What we do
Contact members, associates and partners are currently working collaboratively on a number of identified priority military mental health projects. Each project is led by a nominated Contact member as Executive Lead to advise and assist with work in that area. If you would like further information about any of Contact’s work areas listed below, please contact us.
Photo credit: Combat Stress
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Executive Lead: Cobseo
There has been a growing recognition of the need to improve the beneficiary journey for veterans seeking mental health services and, in particular, the linking of relevant data held by the principal statutory and third sector service providers. Following the first Contact Case Management workshop in Edinburgh in June 2019, Cobseo and Contact convened a Case Management Working Group of key stakeholders in autumn 2019 to consider the feasibility of a more holistic approach. The group’s report and recommendations were supported by the Office of Veterans Affairs (OVA), who agreed to fund a Scoping Study for the development of a Veterans Mental Health Information System (VMHIS), and to appoint an IT consultant to take this work forward.
The key principles identified by the Working Group are that:
– Veterans seeking access to mental health services should only be required to relate their history once.
– The existing silo approach, which often applies when veterans need to access multiple service providers, should be replaced by a process for effective data sharing, covering both statutory and third sector providers.
– The envisaged System should provide an immediate overview of the veteran’s dealings (if any) with mental health providers and welfare systems.
– Approved System users will have pre-determined editing rights, and access to confidential data should be limited to overviews (with links to seek further information where necessary).
– The System should be GDPR compliant, and underpinned by veterans’ consent for personal data to be utilised to support the coherent provision of mental health services.
– The new System should link existing systems, and avoid the wholesale replacement of local networks. It should also be embedded in existing local information networks.
– While the initial focus is on mental health, it is envisaged that the System can evolve at a later stage to incorporate other clinical conditions and physical health issues.
– Finally, and most importantly, the interests of the veteran must be kept at the heart of this project as it proceeds.
The Scoping Study will address the IT development work needed to achieve the aspirations set out in the Working Group report, including the development of a project specification that potential suppliers will draw upon to develop their costed proposals.
The consultant has completed the fact-finding phase, involving engagement with key stakeholders and their front-line service providers, to ensure their perspectives are reflected in the proposed way forward, and has commenced engagement with prospective suppliers.
The success of the project will be dependent on achieving widespread buy-in and support across the public and charity sectors, and a commitment to address the challenges that will need to be overcome which include ensuring understanding and buy-in for the concept, the scope of the system and its target audience, and the governance of the system.
The consultant’s interim report will be considered imminently. The Scoping Study is on track to deliver its specified outputs by this Sept, including a project specification, indicative costs from prospective suppliers, and a narrative on their proposals.
In March 2021, Contact hosted an online military mental health and case management conference (the programme and outputs including a video recording are available at the link) at which the above aims and work were outlined and feedback was invited from attendees, many of whom were service providers. Feedback received to date has suggested that a VMHIS as described above would be welcomed by the sector. Feedback on the project is welcome at any time by contacting us.
Executive Lead: NHS England and NHS Improvement
Contact work on a common assessment framework (CAF) for use by both NHS and charity/independent military mental health treatment providers for assessing users accessing their services is being led by NHS England which chairs a sub-group of Contact members and other relevant organisations working on this issue, now including DMS, the devolved administrations and an NHS England provider. It is envisaged that, as a result of the CAF and accompanying information system, especially for veterans moving between or accessing multiple services (statutory and non-statutory), the common information collected by providers and information-sharing capabilities of the system, will mean that veterans will not be required to repeat their medical and military histories multiple times which can be traumatic, frustrating and time consuming.
The group has recently done some refining of the CAF they have developed in response to feedback about essential and desirable criteria. They will also divide the CAF into separate sections for demographics, clinical information, safeguarding and other categories to aid providers who may carry out different assessments at different stages.
Current plans are to pilot the CAF with the charity sector and selected NHS providers and then roll out the system to providers on a voluntary basis from April 2021, with a view to considering its use with new Op COURAGE contracts sometime after April 2022.
Quality and accreditation
Executive Lead: Royal College of Psychiatrists
Improved quality and accreditation of military and veterans’ mental healthcare (VMH) providers will help members of the armed forces community identify and access services that are operating according to recognised best practice and agreed quality standards. Contact has been collaborating with the Royal College of Psychiatrists to develop the first sector-specific quality network and accreditation programme for military mental health, the Quality Network for Veterans Mental Health Services (QNVMHS) which has now been established and will, in future, be accompanied by an easily recognisable ‘quality mark’ so that those looking for military mental healthcare can quickly and easily identify whether the providers they are considering have been quality assessed.
A clinical advisory group for the network, comprising expert clinicians from the UK military mental health sector, helped to draft the first set of quality standards that will be used to measure the quality of services offered by treatment providers. These were then tested in a 12-month pilot funded by the Department for Health and Social Care and NHS England & NHS Improvement. Ten pilot teams participated, drawn from the NHS in England, Scotland and Wales and charity/independent providers from across the UK.
The pilot ran from autumn 2020 to summer 2021 and, as the full cycle will in future, consisted of a three month period of self-review and peer reviews, followed by the production of reports on each service for internal use and finally the publication of an anonymised, collated summary report of the findings. At the end of the pilot, the quality standards were reviewed and some adjustments made in response to feedback from the pilot teams.
On 8 July, the network’s first online annual forum was held at which the findings of the pilot were presented, pilot teams shared their experiences of participating, relevant workshop sessions were offered and the importance of this programme was highlighted in the context of other work being carried out across the UK VMH sector.
