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Novel approach sees success in treating former Service personnel with PTSD

A new approach in offering treatment to former Service personnel with mental health conditions including Post-Traumatic Stress Disorder (PTSD) launched today, Thursday 6th September, has revealed positive results.

A year-long tele-therapy pilot study, funded by The Forces in Mind Trust (FiMT) and undertaken by Combat Stress, has shown it to be an accessible, flexible and cost-effective approach to delivering trauma-focused therapies. Tele-therapy provides therapy through a live video connection, over the internet such as Skype.

The purpose was to trial an alternative type of therapy to overcome issues that prevent veterans from seeking help. Despite there being a higher prevalence of mental health difficulties among former service personnel compared to the general population, research of UK veterans has suggested that only 30-50% of those with mental health issues access services for support. A number of reasons have been suggested for this, including issues related to stigma, practical issues around not being able to access services due to time constraints, and not knowing where to turn for support.

Evidence from the tele-therapy study shows it to be an accessible, flexible and cost-effective approach to delivering trauma-focused therapies.

Recommendations were made by Dr Dominic Murphy, lead author of the study, about using tele-therapy to treat more veterans in future, these include:

  • Preparing veterans for the demands of the therapy.
  • Ensuring tele-therapy is offered formally in the same way as outpatient therapy, e.g. a formal attendance and appointment policy.
  • Allowing flexibility by creating evening appointments to ensure veterans can attend.
  • Having a clear protocol to deal with technical difficulties, such as poor internet connection, which can result in sudden termination of therapy-session communication.

Veterans attending Combat Stress’ treatment centres were invited to take part in tele-therapy, with a total of 54 people asked, resulting in 27 participants.

Data was collected about treatment uptake, attendance, drop-out rates, time to complete therapy and the cost per case. Quantitative analyses were used to assess the effectiveness of tele-therapy using self-report measures of PTSD, anxiety, depression, anger and alcohol use.

Ray Lock, Chief Executive of the Forces in Mind Trust, said: “The findings from this pilot study show that tele-therapy is an approach to treatment that could benefit ex-Service personnel, in particular those who find it difficult to engage in face-to-face therapy. The recommendations and lessons learned in this trial offer an opportunity for policymakers and service providers to take tele-therapy forward as a cost-effective, feasible and acceptable service for UK Veterans with PTSD.”

Dr Dominic Murphy, Head of Research at Combat Stress and lead author of the study, said: “We were pleased with our results. Importantly, we had positive feedback from veterans telling us they found tele-therapy to be a good way to receive support.  Several people told us that they were not able to engage in face-to-face therapy but tele-therapy allowed to them to complete treatment.”

You can read the full report here

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Ex-Service personnel use of performance enhancing drugs and supplements to be explored

Forces in Mind Trust (FiMT) has awarded £42,357 to the University of Sunderland to conduct a year-long project to identify the prevalence, motivations and mental health status of users of Performance and Image Enhancing Drugs and Supplements (PIEDS) amongst ex-Service personnel.

The study is taking place in the North East of England and will be facilitated by Finchale College, Durham, where researchers will explore why ex-Service personnel take body enhancing drugs, when they became users (pre-, during or post-service), the processes involved, and the level of awareness users have of the negative consequences of PIEDS, in order to inform the development of interventions and education programmes.

Previous or current histories of PIEDS users within the Criminal Justice System will also be investigated, as will any link between usage of body enhancement drugs and supplements with mental health and wellbeing of ex-Service personnel.

Ray Lock, Chief Executive of the Forces in Mind Trust, said: “It is important to get a better understanding of the reasons why ex-Service personnel take performance enhancing drugs and supplements and how and when they become users, particularly given the negative consequences of their use.

“This research is important as for many years there have been concerns about the use of such drugs in sport, and more recently, those concerns have transferred to the wider population, particularly to enhance strength and body image.  The Armed Forces as part of wider society are not immune to this problem, particularly given their need to be physically robust. We look forward to this research to help determine the degree, if any, of this problem amongst our ex-Service personnel to ensure that the appropriate support is in place.”

Dr Ian Whyte, Team Leader and Principal Lecturer in Sport and Exercise at the University of Sunderland, said: “I am delighted to receive this research grant to take forward a project in such a developing and important topic.  Working with the Forces in Mind Trust has already been exceptionally beneficial, both from a personal level as well as for the University of Sunderland as this is the first time that we have worked together.

