Sometimes ….when clearing an old memory stick I come across a forgotten piece of work that is both interesting and sadly still relevant. Way back in 2009 I commissioned George Charlton to carry out a phenomenological piece of research into a group of veterans accessing our very first peer led support group in Sunderland. Pure phenomenological research seeks essentially to describe rather than explain, and to start from a perspective free from hypotheses or preconceptions (Husserl 1970). This abridged version called Camouflaged But No Longer Concealed describes the lived experience of five veterans accessing our support at that time. A ‘Where Are They Now’ exercise would be equally interesting to carry out, sadly I have no idea where most of them are so another lesson learned. Read on…

‘Camouflaged But No Longer Concealed’

When I commissioned this phenomenological enquiry into the feelings and experiences of a small group of Veterans who had served over the last 30 years, it was in order to give some insight into the issues facing Veterans and their families when making the transition back into civilian life. It was also an opportunity to ascertain, from the ‘forces mouth’ as it were, exactly what the issues and barriers were when trying to access mainstream services. Our aim was and is, to give veterans a voice so that they can contribute fully to a society that they struggle to identify with.

During a long career working in numerous frontline and Senior management positions within various social welfare settings I have noticed that increasing numbers of ex forces personnel are becoming ‘noticeably visible’ within areas such as the homeless sector, initially presenting as ‘rough sleepers’ or within mental health support services suffering from diagnosed or undiagnosed Post Traumatic Stress Disorder (PTSD). Many more present at Accident and Emergency departments or at GP surgeries, Drug and Alcohol substitute prescribing services and sadly in growing numbers within the Criminal Justice System.

Many if not all of the organisations commissioned to provide interventions to those in the above categories fail to ask if the individual accessing their services served within the Armed Forces and this omission in the assessment stage or at the Pre-sentence report stage frequently leads to a lack of understanding as to the ‘root cause’ of the multiple complex issues that they may initially present.

Similarly, Veterans are notoriously bad at asking for help and may view survival ‘on the streets’ or when experiencing acute adversity as a continuation of the field exercises or combat missions that they took part in whilst on active service. Couple this with a highly developed sense of pride and a stubborn independence not become viewed as a burden on society. It’s therefore not surprising that civilian orientated support services find it difficult to engage and sustain meaningful interventions with ex forces personnel. Several veterans have told me that they continue to feel a deep sense of shame long after discharge due to the fact they were medically or dishonourably discharged from the forces. It can be no surprise then that they do not readily access the support of the numerous Armed forces benevolent organisations available to them such as the British Legion, Combat Stress and SSAFA as this would invariably necessitate disclosure as to the real reason for discharge.

Whilst the document raises many issues that are already in the public arena not a lot of qualitative research exists in relation to this subject matter. It is hoped that this work will become the catalyst for further research on a much larger scale that will allow us to understand the antecedents that either positively or negatively influence a successful transition to civilian life whilst at the same time, offering an insight into how services can be developed to meet this currently unmet need.

Tony Wright

Chapter One

Introduction

This paper has been produced following the identification of a number of veterans receiving drug and alcohol treatment interventions within the Sunderland area. All of these individuals have spent various amounts of time within the Army, Navy or Air Force and this fact presented an opportunity to explore treatment effectiveness and also highlight any gaps in provision for this hidden population from the point of view of the armed forces.

We believed that conducting this survey would give us privileged access to a hidden population whose needs were greatly underrepresented within our local communities. We also believed that from the data received from the veterans taking part in the survey that we would be able to develop services in partnership with the respondents which would impact on there lives in such a way that they would arguably be in charge of their own destinies and outcomes in relation to that of their life journey. The methods used within this survey to date have not been replicated and there is little evidence to show that outcomes from research papers have been used directly by veterans taking part in research projects to design services for themselves with the help and support of third sector organisations.

The focus of the research was to ascertain the most appropriate interventions to offer to this client group on discharge from the Armed Forces whilst at the same time trying to understand ways in which better links and transitional arrangements can be forged to ensure continuity of care for the individual leaving the Armed Forces when returning to civilian life. The data sample was also seen as an opportunity to provide a base line measure from which to build service delivery.

The main objectives of the peer led Armed Forces survey are outlined below and the approach utilized in gathering data conforms to that recommended by the Audit Commission’s (2002) report on drug treatment entitled, ‘Changing Habits’, which states that all local drug strategies should be based on up to date information on drug use and trends. The Audit Commission report also recommended the use of consumer evaluation surveys to gather information on client satisfaction within specific drug treatment services. We believe this report covers all of these aims as well as meeting the objectives set out for the survey itself.

The objectives of the study are set out below:

Objectives

To assess the nature of substance use in relation to the Ex Armed Forces personnel within the geographical area of the Sunderland.
To explore the effectiveness of current interventions and wraparound services as experienced by the client whilst serving within the armed forces and also when discharged.

To offer a snapshot of an opportunistic sample of ex service men within the Sunderland area, who have had issues associated with Mental Health, PTSD, homelessness and or drug and alcohol problems

To assess the needs in relation to future development of service provision of this client group, in particular the development of a new and dynamic peer led veterans support service.

To offer a user led perspective highlighting prevalent issues effecting today’s Veterans with the aim shaping future policy, planning and development.

To provide a base line sample on which to conduct further research and evaluation relating to experiences of those individuals from an armed forces background who have been affected with Mental Health, PTSD, homelessness, Drug or Alcohol issues and involvement within the Criminal Justice System. We believe this survey meets those objectives.

Name

Regiment

Time Served

Reason for Leaving

Paul

ARMY

3 LI / 2 LI & Rifles

19 Years

SNLR

Steve

ARMY

Royal Logistic Corps

3 Years

Dishonorable Discharge

Mark

NAVY

Submariner

7 Years

Voluntary

Discharge

Geoff

ARMY

Army Ordinance Corps

2 Years

Dishonourable Discharge

Mick

NAVY

Royal Marines

3 Years

Medical

Discharge

What was apparent at this point was that there were many other individuals who were keen to be interviewed, however for the purposes of this initial paper and baring in mind the scale of the research project that would have came to life as a result of letting the metaphorical ’snowball’ run its course, we had to cap the numbers and begin with what we had. During each of the face to face interviews I decided that I would make use of ‘open ended questions’ as a means of gathering data from the participants. Denscombe, 2003 asserts when using open ended questioning styles, “As the answers are open ended, there is more emphasis on the interviewee elaborating points of interest” (Denscombe, 2003, pg, 167) This approach to questioning would hopefully capture the interviewee’s words, feelings, beliefs and experiences throughout the interview process and would be deemed as a ‘person centred’ and positive way to gather data from the volunteer respondents. Once the interviews were complete I was left with the task of analysing the raw data and structuring information into a form via which I could present the findings.

Process of Data Analysis

This section of the methodology, relates to the process of analysing the raw data from the respondent’s interviews. For the benefit of the reader I have chosen to utilise thematic analysis as a means of immersing myself in the data and I feel that this has worked well with the chosen phenomenological study:

“Thematic Analysis is a process to be used with qualitative information; it is not another qualitative method but a process that can be used with most, if not all, qualitative methods” (Boyatzis, 1998, pg 4).

After looking at each of the questions I applied during the interviews and reading the transcripts fully, I felt that I was in a position to begin to look for any emerging patterns which seemed to hold meaning for the respondents. The emerging patterns were then documented on a note pad in no particular order, other than that of the heading of the questions asked during the semi structured interviews:

‘During the rediscovery, “fuzzy” stage of formulation of a research agenda, thematic analysis enables the researcher to access a wide variety of phenomenological information as an inductive beginning of the inquiry’ (Coffey et al, 1996, pg 27)

During the process of working through each respondent’s individual replies to the questions and comparing them to a different respondent’s transcript I felt I was able to see structures and various patterns forming which I was then able to code:

“Another pair of competencies involved are planning and systems thinking. They enable a person to organise his or her observations and identifiable patterns in to a usable system for observation” (Strauss et al, 1990)

For this task I decided that I would make use of different coloured highlighter pens, with each colour representing a repetition or, reoccurrence in the language used or the emerging themes within the interviewee’s responses.

As a result of using the highlighter pens and looking at the data on various occasions, I was aware, and also amazed, at how there seemed to be themes in the clients’ experience that jumped out of the page. I was also aware, when looking at the different responses from each of the interviewee’s, that in some way the same words were being spoken and the reoccurrence of these words seemed to aid me in choosing themes in which to write about:

“Themes are defined as units derived from patterns such as conversation topics, vocabulary, recurring activities, meanings, feelings, or folk sayings and proverbs” (Taylor & Bogdan, 1989, p.131)

I felt that in some way, the process of working through the complexities of the meanings expressed by the respondent’s and the difficulties that could have arisen in understanding some of the slang words used to express various methods of drug administration such as, “having a dig” (method of injecting a substance) and, “having a toot” (smoking illicit substances) would have been made more difficult to understand without my privileged knowledge of “drug slang”.

As a result of tirelessly looking through the transcripts and identifying and gathering themes it became quite easy to see patterns emerging from the data. It seemed as if the themes which I had chosen to write about in this paper in some way chose themselves. This felt like a respectful way to begin to understand the phenomenon and collective experiences of the respondents:

“Recognising an important moment (seeing) precedes encoding it (seeing it as something), which in turn precedes interpretation. Thematic analysis moves you through these three phases of enquiry” (Boyatzis, 1998, pg 1)

In Chapter Four entitled, “Presentation of Results and Discussion” I feel it is important to mention why I offer to the reader, my interpretation of the raw data and why I have encompassed my own understanding of the phenomenon alongside excerpts the respondents’ spoken words from their transcripts:

“A common objective in applied qualitative research is to explain, as well as to illuminate, people’s attitudes, experiences and behaviour. Explanations may be sought in order to address the questions that triggered the research in the first place, or to account for issues and patterns of behaviour which arise from the research itself” (Bryman et al, 1994, pg 191)

Boyatzis (1998) in discussing thematic analysis and the process which a researcher undertakes makes a claim that the process of recognising patterns does not stop, and states that, ‘there is a natural continuation of the quest to search for patterns and themes’ (pg 136).

