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11: Mental health consequences of deployment and overstretch in the UK Armed Forces

Summary of the impact

King's College London researchers showed that increased length of deployment has a detrimental effect on the mental health of the UK Armed Forces, and that Reserves were particularly vulnerable to the effect of deployment. This evidence influenced the `Harmony Guidelines', which determine policy and deployment for the UK military. This prevented an additional 308 (7%) cases of PTSD and 431 (8%) cases of alcohol misuse per year. Internationally it influenced the decision by the US Department of Defence to reduce their deployment length. KCL evidence on the mental health consequences of deployment for Reserves, as opposed to Regulars, greatly influenced policy and increased service provision for current and future Reserves.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

20: Reducing mental health stigma across England

Summary of the impact

Time to Change (TTC) is a national programme to reduce stigma and discrimination related to mental health. King's College London (KCL) researchers have conducted most of the original research that led to the intervention, had a major role in planning TTC with two leading mental health charities, Mind and Rethink Mental Illness, and have led the evaluation of the programme. That TTC is making a difference across England is evidenced by gradual positive changes in attitudes and behaviour. KCL measures are also being used by the UK Government and to evaluate anti-stigma campaigns in Denmark, New Zealand and Sweden.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

25: Brief interventions reduce risky behaviour of returning military personnel

Summary of the impact

Armed Forces personnel are twice as likely to die on the road as civilians, and around 2.5 times more likely to report alcohol misuse. Evidence from King's College London (KCL) has helped highlight these issues and led to the development of specific post-deployment interventions for service personnel in order to mitigate the impact of deployment on driving behaviour and alcohol use. Delivered during post-deployment decompression, as a result of KCL research these interventions have been mandatorily provided to up to 20,000 service personnel returning from deployment and have led to a significant reduction in road-traffic deaths.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

17: International dissemination of best practice in standardised needs assessment

Summary of the impact

King's College London (KCL) researchers developed and disseminated the Camberwell Assessment of Need (CAN) which provides a scientifically rigorous and flexible approach to assessing the mental health and social needs of people with a wide range of disorders. Mental Health services around the world are striving to increase the patient-centeredness of their care. The CAN supports this needs-led care planning to help transform mental health policy and practice. KCL work has resulted in CAN being the most internationally recognised and researched assessment tool available. The CAN is widely used in mental health policies and locally adapted versions are routinely used in clinical practice within both statutory mental health services and nongovernmental organisations in the UK and around the world.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Best Practice Guidance: Responding to the Psychosocial/Mental Health Needs of People Affected by Disasters/Major Incidents

Summary of the impact

The North Atlantic Treaty Organisation (NATO)/Euro-Atlantic Partnership Council (EAPC) Guidance on "Psychosocial Care for People Affected by Disasters and Major Incidents: a Model for Designing, Delivering and Managing Psychosocial Services for People Involved in Major Incidents, Conflict, Disasters and Terrorism" is a conceptual and practical resource for: developing government policy; planning services, and providing training for health and social care staff. It was informed by underpinning research conducted in Aberdeen following the 1988 Piper Alpha oil platform disaster and evidence briefings generated from a comprehensive review of the world literature. Adopted as best practice guidance by all 28 NATO Members and Partner Nations, it has had regional, national and international impact by: enabling authorities to deliver integrated psychosocial care and mental health services; enhance training; raise awareness, and facilitate the effective utilisation of resources in responding to psychosocial/mental health needs post- incident.

Submitting Institutions

Robert Gordon University,University of the Highlands & Islands

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

14: Preventing heroin overdose deaths with take-home emergency naloxone

Summary of the impact

King's College London (KCL) researchers discovered that heroin overdose is a common and accidental occurrence which is usually witnessed. Risk of fatal overdose on prison release is exceptionally high with 1 in 200 dying of an overdose within four weeks. KCL researchers proposed and tested the acceptability of prior provision of take-home emergency supplies of the heroin antidote naloxone. KCL research created the stimulus for a national training project for families and carers to administer naloxone and as a result, lives are now being saved. KCL research had a substantial impact on national and international policy and service delivery with take-home naloxone programs introduced around the world. KCL researchers lead the first trial to assess the effectiveness of naloxone for prisoners on release.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

01: Developing a new treatment: Cognitive Behaviour Therapy for Psychosis

Summary of the impact

King's College London (KCL) researchers developed cognitive behaviour therapy for psychosis (CBTp), which is now a National Institute for Health and Care Excellence-recommended psychological intervention. CBTp is now part of routine NHS treatment and an estimated 25,000 patients in England and Wales receive it annually. Implementation of CBTp has been steered by KCL researchers' involvement with the Government's Increasing Access to Psychological Therapies — Severe Mental Illness initiative. The KCL model for CBTp has been used to develop clinics in Australia and the US and information on this therapy is disseminated via a KCL-led website.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Neurosciences, Public Health and Health Services

Recovery in Mental Health: Generating, Translating and Evaluating Evidence in Policy, Practice and Education

Summary of the impact

University of Nottingham research in the field of recovery has had a major influence on changes in mental health policy. It has led to a new model of service provision both in the UK (including through NICE guidance and the NHS's outcomes framework) and internationally (including in Western Europe, Scandinavia, Canada, Australia and Asia). The work has contributed to a reduction in the use of mainstream services and has enhanced the quality of life enjoyed by people with mental health problems. It has also been central to the Department of Health's Implementing Recovery through Organisational Change programme, which has pioneered the use of Recovery Colleges and peer support workers in mental health care in the UK.

Submitting Institution

University of Nottingham

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Potential and limitations of policies promoting choice, flexibility and control

Summary of the impact

This case study concerns a body of research by Dr Julie Ridley, Dr Helen Spandler and Dr Karen Newbigging into Self-directed Support (SDS) and Direct Payments (DPs), which examines perspectives and experiences of policies to promote choice, control and flexibility in social care, and provides a critique distinguishing between rhetoric and reality. Early qualitative and action research focused specifically on mental health, including work for the Scottish Executive (Ridley) and the Department of Health (Spandler), leading to cutting-edge policy critiques (Spandler), engagement with the field to distil key implementation themes (Newbigging) and later, to broader based evaluation of SDS policy implementation in Scotland. Collectively and over time, this work has had a direct influence on social care policy and law across the UK, as outlined below.

Submitting Institution

University of Central Lancashire

Unit of Assessment

Social Work and Social Policy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

21: Improved Mental Health Assessments for Children in Local Authority Care

Summary of the impact

Prior to King's College London (KCL) research, social workers did not regularly assess mental health needs of Looked After Children (i.e. those in the care of their Local Authority). KCL investigations showed that 45% of British Looked After Children have mental health disorders, considerably pushing this issue up the policy agenda. KCL developed assessments that are now the statutory annual measures used by all Local Authority children's services in England. The assessments enable Local Authorities to identify the treatment needs of Looked After Children and plan accordingly. The Department for Education requires Local Authorities to complete the measures. The measures are used worldwide and are now key elements of treatment trials of social and psychological interventions to reduce the level of difficulties in Looked After Children.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

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