“The Forces in Mind Trust is a very well managed and professional organisation with outstanding support staff.  I have already received considerable support and encouragement from the organisation and look forward to a mutually beneficial collaboration and the development of a long-term relationship.”

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FORCES IN MIND TRUST SPONSORS SOLDIERING ON AWARDS FOR A FOURTH YEAR

The Forces in Mind Trust (FiMT) are continuing their support of Soldiering On Awards for the fourth consecutive year with sponsorship of the ‘Working Together’ award.

The ‘Working Together’ award recognises the commitment and innovative approach to collaboration by an individual, team or organisation within the Armed Forces Community, and will be presented as part of the annual Soldiering On Awards.

FiMT, supported by Soldiering On Awards, is currently evaluating the impact that the Awards have had on winners, nominees and more importantly on the way in which the wider Armed Forces sector collaborates.

Nominations for the 2019 ‘Working Together’ award are now open. Make your nomination via the Soldiering on website http://www.soldieringon.org/2019-award-categories/.

Chief Executive of the Forces in Mind Trust, Ray Lock, said:

“One of Forces in Mind Trust’s objectives is to enhance the effectiveness of the Armed Forces charities sector, in part by improving collaboration across the wide spectrum of people and organizations who support the Armed Forces community. Through our sponsorship of the ‘Working Together’ award we are continuing to innovate and we’re looking to identify and highlight really good examples of collaboration, and so spread the lessons across the sector. I’m already anticipating a great crop of nominations for 2019 following the outstanding 2018 winners, the Cobseo Housing Cluster.”

Managing Director of the Soldiering On Awards, Anne Donoghue, said:

“We are delighted to have the continued support of Forces in Mind Trust. Through this support over the past three years we have been able to shine a light on outstanding results achieved through many examples of collaboration and working together taking place outside of traditional boundaries in support of the Armed Forces community; fantastic examples that the whole sector can learn from.”

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Examining trends in Scottish veterans’ health

Forces in Mind Trust (FiMT) has awarded the University of Glasgow £182,265 to conduct a three-year retrospective study examining the long-term health of Scottish veterans.

This is a follow up study to the original Scottish Veterans’ Health Study (2012-2015), which provided the first insight into the long-term health of 57,000 veterans (born between 1945 and 1985) and compared their health profile to non-veterans.

Researchers propose to examine a further five years of health data to compare the findings with those of the original study to detect emerging trends in ill-health over time, assess the implications for service provision and to evaluate the effectiveness of recent interventions, especially initiatives arising from the Armed Forces Covenant.

A further 10 years of birth cohort data (birth years 1986-1995) will be incorporated, which will include veterans who would have been 19 years of age at the end of operations in Afghanistan, in order to examine important mental health outcomes in these young veterans. There will also be additional health outcomes included in the study such as post-service amputations and joint replacement surgery as they have a bearing on care needs.

Ray Lock, Chief Executive of the Forces in Mind Trust, said:
“This latest research into the long-term health of veterans living in Scotland will help identify important areas of ongoing risk, unmet need, and trends in veterans’ health over time.

“This information will be of great value to service providers and government departments UK wide as the results are expected to be generalisable, and should help inform where interventions and support may be required to close any gap in unmet need, manage ongoing risk, and plan for future needs of this population.”

Dr Beverly Bergman, Honorary Senior Research Fellow at the Institute of Health and Wellbeing, said: “The original Scottish Veterans Health Study has provided an unprecedented insight into long-term conditions, both physical and mental, in veterans who served as far back as 1960. We want to build on that to see not only how these older veterans are doing as they age, but also to look at emerging problems in younger veterans who have served on recent operations. We are delighted that FiMT is making this possible for us.”

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Statement in response on the Defence Committee report on mental health and the Armed Forces

In response to the Defence Committee report released today titled ‘Mental Health and the Armed Forces, Part One: The Scale of mental health issues’, Air Vice-Marshal Ray Lock, Chief Executive of the Forces in Mind Trust has said:

“Having provided evidence to the Committee, we welcome this report and strongly support its headline finding that veterans are being mis-perceived, not just in terms of their mental health but also in many other areas such as housing and employability, and their broader contribution to society.  It is time that this particular and harmful strand of ‘fake news’ is tackled head on, and that means listening to those, such as Forces in Mind Trust, who provide independent and credible evidence based upon sound research to policy makers.

