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Virtual reality can help to treat ex-Service personnel with treatment-resistant PTSD, according to new study

Results of a study into the effectiveness of a new treatment for Post-traumatic Stress Disorder (PTSD) show that it can be effective for ex-Service personnel with treatment-resistant PTSD.

Modular Motion-assisted Memory Desensitisation and Reconsolidation (3MDR) is a new treatment, based on virtual reality exposure therapy and eye movement desensitization and reprocessing, used in a novel context. The patient walks on a treadmill while interacting with a series of self-selected images that are displayed on a large screen and relate to the patient’s past traumas.

The study by Cardiff University was funded by Forces in Mind Trust (FiMT). It found that PTSD symptom severity was statistically and clinically reduced by 37% in an immediate treatment group who undertook 3MDR. A delayed treatment group experienced an average reduction of 14% in PTSD symptoms while waiting for 3MDR, and a further 28% reduction following the treatment.

Developed by Professor Eric Vermetten of Leiden University in The Netherlands, 3MDR is based on the therapeutic principles of traditional trauma focused techniques, virtual reality exposure therapy and eye movement desensitization and reprocessing (EMDR), the important distinction being that these traditional techniques are sedentary.

Ray Lock, Chief Executive at Forces in Mind Trust, says:

“While the majority of ex-Service personnel successfully transition into the civilian world, a number suffer from mental health conditions as a result of their experiences. Approximately seven per cent are thought to suffer from PTSD, which has significant ramifications on their quality of life. The success of 3MDR in treating this debilitating condition offers hope for those affected by it, and FiMT is pleased to have supported the research which has demonstrated this.”

Professor Jonathan Bisson, Professor in Psychiatry at the Cardiff University School of Medicine, says:

“The results of our study are very encouraging and should pave the way for further research into a new treatment that has the potential to make a real difference to a significant number of ex-Service personnel with PTSD that has not responded to standard treatments.”

The full report can be found here.

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Successful study on Complex Post-traumatic Stress Disorder receives further funding to pilot a new treatment programme for ex-Service personnel

Following a study on Complex Post-traumatic Stress Disorder (CPTSD) which found that CPTSD is a more prevalent condition within help-seeking ex-Service personnel than PTSD, Forces in Mind Trust (FiMT) has awarded a new grant to conduct a pilot study of a new treatment especially developed for CPTSD in ex-Service personnel.

The original study, published today, shows that of those meeting the criteria for either condition, 57% report symptoms consistent with CPTSD, compared to only 14% with PTSD.

The study was a collaboration between Edinburgh Napier University and veterans’ mental health charity, Combat Stress, and funded by Forces in Mind Trust (FiMT).  It found that ex-Service personnel with CPTSD take longer to access professional and medical support compared to those with PTSD. Barriers to help-seeking for ex-Service personnel with CPTSD were found to include stigma, feeling unworthy of formal treatment, and concerns about confidentiality being maintained.

The research suggests both conditions should be routinely screened to increase early detection and appropriate intervention, and health care professionals should also be aware of the specialist veteran mental health services in their area so they can refer those with CPTSD.

Ex-Service personnel with CPTSD experience many of the main symptoms of PTSD, including difficulty in regulating emotions, feeling negatively about themselves, and problems relating to others. Several factors increase the likelihood of suffering from the condition, including a history of childhood trauma and experience of a combat role.

Following on from the study, FiMT has awarded a further £304,494 to Edinburgh Napier University in partnership with Combat Stress, to conduct a pilot study on the efficacy and acceptability of a new treatment, Enhanced STAIR (ESTAIR), especially developed for CPTSD in ex-Service personnel.

The first phase of this project will include the pilot study of a tailored treatment programme for ex-Service personnel who meet the diagnostic criteria for CPTSD. It will explore recruitment feasibility, the uptake of therapy, the acceptability of measures and treatment, and retention in the trial.

If the pilot proves successful, the project team will offer free training to the NHS and charitable service providers on modular therapy for CPTSD and look to conduct a larger and international trial. The project, awarded under FiMT’s Health Programme, is delayed due to COVID-19 and will commence in January 2021. It is expected to last 28 months.

Ray Lock, Chief Executive at Forces in Mind Trust, says: “This is a much-needed study which demonstrates significant potential to effect positive change in the ex-Service community. Given that CPTSD is actually more common among ex-Service personnel than PTSD, it is vital that it becomes better understood, especially by service providers.