It is apparent that the natural continuation of looking for patterns and themes is present even when presenting the findings in this paper. I believe at this point I was still in the process of analysing and learning from the client’s raw data and believe that my presence and comments does not detract from the realness of the data received from the respondents and like Bryman (1994) states, ‘a common objective in applied qualitative research is to explain as well as to illuminate’ (pg 191).

Methodological Approach

After much deliberation, it has felt important for me to utilise a phenomenological approach which allows the respondents’ views to be clearly visible and for me to be able to work within their subjective frame of reference, whilst still being aware of my own process in the whole task of gathering the data

“In order to gain access to others’ experience, phenomenologists explore their own, but also collect detailed and exhaustive descriptions from their respondents” (Miles & Huberman, 1994, pg 200)

The methodology I have used is therefore, qualitative rather than quantitative, meeting the “criteria of appropriacy” (Morrison, 1993, pg 110). It feels important for me to mention that in my opinion this method is most suited to the questions of human experience and ideally fits in with the task of understanding the life experiences and an associated feelings of ex service personnel:

“Phenomenological methods are particularly effective at bringing to the fore the experiences and perceptions of individuals from their own perspectives, and therefore challenging structural or normative assumptions” (Lester, 1999).

I was also aware whilst conducting this survey, that many of my own identities may well be present within the survey process i.e. that of the past soldier, the ex drug user in treatment, the recovered substance misuser, the civilian developing a way of working with drug users and also now the principal surveyor within the project and the implications and impact this may have on the overall process and findings.

It seems to me that my presence and my identity are, of course, something that will be present during the interviews and something which is impossible to remove from the process, and as a result it is important to acknowledge this may well have an impact on the way in which the respondent answer the questions that they are asked:

“We bring to interviews certain personal attributes which are ‘givens’ and which cannot be altered on a whim to suit the needs of the research interview regardless of our sex, our age, our ethnic origin, our accent, even our occupational status, all are aspects of our self which, for practical purposes, cannot change” (Denscombe, 2003, pg 170)

It has also felt important to me, whilst conducting this survey, to find literature which I can triangulate into meanings expressed by the interviewees.

I feel that it is not enough for me to have a belief in a way of working which is generated by my own experiences as someone who comes into contact with ex service personnel and take those beliefs as being a true account of how process is experienced by that of the individual.

“Equally, it is hard to imagine a practitioner being able to gain an adequate ability to conceptualise or understand clients and processes through firsthand experience alone” (McLeod, 1995, pg, 11)

As an individual using a ‘phenomenological’ approach, I am systematically trying to find new ways of seeing and understanding the subject of enquiry. It seems to me that this is essentially the best way of understanding the human experience of veterans and with this providing a valuable opportunity of developing a way of working which best meets the needs of the veteran population.

Strengths and Weaknesses of this Approach

In researching the phenomenological approach certain aspects surrounding the theory have become very appealing to me. I have found that by utilising this approach has allowed me to explore and delve into the complex phenomenon I have chosen to focus on and has aided me to reflect the complexity of the social world in which ex service men live within on a daily basis.

It has been important for me to find a methodological approach which allows me to work in a ‘Person Centered’ way and which values the lived experiences of the respondents:

“It carries an aura of humanism and, in its efforts to base its enquiry on the lived experiences of the people in the everyday world; it represents a style of research that is far removed from any high-minded, abstract theorizing” (Denscombe, 2003, pg 106)

Something I have been aware of which could be described as a weakness as a result of utilising this approach, is that working so closely with the human experiences of Veterans / drug users the data which is collected during the interviews may well have been unconsciously contaminated due to my own experiences as a en ex service man and ex drug user and the confusion between what is their experience and that of my own.

Myers (2002) argues that qualitative studies are tools used in understanding and describing the world of human experience and since we maintain our humanity throughout the research process, it is largely impossible to escape the subjective experience, even for the most seasoned of researchers:

“Despite the realisation that total objectivity is neither achievable nor necessarily desirable in qualitative research, researchers often are required to put aside assumptions so that the true experiences of respondents are reflected in the analysis and reporting of research” (Ahern,1999)

Reflexivity

Reflexivity in this paper has been addressed at various stages. I have found that throughout this survey it has been essential to reflect on my own personal experiences and I believe that the phenomenological approach has allowed me to achieve this goal.

Altheide and Johnson (1994) identified themes regarding reflexivity which they claim are significant whilst writing reflexive accounts, such as how contact was made with informants, issues of trust and rapport, how mistakes, misconceptions and surprises were experienced and dealt with.

It has been imperative within this study to make full use of questions, such as those outlined by Altheide and Johnson, and allow the answers to be fully present within the paper:

“It is much more likely that readers will have confidence in qualitative research in which the writer deals with these issues openly, rather than ignoring them” (McLoed, 1994, pg 99)

It appears that the use of reflexivity in this paper has actually strengthened the whole process and has shown my openness in the task of conducting the survey.

“Reflexivity at the very least, involves a process of self awareness that should clarify how one’s beliefs have been socially constructed and how the values are impacting on interaction and interpretation in research settings” (Marcus, 1994, pg 568)

Generalisations

As a result of the small numbers of interviewees taking part in this survey I felt that it would be difficult and also unethical to generalize that the findings could be rolled out to the remainder of the ex service population. Morrison (1993) postulates that the phenomenological approach does not seek to generalize but,

“celebrates the particulars of the situation” and is rich in, “authenticity and honesty with high explanatory potential capable of identifying key features as experienced by the participants” (Morrison, 1993, pg 51).

Within this paper what has felt more important to me than the generalizability of the survey is the personal learning and understanding which I have gained and also the way in which it has highlighted the issues as seen through the eyes of those who have been interviewed throughout this process. This information will be invaluable in designing and developing services which are fit for purpose and truly needs led.

Validity and Reliability

According to Moustakas, ‘the question of validity is one of meaning” judged by whether, ‘one’s own rigorous self-searching and the explications of others present comprehensively, vividly and accurately the meanings and essences of the experience’ (Moustakas, 1990, pg 32). I have been conscious of the question of my own, ‘self-searching’ and this is something I have been aware of at every stage of this study.

I have also been aware that over the years whilst working through the ‘transition’ from being an ex drug and alcohol addict and on to a clinician working within the field of substance misuse I have developed a ‘way’ of working in which I have become confident and this has proved to be effective and beneficial to the clients I serve. It seems that this view of me and my work is something which I have endeavored to place to one side whilst conducting the interviews with the respondents in this survey.

I believe that in order to capture the uniqueness of the phenomenological experiences of each of the respondents the survey would need to be governed by three factors which are outlined below:

“(a) ecologically valid (i.e. must examine real life circumstances of ex service personnel),

(b) Phenomenological (i.e. must capture participants’ self-reports of their subjective, internal experiences),

Another method which was encompassed into the final testing of the emerging themes was to use the Sunderland based ‘Forces for Good’ peer led Veterans Peer Led Support Group as a focus group in order to test the validity of the themes and also to bring the reality check to what was emerging as a result of the thematic analysis.

The members of the group in conclusion of the focus groups stated that the themes themselves were congruent with their collective experiences and as a result were happy that the analysis has highlighted issues that were prevalent to the client group and a true representation of the issues experienced by individuals who had spent time serving within the armed forces.

Ethical Considerations

In undertaking this peer led survey ethical considerations were of the up-most importance in anticipating any undesirable consequences for interviewees who took part in this study.

I believe I have been transparent throughout the whole of the survey process and have given as much information to the respondent as I possibly could. This it seems, aided the participants in deciding as to whether or not they wished to be involved in the overall process:

“We aim to benefit others, ensure that we do not harm, enable research participants to make choices by giving enough information as we are able to, and behaved in a fair and just manner” (Etherington, 2001, pg 13)

Another of the ethical issues which felt important to address during the survey was that of the Veterans self disclosure and how their anonymity would be protected.

Throughout this paper all of names of the respondents have been changed to respect their confidentiality and also to minimise the chance of the identification of the respondents.

The following chapter relates to the presentation of results and findings. Excerpts of the respondents’ raw data will be present in this section combined with a narrative account from the author.

Presentation of Results and Discussion

Introduction

Although this section of the paper will be dedicated to the presentation of findings from the participants’ interviews, it may at times seem to the reader that the author is undertaking many different processes during this chapter such as analysing, presenting and discussing the findings. Bryman et al (1994) postulates that there is an active continuum in qualitative research rather than a distinctive set of procedures and states:

“None the less, all our contributors subscribe to the view that analysis in qualitative research is continuous in that it interweaves with other aspects of the research process” (Bryman et al, 1994, pg 218)

It is with Bryman’s quote in mind that I feel the process of active analysis will be evident throughout this section and indeed be present long after this paper is completed.

The themes which have emerged as a result of analysis will be used as headings and then translated into narrative accounts outlining clearly what the respondents have said and my own interpretation or account of what has been said during each interview. Verbatim extracts from the interviews will be present in order to support the case and give the reader the opportunity to distinguish between what is the perception of the author from that of the spoken word of the respondent.

It is hoped that presenting excerpts of the raw data from the respondents in this section of the paper will offer an opportunity to present a more credible and plausible piece of work in which the reader is able to form an argument either to support or challenge the validity of this paper.

