LIFE FORCE HULL AND EAST RIDING A PRACTICAL GUIDE FOR WORKING WITH MILITARY VETERANS
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Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 2
LIFE
FORCE
HULL AND EAST RIDING
A PRACTICAL GUIDE
FOR WORKING WITH
MILITARY VETERANSVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 3
HULL AND
02 EAST RIDING
CONTENTSVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 4
03
FOREWORD 04
GENERAL BACKGROUND 06
AND CONTEXT
THE RIGHT RESPONSE 07
THE ARMED FORCES, VETERANS 10
AND THE WIDER COMMUNITY
REASONS FOR JOINING THE 12
ARMED FORCES
DISCHARGE, RESETTLEMENT AND 16
TRANSITION TO CIVILIAN LIFE
HEALTH ISSUES AND SERVICES 26
IMPACT ON FAMILIES AND 34
RELATIONSHIPS
COMMUNITY BASED SUPPORT 38
CONTACTS 40
REFERENCES 42
MILITARY STRUCTURE AND SOME 43
COMMON ABBREVIATIONS
ACKNOWLEDGEMENTS 46Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 5
HULL AND
04 EAST RIDING
FOREWORDVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 6
05
We are delighted to introduce this To many people, the term “veteran” After their tour of duty they will
guide which will be an invaluable refers to elderly men who have return to their civilian jobs, but with
resource for anyone whose work retired from the Armed Forces, a set of experiences many of us
brings them into contact with and are generally only seen on will never fully understand.
veterans in Hull and the East Riding. Remembrance Day. In fact it
applies to young and old alike, There are many excellent ex-service
We owe a significant debt to the as well as women who in some charitable organisations and support
men and women of the Armed cases may have been exposed services specifically for veterans and
Forces, who willingly give up the to exactly the same experiences their families. This guide seeks to
safety and comforts many of us as their male colleagues. Many help staff working in non-specialist
take for granted in order to serve veterans have families who have services; employers; fellow workers
their country. Too often, we see lived all around the world in and anyone else who comes into
them as “different” and we too different circumstances to those contact with veterans in the course
easily forget that they are drawn we are used to, and are equally of their work. We hope it will be
from our communities and will affected by the transition back useful in supporting veterans using
eventually return to them. For to civilian life. your services now and in the future.
most, military service is a positive
experience, but there are some for We must also remember Reservists Lastly we have also provided some
whom the transition back to civilian when thinking about our obligations information on issues veterans
life presents real challenges. to ex-Forces personnel. These are may experience in their transition
the men and women who may be to civilian life, as well as some
working alongside us in our normal information about structures,
jobs one day, and serving in customs and language that can
Afghanistan the next, alongside matter greatly to our soldiers
their regular colleagues and facing sailors and airmen, but be
exactly the same challenges baffling to others.
as them.
Christopher Long Billy Watson
Chief Executive Chief Executive
NHS Hull SAMHVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 7
HULL AND
06 EAST RIDING
GENERAL
BACKGROUND
AND CONTEXT
Life Force has been written Some of the characteristics The majority of service leavers
for community-based support valued in the Services such as make the transition to civilian life
agencies including the voluntary ’get on with it’, a ‘can do’ attitude, without problem; many welcome
sector, services provided by stoicism and pride can get in the the change. For all, there is a
NHS Boards, local authorities and way of help seeking – particularly period of adjustment/re-adjustment
charities. These agencies often for psychological problems. The to civilian life and some manage
work with veterans but until now stigma that surrounds mental this better than others. Problematic
have had no specialist advice health adds to this reticence. transition may be due to a variety
on the issues that veterans may of reasons related, or unrelated,
face or the experiences they Whilst in the armed forces, service to service. This guide aims to help
may have had. men and women have a clear chain those supporting people and their
of command and welfare support families who have run into difficulties
Despite the fact that one in to deal with problems as well as but also to give an insight into how
four people will experience a comrades who can provide support normal aspects of service life can
psychological health problem at or advice. Groups have their own affect the transition to civilian life for
some point in our lives, many of us, jargon/shared common language both the individual and their family.
particularly men, still find it difficult which can seem incomprehensible
to talk about our psychological to civilians. The guide identifies the background
health. These difficulties equally as to why it may be difficult for
apply to ex-service personnel, the some ex-service personnel/
majority of whom are men, who veterans to engage with health
may perceive asking for help as services and community agencies,
a sign of weakness and ‘letting how this may manifest itself and,
the side down’. perhaps most importantly, some
suggestions for interventions and
signposting. The content has been
written by SAMH in conjunction with
Humber Traumatic Stress Service.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 8
07
THE
RIGHT
RESPONSE
Civilian agencies provide the It is important not to generalise GET TO THE POINT
majority of support for serving or make assumptions about how Avoid superficial discussions,
personnel after service. In 2006, veterans perceive or engage keep it simple and give complete
The Royal British Legion identified with support from agencies. attention to the individual to prevent
that over half (52%) of the adult The following have been suggested them feeling they are not being
ex-service community had received as a ‘rough guide’ in facilitating taken seriously. Ensure that any
help or advice in a year from state positive engagement with veterans. agreed actions are carried out
or charitable agencies, including promptly; it’s an issue of trust.
health professionals, Citizens THE LANGUAGE OF THE
Advice, social workers, housing ARMED FORCES Acknowledge and apologise if
departments and job centres. Military jargon is an array of distressing ‘off the cuff’ remarks
colloquial terminology commonly are made. Ensure the individual
An understanding of an individual’s used by service personnel, doesn’t misinterpret or dwell on
military experience will help including slang which is unique to something that has been said,
any agency in carrying out an the Armed Forces. It often takes the which might interfere with the
assessment and building a form of abbreviations/acronyms of establishment of trust.
relationship with the veteran. formal military concepts and terms.
