1. UK-US Best Practice in the Care of Service Personnel,
Veterans and their Families and their
Relationship with Society
Colonel Fred E. Hargreaves OBE
Royal College of Defence Studies
SEAFORD HOUSE PAPER
2014
4. i
ABSTRACT
There is growing concern from military chiefs and Service charities in both the UK and US about the
incrementally widening gap between the Armed Forces Community of Service personnel, veterans
and their families, and the society from which they are drawn. This paper identifies the trajectories of
both nations’ attempts to re-balance Clausewitz’s trinity of the government, the military and the
people, highlighting initiatives from a ‘modern trinity’ of the public, private and third sector. It also
demonstrates that the UK Armed Forces, Community and Corporate Covenants are excellent
foundations from which to evolve the relationship between the Armed Forces and society beyond
2014.
In particular, this paper addresses shared UK / US issues and the best practices of each nations’:
national leadership; support to families; wounded, injured and sick; transition and employment; and
community engagement, finishing with a number of recommendations that the UK could take to
improve the civil-military divide. It asserts that the dynamic and proactive sharing of existing
practices and initiatives between the UK and the US delivers much better outcomes than either
nation doing it in isolation.
The key recommendation is:
That the UK needs a dedicated, apolitical ‘Veterans’ Champion’, with national
authority, accountability and responsibility, to drive coherence between the public,
private and third sectors.
5. ii
TABLE OF CONTENTS
Page Title
1 Introduction
3 The UK Context
4 UK Service Charities
5 The US Context
6 US Service Charities
7 Shared Issues and Best Practice: National Leadership
9 Shared Issues and Best Practice: Support to Families
9 Shared Issues and Best Practice: Support to Wounded, Injured and Sick
12 Shared Issues and Best Practice: Transition and Employment
15 Shared Issues and Best Practice: Community Engagement
17 Conclusion and Recommendations
6. 1
INTRODUCTION
Whilst the post 9/11 military campaigns may have been domestically and politically
unpopular, support for the Armed Forces is higher than it has been in decades. Medical advances
have drastically reduced battlefield mortality rates and the media coverage of fallen and wounded
Servicemen and women has significantly contributed to the esteem in which the Armed Forces are
held. There is, however, increasing concern from military chiefs and charities that this support and,
by extension, understanding of what the military does, will diminish on withdrawal from Afghanistan.
This incrementally widening gap between the Armed Forces and the society from which they are
drawn could easily lead to increased difficulties with recruitment and retention of high quality people,
thus jeopardising morale, leadership, training and ultimately the successful execution of the next
campaign. There is arguably, therefore, a narrowing window of opportunity in which to refine and
implement more enduring policies and approaches to stem the loss of, and subsequently improve,
the support and understanding of the Armed Forces and veterans across the nation.
The relationship between society, the military and the government is not a new issue. In the
nineteenth Century, Clausewitz wrote of it in relation to his ‘paradoxical trinity’ of the people, army
and government.1
Even before this, during the American War of Independence, George Washington
identified that, “the willingness with which our young people are likely to serve in any war, no matter
how justified, shall be directly proportional to how they perceive the Veterans of earlier wars were
treated and appreciated by their nation.” 2
This three-way relationship has been enshrined into
British law by the inclusion of the Armed Forces Covenant in the Armed Forces Act 2011. This
creates an “enduring covenant between the people of the United Kingdom, Her Majesty’s
Government and all those who serve or have served in the Armed Forces of the Crown and their
families.”3
It is based on two fundamental principles:
1 – Those who serve in the Armed Forces, whether Regular or Reserve, those who have served in
the past, and their families should face no disadvantage compared to other citizens in the provision of
public and commercial services.
2 – Special consideration is appropriate in some cases, especially for those who have given most
such as the injured and bereaved.4
This paper will examine the historic and contemporary approaches, initiatives and activities
of the UK and the US toward the fulfilment of the social, moral and legal obligation a nation has to
its armed forces, veterans and their families – collectively known as the ‘Armed Forces community’.
It will examine the roles of Service charities, and the shared issues and best practices of: national
leadership; support to families; wounded, injured and sick; transition and employment; and
community engagement. It will finish with a number of recommendations that the UK could take to
improve the civil-military divide, reinforcing the notion that the dynamic and proactive sharing of
practices and initiatives between the UK and US delivers much better outcomes than either nation
acting in isolation. Coherence between the ‘modern trinity’5
of government, third sector (charities)
and private sector is a fundamental requirement to successfully balance Clausewitz’s trinity to
provide the optimum security of any nation. The key recommendation of the paper is the creation of
a dedicated UK Veterans’ Champion who has national authority, accountability and responsibility to
drive this coherence.
The vast majority of material on this subject is available online in the public domain.
However, it remains such a complex topic that even though extraordinary advances have been
made in recent years, there still remains much to do. It is worth noting at the outset that American
culture is skewed towards public demonstrations of ‘veteran-friendliness’, both as a legacy from the
1
Michael Handel. Masters of War: Classical Strategic Thought, (London: Routledge), 2007, p102.
2
Rory A. Cooper et al. Warrior Transition Leader: Medical Rehabilitation Handbook, (Ft Detrick, MA: Borden Institute), pix. Also
downloadable at: http://www.cs.amedd.army.mil/borden/FileDownloadpublic.aspx?docid=6dd7481b-746e-4c73-aca6-705586c69a39
accessed 23 Mar 14.
3
Ministry of Defence. The Armed Forces Covenant, p1.
4
Idem.
5
‘Modern trinity’ is the author’s phrase used throughout the paper to encapsulate the relationship between the government, the private
sector and the third sector.
7. 2
Vietnam War and also post 9/11 where, unlike European nations, many American citizens genuinely
feel they are at war with terrorism. In order to stimulate ideas that could be imported and made
appropriate to the different cultural baseline in the UK, each section of the paper will cover the
relevant UK approaches and initiatives before identifying how it is enacted in the US in slightly more
detail. This weight of emphasis is not intended to imply any criticism of the UK’s approach.
In comparing best practices between the UK and the US, it should be noted that the US has
a Department for Veterans’ Affairs (VA), which is the second largest government department behind
the Department of Defense (DoD), with over 300,000 employees and a budget that has grown by
almost 68% since 2009 ($163.9 billion for 2015).6
The VA is responsible for administering veterans’
health and veterans’ benefits for a significant proportion of America’s 22 million veterans and their
families. In contrast, in the UK, the National Health System is wholly responsible for veterans’
health, with initiatives such as the Murrison Centres7
and the putative Chavasse centres8
providing
specific veteran and/or reservist-focused care in selected NHS hospitals across the country. In
terms of benefits, following the 1st
April 2014 merger of the Service Personnel and Veterans’ Agency
and Defence Business Services, Veterans UK is now the single organisation that is responsible for
circa 900,000 pensions, compensation, welfare and medals.9
During the course of researching this paper, combined with over six years of personal
engagement with many of the issues raised, a number of maxims pertinent to both nations became
apparent:
Just because a policy exists on paper does not mean that it is being implemented effectively.
Accurate metrics are, therefore, essential in order to properly understand whether the intended
effect is being achieved;
Leadership and passion count. At the national level, at departmental level and at board level,
policies and initiatives work best when they are actively and regularly driven by senior leaders;
The vast majority of the Armed Forces and veterans do not expect, nor need, special treatment
from society – they merely wish not to be disadvantaged by their sacrifice and for similar
opportunities to be as open to them as to others in their age or peer group;
The majority of veterans see themselves neither as heroes nor as victims. Given the scale of
deployments over the past decade or more, some will have inevitably committed heroic acts, but
it is a cliché, and possibly a damaging one, to label all veterans as heroes or to portray them all
as somehow requiring the nation’s sympathy;10
There is, however, a small percentage that does need the nation’s support, and these
individuals require a coherent, multi-disciplinary team to assist them, potentially for the rest of
their lives.
