The impact of deployment on aggression and criminality amongst UK military personnel

Lead Research Organisation: King's College London
Department Name: Medicine School Office

Abstract

There is growing concern about increased aggression and criminality in military personnel returning from conflicts in Iraq and Afghanistan and the potential increased strain on the NHS and
criminal justice system. If there is a real increase in these antisocial behaviours, is this a result of pre-service factors, such as early disadvantage and antisocial behaviour, or military service
factors, such as combat trauma? Mental illness and substance misuse may also play important roles. Without understanding the different risk factors for offending in the Armed Forces, it is difficult to make policy recommendations regarding treatment/prevention services. In order to address these questions, data will be used from an ongoing study of UK military personnel in which information has been collected via questionnaire on aggressive behaviour as well as background information on demographics and health and behaviours before and after deployment to Iraq/Afghanistan. We will also link our data with that of the Ministry of Justice in order to get official conviction records as a reliable measure of offending behaviour. Aggression and offending in those who were deployed will be compared to those who were not. Factors associated with changes in level of violence/criminality in the deployed group will also be explored.

Technical Summary

Background: There is concern that an alleged rise in aggression/criminality in military personnel returning from deployment in Iraq/Afghanistan may increase pressures on the NHS and Criminal Justice System. The true scale of the problem and its aetiology must be known in order to develop appropriate services. US studies, which have shown an association between military deployment and increased aggression/criminality, have methodological weaknesses. Recent UK studies of the health and behaviour of military personnel have not examined aggression/criminality.

Aims: The primary aim of the study is to examine the impact of deployment and deployment-related factors on self-reported aggression and official records of offending in UK military personnel. A range of potential confounders/mediators of any associations will be analysed from data collected both cross-sectionally and prospectively. Changes in levels of antisocial outcomes over time and in relation to military deployment will also be examined.

Methods and Design: Data will be utilised from a large representative cohort of deployed and non-deployed UK military personnel (10,272), established by King‘s Centre for Military Health Research and followed up prospectively since 2003. Data, collected by questionnaire, includes pre-service, deployment and combat experiences, past/current health and behaviour, alcohol use and a range of other factors. The cohort data will also be linked to Police National Conviction Records to obtain an objective outcome measure of offending and also an objective measure of pre-military antisocial behaviour.

Scientific and medical opportunities: Mental health and behavioural problems facing those in the military become the problem of society and the NHS and CJS when they return from deployment or ultimately leave the military. High quality information on health and behaviour outcomes post-deployment is necessary to plan health services for serving/ex-serving UK personnel and toevelop strategies aimed at prevention of adverse outcomes. This is a high profile area in which there is a well acknowledged requirement for better research and to develop the next generation of suitably trained academics.

The KCMHR‘s established longitudinal cohort study offers the first opportunity in the UK to describe the prevalence, incidence and aetiology of antisocial behaviour in both deployed and non-deployed troops. Linkage of military personnel data with official criminal records has never been done in the UK and is an important advancement in criminal career research. This proposed study is a great example of translational research which is expected to impact on health policies and decisions with regard to treatment and prevention services for this vulnerable group.
 
Description Advisor in National Veterans Clinical Network
Geographic Reach National 
Policy Influence Type Participation in advisory committee
Impact Influenced by my research findings, a bid has been successfully made to provide criminal justice system veteran mental health inreach services in the london area.
 
Description Advisor to US Army Advisory Board on how to replicate my research over in US
Geographic Reach North America 
Policy Influence Type Gave evidence to a government review
 
Description Advisor to independent review on behalf of secretary of state into Former Armed Forces Personnel in the CJS
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
Impact I gave evidence to an independent cross party review into vets in CJS and was chair of their evidence gathering committee. The review cites my research as the main body of work on which they base their recommendations and has made specific recommendation that as soon as my research into domestic violence is published that it is acknowledged by parliament and acted up.
 
Description British advisor on US veteran policy
Geographic Reach North America 
Policy Influence Type Participation in a national consultation
 
Description Citation in Government report
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact My research was cited extensively in this government report. As a result of this report there has been an uplift in mental health services for veterans in the CJS and a national exercise in improving integrated mental health and CJS services. I have been awarded funding for 4 new prison inreach service for veterans in 4 London prison from the Armed Forces Covenant Fund and there are other examples of this increase in funding for such services across the country. NHS England commissioned scoping exercises into services for veterans in the CJS. I received funding of 50K to carry out scoping exercise in London and to make recommendations for further service development which comes with the promise of more funding. This has lead to improved outcomes for veterans in the CJS - as evidence locally by our prison service evaluations in London and other examples around the country.
URL https://www.gov.uk/government/publications/former-members-of-the-armed-forces-and-the-criminal-justi...
 
