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Veterans Universal Passport: a pilot of a health and social care record for UK ex-service personnel
Background: The transfer of care between different health and social care systems are often associated with poor outcomes and disengagement. Indeed, following the transition from military to civilian life, ex-service personnel report difficulties in navigating civilian health and social care services. Personal healthcare records are associated with a number of benefits, including improved continuity of care and patient empowerment. As such, this pilot project aimed to assess the benefits of the Veterans Universal Passport (VUP) in supporting UK ex-service personnel accessing NHS services. Methods: In-depth semi-structured interviewed were carried out with eight participants (3 ex-service personnel, 2 carers, 3 health and social care professionals) who had used the VUP. Interviews explored the benefits, challenges and unmet needs associated with the VUP. A thematic analysis was used to identify themes within this framework. Results: Participants felt that the VUP improved continuity of care and promoted a feeling of control over care. The military-specific nature of the VUP promoted a sense of identify and provided a 'support scaffold' for navigating the complexities of the civilian healthcare system. Challenges included awareness amongst health and social care professionals, and engagement of users. All participants suggested development into a digital application. Conclusions: Findings suggest that the VUP had a positive impact on veterans access to civilian health and social care services, highlighting that it provided a much-needed structure to their journey through treatment. Considering the parallels with other health and social care transitions, translation for other populations may be beneficial.
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Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces
Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertaining to the prevalence and impact of sexual harassment in the military, explore potential reasons for this gap in knowledge and outline future directions and priorities for academic research.
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'Treat everyone like they're a man': Stakeholder perspectives on the provision of health and social care support for female veterans in the UK
International research suggests that female veterans may experience gender-specific barriers to accessing veteran-specific care. This is the first UK study to report an exploratory qualitative investigation of the provision of health and social care support for female veterans and whether this support meets their needs. The research team carried out 13 virtual semi-structured interviews between October and November 2020, with representatives from statutory and third sector organisations that provide support to UK female veterans. Ethical approval was obtained from the Anglia Ruskin University School of Education and Social Care Research Ethics Committee. The authors identified four overarching themes and nine sub-themes in a thematic analysis following the framework outlined by Braun and Clarke (2006). The findings of this study suggest that practitioners from statutory and third sector organisations perceive the UK veteran support sector as male-dominated and male-targeted, with a lack of consideration for female veterans' needs. Participants reported a lack of engagement with veteran-specific services by female veterans and suggested that women either do not identify with the 'veteran' label or do not feel comfortable accessing male-dominated veteran-specific services. The need for specific services for female veterans split participant opinion, with most of those who were female veterans themselves highlighting the importance of 'safe spaces' for women, particularly those who had experienced gender-based violence during military service. Others felt that the veteran support sector currently lacked evidence of women's unique support needs, and an examination of current provision was required. The authors recommend a thorough assessment of UK female veterans' health and social care needs, alongside development of training and guidance for health and social care professionals, to ensure that veteran services are adequately developed, tailored and targeted with women's needs in mind.
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Same-sex sexual violence in the military: A scoping review
In: Journal of Military, Veteran and Family Health: JMVFH, Volume 6, Issue 2, p. 68-84
ISSN: 2368-7924
Introduction: Sexual violence (SV) is a globally prevalent issue, and the majority of research focuses on the historical view of SV as an act perpetrated by men against women. Same-sex sexual violence (SSSV) incidents represent a small proportion of recorded sexual offences, and therefore prevalence and consequences of this have received little attention. Male-dominated occupations, such as the military, are associated with higher rates of SV and data points to a particular vulnerability to SSSV of male service personnel (SP). Methods: This review aims to map the literature pertaining to SSSV in the military. A comprehensive scoping review methodology was adopted, following a rigorous accepted framework. Four databases were searched for English language, peer-reviewed, original research papers that were focused on SSSV in the military context. Results: Eleven papers were identified that met the criteria for inclusion; 10 originated from the United States and one from South Korea. Themes identified included prevalence and nature of SSSV in the military, characteristics of survivors and perpetrators, barriers to reporting, and the outcomes associated with SSSV in the military. Discussion: The evidence that does exist suggests that male SP are particularly at risk of SSSV, and experience poorer psychological and social outcomes due to SSSV compared to female SP and those who experience opposite-sex sexual violence (OSSV). More research is required internationally to provide accurate and up-to-date estimates of prevalence, and to account for cultural and structural differences in military organizations.