Narrative account of the themes which emerged as a result of data analysis

Through a process of thematic analysis there seemed to be a multitude of themes and sub themes which could have been utilised for the purpose of presenting the findings, however within this paper I have decided to look at seven of the major themes which seemed to offer the greatest opportunity for the voices of the respondents to be fully present within this paper and also to provide the greatest opportunities for learning as a result of the respondents life experiences.

Each of the interviewees were asked a number of questions and their responses have been clustered together to highlight different themes that emerged through the data analysis process. Once again, the author would like to reiterate that the names of the respondents have been changed so as to protect their anonymity.

Overview of respondent’s demographics & feelings surrounding joining the forces

Across the sample there were five individuals identified who expressed an interest to be involved in the survey process exploring the needs of Ex Forces personnel. All of the respondents who expressed an interest were male and were aged between 25 and 49 years of age. Each of the respondents stated that they had spent time within the Armed Forces and the general breakdown of the respondent’s demographics as follows:

Each of the respondents (n5) within the interview process spoke about the reasons as to why they joined the Armed Forces and also of the feelings that they had prior to joining their respective regiments. 100 % of the respondents (n5) stated that joining the Armed Forces was something that they felt was hugely positive and something that brought up a range of emotions from excitement to nervousness and feelings of being proud about joining and the acknowledgement that joining the Armed Forces had been a lifelong dream.

According to the HM forces web site there are many reasons for joining and include the following list which are stated as being good reasons to join the British Military, ‘answering the call to duty, taking a stance against terrorism, education and pension benefits, personal satisfaction and pride, family tradition, honour, devotion to duty, learning useful new skills, personal improvement, the opportunity to see different parts of the world, to do something different with your life’

According to Gee (2008) recruitment literature for Army careers highlights some of the potential benefits as being , ‘career interest and challenge, comradeship, the active lifestyle, travel and training opportunities’, however Gee argues that, ‘It omits to mention or obscures: the radical change from a civilian to a military lifestyle, ethical issues involved in killing, risks to physical and mental health, the legal obligations of enlistment, the state’s legal and moral obligations to its armed forces personnel, and the right of conscientious objection’ (Gee, D, 2008).

For the interviewees within the survey; joining the Armed Forces offered a number of opportunities which they could not find on ‘civvy street’, including travel, access to training, feeling a sense of duty, honour and wanting to better ones self.

Throughout this section of the survey the respondents stated that their reasons for joining were not financial and although many wanted a better future for themselves it was consistent across all 5 interviews, that no respondent stated that their reason for joining was purely financial.

According to the 5th City & Guilds Happiness Index (2008) cited at MOD Defence News (June, 2008) it is stated that, ‘financial rewards are not the answer to job satisfaction. Instead, having an interest in what you do for a living is the number one factor for ensuring on-the-job contentment, with 'happiness levels' remaining constant regardless of salary.

Air Commodore Tim Winstanley, Director Training and Education within the Ministry of Defence postulate’s that, ‘Individuals join the Armed Forces for a huge variety of reasons. Like all occupational areas, there are issues which cause our people to be dissatisfied. However, the evidence we gather indicates that it is the variety, the job satisfaction and excitement of military service that provides overall contentment with the roles they perform’.

Within the peer led armed forces survey each of the respondents had clear memories about their feelings and expectations prior to joining the armed forces and commented on how they were feeling at this time:

PAUL: “excitement” “I just wanted to serve my country, my blood is green”

STEVE: “I was excited and nervous and not knowing what to expect”

MARK: “excited man in an excited land, I wanted to travel and see the world”

GEOFF: “Scared but looking forward to building a future for myself”

MICK: “I was truly excited and wanted to be aboard a ship with a gun, I really wanted to be part of something that was elitist”

Regardless of the reasons for joining, each of the interviewees talked passionately about joining the Armed Forces. It was interesting to see that each person when responding to the question about joining up talked with a smile on their face, their body language had changed and it was obvious to the author that each of these men were proud of their memories and that they had given a part of their life to the Armed Forces and this was summed up well in this section by Paul who served 19 years in the Light Infantry who states:

PAUL: (with a smile on his face) “I never wanted to do anything else with my life, I was so proud when I joined the army, it was the greatest day of my life”

The next section of this paper is pertaining to substance misuse including pre-entry into the force, substance misuse whilst in the forces and also the issue of post armed forces substance misuse.

Substance Misuse: The Complete Journey.

The next theme which arose out of the continued thematic analysis was that of substance misuse and the impact that this has had for the respondents within the survey. It is important to mention to the reader that within the title, ‘substance misuse’, alcohol use and its effects on the respondents will also be discussed within this section. Also, within this theme a number of sub themes emerged, that of substance misuse pre-Armed Forces, substance misuse during Armed Forces service and post Armed Forces substance misuse. Each of these issues will be looked at individually within this section.

Substance Misuse Pre-Armed Forces

Of the five respondents taking part in the survey, 40% of the sample (n2) stated that they had problems associated with alcohol or drug misuse. Two of the respondents claimed that they were heavy drug users prior to joining the Armed Forces and stated that their drug use was something that was still giving them great cause for concern. When asked about whether they had drug problems prior to joining and if so what they were using, the response from two of the respondents was as follows:

STEVE: ‘yes I had a big problem, I was using from the age of 11 and a year before I went in the army I was using mushrooms, speed and necking about 25x10 mg benzos’ (diazepam) every day’

Geoff: ‘I was bang at the drugs before I joined the army, I was using cannabis, LSD, speed, xtc, mushrooms and cocaine…. I would use fucking anything I could get my hands on.

The remaining individuals (n2) did not view alcohol or drugs as being a problem prior to joining the Armed Forces. The two respondents who did have issues stated that one of the reasons that they thought about joining the Armed Forces came as a result of feeling that their drug use was out of control and that the structure of the Armed Forces may well act as a means of, ‘getting off the drugs’.

Geoff: ‘I joined the army because I seen it as a way of getting discipline in my life and also a way of getting off the drugs’

Steve: ‘I knew I was in the shit with the gear and the Army was my way of sorting myself out’

What was interesting in this section is that both Geoff and Steve viewed the Armed Forces as a means of addressing substance misuse issues and both felt that the disciplined and structured environment that the Armed Forces would provide would in itself be a positive therapeutic environment and one which would go a long way to addressing their problems.

It is also interesting to consider that the armed forces sits potentially within the 4 tiered structure outline by the NTA (National Treatment Agency) and could be argued to fit within the Tier One bracket in that the armed forces are, ‘Non-substance misuse specific services requiring interface with drug and alcohol treatment’ (Models of Care, 2002, pg 12) and with that postulates that individuals coming into contact with this client group, ‘need to be sufficiently trained and supported to work with drug (and alcohol) misusers’

It was reported by the respondents that they had not been drug tested prior to joining the armed forces, or when they arrived at their unit or as part of a CDT (Compulsory Drug Test). If testing had taken place and an adequately trained individual from the Armed Forces had been on hand then the appropriate referral could have been made to the relevant drug treatment agency to initiate a drug treatment intervention with a view to re enlisting the potential individual at a later date following successful completion of treatment.

Substance Misuse During Armed Forces Service

‘Research into Compulsory Drugs Testing (CDT) of UK service personnel, published today by the Journal of the Royal United Services Institute (RUSI), has identified a rise in positive tests for illegal substances in the British Army from 517 individual cases in 2003, to 795 in 2005 (and 769 in 2006), and also a four-fold growth in soldiers testing positive for the class-A drug cocaine’ (RUSI, 2007)

Within the section of the survey each of the respondents were asked to comment on their own substance misuse including alcohol use during their time within the Armed Forces. Of the 5 individuals surveyed each of them stated that at one point or another they felt that their consumption of either alcohol or drugs could have been deemed as problematic. Out of the 5 respondents 40% (n2) stated that their drug and alcohol use was out of control during active service and the remaining 60 % (n3) stated that their misuse of alcohol was potentially out of control.

One of the respondents (Steve) who admitted using drugs whilst in the Army spoke frankly of his drug use stating that he was using drugs as soon as he was out of basic training. The respondent went on to report that following basic training he could easily get his hands-on drugs as and when he needed them and stated:

STEVE: “I could easily get drugs from a couple of guys within my unit; they used to get them from outside of the camp and bring them back in and sell them”

Steve also went on to say that during a tour in Iraq he regularly stole Amitryptaline from the medics and would take the drugs whilst on Duty. Steve stated that as a result of the effects of Amitryptaline coupled with whisky which was smuggled on to the compound by Iraq’s civilians he ended up having a serious overdose which inevitably meant that Steve needed to be treated by the army medics whilst in Iraq.

Steve went on to say that he was aware of many other soldiers within his unit who were actively using drugs on a weekend whilst on UK soil, he stated that using drugs was no big deal as long as you were able to do your job the next day no one really took any notice and stated that Armed Forces personnel would generally use ecstasy and cocaine as a drug of choice:

STEVE: “everyone knew you just had to keep it a secret”

When the respondent was asked if he thought drug use was a problem within the army he stated that:

STEVE: ‘without a doubt, people just knew how long certain drugs would stay in their system’

The respondent claimed that people were not concerned about compulsory drug tests within his unit as they had a way of getting around the test and this seems also to echo the findings within Professor Sheila Bird’s report focusing of compulsory drug tests within the British army which argued that:

‘Traces of cocaine are found in urine for only two to three days after use in contrast to cannabis which remains in urine for two to three weeks’ and goes on to say, ‘soldiers’ drug use may have shifted away from cannabis partly to minimise their chance of testing positive in CDT’ (Bird, S, 2007).

