Armed forces community

The size of the Armed Forces community (service personnel, veterans and their dependants) is estimated to be between 6.5 and 6.7 million.

The government defines a Veteran as anyone who has served for at least one day in Her Majesty’s Armed Forces (Regular or Reserve), or Merchant Mariners who have seen duty on legally defined military operations.

Research around transition to civilian life indicates that for a small number of people, leaving the Armed Forces may be a challenge to well-being [Ahern et al 2015; Cooper et al 2016]. It is important to evaluate research evidence on the effectiveness of interventions to protect well-being given a small number do experience difficulties, and also in order to inform decisions about allocation of resources and which interventions it may/ may not be important to develop or fund.

The last decade has seen increasing attention paid to the needs of the ex-Service community. In particular, the principles of the Armed Forces Covenant have been signed into law; namely, that the ex-Service community should suffer no disadvantage due to Service, and that the bereaved and injured are on occasion entitled to special consideration. Assessing progress against these principles is difficult without accurate data on the size, profile and needs of this community. For charities and statutory agencies, such as health bodies and local authorities, accurate data on the size and welfare needs of the ex-Service community will also help with the planning and provision of services.

Myth busting

Myth: veterans are more likely to take their own lives

Research by Manchester University found that suicide was less common amongst veterans than within the general population.

Myth: most Service personnel and veterans suffer from mental health problems rates of mental health problems amongst Service personnel and recent veterans appear to be broadly similar to the UK population as a whole.

Myth: many veterans are in prison

The rate of veterans in prison is broadly similar to the percentage of veterans in the UK population as a whole.

Myth: many veterans sleep rough

Worrying statistics emerged in the 1990s, indicating that around 20% of the London homeless population was ex-Service, however, a 2008 study estimated that the proportion of London’s rough sleeping population who had served in the Armed Forces was 6%.

Source: https://media.britishlegion.org.uk/Media/2275/2014householdsurveyreport.pdf

Local data and intelligence

Currently, no-one knows how many of the armed forces community live, work or have family members in Stockton-on-Tees.

There is insufficient robust local data (and therefore intelligence) to understand the needs of the armed forces communities in Stockton-on-Tees at a population level.

The Office of National Statistics have developed and tested a question on service leavers and concluded that such a question will work; and can be accommodated within the 2021 Census.

This would improve the level of local data/intelligence available, however, this is unlikely to be available to the public until 2023.

GP practice systems in Stockton-on-Tees have the ability to record whether a patient is a veteran, however, these codes are not always used correctly and therefore the data is not robust.

Data around veterans is collected via many other organisations (including the Veterans leavers database (VLD), The Department of Work and Pensions (DWP), within local councils, the voluntary sector, etc.), however there isn’t a systematic process to link this data to gain a full picture of the needs of our veterans.

Age and duration of service

16-34 year olds, particularly veterans and those who live alone, report a number of issues round debt, employment and transition, and a significant proportion have caring responsibilities. Members of this group are often among the most vulnerable Veterans, with complex needs.

Research by Manchester University found that suicide was less common amongst veterans than within the general population, except for one group: young early Service leavers.

The younger age group make up only 6% of the ex-Service community, but their problems differ subtly from other members of the Armed Forces community. They are also more likely to have experienced difficulties – such as school expulsion or having parents with drug or alcohol problems – before entering the military.

Those in the ex-Service community of working age are more likely than the general population to report having musculoskeletal problems, hearing difficulties or depression, or some condition that limits their activity.

Early Service leavers (ESL) are those defined by the ministry of defence as Service leavers who have been discharged - either compulsorily or at their own request after less than four years' service (including people who have served just a few days and have left without completing basic training) are repeatedly identified at risk of poor outcomes in terms of physical health, mental health, homelessness and employment. This makes ESL a distinct group of veterans who need to be additional consideration within service provision.

Complex needs

Veterans with complex needs have issues with drug and alcohol misuse, physical health, employment, housing, relationships and finances, as well as occupational and trauma-focused therapies. These issues can result in devastating outcomes.

There is general agreement that substance misuse within the armed forces community is heavily weighted towards alcohol, rather than drugs.

Risk factors for alcohol misuse within the veteran population are similar as those seen for mental illness: Being male, young, single, separated or divorced, unemployed, and/or having a parent who had an alcohol or drug problem.

Employment

Veterans of working age (between 16 and 64) are less likely to be in employment than the general population.

One of the reason for this is that those who join the UK Armed Forces at a young age, often as an alternative to pursuing higher education or gaining civilian employment experience, are reliant on the training and skills provided through the Services to be able to enter the civilian job market once they leave.