Description Developed educational materials for NHS and allied services staff
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact In my clinical role as consultant psychiatrist for the London Veteran Service, I and my team have developed an education package including workshops and educational materials on Veteran Mental Health which we have delivered to a range of staff from NHS services, probation, Court diversion and Liaison staff. My research findings have contributed significantly to several of the modules that we deliver.
 
Description Expansion of prison inreach services for veterans in London
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
Impact Following on from the research evidence which I provided to the government review on Ex-Armed Forces in the CJS (see last entry) and the support and funding received to establish a pilot mental health service for veterans in prison, we have now been provided with funding to roll out this service into 3 other London prisons.
 
Description Member of advisory committee for NHS England Armed Forces: development of veteran transitional services
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact I sit on an NHS England National Veterans Clinical Network which considers current work force and service planning for veterans. New services for military personnel in transition out of the military were identified as high priority. NHS England announced new tenders for 5 new regional services. As clinical lead for the London Veteran Service I led our team in applying for one of these tenders for London and the South East of England. We were successful and with this money we have been able to design a service informed by my research findings into the needs of military personnel in transition to improve accessibility and quality of mental health services for this population,
URL https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/10/armed-forces-comms-inte...
 
Description Member of advisory panel for NHS England on Veterans in the CJS: Gate to Gate report implementation
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact Based on my clinical and research expertise in the area, I sit on an NHS England committee for the implementation of the report "Gate to Gate" which made recommendations on the integration of mental health services and the CJS in providing services for veterans. I have been commissioned (50K) to lead a scoping exercise into service ffor veterans in the CJS in London area and to provide report and recommendations on service development needed to fill the gaps. This is vital work to improve mental health and social care for veterans and their families in the UK and will lead to improvements in QoL, reduce reoffending and reduce costs for CJS and mental health services through earlier intervention. It involves multiagency integrated working.
URL http://www.ciellp.com/wpress/2016/09/gate-to-gate-report-published/
 
Description Member of expert advisory panel for The Armed Forces Covenant Fund
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact As an expert on this panel we were tasked with developing outcomes measures for all new services for veterans funded by the Armed Forces Covenant Fund. As a group we met monthly and developed guidelines for the choice and implementation of outcome measures by these new services. We have now submitted a proposal for further funding form the Covenant Fund to take this work forward to develop an outcomes framework and means of collecting data from these services to create a prospective dataset for purposes of service evaluation and research. The outcome of this work is the standardisation of outcomes measures across veteran services to allow data to be collected quickly and easily to allow monitoring of service effectiveness and quality and to inform national service development.
URL https://www.gov.uk/government/collections/covenant-fund
 
Description Presentation of NHSE requested research to commissioners followed by a working group to take recommendations forward into practice.
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact On the basis of my research findings into offending by former armed forces personnel, NHS England then requested further research to look at their national data from court liaison and diversion services, which assess offenders at the point of first contact with the CJS, and compare the needs of veterans with non-veterans, in order to identify ways to help improve services for veterans. I applied for and received third sector funding for this research with the support of NHS England and have just presented my findings to a group of key NHS and third sector stakeholders and we are currently developing an action plan to take the recommendations from this work forward which include service development and training of work force.
 
Description Presented to Minister for Defence
Geographic Reach National 
Policy Influence Type Participation in advisory committee
Impact Based on my research the minister for defence recommended that more needed to be done to address the needs of veterans in the criminal justice system. A year later an independent review into vets in the CJS was established.
 
Description Research adviser to NHS England Veteran Service development group
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact My research findings have stimulated the development of prison/probation schemes for veterans in the CJS.
 
Description Service development as a result of government review of my research findings
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact I was invited to present my research as evidence in the government review into Ex-Armed Forces personnel in the Criminal Justice System. The recommendations that stemmed from this review, based on my findings, were for an uplift in provision of mental health support for veterans in the CJS, particularly in prison. As a result funding has been provided through NHSE, CCGs and third sector to develop these services. I applied for funding from NHSE to provide such a service and am now clinical lead for a prison inreach service for ex-Armed Forces personnel. Our service model continues to be informed by my research findings into the mental health needs of this population and risk factors for offending. This service is also being evaluated and the model will be rolled out into other prisons imminently.
 
