiology of childhood trauma, from early physical pain onwards: as relevant as ever in today's fractured world’, European Journal of Psychotraumatology, 2022a, 13(2), read here.
20 During the first six weeks, recruits are allowed ‘controlled access’ to their mobile phones for a 40–60 minute period between 8pm and 10pm; the rest of the time it is kept in a sergeant’s office. British army, ‘Army Foundation College Commanding Officer’s Supervisory Care and Safeguarding Directive Risk Assessment’, 2018, point 2.1. Information obtained under the Freedom of Information Act, ref. FOI2019/05572, 10 June 2019.
21 Under-18s have no legal right to leave at all during the first six weeks, after which a 14-day notice-period applies, and after the first six months a three-month notice period applies. The Army Terms of Service Regulations 2007, no. 3382 (as amended, 2008, no. 1849).
22 Cited in Child Rights International Network (CRIN), ‘Parents of under-18 recruits speak out about abuse at army training centre’, 2021a, read here.
23 Across the armed forces in 2021, one in eight girls under 18 were victims of a sexual offence, according to MoD records of police investigations; girls were ten times as likely as adult female personnel to be victimised in this way. Specifically, 37 girls were victims in sexual offence cases opened by the Service Police, out of a total population of 290 girls serving in the armed forces; a rate of 12.8%. In the same year, 202 adult female personnel were victims of sexual offence cases, out of a population of 16,180; a rate of 1.2%. Leo Docherty MP, ‘Armed Forces: Offences against Children’, 26 April 2022 (2022a), read here; MoD, Sexual Offences in the Service Justice System 2021 Annual Statistics [Worksheet 3], 31 March 2022d, read here; MoD, UK armed forces biannual diversity statistics: 1 April 2021 [Tables 1 and 3], 10 June 2021, read here.
24 An anonymous survey of girls at the Army Foundation College in 2020 found that half (48%) had experienced bullying, harassment or discrimination while training there and 30% said they would report it. Army Foundation College Harrogate, Project Athena: A pilot training to optimise basic training for female junior soldiers, 2022, p.5, read here.
25 Between 2014 and February 2023, AFC recorded 72 formal complaints of violence against recruits by staff, including assault and battery. At least 13 of these cases were proven following investigation. Leo Docherty MP, 2022a, op cit., and 19 May 2022 (2022b), read here; Information obtained under the Freedom of Information Act, ref. Army/Sec/C/U/FOI2021/13445, 30 November 2021, read here; and ref. Army/Sec/C/U/FOI2021/15645, 11 January 2022, read here; and ref. Army/Sec/U/A/FOI2023/02395, 23 March 2023, read here; Johnny Mercer MP, ‘Army: Young people – no. 109376’, 4 November 2020, read here.
26 Army Foundation College Harrogate, 2022, op cit., pp.28, 38.
27 For examples, see D Gee, The First Ambush? Effects of army training and employment (London: Veterans for Peace, 2017), read here; CRIN, 2021a, op cit.; and B Griffin, The making of a modern British soldier [video], 2015.
28 Ibid.
29 Rodway et al., 2022, op cit.
30 ‘Disadvantaged’ is defined by the Department for Education (DfE) for schools in England as students eligible for free school meals or in care. DfE, ‘National table NA21b: Pupil destinations after completing key stage 4 by disadvantage status and gender, state-funded schools (mainstream and special)’, 2019, read here.
31 DfE, ‘Additional tables - rates: participation and NEET 2019’ (Table A7: Participation in education and training of 16 & 17 year olds, England, 1985 onwards), 2020a, read here.
32 Art. 3, Convention on the Rights of the Child (1989).
33 Three-quarters of countries worldwide follow children’s rights standards in allowing only adults to be enlisted. Of the remaining quarter of states that still allow enlistment under age 18, only 16 (mostly Commonwealth countries) recruit from age 16. Child Soldiers International, Why 18 matters: A rights-based analysis of child recruitment, 2018, read here.
34 The Committee’s General Comment on adolescence on the implementation of the rights of the child during adolescence records ‘deep concern’ that adolescent children continue to be recruited into state armed forces (para 81) and specifies that the minimum age for entry should be 18 (para 40). UN CRC, General Comment on adolescence on the implementation of the rights of the child during adolescence, 2016a, read here.
35 UK Children’s Commissioners, ‘Report of the Children’s Commissioners of the United Kingdom of Great Britain and Northern Ireland to the United Nations Committee on the Rights of the Child’, 2020, read here.
36 For example: R Louise, C Hunter, S Zlotowitz, The recruitment of children by the UK armed forces: A critique from health professionals, 2016, read here; K Campbell, ‘Childhood trauma: a major risk factor in the military recruitment of young people’, BMJ Military Health, 2022b, read here; R Abu-Hayyeh and G Singh, ‘Adverse health effects of recruiting child soldiers’, BMJ Paediatrics Open, 2019, 3(e000325) read here;
37 See, for example, letter from CRIN and other children’s rights organisations to the Secretary of State for Defence, 22 June 2021 (2021b) read here.
38 B Quinn, ‘Parents call for British army college to be shut down after abuse claims’, Guardian, 18 November 2021, read here.
39 A YouGov poll in 2022 found that 73% of the public believed the minimum enlistment age should be at least 18, 17% thought it should be 16 or 17 (and 1% that it should be less than 16), and 9% did not express a view. YouGov, ‘Most Britons think you shouldn't be allowed to join the armed forces until you are at least 18 years old’, in ‘YouGov Study of War: Britons on serving in the armed forces’, 2022, read here.
40 Three-quarters of countries worldwide follow children’s rights standards in allowing only adults to be enlisted. Of the remaining quarter of states that still allow enlistment under age 18, only 16 (largely Commonwealth countries) recruit from age 16: Bangladesh, Canada, Cuba, Dominican Republic, Egypt, El Salvador, India, Iran, Mauritania, Pakistan, Papua New Guinea, Tonga, Trinidad and Tobago, United Arab Emirates, and Zambia. Child Soldiers International, 2018, op cit.
41 Between 2017–18 and 2021–22, 27% of the army’s enlisted intake was aged under 18. MoD, UK armed forces biannual diversity statistics: April 2022 (Data tables), 2022a, read here, Table 9.
42 C Cooper, D Gee, ‘Youngest British army recruits come disproportionately from England’s most deprived constituencies’, 2019, read here; Oxford Economics, 2021, op cit., p. 36, read here.
43 S J Lewis, L Arseneault, A Caspi, et al. ‘The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales’, Lancet Psychiatry, 2019, 6, pp. 247–256, read here.
44 Art. 3, Convention on the Rights of the Child (1989).