Leading civilian UK centre of excellence for military health research

The King’s Centre for Military Health Research (KCMHR) is investigating the Adult Psychiatric Morbidity Survey (APMS) to address several research aims (see projects for details). These projects will be utilising the APMS 2014 dataset (https://www.natcen.ac.uk/taking-part/studies-in-field/adult-psychiatric-morbidity-survey/privacy-notice/) which was conducted with ethical approval in 2014 and is held by NHS Digital. The use of the APMS will purely be for secondary analysis of anonymised data, where there will be no attempt to link participant identities to the sample. For more details about our team, please visit: www.kcmhr.org

APMS Data

The APMS is a nationally representative survey of households in England on the prevalence of self-reported treated and untreated psychiatric disorders in adults aged 16 years or over. The 2014 survey is the fourth in the survey’s history, conducted by NatCen Social Research in collaboration with the University of Leicester for NHS Digital.

Access to APMS 2014 data has been obtained by KCMHR via a Data Sharing Agreement between King’s College London (KCL) and NHS Digital. The APMS 2014 dataset contains limited personal data which could potentially allow identification of some participants; however, the risk is considered very small and therefore likelihood of this is highly unlikely.

We take great care in protecting the 2014 APMS data. There are strict contractual standards agreed between KCL and NHS Digital, which as the Data Controller and Data Processor we will adhere to. This includes restricting who has access to the data (approved KCL staff and students) and ensuring the data is stored safely (on secure KCL servers). As legally required under General Data Protection regulations (2018) regulations, and stated as Information Governance good practice, the data will not be kept for longer than needed and will be securely destroyed once no longer required.

Projects

Project 1: Military Dementia study

Dementia is currently incurable, irreversible and a major cause of disability for the world’s older population. The association between mental health problems, such as post-traumatic stress disorder, depression and dementia has been the focus of research for a considerable time within the general population, though limited research is available on military veterans.

Aim: To examine whether military veterans are at an increased risk of developing dementia compared to the general population.

Project 2: Military Domestic Violence and Abuse study

There is growing awareness that Domestic Violence and Abuse (DVA), both perpetration and victimisation, is a problem within military populations and DVA in the UK military has been identified as a priority area of concern by the UK Government. US-based studies have suggested that DVA rates are higher among military populations than civilian and that there are unique military risk factors for DVA. Such research has not been undertaken in the UK. Use of the APMS dataset represents an opportunity to compare data on self-reported DVA among UK military personnel and the general population.


Aims: The aims of the project are to use the KCMHR and APMS data sets to compare the prevalence and severity of DVA among UK military personnel with the general population, to investigate the demographic and mental health factors associated with DVA and to explore whether engagement with support services differ between military and civilian populations.

Project 3: Military employment study

Mental health conditions can have a substantial impact on employment. Such disorders are a major cause of financial loss to the UK economy with estimates in the region of £70 billion per annum being suggested. Mental health disorders may cause both absenteeism and presenteeism with the latter thought to have the bigger impact. Furthermore, as well as poor work performance affecting the lives of those with mental disorders, in rare but tragic cases such as the Germanwings plane crash of 2015, mental health problems amongst those working in safety critical roles can have a much wider impact.

Aim: To examine whether military veterans are at an increased risk of poor employment outcomes compared to non-veterans.

Project 4: Military mental health-female study

As of 2018, the British Army no longer limit roles that women can apply for, including close combat roles There is a body of data available to assess the impact of combat on the mental health of men, however, due to the comparatively small number of women in the UK Armed Forces, research in this group is more challenging. KCMHR has gathered data on the mental health of military women and has generated provisional outcomes for women experiencing combat events while deployed; however, an appropriate comparison group is lacking, and it is therefore challenging to contextualise and properly interpret such data.

Aim: The proposed study will compare women participating in the KCMHR cohort with an occupationally matched sample of women from the APMS cohort.