Those who are experiencing mental Most veterans respect clear and
health problems are more likely Exploring this language with honest communications and want
to trust workers whom they feel veterans may highlight an to be treated by competent and
understand or at least seek to acknowledgement of a forces credible individuals. If you don’t
understand their problems within life and promote engagement. understand, be honest and say
the context of their military service. Important pieces of information so; it will not stop you providing
about the individual and their help or the veteran receiving it.
Veterans’ experiences are unique. service career may be gathered by
Veterans are a heterogeneous breaking down some of the jargon
group with many unique skills. All in collaboration with the veteran.
will have individual accounts, both
positive and negative, as to how
serving their country has affected
their lives and the lives of others.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 9
HULL AND
08 EAST RIDING
ENVIRONMENT/ PRACTICAL INFORMATION – What agencies (veterans and
BODY LANGUAGE FOR GPs AND OTHER Non-veterans) have they
Be aware of the environment in AGENCIES TO ASK engaged with?
which an interview, support, etc is VETERANS – Were they Regular or Reservist?
being carried out as if a veteran has
– What was their service number?
concerns about their safety, it could EXAGGERATION/
affect their relationship with you. – The dates when they joined and
FABRICATION
Check whether they have any left? – How long did they serve?
As with any health presentation
issues in relation to this before – What was their job/trade – there is a possibility of exaggeration
commencing an interview. Avoid infantry, logistics etc.? This will or fabrication of both experiences
making quick body movements, give you a clearer picture of the and symptoms. This can be difficult
quickly approaching the veteran types of experiences they to spot in veterans if you don’t have
from behind or moving into a encountered, very few will have a military background. It’s therefore
veteran’s personal space and been in frontline combat. important to seek corroboration
maintain good eye contact and through accessing a person’s
– What was their rank on leaving?
keep an open posture. service medical records. See page
This will tell you how they fitted in
17 for how to access military
and how others rated them and
medical documents
their abilities.
– What Corps and Regiment did Signs to be alert to include:
they serve in whilst in the Armed
– Person unable to remember
Forces?
service number.
– How did they leave the services –
– Saying they ‘can’t talk’ due to
end of contract, voluntary
the official secrets act or having
retirement (served notice),
been in the SAS.
medical discharge, administrative
discharge (disciplinary, – Vague and/ or changing narrative.
compassionate etc.)
– Non-engagement or
Circumstances of discharge?
non-response to therapy.
– Were they ill in service? Did they
– Involvement in the perpetration
attend a DCMH (Department of
of atrocities.
Community Mental Health)?
– Do they have a copy of their
Medical Documents?
– What Operations were they
deployed on?Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 10
09
‘Those who are experiencing mental health problems are
more likely to trust workers whom they feel seek to understand
their problems within the context of their military service.’
FIND OUT WHAT IS Agencies who seek to understand www.hullpct.nhs.uk
AVAILABLE LOCALLY the veteran’s experience are much
www.humber.nhs.uk
Knowledge of what is available both more likely to gain their trust.
locally and nationally for veterans Veterans need to feel that we have www.hullcc.gov.uk
will assist co-ordinated responses the time and inclination to listen,
when required. There is a large and the capacity to tolerate what www.eastriding.gov.uk
network of veterans associations we hear, and still maintain a positive
www.eastridingofyorkshire.nhs.uk
and agencies within the UK who regard for them. Agencies must
provide different types and forms establish clear information sharing
of support, including welfare, social pathways and follow up any referral
and health. Signposting to these or signposting onwards.
veterans specific supports is a key
factor in facilitating accessibility. There are many civilian practitioners
who engage successfully with
veterans and many veterans who
engage wholeheartedly with their
GP and health and social work
professionals.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 11
HULL AND
10 EAST RIDING
THE ARMED FORCES,
VETERANS AND THE
VETERANS COMMUNITY
The British Armed Forces in order The British Army came into being REGULAR FORCES
of seniority comprises of the Royal with the unification of the Kingdoms Regular Force personnel are
Navy, the Army and the Royal Air of England and Scotland into the employed full-time, and have
Force and constitute one of the Kingdom of Great Britain in 1707. usually signed long-term contracts
largest militaries in Europe. These The British Army consists of 108,840 committing them to regular service.
Forces are made up of regulars regular soldiers (which includes 3,760 After discharge, regular service
and reservists. Gurkhas plus 35,000 Territorial Army personnel are usually liable to a
soldiers, giving it a total of 147,600 ‘Regular Reserve’ commitment
The Royal Navy of the United personnel in October 2008. which means they can be called-up/
Kingdom is the oldest of HM Armed mobilised for operational
Forces (and is therefore known as the The Royal Air Force (RAF) is the deployments for a finite period
Senior Service). The Royal Navy is a oldest independent airforce in after leaving.
constituent component of the Naval the world, having been formed
Service, which also comprises the on 1 April 1918. The RAF operates RESERVISTS
Royal Marines, Royal Naval Reserve 1,109 aircraft and, as of October Reservists may be either Regular
and Royal Marines Reserve. As of 2009, its personnel numbered 44,120 or Volunteer. Regular reservists will
April 2008, the Royal Navy numbered regular and 1,300 volunteer reserve have served in the regulars unlike
approximately 38,720 Regular personnel. These 45,420 active Volunteer reservists who have mainly
personnel of whom 7,500 are in the personnel make it the largest airforce joined directly from the civilian
Royal Marines, in addition, there are in the European Union, and the community and have jobs and
2,900 Volunteer Reserve personnel, second largest in NATO1. careers outside the military. Both
giving a total of 41,500 personnel. groups of reservists train regularly
The Royal Navy is also supported (for which they are paid) and may be
by the Royal Fleet Auxiliary, a civilian called up for training and operational
logistical support fleet which is service when necessary. A reservist
owned and operated by the Ministry can vary in contracts such as Full
of Defence as part of the British Time Reserve Service (FTRS) broken
Merchant Navy. down further into Home Commitment
(HC), Full commitment (FC),
Mobilised (Compulsory called up
under the reserve forces act 96).