6
http://www4.va.gov/budget/products.asp accessed 19 Apr 14.
7
https://www.gov.uk/government/news/new-nhs-treatment-centres-for-military-heroes accessed 19 Apr 14.
8
The President of the British Orthopaedic Association, Professor Tim Briggs, has proposed the creation of a number of Chavasse centres
in certain NHS hospitals to provide better orthopaedic support for veterans and reservists, but his proposals have yet to be formally
launched.
9
The latest data from open sources on the number of SPVA employees (circa 1,000) and budget (£10.0bn in Pay and Allowances,
£3.5bn in Armed Forces Pensions, £0.1bn for Armed Forces Compensation Scheme and £1.0bn in War Pensions) was in 2011.
http://www.veterans-uk.info/index.htm and http://www.veterans-uk.info/arac/SPVA%20Annual%20Report%20and%20Accounts%202010-
11.pdf accessed 19 Apr 14.
10
Eric Liu, a former policy advisor to President Clinton, makes this point very well in his CNN op-ed dated 16 Jan 14:
http://edition.cnn.com/2014/01/16/opinion/liu-help-veterans/index.html?hpt=op_t1 accessed 19 Apr 14.
8. 3
CONTEXT
The UK Situation
2007 was probably the nadir of British civil-military disconnect. With both the Iraq and
Afghanistan campaigns ‘running hot’,11
the media was full of negative stories about the Ministry of
Defence (MoD). Inadequate wards in Selly Oak hospital, squalid living accommodation, and poorly
resourced equipment and welfare of deployed forces, meant that even the Minister for the Armed
Forces and Chief of the General Staff were voicing public concerns about the “growing gulf between
the Army and the Nation.”12
At the Defence Medical Rehabilitation Centre in Headley Court, there
was disturbing local resistance to the purchase by a military charity, SSAFA, of a house in the nearby
Grays Road for use by the families of rehabilitating wounded personnel. There were also complaints
from civilian swimmers in the local Leatherhead Leisure Centre about wounded Servicemen
undergoing rehabilitation in the pool ‘scaring their children.’13
A vociferous motoring journalist,
Jeremy Clarkson, used his newspaper columns in The Sunday Times and The Sun to highlight the
plight of wounded Servicemen at both Selly Oak and Headley Court, and was instrumental in
launching the extremely successful charity, Help for Heroes, on 1st
October 2007.14
The UK Labour government instigated a series of initiatives in an attempt to redress many of
the aforementioned criticisms. On 8th
November 2007 it announced a new Command Paper “to
develop the first ever cross-Government strategy for supporting our Service personnel, their families
and veterans,”15
which was led by the Armed Forces Minister, Bob Ainsworth MP. One month later,
an Independent National Recognition Study was initiated, led by Quentin Davies MP, and in July
2008, “The Nation’s Commitment: Cross-Government Support to Our Armed Forces, their Families
and Veterans” was presented to Parliament by the Secretary of State for Defence.16
This paper
announced improvements in: compensation, health, housing, education and families support. In
parallel, the Conservative opposition initiated their own Military Covenant Commission in March
2008, covering many similar issues, which reported in September 2008.17
When the Conservatives came into power in coalition with the Liberal Democrats in 2010,
they launched a new Task Force on the Military Covenant. This reported in September 2010, and
ultimately led to the Armed Forces Covenant being enshrined into British law.18
It places a remit on
the Secretary of State for Defence to make an annual report to Parliament on the status of four key
cross-government issues: healthcare, housing, education and inquests. It has a Cabinet level sub-
committee to ensure cross-departmental co-ordination, chaired by the Minister for Government
Policy, Oliver Letwin MP, and an independent, external Covenant Reference Group.19
It is supported
by two further Covenants: a Community Covenant which aims to “encourage local communities to
support and promote armed forces issues in their area,”20
and a Corporate Covenant which aims to
“allow businesses to demonstrate their concrete support for the armed forces.”21
These three
Covenants and the associated Annual Report are excellent examples of national policy being
translated into tangible action and progress.
However, even with the time and intellectual effort devoted to identifying the causes and
solutions to optimally supporting Service personnel, veterans and their families, a study by Lord
Ashcroft in 2012 highlighted that whilst support for the military was very high, society’s understanding
11
‘Running hot’ was a phrase used by General Dannatt in his first interview as Chief of the General Staff (CGS) in August 2006 to describe
the Army operating to its full capacity to deliver its commitments in both Iraq and Afghanistan.
12
CGS speech at the International Institute of Strategic Studies dated 21 Sep 07. http://archive.is/BUJKf accessed 1 Apr 14.
13
http://www.telegraph.co.uk/news/uknews/1570130/Disabled-veterans-jeered-at-swimming-pool.html accessed 1 Apr 14.
14
http://www.militaryforums.co.uk/forums/viewtopic.php?t=16711#.UzrtZdxV98M accessed 1 Apr 14.
15
Taken from Ministry of Defence Internal Brief DIB 2007/29.
16
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/238719/7424.pdf accessed 1 Apr 14.
17
http://militarycovenantcommission.wordpress.com/documents/ accessed 1 Apr 14.
18
https://www.gov.uk/government/policies/fulfilling-the-commitments-of-the-armed-forces-covenant/supporting-pages/armed-forces-
covenant accessed 31 Mar 14.
19
See also: http://webcache.googleusercontent.com/search?q=cache:4GyQRldtHn4J:www.parliament.uk/briefing-
papers/SN06519.pdf+&cd=1&hl=en&ct=clnk&gl=uk&client=safari accessed 1 Apr 14.
20
https://www.gov.uk/government/policies/fulfilling-the-commitments-of-the-armed-forces-covenant/supporting-pages/armed-forces-
community-covenant accessed 1 Apr 14.
21
https://www.gov.uk/government/policies/fulfilling-the-commitments-of-the-armed-forces-covenant/supporting-pages/corporate-covenant
accessed 1 Apr 14.
9. 4
of the ‘modern trinity’ was extremely flawed. For instance, ninety percent of the UK population
thought that it was common, or very common, for personnel leaving the Forces to have some kind of
physical, emotional or mental health problem.22
They also felt that the provision of support from the
government to the most seriously wounded must be inadequate due to the increasing reliance on the
third sector for their care. “Help for Heroes reminds me that government isn’t taking care of soldiers.
It’s not my job to contribute to what the government should be doing. I pay enough in taxes.”23
A
reasonable point, but worrying insomuch that if people felt that way whilst the country was still
engaged in a conflict, what hope would there be for support of veterans, injured or otherwise, in
future years? One other effect of society’s disconnect was that many employers do not understand
the transferable skills that a veteran, wounded or otherwise, could bring to their workplace. If a
veteran could not find a meaningful and rewarding job, then it could be the start of a downward spiral
of relationship issues, alcohol misuse, financial woes, increased stress, unemployment,
homelessness or even suicide.
UK Service Charities
The UK has a long tradition of charitable support for its armed forces, stretching back to the
nineteenth Century, with a major new charity forming with every significant campaign. SSAFA were
formed out of the Colonial campaigns in Africa in 1885, The Royal British Legion after the First World
War in 1921, the Army Benevolent Fund (now known as The Soldiers Charity) during the Second
World War in 1944, and Help for Heroes from the post-9/11 campaigns in 2007. There are circa 2000
Service-connected charities in the UK, ranging from large general charities such as The Royal British
Legion and SSAFA, through specialist charities such as Help for Heroes, Combat Stress, and
BLESMA, to a myriad of smaller charities and Regimental Associations. A central focus is provided
by an organisation called COBSEO.24
It has no executive or authoritative powers to co-ordinate its
member charities, but does provide a useful forum to develop opportunities for collaboration on areas
of shared interest.
Service charities provide an extremely useful connection to society, allowing people who
wouldn’t otherwise to have a relationship with their armed forces by contributing and showing their
support. The campaigns in Iraq and Afghanistan have struck a chord with the population, and the
past seven years have seen a significant rise in donations for all major Service charities (Table 1).
