 I'm Dicky. I run a project called Breaking Ground Heritage, which uses archaeology and heritage as a way to promote a recovery pathway to the service community. When I say the service community, I mean serving members of the British military and veteran members as well, so people from the Falklands all the way through to Afghanistan and Iraq. So, it's important to understand the type of people that we deal with. So, some of the most common fictions to the people that get involved in our projects. We're looking at people from intrusive thoughts, like PTSD symptoms here. Thoughts that they'll be doing mundane daily tasks and all of a sudden they'll get thoughts coming to the head that will be a flashback from Afghanistan, from Iraq, from a car crash, it doesn't matter what it is. So, we have people dealing with the whole flashbacks. Sleeplessness, memory problems, anger issues, I think we can all relate to a lot of these actually, hypervigilance. So, people are coming on projects and they're unable to settle down, they're unable to rest. They're constantly looking for markers, looking for windows that may be open, looking for markers to say there may be an IED somewhere, looking for cars driving if it's suspicious. So, these guys are constantly looking out for threats. Restlessness, can't sit down, they'll notice me, I fidget quite a lot, I can't help it. You can't be constantly moving. Nightmares, again goes kind of hanging down with a flashback really. The self-imposed isolation. One of the things that we're starting to see about the mental health side of things is when people start to go on that downwards directly with mental health, the first thing that we notice is that they start to isolate themselves, whether it be on social media, where you do see they kind of do withdrawal. They have a severe lack of concentration, a lack of motivation, well don't we all, and the imminent flash to bang. The imminent flash to bang is an interesting one for us, and it kind of goes hand-in-hand with the anger. A car, you really need a car driver along, somebody cuts you up and there's normally an escalation. Rather, I'm miffed at that, that's really annoyed me. Oh, that was a bit dangerous while that's really pissed me off. Well, this imminent flash to bang is it goes from being someone cuts you up to wanting to get out of your car to really pull their head off for no reason whatsoever other than it's just an instant escalation. So, these are the symptoms that most of our participants will declare that they're suffering from in their daily life. And then the last one is burdensomeness. These guys are very independent, when I say guys I mean ladies and gentlemen. These people are very independent, they're used to thinking for themselves, they used to being the best at what they do. And all of a sudden they're now dependent on other people, dependent on the health service, independent on charities. So, they've become, they feel like they're a big burden to themselves. So, what do we do? We try to combat some of them symptoms by using archaeology and heritage. We do archaeological excavations with a project called Operation Nightingale. I don't know if that's come across here at all. We do research projects with universities. We do building projects, i.e. we built a first-world water tank out of wood because we could. We do outreach work in schools, festivals, events, giving participants that exposure to doing something different, maybe outside their comfort zone, but also pass on their experiences to the general population itself. We also run training modules, so we'll train people how to human remains recovery. A bit weird bearing in mind is people, their trauma comes from death and mutilation. So, doing the human remains recovery, we found it actually a really good way to engage them because they're really interested in it and would never have any negative effects from that really. Things like archaeological photography and an introduction to researching and things. And again, we do that to provide the respite, promote recovery pathways and sample us into employment and education. There's a whole mix of different disciplines there, so the same thing doesn't interest everybody. So we use archaeology as a way to get those people involved that are able to. Historical research, for those that don't want to maybe engage with a social grouping, but they can do it from their own home. Building projects for those that like to do things with their hands. So we try to do as much heritage-based projects as possible to try and include as many people as possible. And the reason we find this works is because archaeology generally is a set of processes. The military guys are used to routine, they used to being told you will be up at 7 o'clock, you will have your breakfast at half past 7, you will be ready at half past 8, you will do this at 10 o'clock at 11 o'clock, you will do this. So it's very formulaic. And archaeology is very much the same, there is a set process of doing things. You can't just do it willy nilly. You have to do it in a very definite way. And the interesting thing about the UK, and I've noticed it's not really happening so much out here, is we have the time team in the UK. Everybody in England knows about geophysics. Everybody knows about isotopes, endocrinology, because they watch the time team. So we have people coming on these projects and we don't have to explain to them what geophysics is. Because they already know, we have kids at school that can tell you about geophysics. So those people are already coming to you with a very fundamental understanding of archaeology. So it's not some weird and wonderful science and magic stuff. It is something that they actually understand. And again, archaeology is looking for the unknown. So you do find, this photograph here, that's in Bulcor, you do find things that you're not expecting. So these are two German swords from the First World War. So it does have its limitations. So taking servicemen that have been blown up or seen the colleagues killed, and then dealing with traumatic incidents like this, it can have its problems. It does have its problems. It's making sure that we've got the right procedures in place to be able to deal with it if it does become an issue, and how we can resolve it there and then so it doesn't develop into something further. Now some of the stuff we've been looking at, so we had a basic understanding of how these projects worked. There was a theory that came across through Karen Bernard's research, and basically a veteran will come back from military service and he doesn't want to talk about his time away because he doesn't want to worry his family with these experiences. His family then in return don't talk about anything traumatic or that might trigger a response to the individual because they don't want to create a problem with them, they don't want to create its tensions. You have the buffers, you have a situation where you're at home and nothing's getting resolved. You're sat there, it's simmering, and you're putting it away. Will we have the people who have taken on these projects? There were the like-minded group of people. With people's shared experiences, the people have probably served together and they've been to Afghanistan, to Ireland or whatever. So these people understand where these people come from, so they will actually sit there and they will talk to each other. The amount of times I've been on a project and someone's turned around to me and said, you know what, that's the first time I've ever sold anybody that, and I think, that's brilliant. You've been in therapy for two years, why isn't your psychiatrist, and it's because they haven't established that relationship where they feel they can. They met me two days ago and they're telling me this stuff already. So there is that mutual