1. www.dasa.mod.uk/modintranet/UKDS/UKDS2008/c2/table207.html
www.dasa.mod.uk/modintranet/UKDS/UKDS2008/c2/table217.html
www.dasa.mod.uk/modintranet/UKDS/UKDS2009/c2/table226.htmlVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 12
11
‘Many veterans have had experiences in the course of service
that will be very different to the majority of the community.’
VOLUNTEER RESERVE FORCE: A veteran has spent a proportion of Many veterans join the Armed Forces
TA, RNR, RMR AND their life serving their country in the as young adults, an important time in
RAVR/RAFR Armed Forces as a regular, or reserve life for shaping values, beliefs and
Being a member of the volunteer or as part of the Territorial Army. attitudes. Figures for the UK Regular
reserve requires training two to three This includes Prisoners of War from Forces for 2007/2008 show that of
weekends per year. In addition these World War II, the Korean War, the 21,325 new recruits, 53% were
personnel are required to attend National Servicemen, former Polish aged between 16 and 19. Joining
fifteen continuous training days every forces under British command and the highly military social culture at
year and therefore require support Merchant Mariners who have seen such a time means that many serving
and commitment from employers to duty in military operations (e.g. the sailors, soldiers and airmen and
achieve this. They are liable to be Falklands Conflict and Northern women are likely to have adopted
compulsorily ‘called up’ for Ireland). More recently, it also military values and ideals as their
operational tours when necessary. includes veterans who have seen own. This process is known as
They complete a series of Military service in both Gulf Wars, the ‘acculturation’ a term which refers
Annual Training Tests throughout the Balkans and those recently to a person acquiring the culture of
year to enable them to stay up to the returning from Afghanistan. the society that he/she inhabits.
standard set.
VETERANS COMMUNITY
VETERANS Veterans together with their widows/
Currently the term ‘veteran’ applies widowers and their dependants
to all ex-servicemen and women. make up the veterans community.
This ‘all encompassing’ use of the
term veteran means that some of
the issues people present with may
relate as much to pre-existing
difficulties as to military service2.
Most veterans dislike the term and
prefer ex-serviceman or woman as
it has less ageist associations.
2. Veteran’s World 8Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 13
HULL AND
12 EAST RIDING
SOME OF THE
REASONS FOR JOINING
THE ARMED FORCES
There are many social and It is not uncommon for people to join During conflicts intimate
economic reasons for joining the the forces to escape difficult home relationships and bonds are formed
Armed Forces including personal environments. Whilst TV advertising with colleagues in order that they
improvement by learning new skills and poster campaigns play their can rely on each other in times
and job security by gaining full time part, many new recruits are of crisis. These bonds can even
employment. There are opportunities influenced by their peer group or be closer than normal family
to see different parts of the world will have a life in the Armed Forces relationships. The deep bond that
and the chance for people to do recommended to them by a family develops over time has been
something different with their life. member or friend who is a serving described as the ‘band of brothers’
or ex-service member of Her throughout history, particularly
For many personnel, military life Majesty’s Forces (HMF) by soldiers.
is ‘a great leveller’; it is a positive
experience (especially for COMRADESHIP For some veterans, continued
disadvantaged youths who enter Comradeship is very important service provides comradeship,
service early) allowing them to enjoy for most veterans. While there and in fact may be the reason many
a more favourable life pathway. are differences in the ways that individuals continue to serve in the
Many recruits do not possess high comradeship is perceived by Forces. All who leave HMF (and
levels of academic qualifications different individuals, it is often everyone does leave) will need to
when they join; however the military seen as something that cannot be re-adjust to once more being a
offers them a career and progressive destroyed by time. Comradeship civilian – some have more difficulty
education not matched by any other is seen as deeper than ordinary than others in managing this
employers. For Officers, the friendship, because of the shared transition.
challenge of leading a group of men hardships, shared lives, and the
and women in arduous and difficult sense of dependency for one’s life
circumstances offers them an on others. This is especially so for
exciting and challenging career that group relationships forged under
is difficult to replicate in civilian life. threat or danger such as combat.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 14
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The legacy of military service may It should be remembered that both
reveal itself in a veteran’s strong veterans and civilians stereotype
identification with other veterans, each other. There is a potential for
which brings with it a sense of mutual suspicion and lack of trust
personal identity and value, as especially if assumptions made by
well as affording a degree of support agencies are uninformed.
‘belonging’ and ‘doing your bit’. Incorrect assumptions may interfere
with a veteran’s smooth transition
Surviving combat and shared return to the community.
hardship are at the root of veterans’
pride in service, of having ‘taken Veterans organisations themselves
part... being there... being ‘part of have identified a ‘dependency
the family’. The other side of this culture’ in the Armed Forces. Some
coin can be a mistrust of others veterans can become institutionalised
who are not part of this ‘group’. and less self reliant, others remain
proud and defiant, of ‘sorting
themselves out... not accepting
charity’ which can lead to difficulties
in resettlement and acceptance of
the need for appropriate support.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 15
HULL AND
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Another difference is that in the I think that over the last 16 months
JOCK’S military you have a common goal or so there are a couple of things
STORY which is the objective for all to
achieve and as part of the “family”
which stand out and should help
in expelling the thought that most
you want it for yourself and the rest ex-serviceman think:
Joined infantry in 1970 and
of the family equally. Whereas in
saw service in different theatres
civilian life although you have a a. welfare and health services are
including Northern Ireland was later
common objectives the over-riding not a waste of time: I have learnt
transferred to the Logistics Corp,
factor is what it brings you that there are professionals out
and saw service again in different there who may not have had the
personally.
theatres, Europe, Africa and NI in experiences that we (the
particular the Bomb Disposal. ex-military) have had but they
I feel that because of the values
Retired in 1993 as an Regimental do understand the effects of what
which are bred through being in
Sergeant Major (RSM). we may have seen/done or been
the military it is extremely difficult
part of and can give sound solid
to accept that it is not considered
The main difference between advice and assistance to help
being a failure if you cannot cope
military and civilians is that the overcome even the most
with every day events. In my own
value sets for both are different. unfortunate experiences in a
case I was being overwhelmed with
In the military the mindset is professionally sympathetic way.