There may also be a negative stereotyping of ex-Servicemen and women that can be acutely felt by veteran job seekers.

https://www.fim-trust.org/reports/

Local authority

Armed Forces Covenant

The Armed Forces Covenant is a promise by the nation ensuring that those who serve or who have served in the armed forces, and their families, are treated with fairness and respect in the community, economy and society.

It has two underlying principles to ensure that this promise is fulfilled:

• Members of the armed forces community should face no disadvantage compared to other citizens in the provision of public and commercial services – in other words, they should have the same access to government and commercial services and products as any other citizen; and
• Special consideration is appropriate in some cases, especially for those who have given the most such as the injured or the bereaved.

In March 2012, Stockton Borough Council was delighted to make its support for the armed forces community official by signing a local Armed Forces Community Covenant.  The community covenant is a voluntary agreement between the local civilian and military community – to work together to support and honour our armed forces community (past and present).

The NHS and the Defence Medical Services (DMS)

NHS England

The following services are commissioned by the NHS England Armed Forces commissioning team for the DMS registered population (including DMS registered families) in England:

• Secondary care services, including emergency care;
• community services;
• mental health services (only for families registered with DMS).

The following services are also commissioned for the Armed Forces community by NHS England:

• primary care for families registered with NHS practices;
• dental, pharmacy and optometry services for families;
• secondary care dental services;
• specialised services;
• public health services..

NHS England also provides lead commissioner or similar support arrangements for other services such as cervical screening for those DMS registered patients overseas, or out of hours primary care services.

Clinical Commissioning Group (CCG)

Most services for veterans are commissioned locally by CCGs, with a veteran being defined as someone who has served a day in HM Forces. There is no definitive record of the number of veterans in Stockton-on-Tees as there has been no systematic recording of veteran status in healthcare records. GPs are encouraged to ask patients registering at their surgery if they are a veteran and Read1 code them as “military veteran” on the system. There are also Read codes for “Member of Military Family” which can be used to identify family members.

DMS

DMS commissions or provides the following services in England:

• Occupational health for military personnel;
• primary care for serving personnel and GP services for DMS registered families;
• all health care when on active operations and prior to return to UK;
• rehabilitation services for musculoskeletal (MSK) and some neurological patients for serving personnel;
• mental health in community and inpatient for serving personnel (but not families).

Voluntary Sector

Royal British Legion - Billingham Branch

• Undertake projects to raise funds for local projects
• Hold social Events during the year, including Breakfast and tea & coffee meetings
• Attend funerals of ex-service personnel
• Undertake local welfare support where necessary to ex-service people and their families
• Give talks in local schools
• Attend local events to support the work of The Royal British Legion

Support for the armed forces in Cleveland (SSAFA)

Helping veterans, service personnel, and their families in the local community. Providing support with experienced, non-judgemental and friendly advice, as well as a variety of practical services which cover a range of social, family and financial issues.

https://www.ssafa.org.uk/cleveland

Stockton Royal Navy Association

Provides comradeship and assistance in need for all naval people in Stockton-on-Tees.

https://www.royal-naval-association.co.uk/branches/no-11-area/stockton-on-tees/

Stockton and Yarm Royal British Legion

Help and support for those who have served and their families.

The Re-Org Trust

The Re-Org Trust is a not for profit social enterprise, specialising in delivering support to Service and ex-military personnel during periods of transition.

This could be post operational, moving from military to civilian life, from prison into the community or from being mentally un-well to recovery.

CTP Assist

Support Wounded, Injured and Sick Serving Personnel and Veterans during their transition from the Armed Forces into civilian life.

Project Nova

Supporting veterans who have been arrested or are at risk of arrest.

In 2015/16, 56% of Veterans engaged with Project Nova were unemployed. Employment can be a key factor in reducing re-offending.  We support veterans towards sustainable employment.

Forward Assist: Salute Her

Forward Assist is a charity based in the North East that facilitates “Post Traumatic Growth” for military veterans, actively campaigned for ‘gender specific’ mental health interventions for women veterans. 

No additional needs assessment is required at present due to a lack of local data and intelligence.

Name: James O’Donnell

Job title: Public Health Intelligence Specialist

Organisation: Stockton-on-Tees Borough council

Phone number: 01642 528360

Contributor/s:

Andy Copland (Hartlepool & Stockton-on-Tees CCG)

Barry Coulson (Department of Work and Pensions)

James Hadman (Catalyst)

Jim Khambatta (NHS England)

Stuart Levin (Stockton-on-Tees Borough Council)

Lt Col Nathan Teale (Ministry of Defence)

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