“FiMT is committed to supporting the Armed Forces community throughout and beyond Covid-19 and this includes the continuation of funding to much needed projects such as this grant”

Professor Thanos Karatzias, Professor of Mental Health at Edinburgh Napier University and study author, says: “This work confirms that many veterans in clinical services suffer from CPTSD. An interplay of combat experiences and childhood difficulties seem to play a key role in the development of those symptoms. This is a very important step in helping us understand how to best support people with CPTSD and suggests that trauma therapies in veterans should address not only combat experiences but also childhood adverse life experiences.”

Until recently, CPTSD was not viewed as a separate medical condition from PTSD and condition-specific literature and data are relatively sparse. This report marks an important step towards better understanding of this condition and those it affects, especially within the ex-Service community.

Dr Dominic Murphy, Head of Research at Combat Stress, says: “Our data supports what we see clinically, namely that help-seeking veterans are more likely to be presenting with more complex symptoms of PTSD, often alongside a range of other difficulties. This piece of research has helped us better understand the needs of this vulnerable group and we hope will provide a stepping-stone to developing interventions to better meet their needs.”

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Forces in Mind Trust responds to Government announcement of new funding for Armed Forces charities

In reaction to the new funding announced by the Government to support Armed Forces charities, Air Vice-Marshal Ray Lock CBE, Chief Executive at the Forces in Mind Trust (FiMT), says:

“I welcome today’s announcement from the Government for funding Armed Forces charities. Both serving and ex-Service personnel have played, and continue to play, a critical role in reacting to the Covid-19 crisis, delivering services on the frontline and supporting some of the most vulnerable people in the community.

“Armed Forces charities, like many others, have faced a drop in funding whilst also responding to an increase in demand. The funding from Government will help to ensure that they can continue to deliver some vital services and support in the short term, but more will need to be done to help the sector cope sustainably. Our research with the Directory of Social Change has highlighted the huge gap between lost charitable income and what the Government has so far pledged.

“Through unprecedented levels of collaboration between organisations, and innovative planning of future services informed by the credible evidence FiMT provides, the serving and ex-Service community can help lead the way out of the current crisis. This is as tough a battle as many within our community have ever fought. We are determined to work resolutely together to help those most vulnerable, but tight financial resources continue to be a key constraint on our work.”

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Forces in Mind Trust awards grant to Queen’s University Belfast for UK-wide study on the psychological health and wellbeing of ex-Service families

Forces in Mind Trust (FiMT) has awarded £306,956 to Queen’s University Belfast (QUB) to conduct a study examining the psychosocial determinants of psychological health and wellbeing for ex-Service families. The project was commissioned by FiMT and benefits from a UK-wide partnership of research institutions including King’s College London, Anglia Ruskin University, Combat Stress, Cardiff University and Glasgow Caledonian University.

The project will identify the psychological health and wellbeing needs of families of ex-Service personnel across each of the four UK nations. Through a survey, in-depth interviews and focus groups with families, the research will examine the drivers that support psychological wellbeing as well as the challenges that come with having a member of the family in the Armed Forces. The research will also identify the likely future needs of ex-Service families.

The two-year long project was commissioned and awarded under FiMT’s Health Programme. As a result of COVID-19, the start date has been delayed until September 2020.

FiMT are committed to supporting the Armed Forces community throughout and beyond COVID-19 and this includes the continuation of funding to much needed projects such as this grant. The latest FiMT COVID-19 response can be found here.

Ray Lock, Chief Executive of FiMT, says: “The importance of families is widely recognised in the Armed Forces and the extent to which a family is able to support a Service leaver during their time in service, and their subsequent exit, is a strong indicator of a successful transition. While most Service leavers and their families make a successful transition from the Armed Forces to civilian life, there is a minority who struggle, and the impact of service on the psychological health and wellbeing of families is an under-researched area. This study will provide us with an important evidence base on the needs of families and offer much-needed recommendations on how best to support them.”

Chérie Armour, Project lead at the Stress Trauma and Related Conditions (STARC) research lab at Queen’s University Belfast, says: “We are delighted to receive this award and take forward this important piece of research. Families are key to the health and wellbeing of our military veteran populations as they provide that first line of support. We understand that being a family member of a veteran can at times come with challenges. Families may have experienced a number of geographical re-locations during a military career, have had worry and upset during times of the Service person’s deployment, and they may have experienced some economic, social, and psychological challenges because of transition from military to civilian life. What we need is a robust and detailed understanding of what that means for the family and their own personal health and wellbeing. This award allows us to investigate exactly that and to provide a solid evidence base which family support providers can call upon when designing support services.””