bond. So we're like the engages in this. And like I said, the medical chain spent a lot of time trying to speak to these people. I think in the UK you get 22 sessions of therapy, that's what I was given. And at 22 sessions, 20 of them was me just trying to figure out who the psychologist was and am I going to talk to her or not. So it didn't mean no favours whatsoever. So again, it's looking at how we can do things on these projects, take away information and then be able to pass it on to the medical chain or pass it on to documentation what they can then give to their chain to go through this. So again, the crux of what we're doing, we're trying to promote this peer support network, trying to create this network of individuals that are like minded on projects or have similar problems and using them to create a baseline to be able to understand what's going on and help each other to get through these experiences. And why is it important? It's important to reconcile these narratives. These traumatic incidents that these people think they're suffering by themselves because of experiences at war. Well, they're not suffering by themselves. These are problems that most people have got. It's them understanding that it's the natural process that they're going through and it's just how they deal with it for them. The further we got into these projects, we started looking at other effects. So what other factors are impacting on servicemen and you have the suicide rates, the high suicide rate. So Castro has developed a theory. This is on American veterans, the interpersonal psychological theory of suicide in the military community. Basically, it looks at three things. In order to commit suicide, you need three factors. The strong perception that you're burden, a sense of not belonging, a sense of isolation, and also the acquired ability to enact lethal self-harm. As a veteran, it's already been established, or as a service personnel, that you've already got that ability to enact lethal self-harm. So straight away from having three factors to suicide, one to two. And then if we look back at this list of people described that they suffer from, we can see that other than two remaining factors, self-imposed isolation and burdensomeness, rate high on most of the people. So you're looking at the general military population straight away about who disposition if you prescribe to that model of suicide. Theoretically, they've got, they had to meet the criteria basically, that there's a tick of one way to happen. So it's a case of looking at what we can do now to help reduce that, if that is what we believe is happening. So what we do is, part of our projects, we have a baseline. What we want to do is we want to build upon this peer support network and by getting people engaged in the project, getting people engaged in this peer group that's starting to contribute again. People that have been isolated for two or three years in their home doing not a lot, getting back into society. It's a big step for them. By getting back involved in these projects, they are starting to contribute again and it's starting to increase their feelings of being valued. It's also starting to decrease the feelings of isolation. Now the way we record this is we will do surveys of the first day of a project and the last day of a project and we'll only survey people that have been in a project for at least a week. We do projects that are two days a day. The data you're going to get from that is really meaningful. So we'll look at at least a week. These are just questions that we've put into the surveys that we use. So we can see that self-declared feelings of isolation for 38 participants has the trend reversed. So the top bar is the pre-project and the bottom bar is post-project. The self-declared feelings of value, again it's reversed again, so people are going from not feeling valued at all to feeling valued sometimes most of the time and always. So there is a change in that. So again that's taking the suicide element away from it. By engaging them, again we're seeing that we're getting groups forming. We're getting P groups developing from that. The surveys we use then is we use the GAD7 which is an anxiety survey. So it self-describes a set of questions and what this does is it measures their anxiety levels pre- and post-projects. And this is from a sample group of 42 people. So we can see, again, pre- and post-projects the trends are reversed quite significantly. We also do the PHQ8. We do the 8 and not the 9. The PHQ9 will ask the suicide question do you have suicidal tendencies or whatever? Obviously the danger of asking that question is to say yes, then it opens up a whole new dynamic of what we have to provide for them. So the developed PHQ8 which means that it's got all those same questions but not the suicide risk. And again you can see that from the depression scale it is shifting so people are leaving the project feeling less depressed than when they came on. And also we use a Warwick Edinburgh mental wellbeing scale. So we're looking for anxiety depression and the wellbeing element itself. And this wellbeing is an interesting one because it scores your wellbeing from high, moderate and low but there's a big bracket within each category. So although you can see there is a definite shift from low wellbeing to people getting better what you can't really see in this is those are suffering from low wellbeing in the extreme area and then getting a positive... they're well being increasing but still being within that low bracket but just being on a borderline law so on that moderate to low bracket. So although the data you can see there is a lot better and it does show that an increasing wellbeing you need to break it down even further and you can actually... I think we've had one instance where one participant has walked away scoring lower than this but then when we looked into it his wife had just taken him to the cleaners in a divorce he'd lost his medical pension he'd lost all his information so then when you kind of put it into context I think everybody's wellbeing would decrease a little bit on that. So across the board other than that one instance we've had no negative effects on the wellbeing So moving forward then we need to deliver more projects that are exciting and will engage the individuals these projects need... it has to be engaging otherwise we'll get an interest from it promoting best practice and archaeology so the archaeology can't suffer as a result of making these guys feel better you still have to provide world-class archaeology and also world-class wellbeing support and wellbeing mentoring we need to look at the social prescribing element and make sure that these sort of projects are sustainable what we've proved now over the four or five years that it's sustainable getting the GPs to then prefer people to these projects is another obstacle because each practice has got its own channels of reporting things in different counties slightly different so that is a bit of a struggle but looking to incorporate what we do into the recovery programme of the beneficiaries so if they've got a recovery programme from their wellbeing adviser from their mental health specialist or whatever it's looking at how we can use what they've already got and incorporate into that incorporate our work into that and also feed back into it in a positive way so it's about being as reactive as possible with what we're doing but at the same time still building upon the extra support that these guys are getting because we're not psychologists we're not potential psychologists we are just archaeologists delivering each project so we need to work with as many different disciplines as possible to really understand how this works and then to look to create some sort of formula to make this more productive Any questions guys?