work because I refused to say no
structured through training and
and allowed the bosses to keep
discipline and depends a lot on b. It is not a weakness to seek help
piling work on me and because but a strength: if there is a need
being part of and working in a team
I didn’t want to let anybody down to recount experiences or
with the attitude that you will not let
(the team) nor be seen like a failure discuss what is being felt then by
your comrades down. The team is
I just tried to carry on until I accessing these professionals
more important than the individual.
eventually realized (through the we can do this without worrying
In civilian life although there is
help I received) that it was okay to that we will be prejudged and
training and team work it is not as
admit that I was under pressure not that the help on offer is neutral,
disciplined nor structured and the
because I couldn’t do the job but understanding and will be
individual, is the most important
it was by refusing to say no and tailored to the individual’s needs.
part and letting the team down
allowing others to pile on the
doesn’t seem to matter as much,
pressure my life was being taken
the emphasis being more
over by work which resulted in no
on I’m alright Jack.
time for anything other than work.
This culminated in me being
extremely uptight and agitated
and constantly worried.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 16
15
‘Because of the values which are bred through being in the
military it is extremely difficult to accept that it is not considered
a failure if you cannot cope with every day events.’
JOCK’S STORY, P30
THE REGIME HOW DO VETERANS
Military training promotes strict SEE SOCIETY?
conformity to values and high Many veterans have had experiences
standards of behaviour in terms in the course of service that will be
of defined discipline, selfless very different to the majority of the
commitment, courage, integrity, community. These experiences may
loyalty, respect for others, punctuality, relate to their exposure to people’s
orderliness, cleanliness and capacity to behave inhumanely
obedience. They are valued so towards others as well as the heights
highly because the lives of friends of human co-operation and
and comrades may depend on unselfishness.
them, especially in combat such
as Afghanistan. During conflict service personnel
are required to respond rapidly in
Pride in the job, not wanting to let dangerous circumstances; to make
others down, responsibility for split second decisions which may
subordinates, and development of save or take a life. Decisions made
specialist skills etc. require a flexibility at the time may be hard but they are
of mind and action which can be made as part of a group. Usually only
attributed to a service career. later, when out of danger or out of
service, individuals may question
Some veterans can find the transition themselves about their decisions and
back into society difficult when those actions. Everyone will be changed
around them demonstrate different by their military service; such change
values and attitudes and do not is usually positive. Going to war or
exhibit attributes learned in the forces. war-torn areas can serve to help
For example, some veterans can find soldiers recognise what they have
it stressful when they are kept waiting at home, what is important in life but
or when things do not run according they may struggle to listen to civilians
to plan. They may find aspects of complaining about what seem to
civilian life frustrating and have a them as trivial matters.
sense that everyone is only out for
themselvesVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 17
HULL AND
16 EAST RIDING
DISCHARGE,
RESETTLEMENT AND THE
TRANSITION TO CIVILIAN LIFE
People leaving the Armed Forces 2 MEDICALLY DISCHARGED 3 EARLY SERVICE LEAVERS
(service leavers) can be grouped SERVICE LEAVERS
into 3 categories: Early service leavers are either
This group of leavers will have discharged compulsorily (e.g.
1. Normal Service Leavers developed physical or mental health as a result of alcohol/drug misuse,
problems attributed or aggravated criminal acts, inefficiency,
2. Medically Discharged
by their service to the extent they temperamental unsuitability –
Service Leavers
are unable to become fully fit to not ‘fitting-in’), losing eligibility/
3. Early Service Leavers fight. There may be an expectation entitlement to resettlement provision
that exit from service will improve or leave at their own request having
their health. Medical discharge completed less than 4 years service.
1 NORMAL does not always mean the
Early service leavers leaving at
SERVICE LEAVERS individual has a long-term serious
their own request have the same
and incapacitating disease or
Normal service leavers are discharge procedures as normal
disorder. All service leavers within
discharged on completion of service leavers but will not have
this group will have had intervention
their Engagement or commission, served long enough usually to
in service and attended an
having submitted their notice to qualify for any resettlement.
occupational medical board which
leave, having been given notice makes the decision about their Whilst few regular personnel are
of discharge under redundancy remaining or leaving the service. discharged at extremely short notice
or reaching the end of their terms Some Service Leavers will be happy it is true they have less time to plan
of service. with the decision taken, others will their transition to civilian life.
not. Some may feel they have been Reservists who are demobilised after
For normal service leavers
‘let them down’ by their unit, the operations may find re-adjustment
entitlement to a resettlement
service, medical services, the difficult which may impact on them
process can be sought anytime
government, politicians and and their families. They are returning
up to two years before the date
demonstrate marked resentment to civilian life and are surrounded by
of discharge.
towards the service. a peer group who have not shared
their operational experiences; this can
increase feelings of social isolation.
Research has shown that Reservists
can be most at risk of combat related
psychological injury (Browne et al,
2007) but some of their problems
pre-date call-up or volunteering to
serve which may be added to if there
were problems in theatre.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 18
17
‘I firmly believe that depression, anxiety can be overcome,
with the right support, patience, realistic goals and guidance,
a positive and happy future is possible’
PAUL’S STORY, P24
WHAT ARE When an individual is medically This system requires the individual
MEDICAL BOARDS? discharged, a resettlement officer to present their FMed 133 to their
Before leaving service every soldier will have been contacted to plan GP. This may be problematic if
has a Discharge Medical by their resettlement actions. All individuals veterans do not register with a
Medical Officer at which they are who are medically discharged are GP on leaving and leave it until
encouraged to note any physical entitled to resettlement provision. there is a problem by which time
or psychological problems they the documents are likely to have
TA injured on operational tour
may have had during service. gone astray.