Project 5: Military mental health-male study

In 2011, Woodhead et al. published a research article investigating the mental health and health-service use of post-national service veterans using the 2007 APMS. No differences were found between male veterans and the general population in rates of adverse mental health, social disadvantage or health-service use. However, some evidence existed that those who left service early experienced worse mental health compared to those who stayed in service for longer.

Aim: This study aims to update the literature on prevalence of mental health disorders, social disadvantage and health-service use amongst veterans using the 2014 APMS dataset, whilst also assessing the differences between early service leavers and those who stay in service longer.

Data Storage and Processing

The APMS data is primarily held by NHS digital. KCMHR will be the data controller and data processor for the purposes of the projects outlined above in accordance with General Data Protection regulations (2018), the Data Protection Act (2018), and KCL’s Research Data Management Policy. Projects will run until at least 2025 to allow for analysis, write up and dissemination of results. Data will continue to be retained until 2028, in line with KCL’s Data Retention policy which is described further here https://www.kcl.ac.uk/aboutkings/orgstructure/ps/audit/records/retention  (relevant category: ‘Unfunded research project’).

The data processing at KCL will only be carried out by substantive employees of KCL or PhD students with a signed contract with KCL. All individuals will be expected to have completed KCL’s GDPR training and have confirmed in writing that they have read and understood the protocols outlined and referred to in the Data Security and Protection Toolkit.

The data will be held on KCL’s network drive in an access-controlled area of the network drive and the data will be accessible to authorised study personnel only. All users have their own username and password, and these will never be shared. Access to the data for the study will be removed as soon as a user leaves the study, KCL, or if they are absent for a long period.

Data will be stored on servers owned and managed by KCL, within the JISC Southern Data Centre. Only individuals with the administrative rights to those servers will be able to access data stored on them. The only individuals with those administrative rights are KCL’s IT Computer & Storage team. JISC is a United Kingdom not-for-profit company whose role is to support post-16 and higher education, and research, by providing relevant and useful advice, digital resources and network and technology services, while researching and developing new technologies and ways of working.

The lawful basis for the processing of this information is:

  • Article 6(1) e) of the UK General Data Protection Regulation (UK GDPR): processing is necessary for the performance of a task carried out in the public interest or in the exercise of the official authority vested in the controller.
  • Article 9(2) (j) of the UK General Data Protection Regulation (UK GDPR): processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.

Processing and dissemination is for research purposes, and also meets the public interest criteria as defined by the UK Information Commissioners Office for good decision-making by public bodies and securing the best use of public resources.

Protection of Personal Data

No data will be linked to patient records.  No data will be passed on to other organisations. No attempts will be made to identify participants from the dataset. All data will be handled with care and in compliance with the GDPR (2018), the Data Protection Act (2018), and KCL’s Research Data Management Policy.

Participant Consent and Rights

APMS 2014 received ethical approval from the West End National Research Ethics Committee (ethical approval reference number 14/LO/0411). During survey collection, participants gave full informed consent for their participation.

The ‘right to be forgotten’ (under Article 17 of the GDPR) does not apply in relation to this research as the stored data by NHS Digital is non-identifiable. Requests for data opt-out also cannot be granted under the National Data Opt-out Programme as data is non-identifiable.

If you have any concerns about personal data handling in relation to this project, these can be raised with the KCL Department of Psychological Medicine researchers, or with the KCL Data Protection Officer (details below). You also have the right to file a complaint about any aspect of data handling with the UK Information Commissioner’s Office (www.ico.org.uk).

Contact Details

Address: King’s Centre for Military Health Research, Third Floor, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ

Email contact: [email protected]

Website: https://kcmhr.org/

The KCL Data Protection Officer is Mr Albert Chan: [email protected]

King’s College London privacy notice: https://www.kcl.ac.uk/terms/privacy

Last reviewed: 14/04/2022; Last updated: 14/04/2022; Updated by: Mr Daniel Dyball

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