The network is now open to all UK military mental health teams that may want to participate in the next annual cycle, starting this Sept. An annual membership fee is £2,500 +VAT per team is payable which covers the costs of running the network. There will be a limited number of partial membership fee subsidies available to selected teams to help with the cost of this and the allocation of these will be decided in late summer.
Further details for teams and organisations interested in participating in the QNVMHS from this Sept can be found on both the Contact and RCPsych websites, including an expression of interest form for teams to complete and submit by 15 August. Please contact us if you have any queries or would like further information.
Executive Lead: Ministry of Defence
Contact and the Ministry of Defence (MoD) have been working together on the development of a UK military mental health data dashboard. The aim is to present a complete picture of the strength and nature of demand, capacity and outcomes across all parts of the UK military mental health sector using all available data on veterans and serving personnel accessing clinical mental healthcare in the UK, including from MoD, NHS and charity/independent providers, together with outcomes data and indicators of capacity.
The dashboard will be updated on a quarterly basis (where data allows) and circulated to those requiring an overview of emerging trends in military mental health. Editions of the dashboard to date have focused on available MoD and NHS data and work is currently underway with Contact charities Combat Stress, Help for Heroes and Walking With The Wounded to explore available data, more fully incorporate their demand, capacity and outcomes data and to develop a coordinated process for data submission in future. The findings have so far indicated that a large quantity and range of data is collected, the first focus of which has been demand, followed by outcomes, and finally capacity data.
A fifth edition of the dashboard was produced for Contact member review and discussion in June. The slides presented included new MoD data on serving personnel, last year’s NHS England data which will be updated in line with new annual data released this Sept, and new charity demand data including numbers of referrals and accepted referrals over FY 2020-21, breakdowns of these by gender, service and UK region, and numbers of veterans in-treatment by quarter of 20-21. There remain slight differences in the timings and types of some charity data collected, some of which will be further worked on in future to enable more comparability, including age, ethnicity and location data.
Support for the data dashboard will shortly move from MoD to OVA data analysts.
Executive Lead: Northern Ireland Veterans’ Support Office
Contact work in the area of Research includes the monitoring of relevant recent and ongoing military mental health (MMH)-related research and interpreting and reporting on it for the benefit of Contact work, its member organisations and the wider sector, as well as identifying and monitoring potential gaps in relevant MMH research.
This is the specific role of the Contact Research sub-group which consists of a selection of Contact Research Associates. The group has twelve members of which eight rotate annually and is currently chaired (for 2020-22) by Dr Alan Finnegan from the University of Chester’s Westminster Centre for Research in Veterans. The group meets quarterly and submits reports to Contact for review and discussion by members.
The group’s work so far has included identifying the following potential gaps in military mental health research which are currently being monitored and explored in further detail:
– Minorities’ access to healthcare
– Ageing veterans (especially women) and dementia
– The needs of service (distinct from war) widow/ers
– The scope and nature of ongoing research into families and children
– Complex grief, including that as a result of violent or traumatic death
– The impact of Covid on military mental health clinical practice
The group recently held a deep-dive discussion on the issue of ageing veterans and dementia. The key findings that were identified and will be developed as a result of this are:
– The group is aware of some planned research to look at experiences in the forces and early onset dementia which will be followed up
– Potential links were noted between PTSD and Parkinson’s disease and between MTBI, PTSD and dementia
– How we care for veterans with dementia and/or PTSD in care home settings
– The issue of caring for elderly relatives with dementia whilst also serving
The group will also aim to capture the quantity and variety of ongoing relevant UK postgraduate research and provide overarching analysis of it, as well as engage with and develop activities with and for UK postgrads engaged in MMH-related research.
Associate membership programme
Executive Lead: Togetherall
The Contact associate membership programme has been introduced for Cobseo member organisations that can demonstrate direct and established involvement in the provision of mental health services or support to serving personnel, veterans or families (though this does not have to constitute core activity). The aim is to bring these organisations into the Contact Group as associate members to complement Contact’s existing core membership. Membership is free of charge and associates benefit from involvement in Contact’s ongoing military mental health-related workstreams (when opportunities arise), relevant consultations, information-sharing and other communications about Contact and the work of the wider sector, including the Contact quarterly newsletter.
Associate members are also featured on our associates page where a summary of activities and useful links can be included. If your organisation is interested in joining as a Contact associate, please read the invitation letter and complete and email back an application form. If you have any queries about the scheme, please feel free to contact us. The programme is currently open to organisations that are members of Cobseo, and in future will be extended to others. Further information about this will be posted here once details are confirmed.
Executive Lead: Walking With The Wounded
Contact’s work in the area of communications is aimed at improving awareness, sector-wide and beyond, of both Contact and its work and that of its members and associates, through the use of various communications channels including the Contact website (the recent redesign and development of which was made possible through a grant from the Veterans Foundation), social media, newsletters and other information-sharing, and the hosting of both online and in-person events.
During the first Covid-19 lockdown, Contact worked with partners to help coordinate a series of regionally-focused online meetings for military mental healthcare providers. The aim was service information-sharing and networking, as well as signposting for beneficiaries. The first meeting, focused on SW England, was hosted by Contact member Togetherall. The second and third meetings, both focused on NE England, were hosted by Contact member Walking With The Wounded. If your organisation is interested in co-hosting or participating in a future online regional networking meeting for military mental healthcare providers, please contact us.