Ex-service Personnel Research Articles

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...

Impact of 'transition blind spots' on access to Higher Education diploma students with a military background: why filling gaps in information, advice and guidance matters

This paper contributes to an under-researched area within the field of military-civilian transition. It explores innovatively the experiences of (mainly) ex-service personnel as they journey to and through ‘Access to Higher Education Diplomas’ (AHED), the majority having come from the lower ranks of the Army, to which many enlist with little or no formal qualifications. Drawing upon empirical research, commissioned in response to anecdotal evidence which suggests a decline in the number of AHED students with a military background, the paper argues that gaps in Information, Advice and Guidance (IAG) on AHEDs contribute to what I have termed ‘transition blind spots’ in the trajectories of these Service Leavers (SL). By addressing the issues discussed in this paper, there is potential to mitigate impact from these ‘transition blind spots’ and facilitate the SL transition through the provision of fully-informed IAG on AHEDs. This paper concludes that this new concept might usefully be employed to identify and understand other challenges faced during military-civilian transition.

Supporting our armed forces.

British Journal of NursingVol. 27, No. 16 RegularsSupporting our armed forcesIan PeateIan PeateSearch for more papers by this authorIan PeatePublished Online:6 Sep 2018https://doi.org/10.12968/bjon.2018.27.16.918AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Deloitte, Forces in Mind Trust, Officers' Association. Veterans work: recognising the potential of ex-service personnel. 2016. https://tinyurl.com/y85npgs2 (accessed 29 August 2018) Google ScholarMinistry of Defence. The armed forces covenant annual report 2017. 2017. https://tinyurl.com/yaqv8yo7 (accessed 29 August 2018) Google ScholarNHS Employers. Evidence base: employing members of the armed forces in the NHS. March 2018. https://tinyurl.com/ycmbkgec (accessed 29 August 2018) Google ScholarRoyal College of Nursing. RCN welcomes launch of nursing recruitment campaign. 7 March 2018. https://tinyurl.com/yad48plq (accessed 29 August 2018) Google Scholar FiguresReferencesRelatedDetails 6 September 2018Volume 27Issue 16ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 6 September 2018 Published in print 6 September 2018 Information© MA Healthcare LimitedPDF download

‘You’re Just Chopped Off at the End’: Retired Servicemen’s Identity Work Struggles in the Military to Civilian Transition

Promoting positive transition to retirement and cultural adaption for ex-service personnel has been identified as a priority for both social-science research and for public health policy in the UK. The Royal British Legion aims to provide support to service and retired service personnel, but to date the transition to retirement experiences of older (60-plus) ex-service personnel remain under-researched. In this article, we employ a symbolic interactionist theoretical framework to examine older servicemen’s experiences and identity challenges post-retirement from the British armed forces. Data were collected primarily through semi-structured, focus-group interviews with 20 former servicemen. Here, we focus specifically upon the challenges encountered by these ex-servicemen in the retirement transition from military to civilian life, a time of identity flux of sociological interest. To navigate this period of identity change and challenge, many participants constructed a ‘modified military self’ through involvement with the Royal British Legion as a key social support network. For many retired personnel the Royal British Legion offered a form of identification and group identity that resonated strongly with earlier experiences of comradeship in the military.

Impact of paternal deployment to the conflicts in Iraq and Afghanistan and paternal post-traumatic stress disorder on the children of military fathers.

Little is known about the social and emotional well-being of children whose fathers have been deployed to the conflicts in Iraq/Afghanistan or who have post-traumatic stress disorder (PTSD).AimsTo examine the emotional and behavioural well-being of children whose fathers are or have been in the UK armed forces, in particular the effects of paternal deployment to the conflicts in Iraq or Afghanistan and paternal PTSD. Fathers who had taken part in a large tri-service cohort and had children aged 3-16 years were asked about the emotional and behavioural well-being of their child(ren) and assessed for symptoms of PTSD via online questionnaires and telephone interview. In total, 621 (67%) fathers participated, providing data on 1044 children. Paternal deployment to Iraq or Afghanistan was not associated with childhood emotional and behavioural difficulties. Paternal probable PTSD were associated with child hyperactivity. This finding was limited to boys and those under 11 years of age. This study showed that adverse childhood emotional and behavioural well-being was not associated with paternal deployment but was associated with paternal probable PTSD.Declaration of interestN.T.F. is a trustee of the Warrior Programme, a charity supporting ex-service personnel and their families. She is also a member of the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee of Combat Stress, a charity supporting ex-service personnel and their families, and President of the Royal Society of Medicine. S.W. is partially funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastle University.