One respondent (PAUL) who did not have a problem with drugs said that he was aware of others within his unit who were using illegal drugs, he stated that:

PAUL: “there were a few lads in my unit who would smoke dope upstairs in the den, but no body said fuck all about it”

Paul also made a statement which seems to suggest that military personnel are at times aware of when so called unannounced CDT’s will take place and stated,

PAUL: “most of the lads were aware of the CDT teams and when they would come out, people knew what drugs they could take and get away with it before the CDT took place”

STEVE: ‘A lot of the lads would use cocaine as it was out of your system quick enough and you would pass the CDT’

Within this section another respondent (Geoff) also spoke openly about his substance misuse whilst in basic training with the Royal Army Ordnance Corps (RAOC) at Deepcut in Surry.

Geoff stated that he had viewed joining the Armed Forces as he seen it as a way out of his addiction to ‘Class A’ drugs prior to enlisting in the Army, however because of worries of how he would cope without ‘Class A’ drugs, he decided to take a substantial amount of cannabis resin with him when he joined his unit.

Geoff stated that it was not long into basic training before he and another recruit were smoking cannabis on the camp and as a result ended up getting caught. Geoff stated that he now realises how crazy it was to think he could get away with drug use whilst in basic training and stated that:

GEOFF: “I was fucking stupid to think I would not get caught, it was almost like I had forgotten where I was”

Geoff went onto say that when his room was searched the Military Police from Pirbright found a substantial amount of cannabis and tested him via a urine sample which also proved positive for other drugs within his system. Geoff claimed that before he knew it he was on CO’s orders and found himself being sentenced to a, “lengthy stretch” in the, “Glass House” (MCTC Colchester).

The respondent went on to say that during this time following his arrest by the Military Police, he was never offered anything in the way of drug treatment and that he was placed within D Wing at the Glass House with a number of other Military personnel, many of whom were in jail for substance misuse offences. Geoff reported that at no point after his arrest was he offered an assessment to ascertain the extend of his substance related problems or indeed to ascertain whether there was a physical dependence to the drugs that he was using and the impact of stopping his drug of choice immediately without the aid of a pharmacological intervention.

It was interesting to listen to Geoff talk about the fact that he enjoyed his time within MCTC and that the structured environment is something that he felt personally helped him to remain clean for a period of time, however he stated,

GEOFF: “I was told by the commanding officer at the prison that he would make a recommendation to my CO that I should be allowed to stay in, but there was no hope I knew I would get fucking bladdered”

As it turned out for Geoff he was Dishonourably Discharged from the Army and sent home without a means of travel, at no time prior to discharge was anything offered in the way of help and support for his addiction nor was anything offered in the way of housing or access to training when Geoff got home.

Geoff stated that the only offer of support that was offered was that of a potential verbal reference that was made by a Staff Sergeant whilst Geoff was working as a runner for the admin department during a period of open arrest. Geoff stated that he was told be the Staff Sergeant that when he was discharged and got home, if he found a job to pass on the Staff Sergeant’s name and address and he would be more than happy to give Geoff a good reference.

Geoff stated that a few months following his discharge from the army he managed to get through an interview to work in a DIY store in the North East and passed on the Staff Sergeants address to the manager for a reference. Geoff stated:

GEOFF: “when I gave his name for the reference he promised me, he wrote back to them saying that I was a drug addict who had been in jail and that I was a disgrace to the army”

“Needless to say, I didn’t get the job, I felt betrayed and lied to by this man; stupidly I thought I could trust him”

For both Geoff and Steve, the return back to the North East did not lead to a life without drugs in fact their problems would get worse before they got better. Both of these individuals would become further involved within the Criminal Justice System and spend many further years addicted to various substances.

In an article published in ‘Scotland on Sunday’, December 2008 discussing the effects of alcohol within the Armed Forces it suggests that, ‘Nearly 6 out of 10 British soldiers drink so much they could be classified as alcoholics, according to a shocking internal report by the Ministry of Defence’.

Of the remaining 3 respondents within the survey 100% stated that at some point during active service their alcohol use was problematic even though they may have not have realised this at the time.

According to the Department of Health guidelines it is stated that men can drink between 3-4 units of alcohol per day without serious risk to health and that this amount is reduced to between 2-3 units per day for women.

In a statement made regarding alcohol treatment within parliamentary questions in January 2009 there is an argument to suggest that those individuals identified within the Armed Forces who were suffering with alcohol problems could gain access to support that would address problematic alcohol consumption via a range of interventions. It was reported within parliamentary questions that, ‘Service personnel identified by the chain of command as being at risk of alcohol misuse receive counselling and welfare support, this can include attendance on preventative early intervention programmes designed to alert them to the harm that alcohol can cause to themselves and others. More serious cases are treated through specialist medical and psychological treatment and rehabilitation, including where appropriate as in-patients’. (Parliamentary Questions, January 2009).

Within this section Paul, Mark and Mick spoke of their alcohol use during their time within the armed forces. When asked if they felt they had a problem with alcohol their responses were as follows:

PAUL: ‘I had a really bad drink problem; I would shake like crazy if I did not have a drink every day’

Paul spent in excess of 19 years within the armed forces and during this time became dependant upon alcohol. He stated that he became a daily drinker and this was a means of dealing with traumatic events which he witnessed during active service in Bosnia. Paul stated that his problems with alcohol was something that got him on CO’s orders on occasion but even on these occasions he was told to go away and sort himself out. Paul stated that he did ask for help around his alcohol problems, but nothing was ever done. Paul stated that:

PAUL: “Like me, many lads drank heavily but now’t was ever done, they were more concerned about keeping the numbers in the battalion rather than offering help to people when they needed it”

Paul stated that he has had problems with alcohol for around 12 years and he felt that he only received appropriate help for his alcohol issues following discharge from the Armed Forces. Paul seemed disappointed that the Army did nothing to help however he stated that he was making good progress currently with his alcohol issues.

What strikes me is how Paul’s alcohol dependence was never treated during his army career.

As a result of Pauls excessive drinking his dependence upon alcohol was so great on discharge from the Army that he was admitted for detoxification, however Paul stated that the Army did not see this as a treatment intervention that was needed during active service.

It seems to me that Paul’s alcohol problem was serious enough to require a medical intervention when discharged from the Army. However, there is nothing to suggest in Pauls story that the seriousness of his drinking problems would have been any different while he was serving with his Regiment. The major worry for me is that of the untreated alcohol problem itself, which was obviously serious enough that Paul would shake and in his own words, “Need a drink every day”.

For Paul, his excessive daily heavy drinking coupled with the serious physical and psychological effects demonstrate someone whose life was during this time controlled by alcohol.

According to Patient UK ‘This is a serious situation where drinking alcohol takes a high priority in one’s life’ and stated that if an individual is alcohol dependant the desire to use alcohol will become overwhelming and will at times mean that the individual will have side effects such as, ‘feeling sick, trembling, sweating, craving for alcohol, and hallucinations and convulsions occur in a small number of cases’ (Patient UK, 2008)

In contrast to Paul, Mark did not view himself as having huge issues with alcohol whilst in the Navy however the quantities that he did drink well exceeded that of the government’s guidelines for safe alcohol use, however, he did state that when you did get time to yourself the culture was to drink:

MARK: There was a culture of drinking, every one was always at the NAFFI bar, every chance you got to buck the system you would have a drink.

According to research undertaken by Henderson et al (2008) looking at alcohol use within the Royal Navy conducted with 1333 respondents it found that, ‘The majority (92%) scored as hazardous drinkers on the AUDIT-C, 40% met the criteria for heavy drinking, 27% for very heavy drinking, 48% reported binge drinking at least once a week and 15% were classed as problem drinkers. (Henderson et al, 2008)

Mark reported that when he was ‘off shore’ on the Nuclear Submarine he worked on there was also a culture of alcohol misuse even to the point where he stated,

MARK: “you should only have had three cans per night but on the Sub you drank as much as you liked”

Mark said that the men he deemed as having problems with alcohol, “always had enough in them to work”. Mark stated that alcohol used to be stored in the torpedo chutes and stated that on one occasion,

MARK: a bloke got a right beating for firing and loosing the beer out of the torpedo chute, one guy nearly got hung as well’.

Mark stated that the Navy was good for him and something that shaped him into the man he is today, Mark did not go on to have alcohol or drug problems and feels that his time in the navy was in his words,

MARK: “a supportive environment that was good for me, it helped me to grow up as I was getting in a lot of trouble before I went in”

The final respondent Mick also stated that he did not have a problem with alcohol or drugs prior to joining the Royal Marines. When asked about his alcohol use during his service within the forces Mick stated that,

MICK: I drank the same as everyone else, you worked hard and you played hard”

On further exploration of this subject Mick stated that when he did drink he drank between 10 to 12 pints on a Friday, Saturday and Sunday and also drank through the week. It feels important to mention that Mick’s drinking on the weekend alone well exceeds the government’s recommended weekly intake of alcohol for men. Mick stated that,

MICK: “everyone would drink as much as they could until you fell down”

According to Mick this attitude towards alcohol was par for the course and the norm where military personnel within his unit were concerned. Mick also commented that during his time within the Marines he was also aware of people who used drugs such as cannabis, speed and those also abusing prescribed medication such as codeine-based drugs.

Mick spoke of one colleague who was taking around 15 to 20 codeine tablets each day and that from time to time this individual would also sniff glue. The respondent said that things like this were no secret and reported that:

MICK: “whatever you did in your own time was your business, you were either a drinker or a drug user and as long as you could get up the next day, no one gave a fuck”

This attitude also seems to echo that of both Steve and also Paul who both stated that there was awareness among Armed Forces personnel of drug taking within the ranks which seemed to be swept under that carpet as long as the individual / individuals concerned were able to function and do their jobs.

Substance misuse post armed forces

Out of the 5 respondents within the survey, 60% (n3) went on to have major problems with alcohol and drugs on discharge from the armed forces.

