Meet the Expert PhD Special Edition– Amber McKenzie
Welcome to a special edition of 'Meet the Expert', our series bringing you informative interviews with Armed Forces researchers, policymakers and service providers. In this edition, we will be featuring a PhD Researcher as our expert. Read on to hear about their experiences during their PhD, the impact of their current work and their insights on key issues impacting ex-Service personnel and their families.
In this issue, we interviewed Amber McKenzie, a PhD student at King’s Centre for Military Health Research (KCMHR). Using a mixed-methods approach in her PhD work, Amber aims to provide a profile of what adjustment disorder [1] looks like for UK Armed Forces personnel and Veterans. Through this approach, she intends to identify potential associated factors and outline clinical and occupational outcomes. Her research interests are occupational mental health, mental health interventions, mental health implications for ethnic minorities and ethnic minorities' experiences in the military.
1. Please tell us about your background and how you came to undertake a PhD relating to the Armed Forces Community.
Before joining King’s College London, I received a BSc degree in 2016 in Psychology from Queen Mary, University of London. In 2018 I completed my MSc degree in Occupational Psychiatry and Psychology at King’s College London. Whilst completing my MSc I became increasingly interested in the Armed Forces as a unique occupation and how this may impact personnels’ and Veterans’ mental health.
After completing my MSc, I sought to begin a career in research with a specific focus on mental health implications for the Armed Forces. I went on to work as a Research Assistant and Study Coordinator on several projects at KCMHR. Previous studies I have worked on before my PhD include an exploration into associations between dementia and trauma for older Veterans funded by Forces in Mind Trust (FiMT) [2], and an evaluation study of a Ministry of Defence (MoD) mental fitness initiative ‘HeadFIT’ [3].
2. Can you describe your PhD project and how you feel this work fits into the bigger picture of understanding and supporting the Armed Forces Community?
My current PhD work explores adjustment disorder in the UK Armed Forces population. According to a recent MoD report, adjustment disorder was the second most given psychological diagnosis for the serving population (MoD, 2023)[4]. However, research examining adjustment disorder in military populations is scarce. I conducted a systematic review [5] summarising the existing literature reporting on adjustment disorder in any military population (including those outside of the UK). Four papers out of the eighty-three included in the final review were based in the UK and all four only reported on the prevalence of adjustment disorder in samples with diagnosed psychological disorders. The systematic review emphasised a need for more research into adjustment disorder in the UK military population and my PhD work aims to address some of these research gaps. My thesis will begin to create a profile of the demographics, risk factors, and stressors associated with adjustment disorder and occupational and clinical outcomes for those with an adjustment disorder diagnosis.
This work will help us to understand what may be increasing the risk of certain military personnel developing adjustment disorder symptoms and begin to identify possible areas to help prevent others from developing symptoms. I also want this work to identify whether there are specific military factors that may be associated with adjustment disorder in the UK population. My PhD will lay down the foundational work for future research to build upon and to address remaining research gaps.
3. Can you tell us about the research methods you are using in your PhD project? Are there any that you are particularly drawn to and enjoy using, and if so, why?
I am using a mixed-methods approach to address this research topic. To do this, I am using existing quantitative data collected through the KCMHR Health and Wellbeing study to identify possible factors and stressors associated with probable adjustment disorder. I have also collected quantitative demographic information and qualitative interview data on the lived experiences of military personnel diagnosed with an adjustment disorder.
I am drawn to mixed methods in my research as I feel you can achieve a much more detailed depiction of a research topic. For instance, the interviews I have conducted with military personnel diagnosed with an adjustment disorder will provide context to my quantitative data analysis of factors associated with adjustment disorder such as childhood adversities. By combining both approaches, I feel you are one step closer towards addressing the meaning of data by building an in-depth snapshot of a topic from multiple data sources. I also thoroughly enjoy using qualitative methods, specifically one-to-one interviews. The conversations I have had with participants really drive my inquisitiveness and as someone who has never served in the military, it gives me insight into what it must be like. Plus, it makes research more worthwhile when you can meet and chat with people who may benefit from the research you are conducting.