Description Forces in Mind Trust Mental Health Research: Health and Welfare of veterans in CJS
Amount £98,000 (GBP)
Organisation Forces in Mind Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2017 
End 03/2018
 
Description Forces in Mind Trust: Domestic abuse victimisation among military spouses/partners
Amount £155,000 (GBP)
Organisation Forces in Mind Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2017 
End 01/2019
 
Description Forces in Mind Trust: Mental health and its relationship with unemployment and disability benefits among UK veterans
Amount £166,000 (GBP)
Organisation Forces in Mind Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2016 
End 12/2018
 
Description Help for Heroes: Improving family member's ability to motivate loved ones to seek help
Amount £330,000 (GBP)
Organisation Help for Heroes 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2017 
End 04/2018
 
Description MRC Centenary award
Amount £64,000 (GBP)
Organisation King's College London 
Department MRC Social Genetic and Developmental Psychiatry Centre (SDGP)
Sector Academic/University
Country United Kingdom
Start 02/2013 
End 10/2013
 
Description Mental health and treatment of veterans
Amount £158,000 (GBP)
Funding ID 142529 
Organisation Forces in Mind Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 04/2017 
End 11/2019
 
Description NHS England
Amount £10,000 (GBP)
Organisation NHS England 
Sector Public
Country United Kingdom
Start 06/2014 
End 08/2014
 
Description PhD studentship for which I am first supervisor: Offending during military service: Prevalence and risk factors
Amount £120,000 (GBP)
Funding ID 1667265 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 10/2015 
End 10/2018
 
Title data linkage with government official records 
Description This research was the first to use the method of data linkage with official ministry of justice criminal records without seeking prior consent from participants due to the bias that this would introduce to the study. This established the ethical and legal arguments for this type of data linkage which is now being replicated. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2012 
Provided To Others? Yes  
Impact I am now involved in further data linkage projects with other research groups both in KCL. other institutions and in the USA, in which we are linking research and health data with offending records. 
 
Description Clinical Health Needs for Ex-Service Personnel 
Organisation University of Manchester
Department Centre for Mental Health and Safety
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a collaborator on this project and have been involved from the writing of the funding proposal stage. I have subsequently been involved in advising on the methodology and design of the study. I continue to provide advice and input.
Collaborator Contribution The Centre for Mental Health and Risk, Menchester University successfully obtained an NIHR grant for this project.
Impact None as yet.
Start Year 2011
 
Description Domestic violence and abuse among military spouses and partners: impact of military life and culture, perceptions of support available and barriers to seeking help. 
Organisation Forces in Mind Trust
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I am PI on this project. I bring specialist experience of research into violence and mental health among military personnel. I am collaborating with Prof Fear and Dr Gribble from King's Centre for Military Health Research who bring experience of working with military partners and families.
Collaborator Contribution Forces in Mind Trust have funded this new research project on which I am collaborating with King's Centre for Military Health ResearchForces in Mind Trust are a key Stakeholder in the area of Veterans health and mental health and have funded the project and will sit on the project steering group.
Impact Only just received news of award.
Start Year 2017
 
Description Health and welfare needs of veterans in the Criminal Justice System 
Organisation Forces in Mind Trust
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I am PI on a new research grant to examine health and welfare needs of veterans in the Criminal Justice System. I bring my expertise and experience in researching offending and mental health among military personnel. I conceived of and designed the project and applied for funding.
Collaborator Contribution This project has stemmed from work with the NHS England Court Diversion and Liaison team who have provided us with their national data to analyse. Forces in Mind Trust are a key Stakeholder in the area of Veterans health and mental health and have funded the project and will sit on the project steering group.
Impact This funding has just been awarded and we are currently recruiting staff to the project.
Start Year 2016
 
Description Health and welfare needs of veterans in the Criminal Justice System 
Organisation NHS England
Country United Kingdom 
Sector Public 
PI Contribution I am PI on a new research grant to examine health and welfare needs of veterans in the Criminal Justice System. I bring my expertise and experience in researching offending and mental health among military personnel. I conceived of and designed the project and applied for funding.
Collaborator Contribution This project has stemmed from work with the NHS England Court Diversion and Liaison team who have provided us with their national data to analyse. Forces in Mind Trust are a key Stakeholder in the area of Veterans health and mental health and have funded the project and will sit on the project steering group.
Impact This funding has just been awarded and we are currently recruiting staff to the project.
Start Year 2016
 