As mentioned earlier Paul ended up with alcohol problems which eventually needed medical intervention as a means of controlling his alcohol use, his marriage broke down and he found himself physically and psychologically dependant on alcohol without any kind of support being put in place even though the Army was aware of his problems prior to discharge. When asked if Paul felt his problems with alcohol came as a result of being in the armed forces Paul stated that,

PAUL: “I never had a problem with drink before I joined the Army, it’s a massive problem in the Army, you drink to bond with your mates but it gets you in the shit”

Paul stated that he only received adequate support for his alcohol addiction when he left the Army, and until this time he was not offered anything in the way of support

For both Steve and Geoff post discharge their drug use got worse, both men spent time within the ‘Glass House’ (MCTC, Colchester) prior to discharge and also spent time within Civilian prisons following discharge from the Army. Both men went on to use drugs such as Heroin and Crack Cocaine and their lives took a downward spiral within the grips of addiction, Steve stated:

STEVE: “I think my drug use got worse in the Army and more so when I came out, I really felt let down and betrayed”

GEOFF: “the Army knew I had a drug problem, fucking hell I got caught for fucks sake, but they did fuck all to help me, I got not treatment, fuck all, the drugs for me just got worse after that”

After being discharged from the Army, Geoff went on to spend the next 10 years in the grips of addiction with his drug use escalating ‘year on year’. Geoff ended up as an injecting drug user and spent much of his life in trouble with the police and was sectioned on 2 occasions under the Mental Health Act due to significant events of self harm.

Geoff spoke of his resentment towards the Army as a result of lack of support that was offered to help with his drug problems and although Geoff acknowledged that the Army was not totally responsible for what happened in relation to his drug addiction, he did state:

GEOFF: “if I had been offered treatment by the Army, I don’t know my life may have turned out very different, I might have got my shit together sooner “

All of the men in this section either had problems with drugs or alcohol or knew someone that did during their time within the Armed Forces. All of the respondents reported that alcohol and drugs was a huge problem within the Forces and that at no time during their own service did any senior officer or NCO offer advice about safe drinking levels or about what to do if an individual had a drug / alcohol problem.

Conclusions drawn from the Henderson (2008) report claimed that, ‘Excessive alcohol consumption, especially binge drinking, is significantly more prevalent in the Royal Navy than in the general population’ and that, ‘Such high levels of drinking are likely to impact upon occupational efficiency and have both short-term and long-term health effects’ (Henderson et al 2008).

It could be argued as we come to the end of this section that the Armed Forces does not offer appropriate treatment to individuals with drug problems and that the ‘zero tolerance’ culture adopted by the Armed Forces potentially places individuals effected by substance misuse issues in a position where they cannot ask for help for fear of immediate discharge and with that the added pressure of being made homelessness as a result of discharge.

‘The British army tests 85% of personnel annually, and those caught are almost always discharged’ (Parliamentary questions Watson in answer to Moore: 58313)

As a result of the fact that discharge will potentially be the final outcome this will leave many of those individuals concerned unemployed and, in many cases, sent back to their home towns or cities without the prospect of employment or even a roof over their heads. This in turn places the individuals who are using the drugs / alcohol problematically in the position of having no idea of how to access treatment or harm reduction information which inevitably will leave the individual concerned at risk of further exacerbated drug / alcohol related problems following discharge.

Mental Health & PTSD

Because of the stigma of mental illness and the avoidance of the phenomena associated with PTSD, many service men and women suffer in silence and fail to seek help or discuss their symptoms, taking their problems with them when they are discharged’ (McCrone et al, 2003)

In this section of the survey the respondents were asked if they had ever suffered from Mental Health problems or Post Traumatic Stress Disorder. Of the 5 respondents interviewed 40 % of the sample (n2) stated that they had suffered from Mental Health problems (Geoff and Steve), 20 % of the sample (n1) stated that he currently suffers from PTSD (Paul) and 40 % of the sample (n2) stated that they did not feel that they suffered from adverse Mental Health problems or PTSD (Mick and Mark).

Both Geoff and Steve spoke of how they felt that mental health problems had been something that was present for them prior to joining the armed forces, however they both claimed that they felt that being in the Army had in some way exacerbated their mental health problems.

GEOFF: ‘I think I had mental health problems before I went in the army, I used to cut myself up a lot with razor blades but I think it got worse when I was in the army’

STEVE: ‘I was always getting fucking bullied and people used to take the piss out of me, I still struggle mow with my mental health’

Geoff stated that when he was in MCTC Colchester, he was to use his words, “mentally tortured” by one member of the prison staff, who shall remain nameless within this paper. Geoff said that during his time in the ‘Glass House’, he was goaded, belittled and told that he was worthless on a daily basis. He said that he felt like hurting himself on many occasions as a result of the relentless name calling and, “beasting” that came from one particular member of staff:

GEOFF: ‘He would always call me names and scream and shout at me, he would call me a fucking horrible Geordie maggot and say that I was a fucking disgrace to my family’

Geoff acknowledged that it was not appropriate for him to have used drugs within the Armed Forces and that his actions had invariably landed him in Prison, however he did say that no one deserved to be treated in the way he was by the staff member in Colchester prison:

GEOFF: ‘This guy always made me feel ill, I was never treated like a human being off him, he always treated me like shit’

On discharge from the army, Geoff went on to have many years of mental health problems and spent long periods being prescribed anti psychotic drugs. Geoff difficulties resulted in regular self harm and, over a number of years, progressively got worse – with him using drugs, alcohol, and prescribed medication as a means of dealing with his ongoing mental health problems. Geoff spent much time under the supervision of psychiatrists and psychologists and was, on two occasions, sectioned under the Mental Health Act following attempting to take his own life.

In total, Geoff spent 10 years within Drug and Alcohol services and Mental Health Services trying to get his life in to some kind of order.

Steve, in this section, spoke of his love for the Armed Forces and how much it meant to him to be in the army. He said that all he wanted to do was be a soldier and have a new family as his own family did not communicate with him.

He spoke about being in Iraq and how, over a period of time, he was bullied persistently by a female Sergeant. Steve stated that he tried to complain about the bullying on many occasions but said that no body would take his seriously and claimed:

STEVE: “I wish I had never bothered trying to make a complaint as I got more stick as a result of it, you had young lads who had a stripe on their arm who thought they were God giving it out to me all the time”

In a report named ‘Informed Choices’ (2008) which looked at the Armed Forces recruitment practices within the UK, it is argued that, ‘Bullying and harassment remain major problems for the armed forces in their own right, and also adversely affect retention of personnel’, and conclusions were drawn that, ‘The forces need to: acknowledge the problems, clarify to new recruits the policy on bullying, remove humiliating practices from all aspects of training, and restore faith in the complaints system by providing an independent complaints channel’.(Gee, D, 2008)

Steve said within this section that he still thinks about making a complaint as he attributes his current anxiety and depression to the fact that he was treated so badly when he was in Iraq. Steve himself stated that he did not know what the future held for him. He did, however, go on to say:

STEVE: “I could not see a future for myself earlier on when I came out, but things are looking much better for me now”.

When Steve was discharge from the Armed Forces, his marriage broke down - ending up in divorce. He became homeless, unemployable due to lack of skills; he began to use Class A drugs (heroin) on a daily basis and was given a custodial sentence for a period of time. Steve, over the past two years, has worked hard to get his life back in order, entering voluntarily into substance misuse treatment and he has been prescribed substitute medication which he is in the process of reducing. Steve attends many educational courses and seems to have real control over his life. Further, he aspires for the future.

Steve now attends a peer led support group and is an active and valuable member of group.

Within the survey, the one respondent (Paul) stated that he suffers with PTSD and spoke of his experiences regarding PTSD, both during his time within the Armed Forces and also the impact currently on his life. Paul said that he was diagnosed with PTSD whilst serving in the army and this diagnosis was made by a psychiatrist at a Military Hospital in Bulford.

Paul stated that even though he was diagnosed with PTSD, nobody really took it seriously:

PAUL: “I was grilled by the Army about my Mental Health, they gave me a fucking hard time, but I was never offered any real help”

Paul spent in excess of 19 years within the Army, during which time he served in many countries including Bosnia, Serbia, Afghanistan, Iraq, Sierra Leone and Northern Ireland (to name but a few). Paul stated that it was during this active service that he felt that he may have developed PTSD,

PAUL: “I think I seen far too much when I was way too young”

Paul went on to discuss his time in Bosnia and Serbia. He said that during his time in these countries he saw countless dead bodies which were lying in ditches by the roadside. He said that even now he could not come to terms with some of the things that he saw whilst he was on active service and this was something that he knows will affect him for the rest of his life. Paul stated that he is haunted by these memories and at times cannot get the graphic images of these dead individuals out of his head:

PAUL: “those bodies we found were rotten, every day I can smell that smell, it was fucking horrible”

Paul states that even now he can be walking down the street and he experiences the images and smells from his time spent in Bosnia and Serbia. He went on to state that this is something very traumatic for him but something he has begun to get used to. Paul stated that there was no opportunity for support of a means to off-load for soldiers who were witness to traumatic events.

Further, he said on one occasion he had seen bodies of dead children and this had affected him significantly, speaking of feeling let down that he was offered nothing to help him to process what he had seen and claimed:

PAUL: “There was fuck all you could do , you were just expected to get on with it”

Within this section Paul was encouraged to talk openly about his experiences and it was amazing for the author to see the physiological changes within Paul when he talked about the forces.

There was no doubt that Paul was a man who dedicated much of his life to the Army and no doubt that he loved everything connected to the Army. His eyes lit up when he talked and it was also interesting how his shoulders went back and he seemed to grow an inch taller when he spoke of the time he served - it was almost like he was bracing up to stand to attention. In this section, the author was in awe of the energy that Paul had put in to his career. Paul received 9 medals during his time in the Army one of which was awarded for finding a weapons stash whilst of duty. Paul has ended up with fluid on his lungs as a result of sleeping on the floor of a metal factory for months during a tour of Bosnia.

