Some veterans struggle to reintegrate into civilian life when they first leave the military, while others find themselves ambushed by physical and mental health challenges years later.
Things like finding a dentist and a GP, or getting your children settled into education in a new area can be more of a struggle for ex armed forces personnel and their families. But here in Cornwall a different approach to health and social care is being trialled. It sees ex armed forces personnel employed to support and advise their fellow veterans.
It’s well recognised that men and women who serve in the armed forces run the risk of serious physical and mental harm during their time in the military. Real time TV coverage of the UK’s military conflicts over the last 30 years has brought home to us in our living rooms pictures stark and raw of the price paid in limbs and lives.
What’s less widely understood, though, are the risks to a veteran’s physical and mental health when he or she leaves the military.
“Readjusting from a strict military environment to a freer, less demanding role in civilian life – is daunting,” says Michael Vickery, a 74-year-old former sergeant in the Royal Signals living in Liskeard.
While many veterans are able to reintegrate into civilian life relatively smoothly, about 15% face a complex mix of physical and mental health challenges that can affect them and their families profoundly, and not always straight away.
“When you’re in the military, you have this intense comradeship, a tight community,” says Marc Walsh, a former Forward Observation Officer in the Royal Artillery who is now employed by Active Plus CIC as Michael’s Armed Forces Community social prescribing link worker.
“Everyone looks out for each other. Someone’s always got your back. You re-enter the civilian world and find you don’t really speak the same language, and everything takes a long time to organise.
“It’s incredibly alienating.”
Marc is one of Cornwall’s two dedicated armed forces community social prescribing link workers. They are taking part in a two-year test and learn demonstration – one of only three trials in the country. If the project shows that specialist social prescribing works for armed services personnel and their families, then the scheme will go national.
His role is to engage with veterans and their families, find out what the barriers are to them accessing services and taking part in civilian life, and help them to find ways round them.
Veterans often have a hard time opening up to civilians about their struggles. This is often down to broken trust – they’ve been passed around from service provider to service provider in the past.
“I can feel that I’m making a difference on a daily basis,” says Marc. “I can hear it in their voices when I talk to them.
“They’ve finally found someone who gets it. Who’s been through it. They start to banter a bit. You speak to them in their own language. And they start to open up and tell you what the real issues are.”
“I suffered with delayed onset PTSD myself six years after I came out,” says Marc.
“Some veterans suffer with it straight away but it’s common for PTSD not to show itself until seven to 13 years after traumatic events. You can be living a normal civilian life with your family and then something triggers it.”
What many armed forces personnel don’t realise – let alone civilians – is that coming out of the military they run a gauntlet of loss: of the career and job security, the housing, medical and dental care that all came as part and parcel of military life.
Veterans overwhelmingly report the same things: difficulty finding a GP practice or dentist, housing and jobs.
“Not only that,” says Marc, “you lose your sense of purpose and belonging. Your self-respect and the respect of your peers, and the security you get from living a highly regimented life.”
“We’ve now got 52 Cornwall veterans on the ‘We Are with You’ scheme. We get them registered with GPs and dentists. Some of these veterans, the only medical help they’ve had for their physical and mental health has been the doctor that visits the homeless hostel once a week.
“The social prescribing is very patient-orientated. We sit down with the veteran and sometimes their families too. We know the military banter, so it’s easier for us to communicate with them that it is for a civilian trying to help them to access services.
“We chat, we get to know them, we talk their language, and they open up.
“They talk to us about what’s really causing their issues. So, if their mental health is suffering because they’ve got money worries, we connect them with services that can help them sort out their finances, as well as the mental health support.
“Often veterans don’t fit in at your average civilian company. Our humour tends to be dark – it has to be to deal with the things we deal with. That kind of humour doesn’t go down too well in a normal civilian organisation. The military banter can seem a bit strong.
“Michael wasn’t engaging with any support services, and nobody really knew why until we got hold of him. It was his teeth. He’d lost a lot of his teeth and it was really affecting his confidence socially and with applying for jobs.
First, we tried finding him an NHS dentist. When that didn’t work, we accessed a veterans’ enablement fund for him which paid for him to see a dentist privately and now he’s going to have dentures fitted.