may be medically boarded after
Those with problems are likely to
treatment options have been Anyone seeking a War Pension/
be seen by a Medical Board.
exhausted and, if not fit for role Armed Forces Compensation
Medical boards are groups of within TA, are provided with (AFCS) will have their case
military health professionals who appropriate compensation. considered by the Service
conduct formal medical They may also be maintained on Personnel and Veterans Agency
assessments in order to ascertain mobilised service until their medical (SPVA) which examine the service
whether someone is fit enough, board. This can be a particularly medical records and determine
or likely to become so, to continue stressful time for both the individual eligibility for the type of pension/
serving in the Armed Forces. Where and their family who may not be compensation claimed.
a decision is be taken to medically used to the demands of full time
GPs seeking advice on how to
discharge or retire a person, the service life and may live away from
request medical records can
board will provide advice on how to the support networks accessible to
contact the records departments
find further treatment after leaving regular service personnel’s families.
via these numbers: providing the
as well as support from ex-service
MEDICAL DOCUMENTS individual’s Service Number will
charities and provide forms of
All those leaving the Armed Forces speed the process greatly.
consent to assist with this process.
have a Discharge Medical, usually
RAF
Consent forms are used to record by their regular Medical Officer
Telephone: 01494 497 410
a preference for passing personal (GP). They are provided with
contact details to a service or documentation (FMed 133) on Royal Navy & Marines
ex-service charity of their choice. which any illnesses, injuries and Telephone: 02392 768 063
The information on this form is vaccinations are noted. They are
used solely to enable the charity encouraged to register with a GP Army
to make contact for the purposes as soon as they leave and are Telephone: 08456 009 663
of providing help or advice. entitled to a full copy of their service
medical record. The address for
such a request is on the FMed 133.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 19
HULL AND
18 EAST RIDING
DEPARTMENTS OF DEFENCE MENTAL HEALTH The two DCMHs covering Hull and
COMMUNITY MENTAL SOCIAL WORK SERVICE East Riding are DCMH Catterick
HEALTH (DCMHS) (DMHSWS) Telephone: 01748 873058 and
The Defence Medical Service Service personnel likely to be DCMH Cranwell Telephone:
is responsible for the health of medically discharged with a mental 01400 267369. For national issues
195,000 Armed Forces personnel health related problem are referred the Head of DMHSWS can be
and approximately 40,000 MoD to the Defence Mental Health Social contacted at DCMH Tidworth
civilians and families abroad. Work Service (DMHSWS). This Telephone: 01980 602236.
The Defence Medical Service tri-Service provision is accessed
runs 15 DCMHs in the UK and through the 15 DCMHs. Mental
several abroad. health social workers support
service personnel and their families,
Departments of community mental
throughout the medical discharge
health are multidisciplinary teams
process and for a period
which carry out clinical, educational
afterwards.
and advisory services to both
primary care and the chain of Assistance may take the form
command. of advice regarding housing,
resettlement, benefits, pensions
Their aim is to provide timely
and other entitlements. For those
assessment and treatment for
with more serious mental health
serving personnel and for those
difficulties or patients who are
who cannot be rehabilitated, to
particularly vulnerable, a more
ensure they receive a smooth
comprehensive needs assessment
transition to civilian life. DCMHs
is undertaken which focuses on
are located in areas with a strong
the development of a care plan.
military population. Standards of
Particular attention is paid to
care are generally extremely high
establishing care pathways into
with fast tracking for urgent cases
appropriate health, social and
and very short waiting times for
veterans’ services that can assist
routine referrals.
with the transition into civilian life.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 20
19
‘Ex-serviceman under 24 were at greatest risk of suicide
and the suicide risk for this group is nearly three times that
of the general population.’
Harry served in the Armed Forces DCMH Catterick therefore
HARRY’S from 1997 to 2008. He began contacted Humber Traumatic Stress
STORY experiencing problems on return
from Iraq in 2003. Harry was
Service and agreed that Harry’s
care would be transferred via his
referred to DCMH Catterick and GP to the local Hull trauma service.
gradually it was identified that he This enabled Harry to continue
had symptoms of post traumatic therapeutic intervention closer to
stress disorder in relation to an home and allowed a smoother
incident in Iraq and also due to transition of services on discharge.
having witnessed the death of
a friend in Germany. Harry is now beginning to feel
more settled within his life, he has
Harry attended regular sessions at regained his driving licence and is
Catterick DCMH and was making re-starting EMDR after a break to
progress using eye movement complete his treatment. Harry is
desensitization reprocessing planning to begin a college course
(EMDR). However he was travelling soon initially part time but hopes
from Hull every week for sessions to complete a full time trade
as he was awaiting a medical focused course in the future.
discharge from the Army and had
to be accompanied which was
proving quite cumbersome.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 21
HULL AND
20 EAST RIDING
THE RESETTLEMENT THE CAREER TRANSITION JOBCENTRE PLUS
PROCESS PARTNERSHIP (CTP) Jobcentre Plus is a government
The Resettlement Process refers The Career Transition Partnership agency supporting people of
to making the successful transition (CTP) delivers free resettlement working age from welfare into work,
from military life to the civilian services to all ranks of the British and helping employers to fill their
world. It is a phased process Armed Forces, to make the vacancies. They are part of the
including advice, information and transition from military to civilian Department for Work and Pensions
training. This includes decisions life as smooth and successful (DWP) and play a major role in
about housing, education (their as possible. They teach service supporting the Department’s aim
own and that of their children), leavers the skills they need to to ‘promote opportunity and
finances and employment. produce a CV, learn interview independence for all through
techniques, research the modern, customer-focused
Resettlement services assist with employment market and services’.
providing advice, information, apply for jobs.
guidance and training to prepare Web: www.jobcentreplus.gov.uk
and find suitable civilian Web: www.ctp.org.uk/ctp/
employment for service leavers. SaBRE
However the package is generally THE REGULAR SaBRE – Supporting Britain’s
not adequate enough to fully FORCES EMPLOYMENT Reservists and Employers – Is an
train a person for a career, the ASSOCIATION (RFEA) impartial body created by the MOD
resettlement options are short The RFEA provides extra support to provide employers with all the
training packages with a limited in assisting servicemen and women information they need, from
budget available – therefore you of all ranks leaving the Armed Reservists’ training obligations
can only obtain a limited course. Forces to find employment from the to employers’ legal rights and
A prospective lorry driver can day of discharge without restriction responsibilities.
acquire a HGV license. However if of time thereafter. It supports
you want to be an electrician your servicemen and women in the Telephone: 0800 389 5459
options are limited. career planning process by Web: www.sabre.mod.uk
providing advice, and guidance,
which enables them to develop
their capacities to determine
and execute immediate and later
career decisions.