“We acknowledge that all four NHSs have made improvements in the delivery of mental health services to veterans, but are alarmed that there seems to be some misunderstanding around the applicability of the UK Armed Forces Covenant.  As with so much surrounding the Covenant, from Local Authorities to small businesses, what is missing are unambiguous and practical statements of what the Armed Forces Community can, and cannot, expect.”

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MOD employment support trial empowers spouses of Service personnel

A new evaluation of the Ministry of Defence’s (MOD) Spouse Employment Support (SES) Trial has shown the advantages of supporting spouses of Service personnel. The evaluation, funded by Forces in Mind Trust (FiMT), and conducted by Anglia Ruskin University, reviewed how spouses progressed when given specific support to improve their chances of employment.

Key findings of the evaluation detail the essential role of employment support in building spouses’ confidence; with 78% of participants saying their involvement in the Trial had had a positive impact on their lives. Additionally, spouses in the Trial highly valued the training opportunities made accessible to them.

A set of key recommendations was produced from the evaluation of the SES Trial, including acknowledging that the MOD continues to recognise spouses in their own right, the importance of continuing access to childcare and transport provision, particularly for those in remote areas, the provision of a training grant to spouses, as well as further employment training opportunities.

Chief Executive of the Forces in Mind Trust, Ray Lock CBE said:

“When the Ministry of Defence announced that it was to undertake a trial of a Spouse Employment Support programme, we were gratified that one of the recurring themes of our evidence on transition, that Service leavers whose spouses were already in employment tended to fare better, was being acted upon. We were also pleased to be invited to provide an independent evaluation through Anglia Ruskin University.

“The eight recommendations contained within the report are based on the learning gained and the wholly positive impact on the spouses who participated in the trial. We are looking forward to working with the MOD to build upon these recommendations.”

The support of service families is a priority for the Ministry of Defence, highlighted by the Armed Forces Families Strategy, launched in 2016. The Strategy focuses on the link between equipping the families of serving personnel with the support and advice they need to prosper, and the delivery of operational capability. The removal of barriers to employment for spouses and partners of those in Service is a priority of the Strategy.

The Spouse Employment Support Trial seeks to aid spouses and partners to find employment that matches their skills, knowledge and experience, as well their career aspirations.

Minister for Defence People and Veterans Tobias Ellwood said:

“Our serving personnel lay their lives on the line to keep our country safe, and we have a duty to ensure that their spouses and partners, who play such a vital role in the Armed Forces community, receive the support they deserve.

“I’m delighted that the Spouse Employment Support Trial has proved to be a success, and I am confident that the spouses and partners of our serving men and women will continue to make an invaluable contribution to society.”

Lieutenant General Richard Nugee, Chief of Defence People, said:

“The spouses and partners of our Armed Forces personnel are often the glue that holds a military family together, and it is important that they are truly valued and recognised for their role.

“The findings and recommendations within this report will now be fully considered by the MOD as we continue to implement support for military families.”

Matt Fossey, Director of the Veterans and Families Institute for Military Social Research at Anglia Ruskin University, said:

“It is well documented that military spouses struggle in their careers as a result of frequent relocations, gaps in their CVs, and lack of affordable childcare. This groundbreaking and illuminating research shows the unanticipated consequences of introducing initiatives that provide employment support for military spouses.

“As well as the tangible employment-related benefits such as new skills, qualifications and confidence, military spouses felt that the Spouse Employment Support Trial was an extremely positive demonstration of the MOD’s commitment to the wider military family, thus improving spouses’ feelings of self-worth and individual agency.”

Read the full report here

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Well-being interventions help ex-Service personnel transitioning back into civilian life

Preventative interventions may have a positive effect on the well-being of ex-Service personnel who are having difficulties making the transition back into civilian life, a new Forces in Mind Trust (FiMT) funded-study has revealed.

The systematic review of research literature led by Newcastle University, published in Plos One academic journal, shows the positive impact of well-being interventions such as journaling and relaxation techniques on the lives of ex-Service personnel and their families.

The report highlights four areas to consider in future research and service development:
• What well-being means to ex-Service personnel transitioning back to civilian life
• Acceptability of interventions which may be perceived as treatment
• Further trials of the effectiveness of interventions with diverse groups of participants
• How and when low-wellbeing should be identified in Service personnel

The review looked at nine studies from the United States of America and evaluated the effectiveness of interventions for current and ex-Service personnel. Researchers found the positive effects on well-being was found in those reporting difficulties making the transition back to civilian life and their families.