“It’s transformed how he feels about himself and life. It’s made the biggest difference to his overall wellbeing.
“There are Armed Forces veterans breakfast clubs (AFVBC) that run nationally across the UK, but who wants to go to breakfast when you can’t chew through a sausage. He doesn’t want to socialise because of the way his teeth look. They’re causing him to lisp, and he can’t eat very easily.
“Another veteran was in serious distress, calling the GP, the police and the ambulance all the time. Other service providers called us in as a last resort because they couldn’t deal with him.
“He was an alcoholic living alone, very isolated. We went and just had a chat with him. He was taking 25 pills – prescribed by a doctor – a day but he didn’t know what any of them were.
“Other services were experiencing his language and mannerisms as aggressive and were backing away from him.
“We went and had a chat with him, we were able to communicate with him on his terms, we weren’t intimidated by his language, we understood what was going on for him. We got a nurse to
talk through all his medication with him. He had a long bush beard and long hair that was bothering him, but he wasn’t able to arrange or afford a haircut.
“We contacted Armour to Barbour in Redruth. William Hamilton who came and gave him a shave and a haircut. We got funding to clear his front garden…it was a total mess and causing friction with his neighbours who were having a bit of a go at him every time he went out.
“For him to be able to look in the mirror and see himself the way he used to look before everything got on top of him has been powerful for him.
“These kinds of things can be overwhelming. If someone drinks, the mental health support services back away, they can’t really engage with people who are drinking. It’s a vicious circle.
Marc set up Veterans Online Wellbeing Support during lockdown – a Friday meeting Zoom call just for Cornish veterans. It’s kept a lot of veterans going through the pandemic. They’ve made friends. Two veterans even coached each other to sobriety through those calls. This kind of peer-to-peer support is making a difference.
Marc and Active Plus CIC are now working hard to get all of Cornwall’s 116 GP practices Veteran Friendly status from the Royal College of Surgeons. Each one is to have an armed forces champion who understands some of the challenges.
“There were 11 accredited when we started,” says Marc, “and now we’ve raised that to 26, so we’ve more than doubled the number. “
“I came out of the Royal Artillery as a young lad and didn’t register with a dentist. I didn’t think about it until I got toothache and it cost me £400 to get treatment privately.
“You’re mothered in the military. You don’t have to worry about housing, food, finances. Often, veterans come out and they move into a community where they know nobody. They can’t find an NHS dentist. They don’t register with a GP. It falls on the partner of the armed services personnel member to sort a new job themselves, find a school for the kids, sign them up for new activities, find a GP.
In the military, alcohol is used as a positive reinforcement tool. It’s a big part of the culture, it’s used to build camaraderie, it’s used as a reward. It’s a big part of the culture.
You’ve served 20 years, you’ve reached the position of Sergeant Major, people say ‘sir’ to you and brace themselves when you walk past. And then you come out and you’ve lost everything – your support network, your responsibilities, the respect.
The kind of leadership qualities you build in the military are valuable in civilian life but it’s hard for veterans to recognise those skills they’ve built up, let alone articulate them in a CV.
I was working on a building site after I came out. I was struggling with my mental and physical health. I saw an ad for the very first Military Veterans and Families Studies Master’s degree.
It was the first course of its kind in the country. I thought, that’s what I want to do. I want to work with vets and give something back.
I didn’t have any formal qualifications. I’d sort of given up at school once I knew I was going into the military, and you’re supposed to have a 2:1 BA honours degree to do a Master’s. Because it was the first course ever, they said I could give it a try as I had the personal experience and had done voluntary work with veterans.
It was a three-year course. Twenty-four of them started and only five made it to the end. I was one of them. But my struggles didn’t end there.
I started applying for jobs in the armed forces community sector and kept getting rejection after rejection. I wasn’t even getting interviews at that point.
I was ringing up for feedback, asking if it was my CV, my interviewing style. Nothing. I had lots of volunteering experience, an MA and my own military experience, but was getting nowhere.
“That rejection experience – a very common experience for veterans trying to adjust to the civilian working world – really knocked me for six.
I gave up, took a job as a night manager at Morrison’s and worked there for six years instead.
