The Together Programme: Supporting Caregiving Partners of veterans
Abstract: In a recent analysis conducted by Combat Stress of UK, partners living alongside veterans with mental health difficulties, rates for depression and PTSD were higher compared to the external population (depression 39% Vs 20%, PTSD 17% Vs 3%. (Murphy, Palmer & Busuttil, 2016). As such this suggests the high burden of need within this group. The support currently available here in the UK mainly comprises of peer based support. Whilst research indicates the positive impact peer led groups can have, the clinical severity of partners symptoms implies a need for more structured, bespoke and evidence based intervention. To this end, a bid for funding to support the development of an evidence based intervention ‘The Together Programme’ for UK veterans partners was made and kindly awarded by The Royal British Legion in 2016. Based on review findings, two US psychoeducational programmes, SAFE and Homefront Strong (see glossary) which have been found to be effective and well accepted within the US military population were selected as the most appropriate base to devloop a UK specific injtervention to support military partners.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.