Same-sex sexual violence in the military – A scoping review
Introduction: Sexual violence (SV) is a globally prevalent issue, and the majority of research focuses on the historical view of SV as an act perpetrated by men against women. Same-sex sexual violence (SSSV) incidents represent a small proportion of recorded sexual offences, and therefore prevalence and consequences of this have received little attention. Male-dominated occupations, such as the military, are associated with higher rates of SV and data points to a particular vulnerability to SSSV of male service personnel (SP). Methods: This review aims to map the literature pertaining to SSSV in the military. A comprehensive scoping review methodology was adopted, following a rigorous accepted framework. Four databases were searched for English language, peer-reviewed, original research papers that were focused on SSSV in the military context. Results: Eleven papers were identified that met the criteria for inclusion; 10 originated from the United States and one from South Korea. Themes identified included prevalence and nature of SSSV in the military, characteristics of survivors and perpetrators, barriers to reporting, and the outcomes associated with SSSV in the military. Discussion: The evidence that does exist suggests that male SP are particularly at risk of SSSV, and experience poorer psychological and social outcomes due to SSSV compared to female SP and those who experience opposite-sex sexual violence (OSSV). More research is required internationally to provide accurate and up-to-date estimates of prevalence, and to account for cultural and structural differences in military organizations.
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We Also Served: The Health and Well-being of Female Veterans in the UK
Women have served within the Armed Forces for over 100 years. Their contribution has been extraordinary but the prevailing military culture, together with evolving terms and conditions of Service, have left their mark on the health and well-being of many. Whilst it is right, therefore, to recognise the progress that has been made, there is a pressing need to evidence the impact of past policies and actions. This timely report is the first major step in addressing this. Almost thirty organisations, drawn from across the military charity sector as well as from statutory bodies including NHS England and NHS Improvement and the MOD, have contributed to this report. It is the first research project to consider holistically the full range of female veteran issues, uniquely capturing the lived experiences of women who have served. Perhaps most importantly, it provides an essential start point for a comprehensive evidence base that will enable debate with a level of insight and clarity that has been missing before, and which will ensure statutory and Service Charity provision is targeted accurately to meet the needs of those women who are serving and veterans. The report is clear that for many that is not yet the case, both for those in Service and for those who have transitioned to civilian lives. It is a timely warning that there is still work to do both in improving in-Service conditions to allow our servicewomen to thrive and, once they leave, for us to tailor our veteran support services to meet their specific needs. This will include the requirement to support and improve the needs of serving women, whether as partners, mothers or in different family situations, and its impact on well-being, whilst at the same time enabling military careers. A prioritised action pl an has been produced in order to a chieve real impact and create long-lasting change. Top of the list is a review of the impact on health and well-being outcomes of Service culture an d sexual harassment, issues which have long been discussed but which continue to persist, with a number of the recommendations from the recent Wigston Report yet to be fully implemented. The report also identifies considerable gaps in our understanding of how in-Service experiences impact on health, wealth, and socio-economic outcomes, and explores what further action is required. Overall, this report is unique in its breadth and depth, in the academically robust processes undertaken and in its capture of the lived experiences of female veterans from across the services and the decades. It is not an easy read. It is, however, a necessary read. By compiling the evidence, the report gives voice to our former servicewomen and sets out an irrefutable case for further and necessary cultural and policy change to improve the long-term health and well-being of those women who have served and are serving.
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Confident, valued and supported: Examining the benefits of employment support for military spouses
Military spouses face numerous challenges in obtaining employment as a result of their connection to the military. Previous research has linked military spouses underemployment to reduced well-being and satisfaction with military life, which in turn impacts on retention of the service person. In response to this the UK Ministry of Defence (MOD) trialled a 2 year programme of employment support for spouses in 2015. This paper reports the findings of a qualitative evaluation of this programme and its impact on spouses. Interviews were carried out with 30 spouses and 23 of their serving partners to examine the benefits and impact of the support provided. The majority of spouses and their serving partners perceived the employment support as providing a positive contribution from the military to help spouses get back into employment or improve their employability. Additionally, spouses felt invested in by the military and valued as constituents in their own right. No impact of employment support for spouses on the intention to remain or leave the Armed Forces was identified. Longitudinal follow up will be required to determine any long-term impact of employment support on employment outcomes and retention.