Concerns about the reduction in profile of the military and its associated incremental disconnect with
society began to materialise in 2012. This is shown by the drop-off of donations in the table below,
against an overall charity sector year-on-year growth of between two and three billion pounds in the
same timeframe.25
The effect of this could be twofold: charities could resort to using increasingly
extreme examples of why they need donations, potentially reinforcing the public perception that the
government is not doing enough to help or that veterans require the nation’s sympathy.26
Alternatively, using a line oft attributed to Churchill, ‘we’re out of money, we’re going to have to think,’
a reduction in income could act as a forcing function to bring more coherence to the sector.
All figures in
£M
TRBL SSAFA H4H ABF
(TSC)
COMBAT
STRESS
BLESMA ANNUAL
TOTAL
2008 104.08 43.57 14.65 7.48 9.70 3.88 183.36
2009 125.08 46.91 19.61 9.65 10.76 4.08 216.09
2010 115.24 47.24 45.72 12.14 12.55 5.11 238.00
2011 136.19 48.45 46.57 16.00 16.17 4.92 268.30
2012 132.82 51.44 40.55 16.86 15.75 4.80 262.22
% RISE OVER
5 YEARS
27.6% 18.1% 176.8% 125.4% 62.4% 23.7% 43.01%
Table 1 - Selected Service Charities' Income (£ Million) Between 2008 and 201227
22
http://lordashcroftpolls.com/2012/05/the-armed-forces-society/ accessed 31 Mar 14, p7.
23
Ibid, p15.
24
http://www.cobseo.org.uk accessed 7 Apr 14.
25
£48.4bn in ‘08; £58.48bn in ‘12. http://www.charitycommission.gov.uk/About_us/About_charities/factfigures.aspx accessed 7 Apr 14.
26
Such as the harrowing Enemy Within’ video at: http://www.youtube.com/watch?v=CK7svcKCAcQ accessed 21 Apr 14.
27
Sourced via Charities Aid Foundation at http://www.charitytrends.org/Default.aspx accessed 7 Apr 14 and cross-checked with a sample
of individual Charities’ Annual Reports to the Charity Commission. Note that these are submitted one year in arrears, hence 2012 is the
latest data available.
10. 5
COBSEO has eight clusters through which it tries to magnify the effect of related charities on
a given issue. However, with less than 200 of the 2000 Service charities on their books, there
remains significant potential for overlapping objectives, unhealthy competition, and most damagingly,
an unclear picture for those vulnerable veterans or families about where to go to for help and
therefore inadequate case management. Whilst the most obvious focus in recent years has been
those wounded and injured post-9/11, the sector has responsibility for veterans and their families
stretching back beyond the Second World War, so some opaqueness is probably inevitable. That
said, there are probably more examples of charities working together than not. Help for Heroes, for
instance, use their own high profile fundraising abilities to support inter alia: Combat Stress - £6.7M;
Fisher House - £2M; Haig Housing Trust - £1.75M; Battle Back - £1.7M; Blind Veterans UK - £1M;
Skillforce - £675k; SSAFA - £520k; Not Forgotten Association - £460k; and Poppy Factory - £384k.28
This sort of co-ordination and mutual support is a model for how they can and should work together,
although the charitable landscape can still be somewhat obscure and incoherent to the people who
need it most. This issue was identified by Lord Ashcroft’s Veterans’ Transition Review of 2014, which
recommended the creation of a single 24/7 contact centre, a helpline and an online directory of
accredited Service charities to ease navigation for their clients and ensure a more co-ordinated
management of individual cases.29
The US Situation
In the USA, 1973 saw the migration to an all-volunteer military force and elimination of the
draft, and was a period that probably marked their nadir of civil-military relations. In his 2012
Memorial Day address, President Obama spoke of the Vietnam War as, “one of the most painful
chapters of our history, especially how we treated our troops who served there it was a national
shame, a disgrace that should never have happened.”30
It is often perceived that today’s support for
the US armed forces and their veterans could not be higher, and in many cases that is true, but there
are definite areas where that perception is not accurate. For instance, whilst tremendous strides have
been made since Vietnam, the US now struggles with the fact that less than one percent of their
population has served in Iraq or Afghanistan, and they believe that there is a disconnect with many of
the other 99 percent. A recent poll by the Washington Post found that, “more than half of the 2.6
million Americans dispatched to fight the wars in Iraq and Afghanistan struggle with physical or
mental health problems stemming from their service, feel disconnected from civilian life and believe
the government is failing to meet the needs of this generation’s veterans.”31
Civil-military relations seem to wax and wane in cycles. In 1944, the US passed the GI Bill of
Rights which entitled veterans to free college education and home loans. This legislation created an
impressive social mobility and prosperous veteran middle class who ultimately returned far more in
taxes than the Bill’s initial investment. The President’s Commission on Veterans’ Pensions further
enhanced this Bill in 1956, and it is worth noting that in his covering letter to the President, the
Chairman stated that, “one-half of our whole population consists of veterans and servicemen and
their families.”32
Today it is less then ten percent. In 2007, President G.W. Bush established a
Commission on Care for America’s Returning Wounded Warriors,33
which highlighted the
requirement for a “sense of urgency and strong leadership” to address a number of key
recommendations, including:
1 – Immediately create comprehensive recovery plans to provide the right care and support at the right
time in the right place;
2 – Completely restructure the disability and compensation systems;
28
http://www.helpforheroes.org.uk/how-we-help/supporting-other-charities/ accessed 13 Apr 14.
29
Lord Ashcroft. The Veterans’ Transition Review, 2014, p135. Downloadable at: http://www.veteranstransition.co.uk accessed 14 Apr 14.
30
http://www.foxnews.com/politics/2012/05/28/transcript-president-obama-memorial-day-remarks-at-vietnam-war-memorial/ accessed 1
Apr 14.
31
http://www.washingtonpost.com/sf/national/2014/03/29/a-legacy-of-pride-and-pain/ accessed 29 Mar 14.
32
http://www.veteranslawlibrary.com/files/Commission_Reports/Bradley_Commission_Report1956.pdf accessed 2 Apr 14.
33
Bob Dole and Donna Shalala. Serve, Support, Simplify. 30 Jul 07. Downloadable at:
http://www.dcoe.mil/content/Navigation/Documents/President's_Commission_on_Care_for_Wounded_Warriors_Final_Report_July_30_07.
pdf accessed 29 Mar 14.
11. 6
3 – Aggressively prevent and treat Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury
(TBI);
4 – Significantly strengthen support for families.34
Subsequently, veterans who had served from 11th
September 2001 onwards had their
eligibility and benefits expanded in the 2008 ‘Post 9/11’ GI Bill.35
In that same year, the US Institute of
Medicine was commissioned by the DoD to better understand the readjustment needs of returning
troops. It published its 800-page report on 26th
March 2013,36
and it is worth highlighting three of its
key points as these go some way to explaining some of the causes of their current problems:
1 – The nation waged war in Iraq and Afghanistan in unprecedented ways, using a limited-size, all
volunteer force; deploying troops repeatedly for up to 15 or 19 months at a time; allowing less than a
year of rest between tours; and filling the military’s ranks with historically high numbers of women,
parents, National Guard troops and reservists.37
2 – 44% of returning troops from Iraq and Afghanistan have reported difficulties, often multiple issues
ranging from PTSD, TBI, depression and problematic alcohol abuse.
3 – Numerous programmes exist to respond to the needs of returning OEF [Operation Enduring
Freedom (Afghanistan)] and OIF [Operation Iraqi Freedom] active-duty personnel, veterans and family
members, but there is little evidence regarding their effectiveness.