Description Intervention study with Help for Heroes: Improving family member's ability to motivate loved ones to seek help 
Organisation Help for Heroes
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution This charity has funded us to carry out this intervention trial of a treatment that was developed in the US and we are implementing it in a UK military veteran population.
Collaborator Contribution Help for Heroes has provided the funding and we will also be working with Help for Heroes therapists who we will train up to deliver this intervention for the study.
Impact We only just in the process of recruiting staff to the project.
Start Year 2017
 
Description Longitudinal Study of the mental health sequelae of gang violence 
Organisation Barts Health NHS Trust
Country United Kingdom 
Sector Public 
PI Contribution I am a co-applicant on this multi-centre grant application and I will head up the longitudinal arm of the study looking at PTSD with victims of gang violence over time
Collaborator Contribution This is a submission for an NIHR grant on which I have been involved and invited to be a co-applicant.
Impact Submitted for preliminary round of NIHR grant applications - not successful
Start Year 2013
 
Description Mental Health Needs of UK Veterans in contact with the Criminal Justice System 
Organisation NHS England
Country United Kingdom 
Sector Public 
PI Contribution I am leading a project to analyse the data from 10 pilot NHSE court liaison and diversion services to compare the profile of offending patterns, mental health and welfare needs of veterans who offend compared to the general population offenders.
Collaborator Contribution NHS England have secured our access to this data.
Impact Pilot data was analysed. Disciplines include psychiatry, psychology and public health. We have now secured funding from Forces in Mind Trust to fund this research - see new collaboration
Start Year 2015
 
Description Mental heath and treatment of veterans 
Organisation Forces in Mind Trust
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I and Dr Laura Goodwin of Liverpool University are co-PIs on a new research grant funded by Forces in Mind Trust for £160K for 18 mths.
Collaborator Contribution Dr Goodwin brings epidemiological expertise and knowledge of the KCMHR military dataset and APMS population dataset. Forces in Mind Trust are key stakeholders in the area of veteran health and provided the funding and will sit on the project steering group.
Impact This collaboration has just commenced and we are currently recruiting staff.
Start Year 2016
 
Description Mental heath and treatment of veterans 
Organisation University of Liverpool
Department Institute of Integrative Biology
Country United Kingdom 
Sector Academic/University 
PI Contribution I and Dr Laura Goodwin of Liverpool University are co-PIs on a new research grant funded by Forces in Mind Trust for £160K for 18 mths.
Collaborator Contribution Dr Goodwin brings epidemiological expertise and knowledge of the KCMHR military dataset and APMS population dataset. Forces in Mind Trust are key stakeholders in the area of veteran health and provided the funding and will sit on the project steering group.
Impact This collaboration has just commenced and we are currently recruiting staff.
Start Year 2016
 
Description NHS England Clinical Research Group: multi-centre study of PTSD treatment in veterans 
Organisation Combat Stress
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I am co-PI on the development of a multi-centre trial of psychological treatments for PTSD in Veterans.
Collaborator Contribution NHS England have brought this group of experts together from King's College London, Combat Stress, Exeter University and Northumbria University.
Impact We are currently developing the proposal.
Start Year 2016
 
Description NHS England Clinical Research Group: multi-centre study of PTSD treatment in veterans 
Organisation NHS England
Country United Kingdom 
Sector Public 
PI Contribution I am co-PI on the development of a multi-centre trial of psychological treatments for PTSD in Veterans.
Collaborator Contribution NHS England have brought this group of experts together from King's College London, Combat Stress, Exeter University and Northumbria University.
Impact We are currently developing the proposal.
Start Year 2016
 
Description NHS England Clinical Research Group: multi-centre study of PTSD treatment in veterans 
Organisation University of Exeter
Department Department of Geography
Country United Kingdom 
Sector Academic/University 
PI Contribution I am co-PI on the development of a multi-centre trial of psychological treatments for PTSD in Veterans.
Collaborator Contribution NHS England have brought this group of experts together from King's College London, Combat Stress, Exeter University and Northumbria University.
Impact We are currently developing the proposal.
Start Year 2016
 