Evidence from the review suggests a need for future robust trials exploring the effectiveness of well-being interventions for the Armed Forces community as a means to help with the challenges of transitioning back into civilian life.

Ray Lock, Chief Executive of Forces in Mind Trust, said: “What has been revealed, in this systematic review of well-being interventions, is that there may be benefit in making these preventative techniques available to ex-Service personnel experiencing difficulty on the transition pathway. These are popular activities, and it is important that they are evidence based.”

Dr Sarah Wigham, Research Associate at Newcastle University’s Institute of Neuroscience, said: “The review has summarized the evidence base for the effectiveness of well-being interventions for Armed Forces personnel transitioning to civilian life. The review findings will be of interest to those tasked with making decisions about which interventions to fund and develop in the future.’’

You can see the briefing document here and the full review here.

The journal article was published in PLOS ONE, you can read it here http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189630

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FiMT: Entering The ‘Third Age’ of the Forces in Mind Trust

On Thursday 28th June 2018, the Forces in Mind Trust (FiMT) launched its ‘Third Age’ at the charity’s FiMpacT Forum held at The QEII Centre in Westminster. The FiMpacT Forum marks the culmination in six years of grant giving, with funding from The Big Lottery Fund, to help ex-Service personnel transition into civilian life.

The Rt Hon Tobias Ellwood MP, Minister for Defence People and Veterans gave the keynote speech.

The forum was attended by 150 people including; politicians, academics, charity leaders and ex-Service personnel. An excellent exhibition of work from FiMT grantees enabled organizations and media to see the great work undertaken and enabled through funding by FiMT.

To date, FiMT has given over 100 grants totalling nearly £15 million, most notably over the past year to health and wellbeing related projects. This has included work into ending veterans’ homelessness, partnering with King’s College London on mental health issues and the associated stigma, and producing a guide for care homes with veterans, in collaboration with Cobseo (The Confederation of Service Charities) and Demos (Britain’s leading cross-party think tank).

Launching the Third Age of FiMT, the focus will be on driving forward and sustaining the positive impact upon ex-Service personnel’s lives already achieved by FiMT’s work to date. This new age will also focus on challenging the negative stereotypes around ex-Service personnel.

Chief Executive of the Forces in Mind Trust, Ray Lock said: “Our approach identifies six areas for improving the lives of ex-Service personnel – covering Housing, Employment (including training and education), Health and Wellbeing (physical and mental), Finance, the Criminal Justice System and Relationships.

“The Third Age will be an exciting move from being activity led, to strategically impact driven and coherently focused. We’re ramping up the impact of our work, whilst maintaining the generation of knowledge and evidence for which we have become renowned.”

Hans Pung, the Chairman of the Forces in Mind Trust, said: “As well as developing the impact of the work we’re already doing, we will also be promoting evidence over anecdote – such as working on altering stubborn perceptions of former Service personnel as “mad, bad, or sad”. We will be doing this through focusing on the real truth of personal lives, and working to establish an evidence base which truly reflects ex-Service personnel’s biographical histories, current situations and future need.”

You can access our latest Activity Report here.

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Improving transition out of the Armed Forces: engaging families through behavioural insights

The Behavioural Insights Team(BIT) were commissioned by the Forces in Mind Trust (FiMT) to assess whether empirical insights from social and behavioural sciences can help Service leavers’ families benefit more from services that support transition from the Armed Forces.

The need for this project came from work around families which FiMT has been developing over the last couple of years, when problems with engagement have been highlighted.

This report identifies the cognitive biases and barriers relevant to accessing services and presents ways in which systems can be designed to reduce them, or work with them.

Ray Lock, Chief Executive of the Forces in Mind Trust, said: “This is the first project we have funded with BIT. Their innovative and scientific approach has offered a unique insight into how service providers can benefit families by improving engagement, both during their time as a Service family and especially as they approach transition.

“The recommendations included in this report offer a range of changes to how services are delivered – such as tapping into Service leaver and family identity; presenting decisions as mattering for today not tomorrow; connecting with social networks; and making that transition easier, not harder. The second phase of this important work is now well underway.”

You can read the full report here.

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