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Gender differences in barriers to mental healthcare for UK military veterans: A preliminary investigation
Introduction: Limited UK research focuses on female military veterans' gender-related experiences and issues when accessing civilian mental healthcare support. This study sought to illuminate a preliminary understanding of any gender differences in barriers that may discourage them accessing mental healthcare support. Methods: A total of 100 participants completed an open online survey of UK triservice veterans who identified as having experienced postmilitary mental health problems. They completed a 30-item Barriers to Access to Care Evaluation scale and were asked to elaborate using free-text questions. Resulting quantitative data were analysed for gender-related differences, while the qualitative text was thematically explored. Results: While stigma, previous poor experience of mental healthcare and a lack of trust in civilian providers were found to act as barriers to postmilitary support for both men and women, significantly more women reported that their gender had also impacted on their intention to seek help. Women also commented on the impact of gender-related discrimination during service on their help-seeking experiences. Conclusions: While efforts are being made by the UK Ministry of Defence to reduce barriers to mental healthcare for those still serving in the Armed Forces, it has been more difficult to provide a similar level of support to the veteran population. With little veteran research focusing on the specific experiences of women, this study suggests that female veterans encounter specific access barriers and issues related to their gender. Further research is therefore needed to ensure these findings are addressed.
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Hierarchies of wounding: Media framings of 'combat' and 'non-combat' injury
In: Media, war & conflict, Volume 14, Issue 4, p. 503-521
ISSN: 1750-6360
In this article, we examine the representational practices of British newspapers in relation to forms of military injury. Using critical discourse analysis, we studied the reporting of injuries sustained by military personnel during the height of the UK's war in Afghanistan in 2009 – and a comparison period five years later – and concluded that representations of injured personnel differed substantially between articles reporting on 'combat' and 'non-combat' injuries. We argue that the different reporting frames work to construct a moral separation of injuries into 'heroic' (combat) and 'non-heroic' (non-combat) forms. The consequences of this hierarchization of injury, we suggest, include the reification of 'combat' as an idealized form of masculine violence, the privileging of some soldiers and veterans over others as exemplars of national heroism, and elision of the day-to-day realities of military injury from public consciousness. Findings are discussed in relation to broader consequences for understanding heroism and the military.
Hierarchies of wounding: Media framings of 'combat' and 'non-combat' injury
In this article, we examine the representational practices of British newspapers in relation to forms of military injury. Using critical discourse analysis, we studied the reporting of injuries sustained by military personnel during the height of the UK's war in Afghanistan in 2009 – and a comparison period five years later – and concluded that representations of injured personnel differed substantially between articles reporting on 'combat' and 'non-combat' injuries. We argue that the different reporting frames work to construct a moral separation of injuries into 'heroic' (combat) and 'non-heroic' (non-combat) forms. The consequences of this hierarchisation of injury, we suggest, include the reification of 'combat' as an idealized form of masculine violence, the privileging of some soldiers and veterans over others as exemplars of national heroism, and elision of the day-to-day realities of military injury from public consciousness. Findings are discussed in relation to broader consequences for understanding heroism and the military.
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Military spouses with deployed partners are at greater risk of poor perinatal mental health: A scoping review
Background: Poor mental health in the perinatal period is associated with a number of adverse outcomes not only for the individual but the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems. Methods: A scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O'Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE. Results: Thirteen papers fulfilled the inclusion criteria, all from the US, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support, and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support. Conclusions: US literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner, and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.
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Transition Support for Vulnerable Service Leavers in the U.K.: Providing Care for Early Service Leavers
In: Military behavioral health, Volume 6, Issue 1, p. 13-21
ISSN: 2163-5803
Transition From the Military Into Civilian Life: An Exploration of Cultural Competence
In: Armed forces & society, Volume 44, Issue 1, p. 156-177
ISSN: 1556-0848
In this article, we employ the theoretical framework and concepts of Pierre Bourdieu to examine the notion of "transition" from military to civilian life for U.K. Armed Forces personnel. We put Bourdieu's concepts of habitus, capital, and field to work in highlighting key differences between military and civilian life. The use of social theory allows us to describe the cultural legacy of military life and how this may influence the posttransition course of veterans' lives. There may be positive and negative transition outcomes for service personnel when moving into civilian life, and by applying Bourdieu's theoretical concepts, we explain how such outcomes can be understood. We suggest that the "rules" are different in military environments compared to civilian ones and that service personnel must navigate a complex cultural transition when moving between environments. There are numerous and significant implications—including policy applications—from understanding transition through a Bourdieusian lens, and these are highlighted throughout.
Dossier : oil and gas: waiting for the rebound
In: The Africa report, Issue 17, p. 84-94
ISSN: 1950-4810
World Affairs Online