Friday 3 November 2017

Why are veterans reluctant to access help for alcohol problems?

Guest post by Gill McGill, Senior Research Assistant, Northumbria University
 
With Alcohol Awareness Week fast approaching, the Northern Hub for Military Veterans and Families Research is busy planning a national conference to share findings from a project on improving veterans’ access to help for alcohol problems. The project was funded by the Royal British Legion and arose from two questions frequently posed by clinical practitioners working within the field of alcohol misuse services: 
  1. Why is it so difficult to engage ex-service personnel in treatment programmes?  
  2. Once they engage, why is it so difficult to maintain that engagement? 
     
In an attempt to test these perceptions, we carried out a systematic literature review of the existing evidence.  We then explored the relationship between being a UK military veteran (ex-serviceman/woman) and alcohol misuse services; and veterans’ experiences of engaging with these services. The research study involved interviews with commissioners and managers of services for alcohol misuse, interviews with veterans who are currently experiencing, or had experienced, problems with alcohol misuse, and focus groups with veterans who had no apparent experience of alcohol misuse.
 
The findings will be discussed in detail at the conference, so please join us there to hear more, but that quick plug aside, we thought we’d give you a sneak preview here!
 
Paradoxically, although alcohol misuse amongst UK veterans is estimated to be higher than levels found within the general population, we found a limited amount of research that specifically considered alcohol problems among UK veterans. Given that there are an estimated 2.56 million UK military veterans[1], this represents an important, but as yet, largely unaddressed public health issue.
 
Commissioners and managers of alcohol services expressed the view that veterans have difficulty navigating available support due to ‘institutionalisation’. Yet, when speaking to military veterans themselves, we found no support for this. Such a view point is also potentially problematic in stereotyping veterans as (at least in part) the architects of their own difficulties.
 
In all cases, it could be said that meaningful engagement with alcohol misuse services was being ‘delayed’ to a significant extent by the veterans involved in our study. They ‘normalised’ their relationship with excessive alcohol consumption both during and after military service and this hindered their ability to recognise alcohol misuse. Yet this was not mentioned by healthcare staff participating in the study. Participants also suggested that seeking help was contrary to ‘military culture’ and that this frame of mind tended to remain with UK military veterans after transition to civilian life. Delay in seeking help often meant that by the point at which help was sought, the problems were of such complexity and proportion that they were difficult to address.

Service commissioners/managers and military veterans highlighted a need for greater understanding of ‘veterans’ culture’ and the specific issues veterans face among ‘front line’ staff dealing with substance and alcohol misuse.
 
As a result of the research, one possible solution identified as worthy of further exploration is a ‘hub-and-spoke’ model of care. At the centre of the hub would be a military veteran peer support worker, with knowledge of local and national services, and experience in navigating existing pathways of care. This solution perhaps offers one way in which UK military veterans experiencing alcohol misuse problems might engage with the full range of existing services in a considered and individually bespoke way.
 
Reference:
  1. Ministry of Defence (2015) Annual Population Survey: UK Armed Forces Veterans residing in Great Britain 2015. Bristol: Ministry of Defence Statistics (Health).

National Conference – Northumbria University and Royal British Legion
Veterans Substance Misuse: Breaking Down Barriers to Integration of Health and Social Care
Newcastle United Football Club (Heroes Suite)
Thursday 16 November
More information on the Fuse website.

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