Understanding
life after service.

Female veterans can face barriers seeking mental health support. This can mean that existing services do not always meet their needs, and they may be less likely to engage with services. Support designed with female veterans may therefore be more relevant, acceptable and easier to use.

Female veterans first reviewed the app in discussion groups and suggested ways to improve it. The updated app was then shared with a wider group of female veterans, who gave feedback on how acceptable and easy it was to use. Participants suggested using images and quotations that better reflected women’s lives after leaving the Armed Forces, rather than focusing mainly on service in the Armed Forces. They also recommended clearer information about other sources of help.

The CBT activities and features designed to encourage regular use were received positively. The study shows that involving female veterans in adapting mental health support can help make it feel more relevant and engaging.

How to interpret this study: Five female forces veterans took part in the focus group, and 21 people completed the later demographic questionnaire; responses to individual usability questions varied. The small, self-selected sample limits generalisability. This was a study of adaptation, acceptability and usability; it did not establish clinical effectiveness.

Female veterans are more likely than male veterans to experience low mood and anxiety, but many do not use veteran-specific mental health services. Researchers have therefore developed IonaFFV, a smartphone app designed to help female veterans manage these difficulties.

The published protocol describes a double-blind feasibility randomised controlled trial. It examines recruitment, retention, app engagement, acceptability and study procedures to inform further evaluation and a future definitive trial. Publishing the protocol makes the study design and methods transparent.

The planned study compared six weeks of access to IonaFFV with a sham app, with follow-up at ten weeks after randomisation. The sham was designed to offer comparable functionality without the active CBT techniques.

How to interpret this paper: This is the trial protocol, not the outcomes report. Its target of 60 participants is a planned sample size. It does not report an achieved recruitment total or demonstrate treatment effectiveness.

Female veterans are more likely than male veterans to experience low mood and worry. Although many use mainstream NHS mental health services, fewer use services designed specifically for veterans. To make support easier to access, researchers adapted a smartphone app called IonaFFV based on CBT to help manage low mood and worry.

The app was originally designed for the general adult population and was adapted for female forces veterans. Researchers set targets for recruitment and app use to help decide whether a larger trial should go ahead. Recruiting participants was difficult, partly because some people who were not female forces veterans tried to join the study.

The comparison app, developed for female Armed Forces veterans, was found to be engaging and acceptable. However, the study did not meet enough of its targets to show that a larger trial could go ahead without changes to the study design. There was also limited evidence that the app would improve emotional wellbeing in a larger trial.

What this means: Findings do not give a final answer about whether the app works but do show that changes are needed before testing it in a larger study. This summary is provided by the research team while the manuscript is under review.

To help improve access to support, a smartphone app that offers low-intensity CBT has been developed for female forces veterans. The research team also wanted to understand what helps or prevents services from offering digital mental health support.

They interviewed clinicians, people who commission mental health services, and female forces veterans. The findings highlight governance, stakeholder alignment, digital inclusion, system readiness and user trust, alongside clinical evidence.

The study produced practical recommendations to help digital mental health support become more widely available for the Armed Forces veteran community. These implementation findings are not evidence that the app is clinically effective.