Description NHSE: Domestic Violence in the UK military 
Organisation NHS England
Country United Kingdom 
Sector Public 
PI Contribution NHSE provided me with money to expand my research into the area of domestic violence by carrying out a systematic review of domestic violence in the military
Collaborator Contribution They provided the money and the platform through which to distribute this piece of work.
Impact NHS England report on domestic violence in the military This project led to me obtaining a postdoctoral NIHR fellowship exploring DVA among serving and ex-serving military personnel. The review was cited in Government report (Phillips, 2014) and the Government called for my follow-on research to be brought to parliament and acted on.
Start Year 2013
 
Description Negative outcomes for general adult psychiatry patients following discharge from hospital 
Organisation University of Manchester
Department Offender Health Research Network
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a co-applicant on this multi-centre NIHR programme grant application and will oversea the running of the study in the South of England if it is successful.
Collaborator Contribution Professor Shaw at Manchester University is the PI on the grant application
Impact This application was rejected
Start Year 2013
 
Description Outcomes framework development for services for military veterans funded by the Government Armed Forces Covenant Fund 
Organisation Anglia Ruskin University
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a collaborator and main advisor on this project which aims to develop a framework for measuring outcomes from services for military veterans funded by the Government Armed Forces Covenant Fund. It brings together an expert advisory panel from Anglia Ruskin University, Glasgow University, Ulster University and Cardiff University.
Collaborator Contribution Anglia Ruskin University have lead on the writing of the bid and in undertaking the development of a wellbeing measure and a broader outcome framework, the IT development and negotiated with the MoD for further funding to create a central data platform. We as the expert panel with myself as the lead advisor have commented and advised throughout the process.
Impact The development of a veteran well being measurement tool: multidisciplinary exercise including Psychiatry, Psychology, Epidemiology, Military Health, Academic Nursing.
Start Year 2017
 
Description Pilot study to develop enhancement of trauma focused CBT 
Organisation Combat Stress
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I am leading a collaboration of research centers with NHS England in developing an enhancement of trauma focused CBT interventions to inform a multicentre treatment trial of PTSD.
Collaborator Contribution I am the lead writer of this bid with expert input from others. It is a multidisciplinary collaboration with quant and qual expertise as well as clinical input.
Impact An application for funding.
Start Year 2017
 
Description Pilot study to develop enhancement of trauma focused CBT 
Organisation NHS England
Country United Kingdom 
Sector Public 
PI Contribution I am leading a collaboration of research centers with NHS England in developing an enhancement of trauma focused CBT interventions to inform a multicentre treatment trial of PTSD.
Collaborator Contribution I am the lead writer of this bid with expert input from others. It is a multidisciplinary collaboration with quant and qual expertise as well as clinical input.
Impact An application for funding.
Start Year 2017
 
Description Pilot study to develop enhancement of trauma focused CBT 
Organisation Northumbria University
Country United Kingdom 
Sector Academic/University 
PI Contribution I am leading a collaboration of research centers with NHS England in developing an enhancement of trauma focused CBT interventions to inform a multicentre treatment trial of PTSD.
Collaborator Contribution I am the lead writer of this bid with expert input from others. It is a multidisciplinary collaboration with quant and qual expertise as well as clinical input.
Impact An application for funding.
Start Year 2017
 
Description Pilot study to develop enhancement of trauma focused CBT 
Organisation University of Exeter
Department College of Life and Environmental Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution I am leading a collaboration of research centers with NHS England in developing an enhancement of trauma focused CBT interventions to inform a multicentre treatment trial of PTSD.
Collaborator Contribution I am the lead writer of this bid with expert input from others. It is a multidisciplinary collaboration with quant and qual expertise as well as clinical input.
Impact An application for funding.
Start Year 2017
 
Description mTBI and the association with violence in the military 
Organisation University of Exeter
Country United Kingdom 
Sector Academic/University 
PI Contribution I have formed a research collaboration with professor Williams and we currently setting up a new study looking at TBI among veterans resident in Combat Stress with a view to further exploring psychological treatment.
Collaborator Contribution Prof Williams has provided research assistance.
Impact Neuropsychology Psychiatry Epidemiology
Start Year 2013
 
Description A range of radio interviews: BBC 5live, radio 4, BBC scotland, BBC Wales, jeremy vine show, 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact I was invted to give a string of bbc radio interviews about my research findings.

I have been contacted by veteran services, probation services, police forces, nhs service across the country with regard to information, advice, collaboration etc etc
Year(s) Of Engagement Activity 2012
 
Description Attended North East NHS Veterans Services Development Working Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact As a researcher into veteran offendning and mental health issues I was invited to take part in this working group that was devising a plan for the development of veteran services in the North East of England.

