Ex-service Personnel Research Articles

From soldiers to vigilantes: the Catholic Ex-Servicemen’s Association in Northern Ireland on the brink of civil war

ABSTRACT This article assesses the importance of an often-ignored vigilante group; the Catholic Ex-Servicemen’s Association. 1969 saw the mobilisation of Irish Catholics in Northern Ireland who had served in the British Army as part of ad-hoc vigilante groups defending nationalist areas. These groups protected Catholic neighbourhoods from loyalist assault and from incursion by the security forces who were increasingly seen as a hostile force. In 1971, this ex-service personnel formed an all-Ireland organisation: the Catholic Ex-Servicemen’s Association. At their peak in the early 1970s, they claimed a membership of 17,000 and an ability to mobilise a further 20,000 in a ‘doomsday scenario’. CESA’s prominence waned by the late 1970s. CESA has received very little academic attention. This article aims to ameliorate that, supplementing the scant secondary literature with newspaper and archival material to account for the emergence of the Catholic Ex-Servicemen’s Association, analysing their importance in shaping the trajectory of the Troubles and saying something of the complexities of identity in the nationalist community in the early period of the conflict.

Evaluation of Community Reinforcement and Family Therapy in the UK military community

ABSTRACT Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT). Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT). Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback. Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one’s mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment. Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately.

Health and well-being of serving and ex-serving UK Armed Forces personnel: protocol for the fourth phase of a longitudinal cohort study

IntroductionThis is the fourth phase of a longitudinal cohort study (2022–2023) to investigate the health and well-being of UK serving (Regulars and Reservists) and ex-serving personnel (veterans) who served during...

Anger Among UK Ex-Service Military Personnel During the COVID-19 Pandemic.

Military service and ex-service personnel commonly experience difficulties with anger. The COVID-19 pandemic had several negative consequences upon social, economic, and health factors that influence anger. This study aimed to explore 1) levels of anger in an ex-serving military cohort during the COVID-19 pandemic; 2) self-reported changes in anger compared with prepandemic levels; and 3) identify sociodemographic characteristics, military characteristics, COVID-19 experiences, and COVID-19 stressors associated with anger. UK ex-service personnel ( n = 1499) completed the Dimensions of Anger Reactions 5-item measure within an existing cohort study. Overall, 14.4% reported significant difficulties with anger, and 24.8% reported their anger worsened during the pandemic. Anger was associated with factors such as financial difficulties, extra/new caring responsibilities, and COVID-19 bereavement. Endorsing more COVID-19 stressors was associated with higher odds of anger difficulties. This study highlights the impact of the pandemic on ex-service personnel, including a strain on family/social relationships and financial hardship, which affected anger.

Employment and mental health among UK ex-service personnel during the initial period of the COVID-19 pandemic

LAY SUMMARY This article examines how employment status changed for working-age UK ex-military personnel in the early period of the COVID-19 pandemic and how this relates to their mental health. Overall, the unemployment rate among ex-military personnel was not worse than that in the general population; however, because ex-military personnel generally have a lower unemployment rate than the general population, this suggests they were worse hit by the pandemic. Part-time and self-employed personnel were more likely to experience negative changes to their employment situation. Both becoming unemployed and being furloughed were correlated with negative changes in mental health. However, it should be noted that the mental health data used for this comparison predate the onset of the pandemic; hence, other factors related to both change in employment status and change in mental health could be the cause of this apparent relationship.

Compassionate mind training for ex-service personnel with PTSD and their partners.