This is what we do as vets. We have a bad experience. We distance ourselves from the military community.
I had a very close friend, a veteran who had been my best mate and he was living 20 miles from me here in Cornwall, but I didn’t see him during that time and then he died of a brain tumour.
“I wasn’t there for him, and I felt so guilty about it that I had all this experience, a qualification, that could have been useful to him, but I was hiding away. Not using those skills because I was afraid of being rejected again.
His death gave me the impetus I needed to try again.
I’d first heard about Active Plus back in 2013 and the work the Wounded Injured and Sick Veterans were doing offering confidence and motivation courses.
After my friend died, I got back in touch with Active Plus, and it just so happened that they had a couple jobs going.
I managed to secure a role as a veterans’ specialist change coach, helping veterans get back into work and education. I also become an instructor on one of the confidence and motivation courses that are run across Cornwall.
The instructors are all veterans, which is great as it uses our shared experiences to help us, the instructors, and our fellow veterans doing the course to build our confidence and motivation together.
Active Plus’s ethos is ‘veterans inspiring people’ and I have really seen that in action.
I separated from my husband when I was three months pregnant with our second child. For years, I stayed living in Kent to keep the kids in contact with their dad, but my ex-husband was suffering badly from PTSD.
Things got bad during the last lock down. I realised that he wasn’t well enough to be around the children, and – when we lost our rented property – I realised I really needed to be closer to my family back in Cornwall. I felt alone and needed the support of my family.
So, I made the decision to move back.
Initially, we stayed with my mum and stepdad but there wasn’t enough room for me, my daughter, who was 16, and my son, who was by then 11.
I got myself a job and I started to look for somewhere for us to live, but I got nowhere with the private letting agents. They seemed reluctant to show me properties, even though I had a job, the deposit, no history of debt and good tenant references.
I was left feeling that they were discriminating against me as a single parent.
It got to the point where we couldn’t stay with my mum and stepdad any longer. We were getting under each other’s feet, and I was worried that us all being there was stressing their dog out.
The council put us up in a hotel at Liskeard. I can’t drive, which made feeding the kids difficult, as I couldn’t drive to a supermarket and there were no shops around. There was no supermarket within walking
Then they moved us to a bedsit in St Austell. I’d just done my first day at a new job, got home exhausted and had messages saying we were being moved to Bodmin.
That was stressful. Starting a new job is a lot to deal with. You want to make a good impression and I had to get my head round packing up all our stuff and moving.
It was stressful. Lots of running up and down lots of stairs. My stepdad came to help us move, but friends and extended family are not allowed in the building, so my daughter and I had to run up and down all the stairs lugging all our stuff.
The first place we moved into in Bodmin had mould, which aggravated my son’s bad asthma, so they moved us.
It was a depressing place and it left a lasting mark on my children.
We were stuck in Bodmin from August 2021 to March 2022. My daughter was having to commute from there to Truro College every day – she’s doing her International Baccalaureate.
It was absolutely exhausting for her, but I’m so proud of her for sticking it out.
We were both trying to commute to work and college by bus, which cost me a lot in time and money. Whenever she could, my mum was coming over from Bugle to Bodmin, driving me to work and then taking the kids back to Bugle with her. It was stressful for all of us.
At Christmas, I realised my daughter had been hiding from me the fact that she didn’t have a winter coat that fitted her. She couldn’t do up her old one and I was wearing my nephew’s tattered old school coat.
It was Marc who got us winter coats and shoes. He accessed a fund for them. And when it came time to move again, this time to Council accommodation in Truro, he arranged for a minivan to come and collect us and our stuff.
The council provides a taxi but with two children, we had more than a taxi’s worth of belongings.
I had to leave most of our furniture and belongings in storage back in Kent when I came to stay with my mum. I can’t afford to go up and collect our things, and I can’t afford to keep paying the storage fee either. I think we will lose all our belongings because I just can’t afford to keep up the payments.
We’re so glad to now be living in a place in Truro so my daughter is near college. It’s a two-bedroom place, so I have to share a room with my son. He has sleep problems and I want my daughter to get a good night’s sleep so she can concentrate on her studies.