Veterans and violence: An exploration of pre-enlistment, military and post-service life

Despite growing criminological interest in the many ex-service personnel mired within the UK’s criminal justice system, there remains a paucity of qualitative research studies examining the (violent) veteran offender. In response, this paper mobilizes the voices of veterans to explore the key life events that can shape their offending behaviour. Countering reductionist explanations of violent crime committed by ex-service personnel, we contend that veterans’ violence may be rooted within personal biographies and psyches, conditioned by military experiences and represent the psychosocial consequences of the socioeconomic transformations of advanced capitalism.

“Describing Misbehaviour in Vung Tau as ‘Mischief’ Is Ridiculously Coy”: Ethnographic Refusal, Reticence, and the Oral Historian’s Dilemma

Since 2009 I have been part of three projects examining the history of service in the Australian military of Aboriginal and Torres Strait Islander people, as well as people who identify as lesbian, gay, bisexual, transgender, and intersex (LGBTI). The oral histories of these current and ex-service personnel contain tales that include family violence (both as perpetrators and survivors), war trauma, alcoholism, and sexual assault. There are also many silences, particularly among Vietnam veterans, when discussing misbehavior on rest-and-convalescence leave in the Vietnamese coastal town of Vung Tau. In this article, I explore some of the ways that I have navigated the ethical dilemmas of writing these histories, referring in particular to how the concepts of ethnographic refusal and reticence have influenced my practice. I argue that interviewers need to be cautious when confronting participants’ reticence to engage with particular lines of questioning. Researchers must consider the wider social, political, and personal implications of their research for their narrators and decide whether ethnographic refusal—avoiding the subject matter to protect the interviewees—is an appropriate strategy.

Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder

Introduction Despite increases in the number of ex-service personnel seeking treatment for post-traumatic stress disorder (PTSD), there remain a number of barriers to help-seeking which prevents many veterans from accessing psychological therapies. Tele-therapy provides one potential method of increasing the number of veterans accessing support. This review aimed to systematically review the literature in order to summarise what lessons have been learned so far from providing trauma-focused tele-therapies to veterans with PTSD. Methods A systematic literature review was conducted from which 41 papers were reviewed. Studies were included if they involved the use of trauma-focused therapies carried out using tele-therapy technologies. Only studies using tele-therapy interventions via video or telephone with populations of ex-military personnel with PTSD were included. Results In the majority of cases tele-therapy was found to be as effective in reducing PTSD symptoms as in-person interventions. Similarly, there were few differences in most process outcomes such as dropout rates, with tele-therapy helping to increase uptake in some cases. Veterans using tele-therapy reported high levels of acceptability and satisfaction. Some challenges were reported in terms of therapeutic alliance, with some studies suggesting that veterans felt less comfortable in using tele-therapy. Several studies suggested it was harder for clinicians to read non-verbal communication in tele-therapy, but this did not affect their ability to build rapport. Technological issues were encountered, but these were not found to impede therapy processes or outcomes. Discussion Tele-therapy provides a viable alternative to in-person therapies and has the potential to increase access to therapy for veterans. Tele-therapy should continue to be evaluated and scrutinised in order to establish the most effective methods of delivery.