US Service Charities
There are circa 40,000 Service-connected charities in the USA, although over 35,000 of these
generate under $100,000 per annum.38
As in the UK, they have a mix of general non-profit entities
such as United Services Organisation (USO), the American Legion, Veterans of Foreign Wars (VFW)
and Semper Fi, as well as specialist charities such as Blue Star Families, Fisher House and the
Wounded Warrior Project. There is no COBSEO-equivalent in the US, so collaboration between them
is generally ad hoc and voluntary but can still be very effective. There are the obvious navigational
and case management issues for veterans or families in need of their assistance, and irrespective of
the tremendous initiatives and policies emanating from Washington DC, the effect at the point of
need is often delivered by a local, independent charity.
Chris Marvin, a veteran of Afghanistan and founder of the US charity Got Your Six, makes
quite a profound point in his Washington Post op-ed about the nature of today’s veterans being
different from their predecessors. His words are useful in terms of classifying Service charities by
what they achieve for the population they aim to serve. Some charities are generic and support
veterans of all conflicts, others are specialised and target niche populations or activities – the mix of
the two is required to prevent, or at least ameliorate, ‘philanthropic fratricide’, where charities
compete with each other in the same space.
Sustained combat operations with an all-volunteer force have yielded a cohort of veterans different
from generations that endured conscription. For better or for worse, veterans from my generation don’t
gather at VFW halls for beers and war stories. Instead, we congregate with Team Rubicon for disaster
relief, with Team Red, White and Blue for physical training, and with The Mission Continues for
community service. Post-9/11 veterans are asking to be engaged, empowered and held to high
expectations.39
34
Ibid, pp5-10.
35
http://www.benefits.va.gov/gibill/post911_gibill.asp accessed 29 Mar 14.
36
http://www.iom.edu/Reports/2013/Returning-Home-from-Iraq-and-Afg3hanistan.aspx accessed 2 Apr 14.
37
Of the 2.6 million who have served since 9/11, over 730,000 were members of the Reserve or National Guard, the largest use of both
forces since the Second World War (http://www.washingtonpost.com/sf/national/2014/03/29/a-legacy-of-pride-and-pain/ accessed 29 Mar
14). In Vietnam, 15 percent of troops were parents; today nearly half have children and 14 percent are single parents. 500,000 of the 2
million children of active duty parents are under 6 years old (Washington Post, Strain on Military Families Felt by Kids, 22 Jul 13, p4).
38
An excellent article on the shape of the US Service-connected charity landscape can be found here:
https://nonprofitquarterly.org/philanthropy/22967-the-community-foundations-response-to-veterans.html accessed 21 Apr 14.
39
http://www.washingtonpost.com/opinions/chris-marvin-for-todays-veterans-service-isnt-over-when-the-uniform-is-put-
away/2013/11/10/98ad9ab0-48b9-11e3-a196-3544a03c2351_story.html accessed 14 Apr 14.
12. 7
SHARED ISSUES AND BEST PRACTICE
National Leadership
The past seven, or even seventy, years have demonstrated that there is an absolute desire
within the senior leadership of both nations to address and improve the care and support of the
military and veteran communities. In the UK, the Armed Forces Covenant, its associated Cabinet
Office ‘oversight’ sub-committee and independent Covenant Reference Group provide excellent
insights, support and direction. In the US, the President has a dedicated Policy Director for Veterans,
Wounded Warriors and Military Families, sitting inside the White House, who reports directly to his
National Security and Domestic Policy Councils (NSC/DPC). 40
This position has the responsibility to
co-ordinate policy and activities across the Departments of: Defense, Labor, Education, Veterans
Affairs, and the Office of Personnel Management to ensure that the federal government upholds its
commitments to veterans and their families. The UK’s closest equivalent is probably a combination of
the Minister for Government Policy, who chairs the sub-committee but has an extremely wide remit
over all Whitehall departments, and the MoD’s Minister for Defence Personnel, Veterans and Welfare
(Anna Soubry MP).41
The UK’s lack of a single, accountable ‘Veteran’s Champion’ was highlighted in
the Covenant Reference Group’s comments last year, stating, “the call for some form of coordination
for the care of Veterans and for a champion to hear their grievances remains unaddressed. These
functions cannot be performed within the Ministry of Defence or by the charitable sector as it is
currently constructed.”42
Lord Ashcroft recommended a similar appointment be created in the 2014
Veterans’ Transition Review, and it is also the key recommendation of this paper.43
On 25th
May 2011, President Obama and Prime Minister Cameron launched a bilateral
Taskforce focused on the Armed Forces, veterans and military families whose aim was to share and
develop best practice across the government, private sector and military charities in the areas of:
mental health, rehabilitation, transition to civilian employment, and families support.44
The creation of
this Taskforce in itself was a recognition that more could and should be done across these areas to
ensure that the clinical and personnel advances that have been made since 9/11 are shared and
capitalised upon to create and further improve enduring policies and relationships. One year later, the
President and the Prime Minister, “re-affirmed their commitment to deliver the best possible support
for the men and women of our armed forces, veterans and their families.”45
However, the ‘modern
trinity’ is not as coherent as it should be, and both nations face continual challenges to ensure that all
three parties are consulted at the outset of an issue, thereby not only achieving cross-sector ‘buy-in’
of any final proposal, but leveraging different skillsets and ideas in the design and development of a
solution. This was also highlighted in last years Covenant Reference Group’s remarks: “This
synergistic effect [of close working cooperation of the Government and Service Charitable Sector]
would be greatly enhanced by the greater inclusion of the Private Sector.”46
As Commander-in-Chief, the US President has a different relationship with the military than
the British Prime Minister and, as such, invests more personal effort on armed forces issues. Indeed,
his last three State of the Union addresses, viewed by up to 50 million people, have had significant
military and veteran themes. In 2012, his opening six paragraphs were focused on the military,
including:
Above all, our freedom endures because of the men and women in uniform who defend it. As they
come home, we must serve them as well as they served us. That includes giving them the care and
benefits they have earned... And it means enlisting our veterans in the work of rebuilding our Nation.47
40
http://www.whitehouse.gov/blog/author/Rosye%20B.%20Cloud accessed 3 Apr 14.
41
https://www.gov.uk/government/ministers/parliamentary-under-secretary-of-state-defence-personnel-welfare-and-veterans accessed 3
Apr 14.
42
Ministry of Defence Armed Forces Covenant Annual Report 2013, p16. Downloadable at:
https://www.gov.uk/government/publications/armed-forces-covenant-annual-report accessed 31 Mar 14.
43
Lord Ashcroft. The Veterans’ Transition Review, 2014, p25 and p168.
44
http://www.whitehouse.gov/the-press-office/2011/05/25/joint-fact-sheet-us-uk-task-force-support-our-armed-forces-personnel-vet
accessed 3 Apr 14.
45
http://www.whitehouse.gov/the-press-office/2012/03/14/joint-fact-sheet-us-uk-task-force-support-our-armed-forces-personnel-vet
accessed 3 Apr 14.
46
Ministry of Defence Armed Forces Covenant Annual Report 2013, p14.
47
http://usatoday30.usatoday.com/news/washington/story/2012-01-24/state-of-the-union-transcript/52780694/1 accessed 3 Apr 14.
13. 8
In 2013 he stated:
As long as I’m Commander-in-Chief, we will do whatever we must to protect those who serve their
country abroad, and we will maintain the best military in the world We will keep faith with our
veterans – investing in world-class care, including mental health care, for our wounded warriors;
supporting our military families; and giving our veterans the benefits, education, and job opportunities
they have earned.48
In 2014, Mrs Obama sat next to wounded Army Ranger Cory Remsburg – a very public and physical
demonstration of the priority she and her husband both place on these issues. In the President’s
initial paragraphs at that address he said:
As this time of war draws to a close, a new generation of heroes returns to civilian life. We'll keep
slashing that [VA] backlog so our veterans receive the benefits they've earned and our wounded
warriors receive the health care - including the mental health care - that they need. We'll keep working
to help all our veterans translate their skills and leadership into jobs here at home, and we will all
continue to join forces to honor and support our remarkable military families.49
The President was talking in his last sentence about the Joining Forces Initiative his and the
Vice President’s wives had launched three years earlier, which utilises their very high public profile to
achieve three primary objectives:
1 – Bring attention to the unique needs and strength of America’s military families.