I’m so grateful to Marc. I think he had a lot to do with getting us moved to Truro.
It’s been the most challenging time of my life and I was in despair a lot of the time.
Being moved around a lot because the accommodation wasn’t right. Not having any control over where you’re living. Having to get to work and back by bus, spending most of my wages on bus fares. Not wanting to quit the job and get another one closer because it looks so bad on your CV if you don’t stick around.
With Marc and the Armed Forces Community social prescribing service, it feels like the army has our back again. It’s like having that army extended family behind you.
I don’t feel so alone.
Michael Vickery was a sergeant in the Royal Signals stationed mainly in Germany and Northern Ireland. He went into the military from school at 16.
“I’ve gone through divorce, I’ve gone through homelessness, I’ve gone through prostate cancer. All on top of each other. It really did bring me right down. I was depressed.
“The military gave me that unique sense of camaraderie you don’t quite get anywhere else. That togetherness and self-assurance. It gave me a trade as a telecommunications operator. Although it was strict, it was enjoyable.
The military is a totally different environment to civilian life.
My marriage of 30 years failed. I had to move out of our marital home. I ended up on the emergency housing list and was put into a travel lodge in St Austell, but I was having treatment for prostate cancer at Derriford in Plymouth and it was too difficult travelling that distance.
It’s very difficult to find private accommodation, especially if you are disabled, as I am. I did eventually get a bungalow in Liskeard and the British Legion and various other support services were able to help me with furniture, a fridge and cooker.
After a while there, I started to get really down. Everything had caught up with me. It was lockdown, it felt like everything was closed off to me. I mentioned this to my social prescriber and put me in touch with Marc Walsh. He was very good. He linked me into various organisations that could help me, got me to go to coffee mornings at the British Legion. He kept ringing me up, giving me information about what support was around.
Eventually, I told him how self-conscious I felt about having lost so many of my teeth.
At first, he tried to find me an NHS dentist that could help me out but there wasn’t one. So, he accessed funding for me to have a consultation with a private dentist. I’m going to have dentures made for me next year. This has made so much different to me. It’s really lifted my spirits.
Marc convinced me to meet up with another veteran who lives near me and we have coffee together. Marc really understands military life and what camaraderie means to another veteran. He understood how much I need to have people around me.
If you come out of the military into civilian life and you find yourself struggling, there are organisations that really can help. Don’t feel that you’re alone because you’re not. There are others who have been through or who are going through similar things. There is information and support if you need it, whether than be for physical health problems, mental health issue or practical challenges.
Marc really helped me. Please, please get in touch and get some support. It’s here waiting for you.
More information and support
What is social prescribing?
Social prescribing involves the individual in the design of their own, personalised solutions. It means that people with social, emotional or practical needs are empowered to find their own solutions to improve their health and wellbeing, often using services provided by the voluntary and community sector.
It’s an innovative and growing movement, with the potential to reduce the financial burden on the NHS and on primary care in particular.
Rather than seeing the veteran as ‘broken’ and in need of ‘fixing’, the power of social prescribing is that it recognises that people’s health and wellbeing are decided mostly by a range of social, economic and environmental factors. Social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.
The MOD estimates that there are around 320,000 veterans living across the southwest making up about 12% of the south west’s population.
More than 60% self-report a health problem that limits their daily activities.
Around 65% of veterans report feelings of loneliness and social isolation with 31% having only one or no close friends. Only half feel able to talk about their feelings of loneliness with family or friends.
Veterans are twice as likely to report having suicidal ideation than the general population.
While the UK Government is only this year starting to make an official count, we know that 89,000 US veterans took their own lives between 2005 and 20018 and a University of Manchester study has revealed that UK service leavers below the age of 24 are three times more likely to take their own lives than their civilian counterparts.
The national lifetime rate of self-harm for UK veterans is 6.6% compared to 4.2% in serving personnel. Lifetime suicide prevalence among veterans is thought to be 10.5% compared to 4.2% among serving personnel.
The Royal British Legion estimates there are 6,000 homeless veterans in the UK. The number of veterans sleeping rough isn’t 100% clear, but most estimates place the figure at around 3% to 4% of the rough sleeping population.