Posttraumatic stress disorder (PTSD) is a significant issue for a substantial proportion of Australian ex-service personnel. In addition to the functional impact on individuals, PTSD can have a significant impact on intimate partner relationships. Research has demonstrated that practicing compassion and self-compassion may be an important component of psychological therapy for survivors of trauma, while also demonstrating benefits to intimate relationships. This pilot study aimed to investigate the utility of a Compassionate Mind Training intervention for ex-service personnel with PTSD and their partners. An uncontrolled, within-subjects, longitudinal design was utilized with assessment at pre-intervention, post-intervention and 3-month follow-up. Twenty-four participants attended 12 biweekly group sessions. Self-report measures of compassion, quality of life and psychological symptoms were administered at each time point. Findings demonstrated a significant reduction in fears of compassion and PTSD symptoms for ex-service personnel at 3-month follow-up and a reduction in depressive symptoms and increase in quality-of-life and social safeness at post-intervention. Additionally, significant reductions in anxiety, stress, external shame and self-criticism at 3-month follow-up were found, and couples reported significant increases in relationship satisfaction. Findings from this pilot study demonstrate promising outcomes, warranting further investigation in a larger randomized controlled trial of Compassionate Mind Training for ex-service personnel and their partners.

Gateways and gatekeepers: Two factors that influence the use of performance and image enhancing drugs (PIEDs) among UK military veterans

Recent reports have identified that PIEDs use is rising within the Armed Forces leading to concerns over health and concomitant operational risks. The aim of this study was to identify the roles of gateways and gatekeepers on PIEDs use among a cohort of UK military veterans. Semi-structured interviews were conducted with 14 ex-Service personnel. Interviews were transcribed verbatim and thematically analysed using NVivo12 software. Common themes were identified around the ways in which the veterans were introduced to PIEDs and how they accessed them. Gateways consisted of two categories of Circumstances and Behaviour, including excessive gym use, the need to cope with fitness demands of military service, overseas deployment, and previous experiences with nutritional and body-building supplements. Gatekeepers included friends, colleagues, and mentors and their roles were captured in two categories of Procurement of PIEDs and Information Dissemination. Recommendations include the need for further research on the roles of gatekeepers and gateways as important pathways to PIEDS use. Additionally, there is a need to build on themes suggested by earlier researchers to identify social, cultural, and economic factors that underpin motives for PIEDs use in the uniformed services. These two recommendations would inform the design and evaluation of PIEDs-related interventions.

Out of the Trenches: A Review of Modern Rheumatology’s Relationship with War

This paper provides a brief review of how wars in recent history have shaped the development of rheumatology as a medical specialty. This history is not widely known in the medical field and appears to have been forgotten. However, it is important to the field of both military medicine and rheumatology in a civilian context. Many rheumatic diseases were recognised for the first time as a result of doctors treating arthritis in soldiers during World War I and World War II. Chemical Weapons in both wars lead to the discovery of many Disease Modifying Anti Rheumatic Drugs still commonly used today in rheumatology. During World War I, 93,000 cases of arthritis were reported in US troops. Ten years after the end of World War I in the US, the government was paying $10,000,000 a year to around 35,000 ex-service personnel for disabilities as a result of chronic arthritis, demonstrating arthritis in military history is significant.

Evaluation of the Warrior Programme intervention among UK ex-service personnel.

Research has shown that of the myriad services available to veterans in the UK, very few have been independently evaluated. This report presents the results of a randomized controlled trial assessing the impact of Time Line Therapy™ delivered by the Warrior Programme (a third-sector organization). This study was aimed to determine if the intervention is effective in reducing emotional and functional difficulties in ex-service personnel. A mixed-design analysis of variance model was used to investigate whether the Warrior Programme had a statistically significant impact on self-reported scores. The intervention and control group provided data on measures prior to and immediately after the intervention, and at 3-month follow-up. Those in the intervention group (n = 23) reported statistically significant improvements in self-reported scores immediately following intervention: the Clinical Outcomes in Routine Evaluation (CORE) scores (CORE global distress mean difference [MD] = 45.0, 95% confidence interval [CI] 31-60) (CORE subjective well-being MD = 5.9, 95% CI 3.5-8.3) (CORE functioning MD = 16.7, 95% CI 11.4-21.9) (CORE problems/symptoms MD = 19.4, 95% CI 13.1-25.7), general self-efficacy (MD = -9.8, 95% CI -13.6 to -6.8), anxiety (MD = 8.6, 95% CI 5.2-12.1), depression (MD = 10, 95% CI 6.6-13.5), post-traumatic stress disorder (MD = 26.3, 95% CI 17-25) and functional impairment (MD = 11.1, 95% CI 5.3-16.8) over time, compared to the control group (n = 29). However, score improvement was not sustained over time or statistically significant at follow-up. The Warrior Programme was effective in reducing emotional and functional difficulties in ex-service personnel immediately after the intervention, but the effect was not sustained at 3-month follow-up.