Paul stated that the treatment he received from Bulford for his PTSD was the only support that he received and when he left the Army this treatment stopped. There were no subsequent referrals for support and, as a result, there was no continuity of care which left Paul without the treatment he so desperately needed.

According to Iverson et al (2005) in a paper entitled, ‘Goodbye and good luck’, which focuses on the mental health needs and treatment experiences of British ex-service personnel, it argues that, ‘There was a sense that even those who had seen a psychiatrist were not engaged with ongoing service provision; few of those with one or more diagnoses had community psychiatric nurse input’ and argues that, ‘ex-service personnel are reluctant to seek help, both while in service and after leaving’. Iverson concludes that, ‘the military therefore should continue to encourage a culture in which consulting about symptoms is acceptable – a cultural shift that will benefit individuals even after they have left the armed forces’ (Iverson et al, 2005).

On return to his home town of Sunderland, Paul went to SSAFA to see if they could assist him with regards to getting back in to treatment. He stated that a member of staff from SSAFA had promised that he would support Paul. However, to date this has not happened and Paul stated that he had called SSAFA on many occasions but that nothing ever seemed to happen:

PAUL: “I feel let down by them I’m sure there ignoring me as they never call me back”

Over a short period of time after Paul had returned home, he stated that his behaviour became out of control, he was angry and snapping at the simplest of things. Paul stated that his marriage broke down and he ended up leaving the family home with no where to stay and no support in place and that he felt isolated and held no hope for the future. He began to drink more in order to deal with and to manage his emotions, and also to combat the images and memories that he had from his time within the Army. He spent a period of time during this section of the survey talking once again about the, “dead children” that he had witnessed and how there is not a day goes by where he is not tormented by these intrusive images and this time in his life.

Paul stated that he has a massive problem with PTSD and that and prioritized this above all else in his life - especially most recently since he has begun to self harm.

Within the survey Paul’s story was extremely powerful. However, it should be noted that this should not, in anyway, detract from the experiences of other individuals who decided to discuss their mental health problems. However, the graphic content of Paul’s responses in this section was something that left the author with a real sense of what many of our Armed Forces personnel experience on a day to day basis and also the lack of support that is offered to Veterans who have experienced combat stress.

Of the two remaining respondents Mark & Mick, both felt that their mental health did not suffer as a result of being in the Armed Forces. Both did mention, however, that they were both aware of many within their units who, in their opinion, were suffering with mental illness. Mick spoke of older men within his unit who had spent time serving in Northern Ireland and stated:

MICK: “You stayed away from these lads, and you accepted that some of the people you were working with … were fucking mad”

Mick highlighted that everyone was aware of the people within the unit that you had to give a wide berth to and claimed:

MICK: “When you wanted to wake them up you would have to poke them with a stick or something because they would go nuts, they were crazy and violent”

It is clear, as we come to the end of this section, that all of the respondents were in some way affected by mental health issues - either that of their own or that of someone else’s.

There once again seemed to be a general acceptance that drug and alcohol issues exist within the armed forces and that mental ill health is something that people suffer from but not much attention is paid to. These revelations would suggest that more work needs to be done to understand the wider mental health implications of this group of individuals but, more importantly, that effective treatment interventions coupled with integrated care pathways need to be developed in order to ensure that those who do suffer with PTSD or combat stress do not suffer in silence.

The final word should go in this section to a young man (Anthony Parsons) suffering with combat related PTSD who stated:

"PTSD is the fear controlling you. Exposing your fear is controlling your PTSD!"

Housing & Homelessness

The next common theme which emerged from the survey was that of post discharge housing.

Each of the respondents was asked about their housing situation following discharge from the Armed Forces, and also about the provision that was put in place by the Armed Forces when each of the respondents left.

Official statistics show that “approximately 24,000 people leave the Armed Forces every year, of which a small proportion may be vulnerable to homelessness” (Dandeker, C, 2005).

In this section 100 % of the respondents (n5) stated that prior to leaving the Armed Forces nothing was discussed or put in place regarding where they would be housed. The respondents reported that they were never questioned regarding their housing situation or, indeed, where they would sleep the following night after leaving their unit.

GEOFF: “When I did leave the army, I had no where to go, I had no means of getting back home and when I did get home, I had no where to live. Not once did the Army ask me how I would cope - they didn’t give a fuck”

MICK “When I was discharged from the Navy I had nothing and no where to go, they knew I was leaving without a home to go to”

STEVE: “I have spent years between my gran’s house, my mam’s house, hostels and prisons. I have never really had a place to settle or call home since I came out”

PAUL: “I had to sort myself out, the Army never asked me fuck all about where I would go or what I was going to do”

MARK: “I didn’t know what I was going to do - I managed to find myself a caravan and lived in that for 9 months”

Each of the respondents spoke about their personal struggle to find suitable housing or, in some cases, finding housing at all. For 60 % of the sample (n3) they were fortunate enough to find friends or relatives who were prepared to take them in for a period of time. One respondent lived in a caravan for 9 months and one respondent went on to live on the streets for a period of time following discharge from the Armed Forces.

A feasibility study commissioned by the MOD and the Office of the Deputy Prime Minister focusing on the extent, cause, impact and cost of ‘rough sleeping’ and homelessness among Ex Service Personnel in England postulates that:

“The Homelessness Directorate (ODPM) has been working with the Ministry of Defence (MOD), the Armed Forces and ex-Services charities to ensure that the best advice and support is given to Service leavers who are at risk of homelessness and to rough sleepers who have been in the Services”. (KCMHR, 2005).

Within this section there seems to be incongruence between the current legislation and policy that exists and how this translates down to grass roots level and impacts on the lives of the individuals leaving the Armed Forces. All of the respondents within the “Camouflaged but no longer Concealed” paper stated that nothing meaningful was offered either prior to leaving the Forces or post discharge and, as a result, further problems were caused for the individuals concerned when returning home.

Only one of the respondents within this paper (Paul) stated that he had received support from the British Legion and that the support he had received had facilitated him to securing a tenancy with a private landlord:

PAUL: “The legion was dead helpful to me, they gave me money for a bond and helped me kit it out”

Paul went on to say that had it not have been for the support of the British Legion his life would have continued to take a downward spiral and he is sure that his life would have ended up far worse than it had if not for the support offered.

The remaining 80 % of respondents stated that they were not aware that the British Legion or any other organisation could have offered adequate support around housing support. It seems this was something that the Armed Forces neglected to tell them.

Once again it is argued within the Kings College (2005) report that in partnership with the Rough Sleepers Unit (now incorporated into the Homelessness Directorate), the MOD has developed a number of initiatives to help vulnerable service personnel pre-discharge, at the point of discharge and post discharge’ (pg 16). An overview of the initiatives are as follows but it should be mentioned that none of the respondents were at any time offered support of this nature at any point either pre or post discharge.

The report postulates that a welfare package has been established to help Service personnel in their transition back into civilian life by which Unit Commanders, as part of their welfare responsibilities, are required to be aware of the trigger factors that lead to vulnerability to homelessness and to take necessary action.

Secondly the 2005 report states that a project called SPACES which is funded through the MOD acts as a housing referral and advice centre aimed at helping service personnel who are at risk of homelessness following discharge from the armed forces. Since the opening of the project in 2000 it is reported that, leading up to 2005, the SPACES project (which is managed by English Churches Housing Group [ECHG]), has received some 1,500 referrals and has placed approximately 390 people in accommodation’

(Dandeker, 2005).

Although the armed forces should be commended for the good work which is undertaken regarding resettlement, the number of individuals identified within the KCMHR report who were placed in accommodation (390) seems to a relatively small number if we take in to account the initial number of referrals (1500) in 2005.

The final initiative identified within (2005) report postulates that two organisations are in place to deal with the issue of resettlement. The Galleries Project’ in Richmond, North Yorkshire, provides 13 short-term accommodation units for vulnerable, single Service leavers immediately after discharge from the Armed Forces and also identifies another organization which offers the following interventions. This is Project Compass, which is a 12-month pilot scheme in London that aims to provide new opportunities for 30 homeless ex-Service personnel by providing modules to develop their self esteem and motivation and providing support and assistance for those who have complex need. Further, it provides opportunities for employment training and subsequent employment placement. (KCMHR, 2005).

It should be acknowledged that the armed forces appear to be developing initiatives that are focusing on the needs of service personnel post discharge. However, once again, there seems to be a very little thought going into the number of physical places i.e. homes on offer or additional support for individuals leaving the forces. If we consider the number of places on offer at both the Galleries project and the compass project we find that there are around 43 places which will be offered on an annual basis to service men and women leaving the forces.

With this in mind, the armed forces needs to do much more work to provide access to appropriate social housing and wrap around support services which can help with the transition in to ‘civilian life’

In August 2007 in a report by the National Audit Office looking at individuals leaving the services it was argued that, ‘the survey found that 5%, mostly young and of junior rank, of Service Leavers had experienced homelessness (including staying with friends). The majority, 51%, had been homeless between one and six months, 14% between seven and 12 months and 12% for over one year’ (National Audit Office, 2007).

The findings within the National Audit Office paper could be argued to echo the experiences of this individuals within the ‘Camouflaged but no longer Concealed’ paper ie that little support is put in place for individuals leaving the armed forces and this it seems this is echoed by the respondents within the paper - all of whom stated that nothing was done in order to support them during their transition from the armed forces in to civilian life.