A working plan for development of services was produced which my research helped to inform.
Year(s) Of Engagement Activity 2011
 
Description BBC 1 breakfast TV interview 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact I was interviewed on the BBC breakfast programme following the publication of my lastest paper into violence in military personnel.

I have been contacted by a wide variety of organisations and agencies to advise/present/collaborate.

I was also invited to do more media interviews.
Year(s) Of Engagement Activity 2012
 
Description BBC radio 4: file on 4 documentary 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact I was interviewed for a file on 4 documentary into violence among UK military personnel following return from deployment.

I received a wealth of media enquiries and contacts from interested public sector and third sector agencies involved in working with veterans and their families. It also sparked a potentially fruitful collaboration with police forces.
Year(s) Of Engagement Activity 2012
 
Description British advisor at US veteran policy round table meeting at Department of Veteran Affairs, DC 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact I was invited to talk about my research and how it could impact on UK veteran policy and to compare and contrast UK and US veteran policy

Our round table discussion is being put together as a paper tp be circulated. Another meeting is scheduled with the aim of putting together a draft policy document.
Year(s) Of Engagement Activity 2012
 
Description International conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I took part as a presenter in a symposium on ex-military personnel in the Criminal Justice System at the International Association of Law and Mental Health. I spoke on pathways to offending (general violence and domestic abuse). The audience was an international mix of legal and mental health professionals. There was a panel discussion at the end. Audience members were very engaged and shared best practice.
Year(s) Of Engagement Activity 2017
URL https://ialmh.org/congress/past-congresses/prague-2017/
 
Description International presentation of research findings at Forensic Faculty Conference in Copenhagen 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Health professionals
Results and Impact I was invited to present my research findings at the annual royal college forensic faculty conference in Copenhagen.

February, 2013

I raised the profile of my research beyond the academic audience to a clinical audience and have since been invited to advice on the development of services for veterans within forensic services.
Year(s) Of Engagement Activity 2013
 
Description Interview for BBC news 24 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact BBC news 24 recorded an interview with me and this was played hourly throughout one day ion the topic of the mental health of military personnel.

See other TV interview response
Year(s) Of Engagement Activity 2012
 
Description King's College London media panel discussion at event to disseminate our military research 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact At an event to disseminate research from King's Centre for Military Health Research, I was asked to be a panel discussant and discuss my research findings and clinical work. The audience was made up of people working in media, policy, health, third sector, academic and patient and public. The event was also covered by the media. I received positive feedback from audience engagement.
Year(s) Of Engagement Activity 2015
 
Description Lecture and workshop on MSc course in War and Psychiatry 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact I gave a lecture on my research in the area of offending by military personnel to masters students on the War and Psychiatry course - a very international group of post grad students. We had a discussion group afterwards with a mini debate.
Year(s) Of Engagement Activity 2017
 
Description Lecture on Trauma and Offending Behaviour 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact I gave a lecture to Master's level students at King's College London which was followed by lots of discussion about research and practice with multiple students approaching me at the end re further study/research/ training in the field.
Year(s) Of Engagement Activity 2018
 
Description Lecture to King's College London MSc students on PTSD and my research 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As Senior Lecturer in our dept at King's I lecture each year to our MSc students who are a very international bunch. The course is forensic mental health and psychology and students are on either a clinical or research pathway. After the lecture each year I get lots of interest in this field of research and students ask to do research with me. I recruited one of my current PhD students this way and she is now undertaking a PhD into PTSD in prisons.
Year(s) Of Engagement Activity 2014,2015,2016,2017
URL http://www.kcl.ac.uk/ioppn/depts/fans/study/pgt/index.aspx
 
Description Live TV interview and participation in panel discussion: Victoria Derbyshire BBC on military mental health, PTSD and problems with aggression/violence 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I was contacted to take part in a live interview and then panel discussion on the above show. There were veterans/service users on the panel. I was asked to discuss mental health and military personnel from a research and clinical perspective. I was able to discuss my research as well as my clinical experience. This was a valuable opportunity to dispel some of the myths about mental health in this population using much of the data from our research at KCL and also to encourage individuals with mental health problems to seek help. Viewers (veterans and their families) emailed in during the programme and expressed how their understanding had been improved as a result of the discussion and were encouraged to seek help.
Year(s) Of Engagement Activity 2017
URL http://www.bbc.co.uk/iplayer/live/bbctwo?rewindTo=current
 