“It didn't bring back the old me but helped me on the path to the new me”: exploring posttraumatic growth in British veterans with PTSD

Purpose This study explores the role of scuba diving therapy in growth experiences of ex-servicemen. Previous research has focused on difficulties arising from re-entering civilian life after deployment. Known mental health challenges occurring after severe combat related trauma exposure include depression, anxiety, and posttraumatic stress disorder (PTSD). However, less is known about the potential positive transformation which can occur when individuals navigate these challenges. Known facilitators of this positive transformation, often referred to as posttraumatic growth (PTG), are still sparse in this participant pool. Methods This study utilized an in-depth qualitative approach of interpretative phenomenological analysis utilizing semi-structured interviews. A homogeneous sample of five male British ex-service personnel with a diagnosis of PTSD who identified with PTG was recruited. Results All participants reported positive mental health benefits from diving with four themes emerging: human connection; meaningful leisure; embodiment; and the calm. Conclusions Scuba diving appeared to afford instant access to lasting relief of anxiety, stress, and symptoms of PTSD and reduction of physical symptoms of their trauma connected to underwater weightlessness. The reduction of PTSD symptoms carved space for PTG, facilitated through a meaningful leisure environment with opportunities for human connection with individuals who had gone through similar experiences. Implications for rehabilitation Veterans with posttraumatic stress disorder (PTSD) respond less well to conventional treatments for PTSD than civilian populations. Scuba diving has the potential to benefit veterans by giving access to relief from anxiety and symptoms of PTSD, such as hypervigilance and invasive thoughts. Scuba diving not only reduces symptoms of physical and psychological ill health but can facilitate wellbeing and growth. Scuba diving, as a meaningful leisure activity, could potentially enhance medical and psychological therapy.

Self-reported auditory problems are associated with adverse mental health outcomes and alcohol misuse in the UK Armed Forces

PurposeAuditory problems, such as hearing loss and tinnitus, have been associated with mental health problems and alcohol misuse in the UK general population and in the US Armed Forces; however, few studies have examined these associations within the UK Armed Forces. The present study examined the association between auditory problems and probable common mental disorders, post-traumatic stress disorder and alcohol misuse.Methods5474 serving and ex-service personnel from the UK Armed Forces were examined, selected from those who responded to phase two (data collection 2007–09) and phase three (2014–16) of a military cohort study. Multivariable logistic regression was used to examine the association between auditory problems at phase two and mental health problems at phase three.Results9.7% of participants reported ever experiencing hearing problems alone, 7.9% reported tinnitus within the last month alone, and 7.8% reported hearing problems with tinnitus. After adjustment, hearing problems with tinnitus at phase two was associated with increased odds of probable common mental disorders (AOR = 1.50, 95% CI 1.09–2.08), post-traumatic stress disorder (AOR = 2.30, 95% CI 1.41–3.76), and alcohol misuse (AOR = 1.94, 95% CI 1.28–2.96) at phase three. Tinnitus alone was associated with probable post-traumatic stress disorder (AOR = 1.80, 95% CI 1.03–3.15); however, hearing problems alone were not associated with any outcomes of interest.ConclusionsThe association between auditory problems and mental health problems emphasises the importance of the prevention of auditory problems in the Armed Forces: through enhanced audiometric screening, improved hearing protection equipment, and greater levels of utilisation of such equipment.

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

ObjectiveTo investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences...