2 – Inspire, educate, and spark action from all sectors of society to ensure veterans and military
families have the opportunities, resources, and support they have earned.
3 – Create greater connections between the American public and the military.50
Their very frequent engagement with wounded warriors, veterans, military families, charities and
employers has given them tremendous insight into the issues that really matter to maximise the effect
of their efforts across the areas of employment, education and wellness. The initiative has a
dedicated military OF5 (Colonel) Executive Director post, sitting in the White House, who is able to
encourage and co-ordinate a range of government, charity and private sector initiatives, and bring a
measure of coherence across the modern trinity to complement and reinforce the work of the
NSC/DPC Policy Director mentioned earlier. In 2013, the First and Second Ladies hosted a ‘military
families mothers day’ at the White House which coincided with the visit of Prince Harry, thus
amplifying their message by ensuring the world’s media, as well as domestic outlets, were exposed
to their activity.51
It is not just the Executive Office that places such value on veterans and military families. The
Chairman of the Joint Chiefs of Staff, General Martin Dempsey, is equally publically committed. His
Strategic Direction has four key themes; the final one is to, “keep faith with our Military Family.”52
On
his official Facebook site,53
he has posted three times recently about: attending the premier of the
Muppets Most Wanted movie at the White House with the First Lady and families of bereaved and
wounded Servicemen (14th
March 2014); attending a Tragedy Assistance Programme for Survivors
(TAPS) Gala Dinner (30th
March 2014) 54
and the Senate’s resolution affirming Gold Star Wives’ Day
(5th
April 2014).55
48
http://swampland.time.com/2013/02/12/president-obamas-2013-state-of-the-union-speech-transcript/ accessed 3 Apr 14.
49
http://www.washingtonpost.com/politics/full-text-of-obamas-2014-state-of-the-union-address/2014/01/28/e0c93358-887f-11e3-a5bd-
844629433ba3_story.html accessed 3 Apr 14.
50
http://www.whitehouse.gov/joiningforces/about accessed 6 Apr 14.
51
http://www.whitehouse.gov/blog/2013/05/09/thank-you-all-you-do-military-mothers-day-tea-first-lady-and-dr-biden accessed 3 Apr 14.
52
http://www.jcs.mil/portals/36/Documents/CJCS_2nd_Term_Strategic_Direction.pdf accessed 7 Apr 14.
53
https://www.facebook.com/GENDempsey?fref=ts accessed 7 Apr 14.
54
http://www.taps.org accessed 7 Apr 14.
55
5
th
April 1945 marked the first meeting of Gold Star Wives, where widows of American servicemen killed in battle could be identified by
the gold star that hung in the window of their homes. http://www.opencongress.org/bill/sres394-113/show accessed 7 Apr 14.
14. 9
Support to Families
The post-9/11 campaigns in Iraq and Afghanistan have claimed 631 British lives (Iraq – 179;
Afghanistan – 452) 56
and 6802 American ones (Iraq – 4489; Afghanistan – 2313).57
Behind the
headlines it is sometimes easy for a war weary society to forget that every one of those deaths
leaves a devastated spouse, parent, sibling or child. Many of these survivors never get over their
loss, they merely find a ‘new normal’. 58
This process can easily take five years or more. Timely
inquests help (hence their inclusion as a specific task in the UK’s Covenant), as does the support
and engagement of people who have experienced similar loss. In 2012, the US Department of
Defense approved the National Military Family Bereavement Study to examine the grieving process
of survivors and provide a scientific basis to inform government policies and improve the support
offered to grieving families.59
Understandably, significant effort by both government and Service charities has gone into
supporting bereaved families. In the UK, SSAFA run a number of specific support groups for
bereaved families and siblings,60
which is similar to the US Tragedy Assistance Programme for
Survivors (TAPS). In the US, TAPS often work in conjunction with the USO to provide immediate
support to families as their loved one is repatriated, and subsequently running grief camps and
retreats to allow families to share their tragic experiences and hopefully to heal together.61
USO has
also worked with an excellent initiative by Sesame Street, which aims to use its characters to help
very young children understand operational separation, homecomings and the loss of a military
parent.62
However, even with all this effort focused toward ensuring the greatest support can be
offered to bereaved military families, some will inevitably ‘slip through the net’, and systems must be
agile enough to apply common sense to resolve issues as soon as they are identified.
There is also the potential to miss how best to address the mental health needs of non-
bereaved families, who have often experienced significant separation from their parent or spouse. A
recent study by the American Academy of Pediatrics identified that, “one in four children of active
duty Service members experienced symptoms of depression, one in three reported excessive worry,
and one in two children had trouble sleeping.”63
There have been a number of cases in the US
where wives have felt so low due to the pressures placed on them that they take their own, and
sometimes even their children’s, lives.64
Great strides have been made in the UK in the provision of
welfare support in the home base whilst a unit is deployed, but it remains extremely difficult to
address the needs of those families who do not live on a regimental married ‘patch’, such as those
of Reservists or individual augmentees. As difficult as this issue has been over the past decade, as
the British Army in particular relies more on deployable Reservists in the future, with a concomitant
drive for soldiers to move away from Service Families Accommodation into their own property, the
ability to generate a coherent welfare support system for the ‘home base’ will become even more
challenging.
Support to Wounded, Injured and Sick
In addition to the high number of fatalities from the campaigns, there are many survivors with
life changing wounds and injuries. From Iraq and Afghanistan, casualty figures include 2,488 British
Servicemen and women classified as Wounded in Action (831 as Seriously or Very Seriously
Injured (Iraq – 221; Afghanistan – 610));65
in the US, there are 51,933 classified as Wounded in
56
http://www.palacebarracksmemorialgarden.co.uk/archive/op_telic.pdf and
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/293123/casualties_afghanistan_7oct01_28feb14.pdf
accessed 7 Apr 14.
57
http://www.defense.gov/news/casualty.pdf accessed 7 Apr 14.
58
http://www.taps.org/uploadedFiles/TAPS/RESOURCES/Documents/FactSheet.pdf accessed 7 Apr 14.
59
http://www.militarysurvivorstudy.org/index.php accessed 7 Apr 14.
60
http://www.ssafasupportgroups.org.uk/bfsg accessed 7 Apr 14.
61
http://www.uso.org/families-of-the-fallen-support/ accessed 7 Apr 14.
62
http://www.sesamestreet.org/parents/topicsandactivities/toolkits/tlc and http://www.uso.org/SesameStreet.aspx accessed 7 Apr 14.
63
Benjamin Siegel and Beth Ellen Davis. Health and Mental Health Needs of Children in U.S. Military Families, June 2013 issue of
Pediatrics (published online 27 May 13): http://pediatrics.aappublications.org/content/131/6/e2002 accessed 7 Apr 14.
64
http://www.military.com/spouse/military-life/military-resources/the-toll-of-war-milwives-and-suicide.html accessed 14 Apr 14.
65
http://www.palacebarracksmemorialgarden.co.uk/archive/op_telic.pdf and
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/293123/casualties_afghanistan_7oct01_28feb14.pdf
accessed 7 Apr 14.