Description Multiple TV and radio appearances 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Throughout 2014/2015 I was invited to give tv and radio interviews relating to my research into violence among UK military personnel:
eg BBC radio 4 Today Programme, News at one, BBC Radio 4 PM programme, Sky news, Channel 4 news, BBC news at 10.
As a result I have received multiple requests for further information about the research and my clinical work (which is related) and members of the public have sought info on our clinical services that can help them or their relatives.
Year(s) Of Engagement Activity 2015
 
Description Multiple tv and radio appearances on several occasions in 2013/2014 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact I have been invited onto radio and tv to discuss my research on a number of occasions usually after a public event linked to my research.It is usually prime time (BBC 10 oclock new, one oclock new, radio 4 today programme, PM programme).

It has allowed me to publicise my research, King's college London and the MRC as well as disseminating my research findings and their broader implications. As a result my clinical service (linked to my research) has gained more referrals and I have been approached to engage in collaborative research work.
Year(s) Of Engagement Activity 2013,2014
 
Description Panel discussion at Conference: Epidemiology and Occupational Health, Barcelona: Opportunities for epidemiology in studying the transition from military to civilian life 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Following a symposium presentation at this conference I was invited to take part in an expert panel discussion. This stimulated much audience discussion with voices given to service users and patients as well as policy makers and academics. Networking afterwards led to international research collaborations.
Year(s) Of Engagement Activity 2017
URL https://kclpure.kcl.ac.uk/portal/en/publications/s046-panel-discussion-and-summingup-opportunities-f...
 
Description Presentation at St Andrews Healthcare Conference on Veteran Mental Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Health professionals
Results and Impact I was asked to talk to health professionals about my research findings and how they impact on the development of clinical services

I was asked to join an advisory panel on the development of mental healthcare for veterans.
Year(s) Of Engagement Activity 2013
 
Description Presentation for Minister for Defence 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact I was invited to present my findings for the Minister for Defence as part of a presentation of key research from King's Centre for Military Health Research with important implications for health policy

I am now involved in Department of Health and NHS England work to develop mental health support services for veterans who end up in the criminal justice system and reduce reoffending.
Year(s) Of Engagement Activity 2013
 
Description Presentation of research findings at International Association of Forensic Mental Health Services 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Conference of the International Association of Forensic Mental Health Services, Miami, April 2012:
"The Impact of Deployment to Iraq and Afghanistan on Violence Among UK Military Personnel", D MacManus

http://www.iafmhs.org/

I formed links with international research groups and was invited to a round table discussion on US veteran policy later in the year at the Department of Veteran Affairs as the British member.
Year(s) Of Engagement Activity 2012
URL http://www.iafmhs.org/
 
Description Presentation of research findings at the Society for Medicine Meeting, London School of Hygiene and Tropical Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "The Impact of Combat, Trauma and Post-deployment Mental Health Problems on Self-reported Violence Among UK Military Personnel", D MacManus, Dean K, Jones M, Hull L, Greenberg N, Fahy T, Wessely S, Fear N.

12th September 2012, London

Made good contact for data linkage work at another academic institution.
Year(s) Of Engagement Activity 2012
 
Description Presentation to British Legion 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I presented to a panel of senior representatives of The Royal British Legion. The are a major military charity who are keenly interested in the work of King's Military Health Reseach and help us disseminate results to active military personnel, ex-serving personnel and the general public. They also offer some funding streams. They were visiting the unit for an update on all the milityary research and were particularly interested to hear about my research project which sparked alot of discussion and questions.

The British Legion expressed particular interest in my anticipated results and requested another update when I have further results.
Year(s) Of Engagement Activity 2010
 
Description Presentation to British Military 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I presented my findings as part of a day in which KCMHR shared and discussed ongoing research on the UK military with representatives from the military.

Interest expressed in future findings and discussions had about further research within the military
Year(s) Of Engagement Activity 2011
 
Description Presentation to The Howard League for Penal Reform 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact I presented to a core group of members of the Howard League for Penal Reform and they were invited to attend the department of King's Centre for Military Health Research for a morning of interactive discussion.

I received, under embargo, a copy of a report The Howard League had undertaken on Veterans in Prison on which I then wrote an editorial for the BMJ. I was subsequently invited to attend the House of Commons launch of the report.
Year(s) Of Engagement Activity 2011
 
Description Presented for the minister of defence 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact I was invited to present and discuss my research findings to the Minister for Defence as part of a presentation of the research work of KCMHR.

