The Contact Group

The UK collaboration for military mental health policy, treatment and research

Contact Armed Forces

The UK collaboration for military mental health policy, treatment and research

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

Case Management >

Common Assessment >

Quality and accreditation >

Data Dashboard >

Research >

Associates programme >

Communications >

Case Management

Executive Lead: Cobseo

There has been 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 for 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 these aspirations and will include the development of a project specification that potential suppliers will draw upon for their costed proposals.

Work on the Scoping Study is currently ongoing. As part of this, the consultant has completed a comprehensive fact-finding phase, involving engagement with key stakeholders and their front-line service providers, to ensure all perspectives are reflected in the proposed way forward, and is now starting to engage with prospective suppliers. The information-gathering process has been challenging, usually because of the need to extend the engagement process to get to the heart of issues that need to be addressed, and the many constraints that will need to be overcome, including: promoting understanding and buy-in of the aims beyond the immediate stakeholder community; addressing the challenges of operating across devolved boundaries (involving both data sharing and differing IT and/or non-IT business processes); getting a sense of beneficiary numbers, both now and looking ahead; and establishing a representative baseline (including at least 3 of the devolved administrations) for the initial implementation phase. 

The Customer Group that has been established for and consulted during this process has also recognised the importance of seeking input from clinicians before engaging with prospective suppliers, and there are plans to establish a Focus Group. The consultant is also working to finalise the framework document which will inform the specification that will be sent to 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, including ensuring understanding and buy-in for both the concept, the scope of the system and its target audience, and the governance of the system.

The Scoping Study is on track to deliver its specified outputs, anticipated to be by the end of Nov 2021, including a project specification, indicative costs from prospective suppliers, and a narrative on their proposals.

Related to this work, 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), as part of 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

Common assessment

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, 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 using the CAF and its information-sharing capabilities will mean that veterans will not be required to repeat their medical and military histories multiple times at the point of assessment, which can be traumatic, frustrating and time consuming.

The sub-group has refined the CAF document they have developed in response to feedback about essential and desirable criteria and divided it into separate sections for demographics, clinical information, safeguarding and other categories to aid providers who may carry out different assessments at different stages.

The main challenge now is identifying the best way to implement the CAF to suit different providers. The group has done some investigating into the complexities involved as there are many different assessment frameworks currently used, for example, by GPs, for self-referrals, by charities, etc. There is also much work ongoing in this space and a lot of potential change, so the choice of system and timing will be important.

The CAF can be used by the charity sector and NHS providers on a voluntary basis currently, please contact us if interested. NHS England will 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 veterans’ and families’ mental healthcare will assist members of the armed forces community to more easily identify and access services that are operating according to recognised best practice and agreed quality standards. With Prof Neil Greenberg of King’s College London and the Royal College of Psychiatrists (RCPsych), the Contact Group has produced the Contact Guiding Principles for the delivery of veterans’ and service families’ mental healthcare.

Contact has also collaborated with RCPsych to develop the first sector-specific quality network and accreditation programme for military mental healthcare providers, the Quality Network for Veterans Mental Health Services (QNVMHS). This is now established and the future accreditation it will award to participating teams that meet the agreed quality standards will include an easily identifiable and widely recognised ‘quality mark’ so those looking for military mental healthcare can more quickly and easily identify providers that have been quality checked.

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 for the network and these were 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 third sector/independent providers from across the UK.

The pilot ran from autumn 2020 to summer 2021 and consisted (as future cycles will) of a three month period of self-review, followed by peer reviews, and then reports on each service for their own internal use, and finally the publication of an anonymised, collated 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. The network’s first online annual forum was also held at which the findings of the pilot were presented, pilot teams shared their experiences of participating, relevant workshop sessions were held and the importance of this programme was highlighted in the context of other work being carried out across the UK military mental health sector.

The network is now open to all UK military mental healthcare providers/teams that may want to participate in the next annual cycle, starting in autumn 2021. An annual membership fee is £2,500 +VAT per team is payable to RCPsych which covers the costs of running the network. Further details and registration instructions for teams and organisations interested in joining can be found on the RCPsych website. Please contact us or email veterans@rcpsych.ac.uk with any queries or for further information.

Data dashboard

Executive Lead: Office for Veterans’ Affairs

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 is updated on a quarterly basis (where data allows). Editions of the dashboard to date have focused on available MoD, NHS and third sector data. Work is currently underway, through a series of online workshops, 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 data and this will be followed by a closer look at outcomes and then 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 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 areas of charity data, some of which will be worked on further to enable more comparability in future, including categories for age, ethnicity and location data.

The Executive Lead and support for the data dashboard has recently changed from MoD to the OVA who will produce future editions of the dashboard on behalf of Contact. 

Research

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 it for the benefit of the work of Contact, 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 nine 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 provides input for Contact.

The group’s work so far has included identifying the following potential gaps in military mental health research which will be 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 impact of recent events in Afghanistan on veterans’ and families’ mental health

The group recently held a deep-dive discussion on the issue of ageing veterans and dementia. The key findings/questions that were identified and will be explored further were:

– Planned research to look at experiences in the forces and early onset dementia will be monitored
Potential links 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, as well as (in collaboration with others) 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 an organisation’s core activity). The aim is to bring these organisations into Contact 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.

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 shared once details are confirmed.

Communications

Executive Lead: Walking With The Wounded

Contact 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

Contact us

If you have queries about the work of the Contact Group or its membership, please email the Contact Project Officer, Anna Owen on: anna.owen@contactarmedforces.org.uk