Professor Nicola Fear, from the King’s Centre for Military Health Research (KCMHR) at King’s College London says: “KCMHR is excited to be involved in this upcoming project. With much of the research to date focusing on families during Service, the findings from this study will provide evidence to understand how families of ex-serving personnel manage after leaving the military community and the influences on their health and wellbeing.”

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Forces in Mind Trust responds to the call for evidence from the Health and Social Care Committee

Forces in Mind Trust has responded to the call for evidence from the Health and Social Care Committee on Delivering Core NHS and Care Services during the Pandemic and Beyond.

The full response can be found here.

New review reveals that more needs to be done to address mental health problems in the Armed Forces community

UK serving and ex-Service personnel experiencing mental health problems such as Post-traumatic Stress Disorder, depression and anxiety disorders, and alcohol misuse need earlier identification and better support, according to a new review commissioned by the Forces in Mind Trust (FiMT) and conducted by the National Centre for Social Research (NatCen).

The study offers new insights into the prevalence of mental health problems, the experiences of serving and ex-Service personnel and their family members, and the effectiveness of current interventions. It brings together a review of 190 research studies and interviews with stakeholders from the Ministry of Defence, NHS England, military charities and academic institutions.

The findings reveal that deployment and combat are strong predictors of mental health problems, with common mental disorders such as anxiety and depression the most prevalent conditions for both serving and ex-Service personnel. For serving personnel, work culture, workload, and peer or leadership support are important determinants of mental health. For ex-Service personnel, the transition into civilian life can come with challenges such as isolation, feeling misunderstood and relationship problems.

Barriers to help-seeking for serving personnel include stigma and the fear of adverse impacts on their military career. Barriers for ex-Service personnel include not always being aware of the different treatment options available, and trying to cope with mental health challenges alone.

To better support the mental health of the Armed Forces community, the report recommends that there should be:

  • Earlier identification of ‘at risk individuals’ and early intervention to prevent escalation of mental health problems
  • Improved awareness amongst healthcare professionals of the needs of ex-Service personnel and their entitlement to priority support.
  • Greater connectivity between Armed Forces and civilian services, to manage the transition to civilian life and ensure ex-Service personnel do not slip through the net.
  • Increased education on mental health and stigma for military personnel and their families, to support help seeking and address concerns around career impacts.

Ray Lock, Chief Executive at Forces in Mind Trust, says:

“While just a small minority of serving and ex-Service personnel struggle with mental health challenges, our goal is for all ex-Service personnel and their families to be able to access good quality health and social care where and when they need it. This review brings together evidence to support FiMT’s wider Health Programme by collating existing research to provide us with an evidence base on the mental health needs of serving and ex-Service personnel that can be used by the whole sector to better support them.

“As we move forward, it is important that policy makers and service providers take account of the impact of Covid-19 too. This is already affecting the mental health of many in society, including serving and ex-Service personnel, some of whom are working on the frontline. This is an issue we will be looking at as we continue to develop our Health Programme.”

FIMT’s Policy Statement on Health, also published today, is available to read in full here.

Daniel Phillips, Head of Evaluation at The National Centre for Social Research, says:

“This review offers important new insights into the mental health needs of military personnel and families. Deployment and combat are strong predictors of later mental health problems, while difficulties in the transition to civilian life also impact on the mental health of veterans and their close relations.

“While effective interventions are available, barriers such as perceived stigma can prevent personnel and their families from seeking help. More could also be done to ensure military personnel and their families are aware of the support available to them and feel confident about using it. We hope the recommendations in this research will help shape more proactive identification, intervention and support for serving and ex-Service personnel and their families.”

Andy Bell, Deputy Chief Executive at the Centre for Mental Health says: “This important study provides valuable insights into the mental health needs of Service and ex-Service personnel. It identifies not just the types of mental health difficulty people may experience during their transition to civilian life but also the groups with the highest risks. It also points out significant gaps in research that need to be addressed. We hope that this report will help to put resources where they are needed most and inform the next generation of research on this crucial topic.”

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Policy Statement on Health

This Statement sets out Forces in Mind Trust’s (FiMT’s) policy position on the health needs of ex-Service personnel and their families, and how these are met.  It provides an overview of the evidence that exists to support it, the issues that inform it, and the changes that are needed to achieve it.

Click here to download the Policy Statement on Health.