‘One Is Too Many’ preventing self-harm and suicide in military veterans: a quantitative evaluation

Introduction: In 2021, the Armed Forces Covenant Fund Trust allocated over £2 million to programmes designed to have a clear and demonstrable impact on suicide prevention. Four grant holders delivered a combination of psychotherapeutic interventions, group activities, social prescribing, peer support mentoring, life skills coaching, educational courses and practical help with housing and employment. The evaluation was completed between August 2021 and July 2023. Methods: A survey was completed by 503 participants at entry and 423 at exit. It captured data regarding demographic and military-specific details, health status, situational stressors, predisposing symptoms, help-seeking behaviour, social engagement, housing, living arrangements and employment status. The questionnaire included a number of validated psychometric questionnaires. Results: This evaluation revealed reductions in situational stressors, symptoms and mental health illnesses. Seventy-six per cent of participants had completed an Operational Tour, and 77% were exposed to a traumatic event during service. It was the negative impact of unresolved traumatic effects that influenced service-users to require support. Forty-nine per cent delayed seeking help, and 36% self-referred to the One Is Too Many programme which demonstrates the importance of this option. There were improvements in the participants’ social networking, social activities, club membership and having people to rely on. Only 4% of participants were women which reinforces the requirement to explore initiatives to engage with female veterans. Conclusions: Timely therapeutic and social prescribing interventions in a safe environment lowered depression, anxiety and the associated situational stressors leading to self-harming and may have reduced suicide. It presented another option to veterans and their families regarding where they can obtain support, care and therapeutic interventions. The programme provided a strong foundation for delivery organisations to forge lasting collaborative partnerships that can be extended to working with other authorities and institutes. The results highlight pathways for prevention and intervention strategies to inform policymakers, healthcare professionals and third-sector organisations.Funder: Armed Forces Covenant Fund Trust; Grant(s): 2018-108214 / Change Request 2 dated 14 April 2021Acknowledgements: Lauren West & Annie Ellerton, Westminster Centre for Research in Veterans, University of Chester; Natasha Green, Defence Medical Welfare Services; Sonia Howe and Steven Inman, Armed Forces Covenant Fund Trust

Evaluation of the NHS England ‘Op COURAGE’ High Intensity Service for military veterans with significant mental health problems

In November 2020, The NHS for England launched a pilot High Intensity Service (HIS) programme for treating military veterans complex mental health problems. Seven regional grants were awarded to manage the HIS, including NHS Solent, in South East England. This paper details an evaluation of the HIS, which was conducted from February 2021 to August 2022. Methods: This mixed-methods study gained quantitative data from a specifically designed questionnaire that included a number of validated psychometric questionnaires. These were completed by either HIS staff or beneficiaries at entry and exit from the HIS, and qualitative data were gained from semi-structured interviews with the HIS staff. Results: Data were sourced from 45 pre-questionnaires, 25 post programme questionnaires and 11 interviews. This evaluation identified reductions in situational stressors, symptoms and reported illnesses for veterans in crisis. There were reductions in depression, anxiety and post-traumatic stress disorder following programme exit. Staff reported that there was no notable changes in stress levels which appeared to remain high at programme exit. Staff interviews highlighted the importance of simultaneously understanding the social and psychological needs of veterans in mental health crisis. The benefits of integrating veteran staff members into military veteran health services were identified, demonstrating improvements in education around military culture in civilian services. Conclusions: The importance of collaboration between clinical and veteran staff members in veteran health services was noted, demonstrating the positive impact social care provision has on veteran’s overall health and well-being. Veteran engagement with the service was advocated as a result of veterans accessing the service feeling understood. This first independent evaluation of the HIS provides a positive reflection, and adds to the limited empirical evidence exploring veteran engagement in health services.Acknowledgements: The authors would like to thank Tamsyn Howells, Talking Change Psychological Services, Solent NHS Trust

An evaluation of the veteran friendly practice accreditation programme.

From PubMed via Jisc Publications RouterHistory: received 2022-01-24, accepted 2022-02-22, revised 2022-03-15Publication status: aheadofprintThe Royal College of General Practitioners Veteran Friendly Practice Accreditation Programme launched in 2019, aiming to allow practices to better identify, treat and refer veterans, where appropriate, to dedicated NHS services. Evaluate the effectiveness of the accreditation programme, focusing on benefits for the veteran, the practice and the delivery of the programme itself. The study evaluated the views of Veteran Friendly Accredited GP Practices across England. Mixed-methods study collecting data via an online survey from 232 accredited Primary Healthcare (PHC) staff and 15 semi-structured interviews with PHC Veteran Leads. Interviews were analysed using modified Grounded Theory. 99% (N=228) of respondents would recommend the programme, 77% (N=124) reported improved awareness and 84% (N=193) a better understanding of veteran's needs. 72% (N=166) identified benefits for veterans who were engaging more with PHC but participants felt more time was needed, largely due to the Covid-19 pandemic, to fully assess the impact of the programme on help-seeking behaviour. Challenges included identifying veterans already registered, promoting the accreditation process and ensuring all PHC staff were kept up to date with veteran issues. The programme has increased signposting to veteran specific services and greater understanding of the NHS priority referral criteria for veterans. Recording of veteran status has improved and there was evidence of a better medical record coding system in PHC practices. These findings add to the limited empirical evidence exploring veteran engagement in PHC and demonstrate how accreditation results in better treatment and identification of veterans. [Abstract copyright: Copyright © 2022, The Authors.