A preliminary investigation of the well-being of visually impaired ex-service personnel in the United Kingdom

Research has shown that visual impairment may impact daily functioning, health, and well-being negatively for adults of all ages. Ex-service personnel (‘veterans’) too may be at risk of poor health and well-being outcomes associated with post-military life, and this may be exacerbated by the presence of visual impairment. Despite this, research considering the experience of blind veterans has been limited and has not yet assessed well-being for these individuals across a broad spectrum of life domains. Rather, it has highlighted poor mental health and psychological well-being in working-age visually impaired veterans. However, the experiences of older visually impaired veterans (who make up the majority of visually impaired veterans in the United Kingdom) have been poorly represented in the literature. This pilot study aimed to provide a preliminary assessment of holistic well-being in an adult sample of 97 UK blind veterans, predominantly composed of older age veterans (majority over 80 years). Cross-sectional well-being data were collected using a validated measure of well-being (the Well-Being Inventory [WBI]). Results suggest that members of Blind Veterans UK are functioning well and are satisfied across four life domains (vocation, finances, health, and social relationships). Lower health satisfaction was identified, particularly in blind veterans with comorbid mental health conditions. Results are discussed in relation to the older age of the sample, the limitations of face-to-face survey administration, and the applicability of the WBI finance domain in this age cohort. Recommendations are made for future research in this population.

Psychosocial Outcomes of Australian Male and Female Veterans Following Participation in Peer-Led Adventure-Based Therapy

Adjunct or second-line therapies are increasingly being utilised among military populations to address treatment barriers and improve mental health outcomes. This study evaluated the psychosocial outcomes of an Australian peer-led adventure-based therapy program, Trojan’s Trek, for 60 ex-service military personnel (i.e., veterans, 56.7% male). Participants completed 1 of 6 Queensland Trojan’s Trek programs—a 6-day, live-in program consisting of 10–12 structured CBT-based group sessions and 11 nature-based activities—between March 2018 and March 2019. A non-controlled, within-subjects longitudinal design was utilised with assessment at pre-intervention, post-intervention, and 2-month follow-up. Changes in psychosocial outcomes were assessed using the Depression, Anxiety, and Stress Scale 21 (DASS-21), PTSD Checklist-5 (PCL-5), Positive and Negative Interactions Scale (PNI), General Self-Efficacy Scale (GSES), and the Life Satisfaction Questionnaire (LSQ). Mixed-factorial ANOVAs indicated a significant time x gender effect for anxiety (male <em>F</em>[2, 28] = 31.1, <em>p</em> &lt; .001; female <em>F</em>[2, 19] = 4.05, <em>p</em> = .025); and stress (male <em>F</em>[2, 28] = 45.3, <em>p</em> &lt; .001; female <em>F</em>[2, 19] = 9.98, <em>p</em> &lt; .001). There were significant improvements between pre- and post-intervention for depression, anxiety (male only), stress, posttraumatic stress, perceived positive relationships with friends and family, perceived negative relationships with family and partners, self-efficacy, and life satisfaction. Improvements were maintained or established at 2-month follow-up for depression, anxiety (male and female), stress, posttraumatic stress, perceived negative relationships with friends, and self-efficacy. This study demonstrates utility of the Trojan’s Trek program for male and female Australian veterans with mental health difficulties. However, a controlled trial is required to determine program efficacy.

Barriers and facilitators to ex-service personnel obtaining employment within social care roles with older people: a scoping review

PurposeThis purpose of this paper is to review evidence about the barriers and facilitators to ex-service personnel obtaining employment within social care roles. Social care has long-standing, well-recognised problems of staff recruitment and retention. Policymakers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may face barriers to such a move which may need to be addressed.Design/methodology/approachDatabases and grey literature were searched systematically to provide an overview of evidence on this topic. In total, 23 articles were included in the review.FindingsA narrative analysis revealed barriers to ex-service personnel obtaining employment within social care not only related to their previous occupation, health status and identity but also facilitators related to the sector’s severe recruitment challenges and the transferable skills of ex-service personnel. Evidence suggests that learning from health services may be highly relevant and transferable.Research limitations/implicationsThis review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups.Originality/valueThis review identified evidence suggesting that learning from health services may be highly relevant and transferable to the social care sector so as to facilitate the transition of more ex-service personnel into social care work with older people.