‘We may be falling apart but we still keep going’: retired servicemen’s experiences of their ageing bodies

Currently, there is scant research that investigates in-depth retired servicemen’s perceptions and experiences of ageing and being physically active, particularly in relation to retirement experiences. In this article, we employ a novel theoretical combination of figurational sociology and symbolic interactionism to explore a topical life history of 20 retired servicemen’s experiences in relation to physical activity (PA), the ageing body and constructions of identity in later life. Participants were aged 60+ and members of the Royal British Legion in a city in the English Midlands. Three semi-structured focus-group interviews and follow-up conversations were completed, together with informal observations. Key findings revealed that although participants recognised the need for regular PA, their perceptions routinely centred upon the ‘felt’ limitations of the ageing body, often in stark contrast to their former ‘disciplined’, active, military bodies. Corporeal challenges and limitations discouraged some from taking part in PA altogether. Despite their perceived bodily limitations, however, many ex-service personnel still endeavoured to stay physically active. Findings highlight the salience of the temporal aspects of older adults’ lived experiences of exercise and PA, for past experiences of PA and exercise were identified as strongly shaping current-day motivations, attitudes and behaviours.

Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity.

Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.

Veterans' Benefits and Indigenous Veterans of the Second World War in Australia, Canada, New Zealand, and the United States

Veterans’ Benefits and Indigenous Veterans of the Second World War in Australia, Canada, New Zealand, and the United States R. Scott Sheffield (bio) “One day a notice came out of the first sergeant’s office with my name on it. It was my pass to go back to the states! After thirty-four months, five campaigns, and many battles, I was going home! I had made it, but my brother had not.”1 With these words, Hollis D. Stabler began his journey home and his transition from an Omaha soldier into a Native American veteran. It is difficult to imagine the immensity or complexity of the feelings that Second World War Indigenous service personnel experienced, after months or even years away in military services, in anticipating and living through their homecoming, “most filled with jubilant anticipation, some plagued by weariness, and a few haunted by the dark memories of battlefield carnage.”2 For many, the warmth of welcome, the kinship of family, and the familiarity of home deeply comforted them. “I didn’t believe that I was home until I got to see my folks,” one Canadian Cree veteran recalled. “I said to myself, ‘I’m on home ground now. I’m safe.’”3 Such commentaries highlight the shared humanity and commonalities in experiences between Indigenous service personnel and their non-Indigenous comrades in arms. At the most basic and personal level, the war’s end was about a young man or woman returning home to families and lives left behind, each story unique though replicated countless times across Australia, Canada, New Zealand, and the United States. Yet arriving home was only the beginning of a war veteran’s experience. Subsequently, the legislative and administrative architecture [End Page 63] prepared to aid returned service personnel transition back to civilian life figured prominently. The relative success of reestablishment measures for the bulk of American, Australian, New Zealander, and Canadian ex-service personnel has contributed hugely to the popular view of the Second World War as the “good war.” The degree to which Native American, Māori, Aboriginal, and Torres Strait Islander Australian and First Nations veterans participated in this rosy postwar story is uncertain. This study addresses this gap in our understanding through a transnational examination of the administration of veterans’ benefits for Indigenous military personnel in four victorious settler societies that all mobilized significant recruits from their Indigenous minority populations. The value in this approach is in helping to distinguish peculiar conditions within any individual Indigenous community or country from broader shared patterns of settler colonialism. This broader lens works dialectically with more localized studies, challenging assumptions and drawing in concepts and patterns from other experiences in comparable societies. To date, the postwar experiences of Indigenous Second World War veterans have garnered little scholarly attention in these four settler societies.4 Canada is a partial exception to this pattern due to a high-profile lobbying campaign over Indigenous veterans’ grievances from the 1970s to the 2000s.5 Central in transitioning to civilian life was the support available to returning servicemen and servicewomen from their governments. All four of these victorious states developed elaborate and generous packages for all veterans. Though the precise mechanics differed, each government tended to craft a similar blend of financial reward, transitional funds, training/educational provisions, employment support/advantages, access to loans for land or business development, disability pensions, and other miscellaneous measures.6 Governments had learned from the inadequacies of programs for veterans after the First World War and sought to construct a more flexible, compassionate, and comprehensive system the second time around.7 In each country, veterans’ programs were early and massive experiments in state social welfare development.8 The integration of Indigenous minorities into broader welfare structures was a complex process of converting Indigenous people from segregated services supposedly designed for distinct groups to inclusion in state programs designed for all citizens. The relationship between Indigenous service personnel and the benefits available to veterans was a microcosm of the broader integration of Indigenous populations into settler state welfare. For Indigenous peoples and settler societies alike, access to military service and status as army, navy, or air force members had been an important and...