The minister discussed my findings and their potential impact on health policy in veterans. He asked me to provide him with a paper outlining the important issues in the area.
Year(s) Of Engagement Activity 2012
 
Description Presented research findings at National Forensic Services Conference (keynote speaker) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact I was invited to be a keynote speaker and present my recent research findings at the National Conference of Forensic Service at the Institute of Psychiatry which is a conference with a national platform.

March, 2013

This raised my profile as a researcher in this field and brought my research findings to a clinical and academic audience. As a result of this exposure I was approached by senior researchers from other academic institutions to collaborate on research projects.
Year(s) Of Engagement Activity 2013
 
Description Presented to South West NHS Veterans Services Development Working Group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact NHS and Criminal Justice System professionals attended and were very eager to hear about my findings which stimulated much discussion.

I was invited to attend further such meetings and contribute to working groups in future
Year(s) Of Engagement Activity 2011
 
Description Press conference and range of radio and prime time TV interviews following the release of the Lancet paper 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The Welcome Trust held a press conference prior to the release of my paper in the Lancet and this was followed up by a range of TV, radio and newspaper interviews both national and international.

My research findings received a worldwide platform and reached a wide lay and academic audience, stimulating a lot of interest in this research.
Year(s) Of Engagement Activity 2013
 
Description Press release for Press Association 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact I was interviewed over the phone by news reporter for press association regarding my recently published results.

My findings were published in all the main broadsheet newpapers and tabloids in the UK and also many international publications - reaching an international audience.
Year(s) Of Engagement Activity 2012
 
Description Public lecture at London School of Economics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact I was invited to give a evening public lecture alongside Lord Alderdice on the theme of "The Psychology of Violence: insurgents and counterinsurgents". I presented my research findings on violence among UK military personnel. The event was very well attended and the audience included an international base of postgraduate students, other academics and the general public. The events stimulated much audience discussion and questions. I subsequently received multiple emails from audience members about the research, my clinical work and involvement in related projects.
Year(s) Of Engagement Activity 2013
 
Description Several meetings with NHS England and the DoH 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact I am the research advisor to the National Veterans Network panel which is evaluating UK veterans services in order to develop and improve provision of and practice within mental healthcare for this population. The panel consists of representatives from NHS England and the DoH.

I have been asked to take the lead on setting up a research project to extract a minimum dataset from these services which can ultimately be used as platform for other research. The DoH will fund this.
Year(s) Of Engagement Activity 2013
 
Description Speaker at charity conference on veterans in prison 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I was invited to speak at the No Offence conference called 'Broken Soldiers', 3 july, 2013, Wolverhampton

Research findings disseminated to a wide non-academic, service user and policymaking audience.
Year(s) Of Engagement Activity 2013
 
Description Speaker at symposium at conference of Epidemiology and Occupational Health, Barcelona: Exploration of pathways to offending by uk military personnel using data linkage 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I was invited to be a speaker at a symposium on: Military Personnel and Problems in Transition out of the Military, at the above named conference in Barcelona. It attracted a large international audience and led to much discussion and the beginnings of international collaborations afterwards.
Year(s) Of Engagement Activity 2016
URL https://kclpure.kcl.ac.uk/portal/en/publications/s045-exploration-of-pathways-to-offending-by-uk-mil...
 
Description TV documentary 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact I was asked to participate in a TV documentary by a filmmaker exploring veterans and the criminal justice system.

This has not yet been broadcast.
Year(s) Of Engagement Activity 2012
 
Description TV interview for British Forces TV 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Participants in your research and patient groups
Results and Impact I was interviewed about my research for British Forces TV.

We got an increase in the number of serving and ex-serving military personnel making inquiries to our research office about how to access mental health treatment.
Year(s) Of Engagement Activity 2012
 
Description Training to police and probation on offending among military personnel 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Based on my research into risk factors for offending among military personnel, I developed a training session for those working in the Criminal Justice System (probation, police, court diversion staff) on ex-military personnel offenders and mental health problems: epidemiology, clinical presentation, management. I delivered 3 sessions which were very well attended and positive feedback received. Further sessions have been requested.
Year(s) Of Engagement Activity 2015
 
Description Undergraduate psychology workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact I held a lecture based on my research followed by a debate workshop on the undergraduate psychology degree course at King's College London. A group of approximately 40 undergrad students took part . A number of students have since asked if they can either do their undergrad dissertation with me or spend some time on placement with me.
Year(s) Of Engagement Activity 2018