Perceptions of health and healthcare in ex-Army residents of Tameside: a pilot qualitative study

BackgroundLocal authorities and other service providers need data on their local ex-military communities to be able to plan services. However, published research and data may not be applicable to the...

Negotiating a Postmemory Dichotomy: Nostalgia and Aversion in Malta

The island of Malta has served as a strategic colony since the dawn of history. Since Phoenician and Roman times, the island has been an important base in the middle of the Mediterranean Sea. Its last colonisers, the British, spent about 180 years using the islands for their imperial needs. The official closing of the British base on 31 March 1979 heralded a new economic and social reality supposedly unhampered by the exigencies of foreigners. Two major post-memory reactions kicked in – nostalgia and aversion to ex-colonial life. The postcolonial Maltese generations exhibit a range of reactions oscillating between love and hate for the British. On the other hand, British ex-service personnel and their families have continued to feel an affinity with the island base which they had come to acknowledge as a second home. This allows for a new type of relationship between the Maltese people and their British visitors where issues of colonial post-memory are negotiated. These are seen at their best in the local tourism industry. Malta woos British tourists and goes to great effort to attract them. It uses to its advantage the colonial affinity to create an attractive destination for the British which benefits the locals and the Maltese economy. In Malta post-memory has evolved in line with necessity and expediency, where animosity, though manifestly tangible, has gradually morphed into a rather benign residue in the collective reaction to the colonial past.

Veterans Universal Passport: a pilot of a health and social care record for UK ex-service personnel

BackgroundThe transfer of care between different health and social care systems are often associated with poor outcomes and disengagement. Indeed, following the transition from military to civilian life, ex-service personnel...

Who is a ‘Veteran’?

There are currently an estimated 2.8–3.8 million people in the UK who fulfil the UK Ministry of Defence definition of a military veteran (a minimum of one day’s military service). Despite these numbers, there is little research on who the public views as a veteran and how this differs across society. Rachael Gribble, Simon Wessely, Susan Klein, David A Alexander, Christopher Dandeker and Nicola T Fear examine public conceptualisations of the term ‘veteran’ compared with definitions from the Ministry of Defence and those of ex-service personnel themselves. Factors associated with commonly endorsed definitions are identified.

Legal Protections for Armed Forces Personnel and Veterans serving in operations outside the United Kingdom: Response to Public Consultation Questionnaire

The UK Ministry of Defence announced a public consultation in July 2019.* Its first proposal was a statutory 'presumption against prosecution of current or former Armed Forces personnel for alleged offences committed in the course of duty outside the UK more than ten years ago' where previous investigations had not resulted in prosecution. The Ministry of Defence intended to 'raise the threshold to be applied by prosecutors when considering whether a prosecution is genuinely in the public interest in such cases.' Investigations might be re-opened, on these proposals, only in exceptional circumstances, such as the emergence of new evidence. In response, we argue that these proposals will not remove the uncertainty ex-service personnel face regarding investigations and potential prosecutions for alleged historical crimes during extra-territorial military operations. The proposed measures, analogous as they are to time bars, amnesties and other impediments which limit criminal proceedings for historical crimes, would be incompatible with the UK's obligations under international human rights law, international humanitarian law and international criminal law. The proposals cannot remove the possibility that service personnel will be tried before the International Criminal Court or in other jurisdictions. The proposed measures are also unduly restrictive of the circumstances in which investigations can be re-opened by the State; and the UK’s track record in investigating alleged wrongdoing during extra-territorial military operations is poor. The combination of these two factors is a serious cause for concern and may create perverse incentives, where poor investigations are conducted in the future, followed by reliance on the presumptions proposed.