Web: www.rfea.org.ukVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 22
21
MANAGING FINANCES THE SERVICE PERSONNEL HOUSING
The move to civilian life away AND VETERANS AGENCY The military are required to provide
from the more structured forces (SPVA) suitable accommodation for
community may prove difficult for The Service Personnel and serving personnel to allow its
some veterans now managing new Veterans Agency is aimed at members to move as and when
finances within different and often improving personnel, pensions, required to do so. The Ministry of
complicated structures. welfare and support services to Defence provides accommodation
members of the Armed Forces and to many of its personnel. Service
On discharge veterans may face veterans. The responsibility for all Family Accommodation (SFA)
a situation where they need to deal pension provision, whether a war accounts for 47,000 family homes
with issues like accommodation pension or an Armed Forces and Single Living Accommodation
and utility costs, and perhaps pension now falls under the (SLA) provides 112,000 single
applying for benefits for the direct control of SPVA. living spaces.
first time.
As part of the resettlement process JOINT SERVICE HOUSING
The wait for financial support post service leavers will have received ADVICE OFFICE (JSHAO)
discharge is a potentially vulnerable a service leavers pack from the The JSHAO is set up to provide
time for some veterans and their SPVA nine months before they service personnel and their families
families. Proud veterans trained were scheduled to leave. This pack with information and advice on
not to show weakness may not be contains information about service the increasingly complex range
assertive in highlighting financial pensions and supporting charities. of civilian housing options.
problems, thus lengthening the The JSHAO provides a focal point
scale and impact of the problem. SPVA has a national network of for housing information and advice
welfare offices across the UK and to all service personnel and their
Veterans may encounter significant Ireland. Welfare Managers are families in particular those about
difficulty with budgeting and money available to provide one to one to return to civilian life, and to
management. Some veterans may assistance in the home, offering ex-service personnel who are still in
be at risk of being seriously practical welfare advice such as Service Families Accommodation.
affected by debt, thus highlighting liaising with local authorities,
a need for targeted and ongoing completion of forms and Telephone: 01722 436575
support in this area. claiming benefits. Web: www.mod.uk/
DefenceInternet/DefenceFor/
Free veterans helpline: 0800 169 22 ServiceCommunity/Housing/
Email:
veterans.help@spva.gsi.gov.ukVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 23
HULL AND
22 EAST RIDING
SPACES (SINGLE PERSONS Telephone: 01748 833797 Service personnel experiencing
ACCOMMODATION CENTRE 01748 872940 homelessness may consider
FOR EX-SERVICES) (9) 4731 2940 themselves better equipped to
The SPACES project, based within Fax: 01748 835774 endure, and are less fearful of, the
the Resettlement/Welfare complex Email: spaces@echg.org.uk hardships of street life. They may
at Catterick Garrison, North be less inclined to seek or accept
Yorkshire provides accommodation LOCAL AUTHORITIES help given their tendency to elevate
placements across the country for Local Authorities provide an advice the perceived ‘shame’ of their
single personnel being discharged service both for council tenants situation. These factors, together
from all three services. and people living in private sector with their greater propensity to
accommodation. They can deal drink heavily – which many claim
The overall aims and objectives with general housing enquiries, was initiated or exacerbated by the
of the project are to assist single information and advice on how military lifestyle – combine to make
service leavers to secure to apply for a council home or them more susceptible to sustained
appropriate accommodation on other housing options, advice or repeat homelessness.
as they leave the Armed Forces, for chronically sick or disabled
attempting to reduce the likelihood people on adaptations to their An important area of ongoing
of them becoming homeless or home, and advice on benefits concern articulated by a significant
rough sleepers. SPACES work with and homelessness. number of formerly homeless
all single service leavers regardless ex-service personnel is social
Web: www.hullcc.gov.uk
of Rank and length of service, isolation. For some, loneliness is
www.eastriding.gov.uk
especially those with less than a defining feature of everyday life.
4 years service. SPACES can refer In the military population those who
HOMELESSNESS &
you to The Galleries in Richmond, failed to fit in well or developed
VULNERABILITY
North Yorkshire, and Mike Jackson mental health problems are
Single service personnel may be
House, Aldershot both of which more likely to leave the service
vulnerable on discharge from HMF
provide temporary accommodation prematurely and are more at risk
if they have nowhere to go. Staying
for single service leavers in of being socially excluded e.g.
with relatives or friends is seldom a
modern, fully-furnished, becoming homeless.
satisfactory arrangement and they
self-contained flats with support can easily fall into the cycle of no
staff on site. In addition there is job and no house. These difficulties
a new scheme presently under can be compounded if the veteran
construction in North Yorkshire is returning to an area of high
called The Beacon which should be unemployment.