15. 10
Action (Iraq 32,239; Afghanistan – 19,694).66
Many of these are in their teens or twenties and will
need some form of care and support for the next sixty years or more. The effort that has been
devoted over the past seven years or so to address the needs of wounded, injured and sick on both
sides of the Atlantic has been exceptional and advances in front line medical training and equipment
to deployed troops have saved innumerable lives. These improvements include: advanced body
armour and helmets, ballistic eye protection and underwear, all of which help protect the vital areas
in an explosive blast; team medics in every patrol; haemostatic (blood clotting) agents and quick
action tourniquets; the introduction of the ‘platinum 10 minutes’ – stopping external bleeding quickly
enough to ensure that the casualty gets into the formal military medical chain within the ‘golden
hour’; helicopter casualty evacuation by Medical Emergency Response Teams (MERT);67
and
extraordinary trauma and resuscitation teams at hospitals like Camp Bastion’s Role 3. What these
improvements have done though, is to create a generation of “unexpected survivors”, whose critical
support needs over the coming years will challenge the health system considerably.
In the UK, the provision of a military-managed ward at the Queen Elizabeth Hospital was a
much needed development. Facilities at the Defence Medical Rehabilitation Centre (DMRC) at
Headley Court have had significant investment, including the Help for Heroes’ funded rehabilitation
complex. Plans are also developing apace to build a new £300 million Defence and National
Rehabilitation Centre (DNRC) at Stanford Hall, near Loughborough, to replace the DMRC by
2017.68
This will take best practice from Headley Court, Europe and the USA to deliver a world-
leading rehabilitation facility that will not only look after future generations of injured Servicemen and
women, but may provide a focus for national civilian rehabilitation research and delivery.
In November 2011, US Army and Navy medical facilities were consolidated and renovated to
create the Walter Reed National Military Medical Centre in Bethesda, Maryland, the largest facility in
the US dedicated to the care of wounded, ill and injured (WII).69
In San Antonio, Texas, the Brooke
Army Medical Centre (BAMC) hosts the Centre for the Intrepid (CFI) – a state of the art, privately
funded $60 million facility focused on Wounded Warrior rehabilitation, research, education and
training.70
BAMC is also the home of the only DoD Burn Center. The US Army’s Warrior Transition
Command, and the US Marine Corps’ Wounded Warrior Regiment exist to ensure that their
respective Service’s WII receive the most appropriate treatment, support and transition to the next
stage of their careers, be that returning to active duty or being medically discharged to civilian life.71
The UK’s Army Recovery Capability (ARC)72
and Naval Service Recovery Pathway are broadly
similar, and these are supported by five Personnel Recovery Centres at Edinburgh, Catterick,
Colchester, Tidworth and Plymouth. These are funded in the most part by Help for Heroes (£140
million) and The Royal British Legion (£50 million) under the Defence Recovery Capability, and are
manned by a mixture of military and civilian staff to create multi-disciplinary support teams and
recovery events. The £140 million commitment from Help for Heroes constitutes the largest
charitable donation in British military history.
There has been much commentary about the mental health of the armed forces in both the
UK and US in recent years, with significant focus on Post-Traumatic Stress Disorder (PTSD) and
rates of suicide. Comparison to society’s own ‘norm’ of mental health is often misunderstood, so it is
worth looking at some statistics. In February 2011, the UK Government produced a Mental Health
Outcomes Strategy for People of All Ages which stated that mental health problems are a common
feature of modern life: “at least one in four people will experience a mental health problem at some
point in their life and one in six adults has a mental health problem at any one time Almost half of
66
http://www.defense.gov/news/casualty.pdf accessed 7 Apr 14.
67
A MERT is made up of a consultant, emergency nurse and two paramedics – effectively taking an Accident and Emergency capability
to the point of wounding.
68
Further information about the DNRC, including how it is to be funded, is at: http://www.stanfordhallredevelopment.org.uk accessed 30
Mar 14, and
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/33725/DNRCVolume1FeasbilityStudyReport.pdf accessed
8 Apr 14.
69
http://www.wrnmmc.capmed.mil/About%20Us/SitePages/Facts.aspx accessed 8 Apr 14.
70
http://www.bamc.amedd.army.mil accessed 8 Apr 14.
71
http://www.wtc.army.mil/index.html and http://www.woundedwarriorregiment.org accessed 8 Apr 14.
72
http://www.army.mod.uk/welfare-support/23864.aspx accessed 8 Apr 14.
16. 11
all adults will experience at least one episode of depression during their lifetime.”73
The 2013 Armed
Forces Covenant Report identified that, “ the prevalence of PTSD is around 4% within UK Service
personnel, which is broadly similar to its prevalence in the general population in England.”74
A more
recent report by the Kings Centre for Military Health Research (KCMHR) did, however, identify that
rates of PTSD among troops involved in direct combat are higher, at around 7%.75
It also highlighted
that, “rates of PTSD remain significantly lower for UK troops compared to their US peers, where
recent studies have reported rates of PTSD range from 21% to 29%.”76
In the UK, there has been a
12% increase over the past year of individuals presenting to Combat Stress, the UK’s veterans’
mental health charity. 77
Combat Stress also note that, “eight years ago our average age veteran
was 60 years old Today it is 42 years old and falling.”78
There is a strong link between PTSD and
suicide, and between those who have experienced significant trauma, either before military service
such as bereavement or physical/sexual abuse, or during service such as being wounded in action.
This is a problem in the US especially, where one active duty service member takes their own life
almost every day, and on average 22 veterans, generally between 50 and 59 years old, commit
suicide daily.79
Broadly, one in five Americans who commit suicide was or is in the service.80
Whilst the mental health of armed forces and veterans is an issue which must be addressed,
it can also be misrepresented and misunderstood by the general public – as evidenced by the 90
percent statistic of the UK population who viewed Service leavers as having, “some kind of physical,
emotional or mental health problem” in Lord Ashcroft’s 2012 Review.81
In the US, the VA has
increased the spending on mental health by 57 percent since 2009, there have been two DoD-VA
Suicide Prevention Conferences (2010 and 2012), and in 2013 the White House hosted a Veterans
and Military Families Mental Health conference following up on the President’s 2012 Executive
Order to improve access to mental health services.82
Numerous excellent websites, advice lines and
resilience training have been introduced targeting Service members, their families and friends.83
The
UK is learning and sharing lessons and approaches, considering the introduction of routine mental
health screening for active duty personnel, funding and developing The Big White Wall,84
running
mental health summits and sponsoring specific academic research, such as the KCMHR and
Academic Centre for Defence Mental Health.85
It has opened a Joint Stress and Resilience Centre
at the Defence Academy in Shrivenham,86
and is aiming to trial through-career resilience
programmes as part of the New Employment Model.
The most seriously wounded and injured cohort could be considered to be a high-risk
population for PTSD or even suicide, and whilst a number of them may have contemplated suicide
when they initially realise the extent of their injuries, the opportunities open for them to regain an
active and stimulating life can ultimately mitigate their trauma. Nietzsche stated, “that which does
not kill us makes us stronger,” which could arguably be the strapline for an evolving concept known
as Post-Traumatic Growth (PTG).87
A PTG Index has been created to attempt to measure a
traumatised individuals’ mental state over time, and includes factors such as: relating to others; new
73
Department of Health. No Health Without Mental Health, p8.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213761/dh_124058.pdf accessed 8 Apr 14.
74
https://www.gov.uk/government/publications/armed-forces-covenant-annual-report accessed 31 Mar 14, p25.
75
Diedre McManus et al. The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity, dated 27 Feb
14,
http://www.kcl.ac.uk/iop/news/records/2014/February/UK-troops-mentally-resilient-and-faring-better-than-US-peers.aspx accessed 8 Apr
14, p3.
76
Ibid, p4.
77
Combat Stress Annual Review 2013, p4. http://www.combatstress.org.uk/media/132771/cs_1035_annualreview_aw_low-res_-
_for_web.pdf accessed 8 Apr 14.
78
Idem.
79
http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf accessed 10 Apr 14.
80
Boston Globe, Researchers Track Users’ Postings in a Bid to Cut Death Rate Among the Military. 22 Jul 13, pB5.
81
http://lordashcroftpolls.com/2012/05/the-armed-forces-society/ , p15, accessed 2 Apr 14.