Education Training and Employment

In this section of the survey the respondents identified that there was little support offered in relation to education, training and employment when leaving the Armed Forces. Each of the respondents said that when they were discharged from the forces they felt that they would have to fend for themselves in every aspect of their lives and employment was one factor which gave them great cause for concern.

Out of the sample 100% (n5) stated that one of the 3 major factors which were causing problems when they left was that of gaining employment.

Within this section Paul stated that he felt let down by the army after giving, ‘19 years of his life’ and being told to leave the camp with not so much as a warrant card to get home:

PAUL: “I just walked past the guard room and stuck my fingers up at those pricks who were laughing at me. I couldn’t believe it - I didn’t even get a train ticket home. I had to make my own way back from Salisbury to Sunderland, they didn’t give a shit about me”

Paul stated that he was not offered any pre-discharge employment advice and nor was he signposted to an organisation that could offer training or additional support such as the British Legion. Paul spoke of his concerns and said that he was so frustrated and worried about his future return to civilian life.

PAUL: “I didn’t know what I was going to do for a job or how I was going to get one, all I knew was how to be a soldier and without that I was fuck all”

Like the remainder to the respondents in this section, Paul felt vulnerable when discharged from the armed forces and also felt extremely isolated, de-skilled and de-motivated:

STEVE: “I didn’t have anything positive to do with my life when I left the army, I felt so alone”

Steve stated that when he left the army he had no formal qualifications that would help him to get a job when he came out. He said that he would have loved to continue doing cookery as he had been a chef in the Army but, as he had gained no formal qualifications during his time served, he was stuck when it came to finding a job post discharge:

STEVE: “All I wanted to do was get a job, get some new friends and ry and get my family back”

Unfortunately, like Paul, Steve said that he was not offered help prior to leaving the Army or told where he would be able to get support from once he had left. To date Paul has not had a job since leaving the Armed Forces.

Within this survey Mark stated that he had put his notice in around 18 months prior to leaving the Navy and that during this time he also had not received any support or advice about moving on in ‘civvy street’. When asked what was offered Mark stated:

MARK: “ Nothing whatsoever, no resettlement package, nowt, I was discharged from Rosyth with no job or home to go to, the only thing they tried to do was get me to stay in and talk me out of it”

The theme within this section of lack of support around education, training and this is also echoed by both Geoff and Mick.

GEOFF: “I was offered fuck all prior to being discharged, I ended up coming back home without a clue about what I would do for work, it took me six months after that to get a job, but it was shite with no prospects”

MICK: “All I was offered was £1600 and an opportunity to do my driving lessons and test which they would pay for”

Mick went on to say that no one had spoken to him about what he would do on discharge or how he would manage in the future. He stated that he was made aware that as he had a medical injury as a result of being in the Forces he could, “Jump to the front of the NHS queue” but stated that other than this he was given a warrant card to get home and that was all that was offered.

Both Mick and Paul did attend SSAFA for support around getting into employment. However, both respondents claimed that they felt that they were not listened to and there was nothing really meaningful in the way of employment on offer. Mick stated that a “bloke at SSAFA” had said that there was nothing available at the time and would get in touch when something came up but according to Mick, they never called or sent anything that could help him. Mick stated:

MICK: “29 years later and I’m still waiting to hear from them!”

100% of the respondents felt that something should have been done to assist them regarding education training and employment prior to leaving the Armed Forces and that had this have been the case they all would have felt more hopeful about their futures post discharge However, as it turned out, each of them were unhappy that nothing was on offer.

40 % of the sample (n2) are currently unemployed, both of them wanting to work but to date having had little in the way of success. Both individuals have, however, successfully undertaken voluntary placements and try hard on a regular basis to better themselves - with one individual (Paul) most recently completing an FA accredited football coaching course and the other (Steve) completing a course which will further assist him in his search for employment.

Of the remaining 60% (n3) all stated that following discharge from the Armed Forces they needed to’ re invent’ themselves. The respondents stated that they felt they had no transferable skills and the only way they would progress in the future was to retrain themselves following discharge.

Of the three remaining respondents all eventually went into paid employment roles. It is important to mention that for these respondents the qualifications achieved and their subsequent employment were a result of their own hard work and did not happen overnight. The concept of re-inventing themselves was something that evolved over a period of 5 or more years.

The Armed Forces and the Criminal Justice System

As a result of the survey process another emerging theme was that of the Criminal Justice System and how this had played a significant part in the lives of a number of respondents within this paper.

According to NAPO, the estimated current population of individuals detained within the prison system is 93, 574 (NAPO, 2008). Of this number an estimated 7,350 are believed to have been in the Armed Forces. This amounts to 9.1% of the prison population.

Of the five individuals who took part in the survey 60% (n3) had spent time within a custodial setting following discharge from the Armed Forces and 40 % (n2) also spent time within MCTC Colchester pre-discharge. One respondent within the sample reported that although he had not been formally in trouble with the Police or the Criminal Justice System, his behaviour post Armed Forces relating to violence towards others was something that the individual now found disturbing and something he feels would have had him locked up if he had been caught by the Police:

MICK: “When I came out I would get hammered on the drink and go out looking for trouble, I used to go crazy and got into a lot of fights”

Both Steve and Geoff reported that criminal activity became a way of life for them following dishonourable discharge from the Army. Both men spent a period of time within MCTC Colchester, with Geoff spending 2 years for possession of a substantial number of drugs and Steve spending a number of months in Prison for theft which he reported was to fund his Crack Cocaine addiction whilst in the Army. Both individuals spoke openly about their convictions within the Forces and reported:

STEVE: “I got done off the Civvy Police a couple of times for drunk driving and then I finally got jailed at Collie (Colchester) and then chucked out for shop lifting”

GEOFF: “I had been in bother before I joined the Army but never now’t serious, but getting caught with the drugs at my unit was just too much for them, jail and then binned”

Both Steve and Geoff in this section spoke of how they felt that their substance misuse within the Army was something they deemed as problematic. Both men felt that their drug use was out of control when they were sent to MCTC with Geoff stating:

GEOFF: “If I didn’t get caught when I did I would have soon enough, I was hooked and I was kidding myself that I could stop using when I joined up”

Following an inspection of Military Corrective Training Centre Colchester by HM chief inspector of prisons (2008) it was reported that 15% of detainees stated that they had a problem with drugs and 28% had a problem with alcohol on arrival (pg 43).

Neither Geoff or Steve within the ‘Camouflaged but no longer Concealed’ report was offered any kind of treatment intervention when they were initially jailed and held in close arrest within the guard room awaiting CO’s orders. Again, it was reported that neither man was offered a comprehensive assessment on arrival to MCTC to ascertain the physical and psychological dependence to their respective drugs of choice.

Her Majesties Inspectorate of Prisons Inspection report (2008) postulates that, ‘The centre had a comprehensive drug and alcohol detoxification policy” which had been produced in August 2008 and reports that the policy ‘had been used for one detainee in relation to alcohol’.

Also within the Chief Inspector of prisons report (2008) it is argued that Staff within MCTC, ‘anticipated it (the policy) would not be needed often’, However, this is of some concern as it was reported that ‘16% (of the respondents) stated that it was easy or very easy to obtain illegal drugs whilst detained at the centre’, and, ‘Drug testing was undertaken on a random basis, usually if requested by the sending unit’ (pg 44).

It feels important to mention that the 2 respondents within the paper who were held within MCTC, their release from the military prison led to discharge from the Armed Forces due to the severity of their crimes. During their time within the Military Prison and also whilst held in open arrest back at their Units whilst awaiting discharge, neither man reported being offered any support around their substance misuse. Nor were they offered any training or support in relation to their resettlement needs. This was summed up in a quote by Geoff who stated:

GEOFF: “When I got back to my unit after being in the Glasshouse I was treated like shit……. I felt degraded and was threatened, nobody really cared about me- they just wanted me out”

Following discharge both Geoff and Steve ended up within the criminal justice system, with their substance misuse escalating and resulting in more crime to fund their drug addictions. This in turn resulted with the 2 individuals ending up within civilian prisons and also receiving Probation Orders on completion of custodial sentences. One of the respondents within the paper (Steve) is currently on a DRR (Drug Rehabilitation Requirement) order for his persistent crimes and states that it is the best thing that has happened in his life in a long while as a result of the structure which came as result of being on the court order.

Steve reported that the structure of the order and the medical intervention which he receives for his heroin addiction has led to him being free from drugs now for in excess of 9 months and able to hold down Voluntary Work and Educational Courses for which he is truly grateful and states has giving him a chance at having a life worth living.

STEVE: “I feel like I am getting better now and my confidence is getting better as well”

The other respondent within this section (Geoff) who spent time within MCTC and also within the Criminal Justice System went on to do well following a period of time engaged within Specialist Drug Services and also having access to Education, Training and Employment opportunities all of which were found by civilian services post- discharge from the Armed forces.

Geoff went on to become drug free and has sustained abstinence from drugs for in excess of 9 years, with him progressing to win a National Training Award.

Geoff also reported that as a result of the structure of being in treatment, coupled with the learning opportunities he found himself being offered were hugely significant to his recovery. This was only second to the support and belief that was offered by individuals who did not see him as a lost cause.

The experiences of these two men seems to suggest that had they have been afforded the opportunities of having access to pharmacological interventions regarding their substance misuse and also access to educational interventions and ongoing support pre-discharge, their stories once discharged would potentially have been very different. However, as identified earlier in this section, neither man was offered a comprehensive assessment of need either pre MCTC.

This it seems is qualified within the 2008 inspectorates report of MCTC which postulates with regards to assessment that “The initial reception screen was perfunctory (see health services section) and did not elicit much information about drug or alcohol abuse” (pg 43) and poses the argument that, ‘We did not believe that issues of concern, especially in relation to mental health, were always identified (see paragraph 4.34). Of equal concern was the fact that in the two weeks prior to the inspection, 46 of the 80 detainee admissions had arrived between 5pm and 6am. Seven (9%) had arrived after 10pm when staff from the medical centre were not on duty, so they did not see a member of the health services team until the following morning’ (HM Chief Inspector of Prisons ,2008, pg 47).