ready to take tenants in the spring
of 2011. For further details please
contact the SPACES office.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 24
23
‘Those who have had problematic or unsuccessful
military careers are more likely to be vulnerable at their
transition to civilian life’
A report commissioned by HULL HOMELESSNESS
Veterans Aid identifying the London STRATEGY
homeless population in 2008 Homelessness is one of the city’s
suggested that there were an most important issues. Hull City
estimated 1100 non statutory Council has the principal role in
(single) homeless veterans in addressing this problem but also
London on any one night, mainly recognises the very important
hostel residents but including some contributions made by other
rough sleepers. Those homeless agencies in developing and
veterans who remained on the delivering this Strategy. Key
streets were more likely to have agencies and the Council have
alcohol misuse, physical and/or established close working
mental health problems than other partnerships, extensive joint
homeless persons. It was noted training programmes, and
that only a small minority of shared protocols.
homeless veterans ‘reported’
vulnerabilities unique to people The principal focus of the
with a military history (e.g. combat Homelessness Strategy is,
related PTSD). However it was therefore, based on a partnership
found that veterans are more approach to prevention and
susceptible to sustained or towards an overall reduction in
repeated homelessness than the incidence of homelessness,
other homeless people and responding to its occurrence
(Johnsen et al, 2008). when it is unavoidable. It has been
developed as a result of extensive
VETERANS AID consultation with a variety of
The leading charity for homeless individuals, agencies and
veterans in the UK. Can provide organisations at local,
direct and immediate help to regional and national level.
vulnerable veterans with: Hostel
accommodation, financial Web: www.hullcc.gov.uk/portal/
assistance, meal vouchers & page?_pageid=221,106882&_dad
clothing, advice and advocacy. =portal&_schema=PORTAL
Freephone: 0800 012 68 67
Web: www.veterans-aid.netVeterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 25
HULL AND
24 EAST RIDING
Paul served for 12 years in the RAF During one meeting with my
PAUL’S as an Air Traffic Controller both in solicitor I learned about IAC
STORY the UK and Germany. As his 12-year
point was approaching, the Civil
(Intensive Alternative to Custody).
I was beginning to feel different
Aviation Authority was recruiting than the last few years; I was
so he left the Forces. Sadly his life becoming more relaxed and
soon started to deteriorate and he positive. Some structure was
drifted into a life of crime. returning to my life and inside
me I felt more comfortable, in
“...The crimes went on for too long. control and less anxious.
I deserved prison, deserved for
the punishment to fit the crimes. After prison I had nowhere to live
It was never about the “buzz” or and had to spend four nights at the
adrenaline rush; more about me Dock House homeless hostel in
and anxiety, what I used to describe Hull. The support staff at Dock
as desperation or depression. House were very good, and referred
I always needed a means to escape me to the Salvation Army William
and have peace and tranquillity, Booth hostel.
despite always thinking of it as
wrong. William Booth is a good place.
The staff there are friendly and I felt
After a while the conscience safe and secure for the first time in
became too much for me to bear a long time. Within one month I was
and I handed myself in to the police. on the 6th floor, reserved for those
I have to admit that it was a relief to committed to a resettlement
finally tell all. The police were very programme. Housing applications
good, thorough and constructive were completed and I helped the
and they clearly appreciated my staff a little bit. One day the Centre
honesty. Being on remand in HMP Manager approached me and
Hull was a bit hard but I felt I should asked if I would run the Residents
be there, and that I warranted a Forum Committee. I felt comfortable
custodial sentence after remand. enough to do it.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 26
25
‘I thought my recollections of Kosovo were just unpleasant memories
I had to live with and that no one would be interested or be bothered
to listen to me. Even now after being diagnosed with PTSD I initially
refused to accept it because I felt that I was weak and a coward since
a nurse and an officer is supposed to be able to cope.’
ROSIE’S STORY, P30
Since August 2009 things have I joined the Council panel on
moved on more. I started an NVQ Enhanced Housing Options, which
Level 2 in Business & Administration is about the new hostels to be built,
with the Goodwin Trust. The Centre and worklessness / homelessness
Manager needed someone to go issues and social enterprise.
to the Homelessness Service Council Officers come to see
Improvement Group (SIG) at the me now at WB and vice versa.
City Council. I attend usually with
one of the WB management team. The Royal British Legion have also
From that beginning I now liaise given guidance and acted as a
with the Council Participation Team. supporter to my future home.
Through them I have done various
training courses. I am now the Now I am in employment as a
contact between WB and the City support worker, shortly moving into
Council Participation Team and my own place. I have a girl friend.
homelessness issues and Strategy It has not been easy. In actual fact
Group. Suddenly I am being trusted sometimes very hard. But the main
again, working hard, slowly gaining difference being that I now have the
some self respect. confidence to be part of, and in my
small way, contribute to society. It is
The Royal British Legion has also a very good feeling. I firmly believe
been good for me, talking through that depression, anxiety can be
things, making sure I stay focused. overcome. With the right support,
The support team always listen, and patience, realistic goals and
put me in the right direction, being guidance, a positive and happy
there for when I move into my own future is possible.”
place. It is reassuring to have the
Legion around, it helps beyond
words. I now liaise with WB support
staff and the Legion on behalf of
any veterans in the hostel, there
are presently 9, including me.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 27
HULL AND
26 EAST RIDING
HEALTH
ISSUES AND
SERVICES
Within civilian health services, PSYCHOLOGICAL HEALTH medically unexplained symptoms.
clinicians will not automatically The military take a number of It is important to remember PTSD
have any way of knowing that their steps to ensure the welfare of their is only one outcome and that military
patient has served in the Armed personnel, for example, briefings service should not preclude a
Forces, or that his or her condition on stress and trauma-related diagnosis of PTSD. The interventions
may be related to their period of problems are provided before and are the same for civilians and
service. This can be problematic after deployment. These briefings veterans, only the context differs.