82
http://www.whitehouse.gov/blog/2013/07/12/veterans-and-military-family-mental-health-conference and http://www.whitehouse.gov/the-
press-office/2012/08/31/fact-sheet-president-obama-signs-executive-order-improve-access-mental-h accessed 10 Apr 14.
83
http://www.defense.gov/home/features/2012/0812_suicide-prevention/, http://www.ptsd.va.gov/public/problems/ptsd-suicide.asp,
http://www.cstsonline.org/courage-to-care-suicide-facts-for-families/, http://www.defense.gov/news/newsarticle.aspx?id=118006 and
http://www.defense.gov/news/newsarticle.aspx?id=117947 accessed 10 Apr 14.
84
https://www.bigwhitewall.com/landing-pages/default.aspx?ReturnUrl=%2f accessed 1 Apr 14.
85
http://www.kcl.ac.uk/kcmhr/pubdb/ accessed 30 Mar 14.
86
http://www.da.mod.uk/colleges/cmt/the-stress-management-training-centre-smtc accessed 10 Apr 14.
87
http://www.posttraumaticgrowth.com/what-is-ptg/ accessed 10 Apr 14.
17. 12
possibilities; personal strength; spiritual change; and a deeper appreciation of life.88
This theory of
PTG, when combined with Maslow’s hierarchy of needs (physiological, safety, social, esteem, self-
actualisation),89
and possibly Kubler-Ross’s five stages of grief (denial, anger, bargaining,
depression, acceptance),90
may go some way to understanding the motivation of seriously wounded
and injured individuals who drive themselves to achieve much more than they did prior to their
trauma. Rather than be defined by their injuries, their self-identity (self-actualisation) becomes about
what they can achieve, not what they can’t. In recent years, British wounded, injured and sick
Servicemen and women have walked to the North and South Poles, attempted to climb Everest,
rowed across the Atlantic, competed in the summer and winter Paralympics, run 100 marathons in
two years, raced in the Dakar Rally, competed Ironman triathlons, and cycle-raced across America.
It is important, however, to consider whether individuals will still feel the same about their PTG in
twenty or thirty years as other parts of their bodies begin to fail as a result of compensating for their
original injury.
As far back as the Second World War, sport and challenge has been a vital component of
the recovery of military wounded, injured and sick (WIS), giving them hope and a focus of returning
to an active life in their ‘new normal’. Sir Ludwig Guttman’s use of competitive archery for spinally
injured veterans at Stoke Mandeville hospital, coincident with the 1948 London Olympic Games, is
generally seen as the birth of the global Paralympic movement. 91
In more recent times, on 28th
July
2008, the UK MoD launched Battle Back, which provided the first formal programme of sport and
adventurous training opportunities for contemporary WIS. This has subsequently developed from its
initial cell based in Headley Court, which focused on active duty personnel only, to staff at the
Personnel Recovery Centres and the rightful inclusion of veterans under the Help for Heroes’ Battle
Back (Phoenix) programme.92
This latter programme supports on average 1800 WIS per annum,
allowing them to participate in over fifty different adaptive activities and events. The Royal British
Legion have dedicated £27 million to the creation of a Defence Adaptive Sport and Adventurous
Training Centre in Lilleshall, which runs five-day programmes for active duty WIS as part of their
Individual Recovery Pathway aiming to promote confidence, resilience and wellbeing through the
medium of adaptive activities.93
In 2010, the US Olympic Committee and the US Department of Defense instigated the
Warrior Games in order to provide an opportunity for injured Service personnel and veterans to
compete for their single Services in seven Paralympic-style events.94
This is designed to act as a
‘feeder’ to the national Paralympic squad for the very talented, similar to the Paralympic Talent
Identification events organised in the UK by the English Institute of Sport and Battle Back, or merely
as a means to encourage individuals to remain active when they return to their local communities.
Under the aegis of the President and Prime Minister’s Taskforce, a team of active duty personnel
and veterans from the UK has been invited to compete for the past two years, which last year
inspired Prince Harry to initiate the Invictus Games due to be held in September 2014, a 14-nation
sporting competition for military WIS, using the infrastructure of the 2012 London Olympics and
Paralympics.95
Transition and Employment
In September 2012, Lord Ashcroft was appointed as the Prime Minister’s Special
Representative for Veterans’ Transition. His highly acclaimed 200-page report was published on
11th
February 2014 after consultation with hundreds of individuals from academia, the Armed
Forces, the third sector, government and industry.96
It made 62 recommendations covering:
education and training; resettlement and employment; housing; health; welfare and the third sector;
88
Ibid.
89
http://www.simplypsychology.org/maslow.html accessed 11 Apr 14.
90
http://en.wikipedia.org/wiki/Kübler-Ross_model accessed 9 May 14.
91
http://paralympics.org.uk/games/ludwig-guttmann accessed 8 Apr 14.
92
http://www.army.mod.uk/welfare-support/23692.aspx and https://www.gov.uk/the-battle-back-programme accessed 8 Apr 14.
93
http://www.britishlegion.org.uk/can-we-help/military-recovery/battle-back-centre-lilleshall accessed 8 Apr 14.
94
http://www.teamusa.org/US-Paralympics/Military/Warrior-Games-presented-by-Deloitte/About accessed 11 Apr 14.
95
http://invictusgames.org accessed 11 Apr 14.
96
Lord Ashcroft’s Veterans’ Transition Review can be downloaded from: http://www.veteranstransition.co.uk accessed 14 Apr 14.
18. 13
financial aspects of transition; the Armed Forces Covenant and veterans’ advocacy; information
provision; and reservists. Speaking at the launch of the Review, Lord Ashcroft stated:
the Armed Forces are perhaps the biggest and best training and apprenticeship scheme
we have, and a remarkable engine of social mobility. Not surprisingly, most of those leaving
the Forces go on to do well in civilian life Nevertheless, some do struggle with transition or
find it harder than they should to achieve their full potential in the civilian world.97
On average, 20,000 people leave the Regular UK Armed Forces every year. The majority of
these who have served over four years utilise the Career Transition Partnership (CTP). A subset of
this designed specifically for WIS who may have more challenging employment needs, the
Recovery Career Services, was launched in January 2013.98
The Armed Forces Corporate
Covenant, launched in June 2013, formalises the support of over 100 private sector signatories,
some of which offer specific veteran initiatives, such as Barclays’ AFTER programme99
and
Deloitte’s Military Transition and Talent programme.100
A significant number of existing and new
charities exist to enhance the transition support on offer, although their interpretation of the scale of
the issue is variable. For instance, SSAFA state, “Employment outcomes are good: the vast majority
– around 85% – of Service leavers who use the Career Transition Partnership are employed within
six months of leaving the Armed Forces.”101
Alternatively, another charity believes that, “On leaving
the armed forces one hundred per cent of personnel are made unemployed. After one year the
figure of unemployed Service leavers remains as high as 70 per cent.”102
The former assessment is
more accurate, but it does highlight how facts can be misinterpreted by well meaning organisations
with a resultant skewing of public perception.
In the US, the Joining Forces Initiative, launched in May 2011, shone a national spotlight
onto the absolute utility of veterans and their spouses to employers, and on the nation’s
responsibility towards them. “Let’s make sure no veteran has to fight for a job at home after they
fight for our nation overseas,” was a key strapline.103
The recent article for their third anniversary
highlighted just how much has been achieved by working with partners from the VA, the USO, US
Chamber of Commerce, TAPS and others.104
On average, 200,000 US Service personnel leave
each year, and around the same time as Joining Forces was launched, the US Chamber of
Commerce initiated the Hiring Our Heroes campaign.105
Using their national network of some 4,000
local chambers, and a very sophisticated analysis of which areas of the country continued to grow in
which sector, despite the global financial crisis – known as Fast Track –106
they have conducted
over 700 job fairs across the country, matching Service leavers, spouses and veterans with
prospective employers. Working with their own network of circa two-and-a-half million businesses,
the Department of Labor, Joining Forces, Syracuse University Institute for Veterans and Military
Families (IVMF) and many others, they have helped to shape the American employment landscape
for the benefit of veterans and spouses. It also helps that Congress has legislated tax credits of
$9,600 for employers who hire a disabled veteran. As a result, not only do they get an individual
who has been through one of the best training organisations in the world, but they are also paid for
doing so.107
Equally, disabled veterans can receive positive discrimination, known as Veterans’
Preference, when applying for jobs in the federal government.108
There are a myriad of private sector initiatives that have been set up in recent years in the
US to aid veterans’ employment. Walmart have made a commitment to hire 100,000 veterans by
97
http://www.veteranstransition.co.uk/pressrelease.pdf accessed 14 Apr 14.