Mental Health Difficulties and Help-Seeking Beliefs within a Sample of Female Partners of UK Veterans Diagnosed with Post-Traumatic Stress Disorder.

In the UK there is a paucity of research about the needs of partners who are supporting ex-service personnel with mental health difficulties. In this study, we surveyed the mental health needs and barriers to help-seeking within a sample of partners of UK veterans who had been diagnosed with PTSD. Our sample included 100 participants. Forty-five percent met criteria for alcohol problems, 39% for depression, 37% for generalised anxiety disorder and 17% for symptoms of probable PTSD. Participants who met case criteria for depression, anxiety and problems with alcohol were more likely to report a greater number of help-seeking barriers. Participants who were experiencing mental health difficulties were more likely to endorse barriers connected to stigmatising beliefs than those associated with practical issues around accessing mental health services. The evidence presented suggests there may be a considerable burden of mental illness within this population. It would seem prudent to conduct further work to understand how best to address this clinical need.

Psychosocial impact of visual impairment and coping strategies in female ex-Service personnel

PurposeTo examine how vision loss affects the psychosocial well-being of female ex-Service personnel and how they cope with their visual impairment.MethodA cross-sectional study was conducted consisting of two study phases....

‘Masters in Their Own House’: Britain, the Dominions and the 1946 Ex-Service Free Passage Scheme

ABSTRACTThe dominant narrative of post-1945 British migration is that of the ‘ten pound poms’: British civilians who availed themselves of the system of subsidised migration and emigrated to Australia for the bargain price of £10, with the rest of the cost of passage being split between the British and Australian governments. It is little wonder that historians have tended to focus on this scheme, as between 1947 and 1972 around one million Britons used it to resettle in Australia.1 However, concealed within huge movement of people is a much smaller, but nonetheless important, migrant stream: the free passage scheme, a program which was open to veterans of the British forces and the Merchant Navy, under which almost 50,000 people settled in Australia. It operated only between 1946 and 1955 and was designed as a part of the package of benefits offered to all British veterans of the Second World War. The research on which this article is based, which was funded by the Scottish Centre for Diaspora Studies at the University of Edinburgh and headed up by Professor Sir Tom Devine, aimed to investigate the background and implementation of the 1946 free passage agreement. The project revealed significant differences between the 1946 scheme and its post-First World War equivalent. The British government's attitude towards the concept of empire migration had shifted from support to reluctance, as post-1945 planners worried about a shrinking British population and potential economic competition from the dominions. At the same time, the dominions were determined to prioritise their own reconstruction programmes, rather than assist Britain in resettling its veterans. Only Australia agreed to take British ex-service personnel, but as part of a much wider immigration plan designed to boost the Australia population and economy.

Visual impairment, coping strategies and impact on daily life: a qualitative study among working-age UK ex-service personnel.

BackgroundSustaining a visual impairment may have a substantial impact on various life domains such as work, interpersonal relations, mobility and social and mental well-being. How to adjust to the loss of vision and its consequences might be a challenge for the visually impaired person. The purpose of the current study was to explore how younger male ex-Service personnel cope with becoming visually impaired and how this affects their daily life.MethodsSemi-structured interviews with 30 visually impaired male ex-Service personnel, all under the age of 55, were conducted. All participants are members of the charity organisation Blind Veterans UK. Interviews were analysed thematically.ResultsYounger ex-Service personnel applied a number of different strategies to overcome their loss of vision and its associated consequences. Coping strategies varied from learning new skills, goal setting, integrating the use of low vision aids in their daily routine, to social withdrawal and substance misuse. Vision loss affected on all aspects of daily life and ex-Service personnel experienced an on-going struggle to accept and adjust to becoming visually impaired.ConclusionsHealth care professionals, family and friends of the person with the visual impairment need to be aware that coping with a visual impairment is a continuous struggle; even after a considerable amount of time has passed, needs for emotional, social, practical and physical support may still be present.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2455-1) contains supplementary material, which is available to authorized users.

