The provision of services in the UK for armed forces veterans with post-traumatic stress disorder: a rapid evidence synthesis

ID: 

320

Session: 

Poster session 3

Date: 

Tuesday 18 September 2018 - 12:30 to 14:00

All authors in correct order:

Dalton J1, Thomas S1, Melton H1, Harden M1, Eastwood A1
1 Centre for Reviews and Dissemination, University of York, UK
Presenting author and contact person

Presenting author:

Sian Thomas

Contact person:

Sian Thomas
Abstract text
Background:
There is an increasing demand for psychological trauma services in the UK, particularly for armed forces veterans with post-traumatic stress disorder (PTSD).

Objectives:
To explore what is known about current UK service provision, and establish potentially effective models of care and treatment for veterans with PTSD.

Methods:
Rapid synthesis of the research literature on models of care and on treatments, guided by information from UK service providers.

Results:
We included 61 studies in the rapid evidence review on models of care, and seven systematic reviews in the rapid meta-review of treatments. Promising models of care from more robust studies included: collaborative arrangements and community outreach for improving intervention access and uptake; integrated mental health services and behavioural intervention on increased smoking abstinence; and peer support as an acceptable compliment to PTSD treatment. Promising treatments were psychosocial interventions (eye movement desensitisation and reprocessing; cognitive processing therapy; trauma-focused and exposure-based intervention) and pharmacotherapy (antidepressants, anticonvulsants.

Conclusions:
The evidence tentatively supports the effectiveness of some models of care and certain treatments currently delivered in UK practice. Our findings represent a timely update to commissioners and service providers when developing the present suite of activity in veterans’ healthcare.

Patient or healthcare consumer involvement:
We drew on both published public and patient involvement data, and experts with academic, military, and commissioning backgrounds.
An army veteran with 35 years’ military service provided advice and input into the interpretation of our research findings, drawing on his deployments in worldwide conflicts and from reflections on his engagement with UK health services following a diagnosis of PTSD.
His input enriched researcher interpretations, including those around the influence of stigma, reticence to seek help, and associations with complex presentations of PTSD compounded by co-morbidities. He drew our attention to personal experience of time-lapse between trauma and presentation of PTSD, supporting the case for pre-emptive intervention early in the transition from military to civilian life.

Relevance to patients and consumers: 

Alongside the published evidence, we spoke to experts with academic, military, and commissioning backgrounds. In particular, an army veteran with 35 years’ military service helped interpret our research findings, drawing on his deployments in worldwide conflicts and from reflections on his engagement with UK health services following a diagnosis of PTSD. He helped researchers understand the influence of stigma, reticence to seek help, the impact of other health conditions in combination with PTSD, and the importance of intervening early in the transition from military to civilian life.