4. What are your future aspirations following your PhD and any hopes for the impact your research may make?
I wanted to embark on a career in research all those years ago to contribute to change and help to improve individual’s wellbeing and this drive remains today. I hope to work as a "Post-Doc" [6] after I complete my PhD and continue researching the Armed Forces community. I feel there is still a lot to be understood about the Armed Forces and the impact serving and transitioning out of the military can have on personnel’s mental health, so I hope to continue working within this area for a little while longer. I have always been interested in mental health research and ways to prevent the development of psychological disorders for particular groups. For example, there is a scarcity of research looking at the experiences of ethnic minority personnel in the UK Armed Forces. My aim for the future is to one day combine my research interests and begin to address both areas.
5. What other areas of research or policy relating to the Armed Forces Community are you especially passionate about? Please expand on this and tell us about them, as much as you can.
I am especially interested in looking at the experiences of minorities, especially women and those from racial and ethnic minority backgrounds, in the Armed Forces community. I want to do this to contribute to improving their experiences whilst serving and as Veterans, but I hope to do this through a qualitative lens. As a black woman, I am aware of how being a minority impacts my day-to-day and so minorities in the military may face unique experiences and obstacles. Civilian research into inequalities in the workplace and healthcare suggests minorities’ experiences significantly differ. This suggests Service personnel may have different experiences, but we need to do the research to see if this is mirrored for the Armed Forces too.
6. What do you think are the key challenges impacting current Veterans and their families, and how do you think research and/or policy can be best used to address them?
I think one of the most salient challenges faced by Veterans is not fully understanding the impact that transitioning out of the military and re-entering civilian life may have. I think it's important to stress to Veterans that the transitioning process can be a difficult one, and I think Veterans are often unaware of the support and resources available to them to assist with their adjustment. This should be understood early on in Service personnel’s careers even before they want to leave, to prepare them for the transitional period. I think policy can be best used to increase education and awareness of the impact that transitioning out of the military may have on psychological wellbeing, and to facilitate more communication and signposting towards the many resources available to Veterans and their families.
7. What do you think will be the leading challenges for the next generation of Veterans and how do you think research and/or policy can be best used to address them?
With the nature and requirements of deployments changing, new challenges may arise with Service expectations and unfulfillment when personnel leave the military. Unlike Veterans who served between 2001-2015, a combat role looks a lot different now and Veterans could be faced with Service unfulfillment as their Service wasn’t exactly what they expected it to be. However, policy could address these issues through better management of Service expectations for new recruits and communicating alternative career opportunities available to personnel.
8. Given unlimited funding and time, what would be your dream piece of research to undertake involving the Armed Forces community?
A longitudinal mixed-methods cohort study following minority groups as they join the Services and throughout their careers reporting on the occupational and mental health outcomes for this group and comparing outcomes to a control group. That would be such a fantastic lens to follow the career span of minority groups in the military!
Many thanks to Amber McKenzie for sharing her insights.
Catch us next month for another interesting and informative interview with an expert from the Armed Forces research community.
[1] Severe behavioral and emotional response and impairment in social or occupational functioning following a stressful life experience.
APA. (n.d.). APA Dictionary of Psychology. American Psychological Association. https://dictionary.apa.org/adjustment-disorder
[2] Greenberg, N., Stevelink, S., Rafferty, L., Greenberg, K. & McKenzie, A. (2020). A case-control study examining the association between service-related mental ill-health and dementia in male military veterans over the age of 65. Available at: https://kcmhr.org/pdf/2020_MIDST_report.pdf.
[3] McKenzie, A., Croak, B., Rafferty, L., Greenberg, N., & Stevelink, S. A. (2021). A Service Evaluation of the Military HeadFIT Initiative: An Implementation Study. International Journal of Environmental Research and Public Health, 18(14), 7375.
[4] Ministry of Defence. (2023). UK armed forces mental health 2022/2023: annual report.
20230629_MH Annual Report_O (publishing.service.gov.uk)
[5] McKenzie, A., Burdett, H., Croak, B., Rafferty, L., Greenberg, N., & Stevelink, S. A. (2022). Adjustment disorder in the Armed Forces: A Systematic Review. Journal of Mental Health, 32(5), 962–984. https://doi.org/10.1080/09638237.2022.2140792
[6] A person engaged in postdoctoral research.