Phoning in sick--telehealth in the iPhone age: As mobile devices become ubiquitous, can health care finally be delivered effectively over the Internet?

Phoning in sick--telehealth in the iPhone age: As mobile devices become ubiquitous, can health care finally be delivered effectively over the Internet?

The mental health of UK ex-servicemen with a combat-related or a non-combat-related visual impairment: does the cause of visual impairment matter?

AimsSince the start of the conflicts in Iraq and Afghanistan, the numbers of young service personnel who have sustained a combat-related visual impairment have increased. This cross-sectional study examined the...

Perspectives and contexts of arts, social health and the military

The paper outlines and introduces the context for the Special Edition on the arts, social health and the military. The social imperative of arts work in this area is founded on current statistics of between 18% and 30% of those returning from war zones to civilian life can be expected to suffer mental health issues, which can lead to family breakdown, homelessness and other social problems. In the USA for example, there have been 103,792 cases of post-traumatic stress (PTS) diagnosed in returned service personnel (in the period from 2000 to 2012). The paper provides a brief overview of the history of PTS and the ways in which arts-based strategies have been integrated into this history. The paper discusses the contemporary context of arts and health with military personnel, arguing that considerable work has grown out of alliances with small veteran support organisations interested in finding new and complimentary approaches to supporting ex-service personnel on their transition from military to civilian life.

Help for heroes? Evaluating a case management programme for ex-service personnel in the United Kingdom.

There is increasing recognition of the health and social needs of ex-service personnel, but the UK evidence base on interventions is small. This article presents the findings from an evaluation of a vocational case management programme co-funded by the National Health Service (NHS) to prevent ill health among ex-service personnel. Qualitative, semi-structured interviews with 15 ex-service personnel were conducted. Five interviews with case management staff were also undertaken. Data were transcribed, thematically coded and analysed using NVivo. Ex-service personnel valued the service and consistently highlighted 'being listened to', 'being made to feel valued by programme staff', 'having their problems taken seriously' and 'being treated as an individual' as the most valuable aspects of the programme. Respondents particularly valued the personal support that case managers provided and the environment in which the service was delivered. Case management is a viable way in which the military, health professionals and support services can provide ongoing support for ex-service personnel in transitioning successfully to civilian life.

Exploring Patterns in Referrals to Combat Stress for Uk Veterans with Mental Health Difficulties between 1994 and 2014

Little is known about the patterns of help-seeking in UK veterans with mental health difficulties. The aim of this study was to explore referral patterns to Combat Stress over a 20 year period. Combat Stress is a national mental health charity that offers support to UK ex-service personnel. Data was extracted from an electronic patient database system that included information on referrals to Combat Stress between 1994 and 2014. Data included time since leaving the Forces, area of deployment and whether participants engaged in clinical services. A fourfold increase in the number of referrals received each year over the duration of the study period was observed. Ex-service personnel who had served in Northern Ireland made up the largest proportion of helpseekers. In recent years significant increases in referrals from veterans from Iraq and Afghanistan were noted. Over the study period the time it took for participants to seek help after they left the services reduced by a half. There has been a recent sharp increase in veterans seeking support for mental health difficulties. This may reflect a period effect with individuals more willing to seek help sooner now than in the past. For example, veterans from Iraq and Afghanistan are seeking help more quickly than veterans from previous conflicts. The data presented within this paper suggests that there will continue to be an increase in the numbers of veterans seeking support for mental health difficulties over the coming years.