The Warrior Programme: which Prof Neil Greenberg is speaking?

  1. We just don’t know whether it works at all,” said Prof Neil Greenberg in the lead story on the front page of The Sunday Times on 18 September 2016. The influential academic psychiatrist was talking about a new therapeutic approach, from charity the Warrior Programme, for military veterans with mental health problems. Damning, particularly as he was involved in the independent evaluation of the intervention via a randomised controlled trial (RCT). Hang on though, Prof Greenberg occupies many more different roles than the two identified in the newspaper, professor of defence mental health at King’s College London and lead for military and veterans’ health at the Royal College of Psychiatrists. He’s a director of Forces in Mind Trust (FiMT), for example, the charity that funded the RCT. And it interpreted the results of the trial rather differently. There was “a positive outcome,” said FiMT in June 2015, adding: “ex-service personnel do indeed benefit from this intervention.” To further the confusion, Prof Nicola Fear, a colleague of Prof Greenberg at King’s in the academic department of military mental health (ADMMH), became a trustee of the Warrior Programme in November 2015. She’d collaborated with Prof Greenberg on the analysis of the RCT results. As a trustee, Prof Fear demonstrates support for the charity.
  2. In 2013, FiMT (registered charity number: 1145688) awarded £79.5k to the Warrior Programme (registered charity number: 1120893) for an independent evaluation of its new intervention via a RCT. In June 2015, the Warrior Programme published the results of the trial as a brochure, available on its website: www.warriorprogramme.org.uk/files/Warrior_Programme_RCT_brochure-LR.pdf. In his introduction Air Vice-Marshal Ray Lock, FiMT chief executive, commended Warrior for electing to test the effectiveness of its therapeutic approach via a RCT. His organisation was “delighted that the bold step the Warrior Programme took has been repaid by a positive outcome – ex-service personnel do indeed benefit from this intervention.” The report “supported the Warrior Programme in their work,” said the Trust. (Air Vice-Marshal Lock was clearly speaking for his employer, not in a personal capacity.) FiMT again referred to the “positive outcome” of the trial in its directors’ annual report for financial year ending 31 December 2015, explaining that the “positive outcome” had helped Warrior to secure “core and expansion funding”. (In August 2015, the Warrior Programme was awarded £1.07M by the Big Lottery Fund, for example.)
  3. There was no mention of FiMT in The Sunday Times on 18 September 2016, nor the fact that Prof Greenberg has been a director since December 2014. FiMT has a single corporate trustee, FIM Trustee Limited (registered company number: 07855145). He’s actually a director of FIM Trustee Limited.
  4. On the Warrior Programme approach, Prof Greenberg told the newspaper: “we just don’t know whether it works at all”. The trial “did not provide evidence that this technique should be rolled out. It was rather embarrassing how people at the launch were saying this was great, the Warrior Programme has come of age, and I was thinking, that’s not what the academic bit of the study says.” The psychiatrist apparently neglected to say that those acclaiming the Warrior Programme included FiMT, as the brochure shows. As a director he shares collective responsibility for the Trust’s actions, including the directors’ annual report also hailing the “positive outcome” of the trial. Further, FiMT made an unambiguous statement on its website at the launch of the RCT findings: “The results of the RCT have demonstrated the effectiveness of the Warrior Programme and provide evidence-based research from which other services can benefit.” (screen shot in Figure 1)

    Figure 1. Forces in Mind Trust website: 30 June 2015 press release (date of capture: 26 September 2016)

    Figure 1. Forces in Mind Trust website: 30 June 2015 press release (date of capture: 26 September 2016)

  5. It’d surely have been appropriate for Prof Greenberg to declare a relevant interest to The Sunday Times – namely he’s a director of FiMT. We don’t know what he actually told the newspaper (obviously), only what it reported. I therefore asked Prof Greenberg in an email whether he’d disclosed that he’s a director of the Trust to Andrew Gilligan, author of both reports on 18 September 2016. In his response Prof Greenberg declined to answer the question.
  6. It’s unfortunate that the Warrior Programme brochure of the trial results, too, fails to disclose anywhere that Prof Greenberg is a director of FiMT. Again, the reader should surely know this.
  7. It’s a shame that Prof Greenberg’s stance on the Warrior Programme and its RCT apparently varies according to his role. The inconsistency risks undermining not only his credibility, but also that of the organisations whose roles he occupies.
  8. In an email Prof Greenberg denied varying his stance on the Warrior Programme and its RCT. Though he accepted that he disagrees with FiMT’s view. Nevertheless collective responsibility means that as a director of the Trust he’s jointly responsible for its public stance. Hence, I argue, the variation by role in his stance.
  9. To further the confusion, Prof Nicola Fear, a colleague of Prof Greenberg at King’s in the ADMMH, became a trustee of the Warrior Programme in November 2015. She’d collaborated with Prof Greenberg on the analysis of the RCT results, the June 2015 brochure shows. As a trustee, Prof Fear demonstrates support for the charity.
  10. Finally, I want to make clear that here I’m not making a case for or against the Warrior Programme and its therapeutic approach. Rather, I’m raising my concern at the apparent variation by role in Prof Greenberg’s stance on the Warrior Programme and its RCT. The discrepancy identified suggests that his opinions, regularly quoted in the media, should be interpreted with reference to his many different roles. My intention too is to highlight the fact that colleague and collaborator Prof Fear is now a trustee of the Warrior Programme. Her becoming a trustee is a clear indication of support for the charity.
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