Once again this suggests that a more ‘Person Centered’ and individually tailored, needs led way of working with ex Forces Personnel who are within the Military Criminal Justice System would go a long way towards helping individuals who are experiencing problems with substances and potentially offending whilst actively serving within the Armed Forces.

Recommendations coming out of the 2008 report with regards to the,’ primary care’ of those individuals receiving a custodial sentence within MCTC Colchester suggest that, ‘The health needs assessment should be repeated to ensure that the relevant services are being provided for detainees’ and, ‘Detainees’ poor perceptions of the quality of care provided by doctors should be investigated and any necessary action taken’ (pg 43)

Recommendations were also made regarding those individuals affected with substance misuse issues and also receiving custodial sentences within MCTC suggests, ‘There should be effective lines of communication (with the consent of detainees) between the welfare officer, medical centre staff and mental health staff so that detainees requiring help with drug and alcohol abuse issues receive a comprehensive care package’ and also postulates that, ‘The initial reception screen should identify detainees with drug or alcohol abuse issues and symptomatic relief should be provided if required’ (pg 43).

According to the National Association of Prison Officers -who conducted a report in 2008 looking at the extent of ex armed forces personnel within the criminal justice system - ‘large numbers of ex-service personnel are being convicted for a range of offences, primarily involving violence, within a short period following discharge from the forces. The majority are drug or alcohol related’ (NAPO, 2008).

Within the NAPO report which focused on a number of case studies of individuals within a custodial setting, it is argued that ‘The case histories examined by Napo show that the majority of the ex-soldiers were suffering at some stage from post traumatic stress disorder (PTSD) and that very few had received any counselling or support at any time after discharge’.

This it seems would suggest that the Armed Forces have a far greater role to play in the identification and treatment of PTSD and substance misuse - be it either pre or post discharge as evidentially many men and women are leaving the Forces with issues surrounding PTSD and developing substance misuse issues. It could be argued that closer working links with the PCT, Criminal Justice System, statutory, non-statutory and third Sector organisations is something that should be key to implementing integrated care pathways and ensuring tailor made packages of holistic support and care are offered to ex forces personnel prior to leaving the armed forces.

NAPO concludes within the report that ‘It is apparent that there are alarming numbers of former service personnel serving sentences in prisons in England and Wales and also under supervision by the Probation Service in the community’

The NAPO report goes on to suggest, ‘It is also apparent from these case studies and from evidence gathered elsewhere from military support organisations that the amount of assistance available on site and at the point of discharge from the services is minimal’. This it seems also echoes many of the respondents within the ‘Camouflaged but no longer Concealed’ paper who stated that transitional arrangements, resettlement arrangements and additional support on discharge were none-existent and eloquently summed up by one respondent Paul who stated:

PAUL: “I got no help at all in fact I was told I had 2 days to get off camp, they just gave me no fucking help at all”.

Throughout the ‘Camouflaged but no longer Concealed’ paper each of the respondents stated that help and support post discharge was something that they would have all benefited from and this in itself would have been something that would have made the transition back to civilian life a more pleasant, meaningful and rewarding experience for all. Instead without support respondents left with feelings of fear, anger, and resentment and little hope for the future.

Identity

The final theme to emerge from the survey process was that of ‘Identity’ and the impact that being in the Armed Forces had regarding the ‘self’ and the identity of the individuals within the paper. For all of the respondents within the paper there was no doubt that being in the Armed Forces was something that had changed their lives in a profound way and something that will remain significant to them for the rest of their natural lives.

PAUL: ‘I have been out a while now, but I’m still a soldier in my heart. That will never go’

According to General Sir Richard Dannatt, (2008),

“Humans are naturally team players; we all seek the company of others and like to share our experiences”

The British Army is the ultimate team. It has an excellent reputation across the world, which is built on trust. Much is expected of you as a British Soldier; you will be required to serve in dangerous places, risk your life for your teammates and put up with uncomfortable conditions.

Our Values and Standards are essential to the British Army, they define what the British soldier is. They are more than just words, we must all believe in them and live by them. I expect you to behave and conduct yourselves to the highest standards at all times’

Significant for me within General Sir Richard Dannatt’s quote is the point at which he states, ‘our values and standards are essential to the British army, they define what the British soldier is. They are more than just words; we must all believe in them and live by them’.

It seems important to mention that the values and the way of life that is internalized into any member of the Armed Forces and internalized within the self concept of the individual is not something that leaves a person on the day of discharge. It seems that once you give yourself to the Armed Forces it’s a case of “once a Soldier, Airman or Seaman, always a Soldier, Airman or Seaman” and for this group of men this seems to be a positive label that sticks for life.

Each of the individuals within the survey talked about their loyalty and commitment to their respective Regiments and claimed that although for many their time out of the Armed Forces was significant, there was something deep inside them that they felt still made them think and feel like an Armed Forces member. All of the individuals missed the camaraderie and the feeling of belonging to something great.

For many leaving the Armed Forces was like losing a family member. Yet, they were proud of their time within the forces. It seemed clear to the author that for each of the respondents talking openly about the forces was something, at times, they found difficult. There was a sense of disloyalty at times when they spoke of what they deemed as failings within the Armed Forces. I know each of them were still loyal to each of their respective regiments, but each of them also felt passionately about wanting to be heard and how their voices could perhaps influence change within the wider Armed Forces structure and beyond.

Conclusion

It feels like words could not do justice to any of the respondents when beginning to explain the depth of feeling - both individually and collectively that existed in relation to time these men have spent within the armed forces and also following discharge. It is really important to make it clear that each of the men who talked so openly about their time within the armed forces did so with a sense of pride and honour. Pretty much every one of them stated that their time in the armed forces was the best thing that had ever happened to them and it had shaped them in to the men that they were today.

However, as we have found throughout the survey, there have been times when these men have felt let down by an institution that they valued so highly. It seems that the message which comes through loud and clear is that each of the men within this survey felt at some time that when they were discharged - that was it. You had to fend for yourself, you had to find your own way, and for the respondents in the paper, this is where they struggled the most.

It’s hard to imagine what it must feel like to give 19 years of your life to the army in the case of one of the respondents just to be discharged without any idea about what the future would hold. Each of the men within the survey agreed that much more needed to be done to ensure that the transition from armed forces life into civilian life was much smoother. Each of them felt that the armed forces did not do enough around this issue.

Each of them had a story to tell, some more traumatic and disorganized than the others. Yet, they draw strength from one another and in the room where they meet there is something very special that happens, they are a team again. They have a new family and new support mechanism. They have the chance to make sense of their past and also the opportunity to help others who have been through the same issues as themselves. All of a sudden, the common bond is their again and to witness this is totally magical. It could be argued that everyone needs someone in life and for the respondents in this paper it is no different, being part of this group has given them a purpose and also a place to further develop their self-concept and future lives.

Final Comment

Former servicemen and women are recognised as one of the country’s greatest assets. The training they receive during military service allows many to re-establish themselves successfully as they integrate back into civilian life. However, in recent years a growing number has become involved in the Criminal Justice System and/or drop out of the welfare support system becoming homeless, disenfranchised from main stream services and socially isolated.

Subsequently, mainstream services struggle to engage with this group simply because of a lack of understanding of the cultural differences between military and civilian lifestyles. As a result of this, unemployed, homeless ex forces personnel are probably the most feared, misunderstood and marginalised minority groups within our society.

Whilst it is recognised that many leave the armed forces and continue to contribute positively to society a significant number have great difficulty coping with the transition from the institutionalised lifestyle military service brings. Many find it difficult to cope with the lack of structure, a loss of identity and many miss the camaraderie and social activities that dictate service life on an hourly and daily basis.

The reintegration process to civilian life is exacerbated on many different levels dependant upon how an individual exits the services. Many are discharged following successful and lengthy periods of service but struggle to find sustainable employment; others are medically or dishonourably discharged following their involvement in unacceptable and/or criminal activity. The latter find it extremely difficult to re-establish themselves in the civilian Job Market.

A growing number of individuals are returning to civilian life following active service in the numerous theatres of war that have been fought almost continuously since the end of World war Two. For example; Northern Ireland, The Falklands, The Balkan Campaigns and The Gulf wars involving Iraq, Afghanistan and other Middle East Countries. It is a matter of considerable debate as to impact combat experience is having on any given individual’s ability to readjust to the sedentary lifestyle of peace time Britain.

Many servicemen and women are reluctant to accept or acknowledge that they need help and support and may in fact exhibit a stubborn independence that alienates them from the main stream welfare services. As a result, they ‘fall through the net’ of service provision. Many can be accurately described as suffering chronic social exclusion. In order to cope with their change in circumstances many become alcohol and drug dependent. This factor alone, notwithstanding any undiagnosed mental health problems and associated anti social behaviour has led to a disproportionate number being incarcerated within the Prison System.

Former service personnel are often vulnerable people with complex needs. A range of flexible responses and options are necessary to help them address and manage their changing needs. These may include help with managing their drug and alcohol use, dealing with mental health issues, managing debt, developing life skills and helping rebuild relationships

We work with a range of partners, to identify and promote practice which supports positive steps that can help build confidence and self esteem. This includes participation in activities involving peer led support groups, the arts, sport, volunteering and a range of other activities that involve setting and achieving goals.

Current research indicates those experiencing homelessness or rough sleeping have six or more unmet needs. It is our aim to offer a confidential, bespoke and individualised package of care and support in collaboration with the client to address each individual’s unique unmet needs.

Tony Wright

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