as some conditions show are also designed to address
symptoms months or years after barriers to care, such as the stigma There are a number of more recent
the person has left the Armed of mental health problems, which is comprehensive studies (mainly
Forces (particularly in relation a significant issue for the military. by Iverson, et al at KCL) that show
to psychological health). that depression is the most
Service personnel’s concerns common mental health problem
Specific vulnerabilities linked to include how they will be perceived faced by the veterans community
life in the Forces may include: by their peers, subordinates and the (as well as issues related to
chain of command. Thoughts of substance misuse). Veterans with
– Issues from childhood and shame, guilt, weakness and failure psychological health problems
adolescence including are common in service personnel identified during service may be
attachment problems, chaotic with mental health problems. They at higher risk of social exclusion
family life and problematic are thus less likely to talk to a Military after leaving the Forces and
backgrounds which were carried Medical Officer (GP) about such therefore these individuals
into Forces life and later into problems for fear of damaging their represent a potentially vulnerable
civilian life. credibility and career. group of the veteran population
– Difficulties that originated during Psychological health problems Concerns about stigma, including
service, such as the onset of following operational deployment ‘self-stigma’, may prevent those
substance or psychological are not inevitable outcomes of most in need of help from seeking
health problems. operational exposure - only a support. Issues of pride, guilt,
minority of those on operations shame, memorialisation, stoicism
– Problems in coping with the are for example directly involved in and self sufficiency may lead
transition back into civilian life. combat. Psychological injuries post veterans to use avoidance as a
operational deployment and during primary coping strategy, specifically
– Experiences which occurred service mimic the civilian population by using alcohol and keeping busy,
following return to civilian life, in that they include depression, which delays the process of
including relationship difficulties, anxiety, alcohol problems, requesting support and increases
financial problems and adjustment disorders, post the risk of the development of
unemployment. traumatic stress disorder, secondary problems.Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 28
27
We do not know how many SINGLE POINT OF ACCESS SUICIDE RISK
veterans with psychological health SERVICE (HULL) In 2009 Nav Kapur (Centre for
problems seek help. Individuals Single Point of Access to Suicide Prevention, University of
may only seek support when they psychological support, based at Manchester, UK) and colleagues
are struggling and lack appropriate Miranda House. This is an NHS conducted a cohort study, in which
resources. they linked data on everyone who
resource, intended to act as the
left the UK Armed Forces between
first point of contact for individuals
Veterans with psychological injuries 1996 and 2005 with information on
needing mental health support.
suicides collected by the National
may display: Anyone can refer themselves, or Confidential Inquiry into Suicide
– Poorer family adjustment someone they are worried about. and Homicide. During the study
SPA are able refer to a wide range period 233,803 individuals left the
– Relationship problems of mental health services including Armed Forces and 224 died by
counselling, psychological suicide. The study, funded by the
– Problems with intimacy
therapies, psychiatric support and Veterans Policy Unit in the UK
– Parenting problems social care depending on the need Ministry of Defence, found that
of the individual on assessment. ex-servicemen under 24 years old
– Lower family cohesiveness
were at greatest risk of suicide,
– Difficulties communicating with Telephone: 01482 617560 and that the suicide risk for this
partners group is nearly three times that of
Email: singlepointofaccess@
the general population, with those
humber.nhs.uk
– Problems controlling their anger of lower ranks proving most
vulnerable. It is not possible to say
Those who have had problematic
IMPROVING ACCESS whether this relates to traumatic
or unsuccessful military careers
TO PSYCHOLOGICAL or other military related events or
are more likely to be vulnerable at
THERAPIES (IAPT) pre-enlistment vulnerabilities and
IAPT Aims to improve access to experiences. The overall suicide
their transition to civilian life. The
evidence based talking therapies in risk was no greater for ex-military
psychological effects of operational
the NHS to support the personnel than for civilians when
deployments are the product of the
implementation of NICE guidelines all age groups were considered –
interaction between the individual,
for people suffering from anxiety 16 to 49 years. Men aged 30-49
the event(s), the environment and
and depression disorders. years had a lower rate of suicide
civilian/military culture. Remember than the general population.
not every serviceman or woman
A Special Interest Group has
sees combat. As with any The research also found that
produced a positive practice guide
psychological problem, there is veterans had a low rate of contact
for working with veterans which can
likely to be a major impact on with mental health professionals in
be viewed through the IAPT website
family members. the year before death – just 14%
for those under 20 years of age
Web: www.iapt.nhs.uk/ and 20% for those under 24 years.
special-interests/Veterans Brochure HULL_Layout 1 01/11/2010 16:12 Page 29
HULL AND
28 EAST RIDING
SUICIDE PREVENTION Helpline cards have been widely ADDICTION PROBLEMS
IN HULL AND THE distributed and in Hull there Misuse of alcohol is common in
EAST RIDING is shortly to be a men’s mental some Armed Forces personnel and
There is a Hull and East Riding health campaign which will aim to recognised as a general issue for
Suicide Prevention Strategy Group encourage men to be more aware the services in a culture of “work
who have developed a local suicide of their mental health needs and hard, play hard”. Alcohol plays
prevention strategy. The local to seek help when necessary. an important part in military social
programme undertakes a regular life and allows those in a rigid
audit of local deaths by suicide Hull: 01482 344808 hierarchical organisation to let off
and in recent years no deaths East Riding of Yorkshire steam, it aids morale. It is easily
of forces personnel or veterans 01482 672026 available throughout all three
have featured in the audit. services. Alcohol and drugs can
Crisis resolution service be potent self-medication for those
01482 335790 suffering from psychological health
Locally there is a strong focus
on training; the internationally Web: www.hullpublichealth.org/ problems, whatever their cause,
recognised ASIST (Applied Suicide mental_health.htm and habits formed within the Armed
Intervention Skills Training) has Forces may reinforce this.
been delivered regularly. Mental
Health First Aid and Safetalk Combat Stress identify alcohol
training is also delivered. Safetalk misuse as more typical than illicit
teaches people to become alert drug misuse, this may be an
to suicide intention and how to artefact of age and the availability
intervene appropriately to enable and social acceptability of alcohol
people to get to the help they need. in society. Younger veterans are
more likely to use illicit drugs in
addition to alcohol
ADDICTIONS SERVICES
Telephone: 0800 77 66 00
Web: www.talktofrank.com
Hull and East Riding Services
Web: www.humber.nhs.uk/
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