98
https://www.recoverycareerservices.org.uk accessed 14 Apr 14.
99
Armed Forces Transition, Employment and Resettlement (AFTER) programme, launched in 2010.
http://www.newsroom.barclays.com/Press-releases/Barclays-signals-commitment-to-Armed-Forces-aa5.aspx accessed 14 Apr 14.
100
http://www.deloitte.com/view/en_GB/uk/about/6e902857a2b24410VgnVCM1000003256f70aRCRD.htm accessed 14 Apr 14.
101
http://www.ssafa.org.uk/news/2014/02/11/veterans-transition-review/ accessed 8 Apr 14.
102
http://www.hireaherouk.org/support-us/corporate-partners accessed 8 Apr 14.
103
http://www.whitehouse.gov/joiningforces accessed 14 Apr 14.
104
Published on 11 Apr 14 at: http://www.whitehouse.gov/blog/2014/04/11/joining-forces-third-anniversary accessed 14 Apr 14.
105
http://www.hiringourheroes.org accessed 14 Apr 14.
106
http://www.hiringourheroes.org/fasttrack accessed 14 Apr 14.
107
http://www.huffingtonpost.com/mark-steber/hiring-veterans-tax-credit_b_3743225.html accessed 14 Apr 14.
108
http://vaforvets.va.gov/hr/Pages/Federal-Hiring-Process.aspx accessed 14 Apr 14.
19. 14
2018;109
General Electric leads twenty other companies in the Get Skills to Work Coalition which
aims to train 100,000 veterans for advanced manufacturing jobs by 2015;110
JP Morgan Chase
leads over 140 other companies in a 100,000 Jobs Mission which champions best practices on
recruiting and employing veterans and this has lead to the hiring of over 117,000 since 2011;111
Monster.com, a global online employment company combined forces with Military.com, a 10 million
member organisation, aiming to, “accelerate growth and change the playing field for career and
educational opportunities for Service members, veterans and military spouses”;112
In June 2013, the
Clear Channel media company, the largest in the US, dedicated $75 million to raise awareness and
support of veterans’ employment issues. Known as ‘Show Your Stripes’, it utilises its national reach
via its 850 radio stations and the direct engagement of musical stars like Elton John, Kelly Clarkson
and Michael Buble, to reach the homes and cars of some 243 million monthly listeners;113
IVMF run
a number of educational and entrepreneurship courses for Service leavers, and partner with Hiring
Our Heroes and Hire Heroes USA114
to run VetNet115
- a free, online resource which includes
networking tools, career training, job opportunities and entrepreneurship classes. It also conducts
targeted and actionable research to aid veterans, employers and policy-makers in their decision-
making.116
In the UK, nascent initiatives such as the Defence Growth Partnership (DGP)117
and
Barclays’ putative Veterans Employment and Transition Support (VETS) Charter118
are encouraging
signs that elements of the private sector are proactively addressing closer relationships between the
public, private and third sectors. Whilst DGP doesn’t appear to have a specific ‘veterans’
employment’ aspect to it at the moment, there is significant potential for the UK Defence industry to
emulate some of General Electric’s Get Skills to Work Coalition and possibly leverage existing
relationships with their partners in the US defense industry to refine their approach. Barclays VETS
scheme could equally take ideas from JP Morgan’s Jobs Mission, Monster.com’s online initiative
and IVMF’s various educational schemes as it attempts to form a ‘coalition of the willing’ across the
private and third sector in support of the Armed Forces Covenants.
Undoubtedly, the best advocates of veteran employment are business leaders themselves.
Most, if not all, of the aforementioned private sector initiatives have Chief Executive or other Board
level champions to lead, inspire and drive the veteran initiatives and ensure intent is turned into
deliverable action. The depth of analysis and research in the programmes allows a sophisticated
understanding of both current and future job opportunities across many sectors, and also highlights
the empirical benefits of hiring a veteran. IVMF produced a short, research-informed ‘business case
for hiring a veteran’ which listed ten definitive attributes and characteristics that veterans bring to the
workplace. These include: entrepreneurship, trust, adaptability, accustomed to challenge, resilient,
organisationally committed, leadership and team building, well trained, and experienced in cross-
cultural and diverse environments.119
These proven qualities give any employer the confidence to
know that hiring a veteran is not an act of moral charity but is a smart business decision. It has also
allowed CEOs, such as those of Lockheed Martin and General Electric respectively, to make public
comments like this:
Military veterans are an extraordinary group of people. They have already been tested under very
high pressure situations and they have demonstrated a commitment to mission, and the ability to work
on a team There is no business in America, large or small, that can’t benefit from individuals who
109
http://corporate.walmart.com/global-responsibility/veterans-military-families/careers-recruitment accessed 19 Apr 14.
110
http://www.genewscenter.com/Press-Releases/GE-MANUFACTURING-INSTITUTE-ALCOA-INC-BOEING-and-LOCKHEED-MARTIN-
LAUNCH-COALITION-TO-TRAIN-U-S-VETERANS-FOR-JOBS-IN-ADVANCED-MANUFACTURING-3bbd.aspx accessed 19 Apr 14.
111
https://www.veteranjobsmission.com/about-the-mission accessed 19 Apr 14.
112
http://www.military.com/aboutus/aboutushome.htm accessed 19 Apr 14.
113
http://www.clearchannel.com/Pages/Clear-Channel-Launches-iHeartRadio's-Show-Your-Stripes.aspx accessed 19 Apr 14.
114
https://www.hireheroesusa.org/wp-content/uploads/2014/02/HHUSA-Fact-Sheet-Jan-2014.pdf accessed 19 Apr 14.
115
http://vets.syr.edu/education/vetnet/ accessed 19 Apr 14.
116
http://vets.syr.edu/about/ accessed 24 Mar 14.
117
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/237314/bis-13-1154-defence-growth-partnership.pdf
accessed 9 May 14.
118
Conversation between the Author and Stuart Tootal of Barclays dated 22 May 14. Barclays are attempting to establish a formal
mechanism and partnership to aid and mentor Service leavers to maximise their civilian employment prospects.
119
Available at http://vets.syr.edu/ivmf-9/ accessed 24 Mar 14.
20. 15
know how to work on a team and know how to be effective leaders. Bob Stevens (LM), March 2012
on CNBC.120
Veterans arrive at GE with not only translatable skills and expertise but with the intangibles and
values that we believe define our culture and determine our success Veterans believe in getting the
job done and doing it in the right way. For our veterans, globalization is not an abstract concept, or
even something to be feared; instead, they’ve experienced it first-hand. They are proud to work
together to reach a common goal, bigger than any one individual. Veterans know how to compete and
win. Jeff Immelt (GE), March 2012 on CNBC 121
Community Engagement
On 20th
June 2011, the Community Covenant was launched in the UK to complement the
Armed Forces Covenant, aiming to promote understanding and awareness of the Armed Forces
Community and encourage activities that help integrate them into local life. It allocated £30 million
over four years to fund local projects that bring together the civilian and armed forces communities,
although it is unclear what happens beyond June 2015. Almost 400 local authorities across
England, Scotland and Wales have signed the Covenant, with many councils appointing an ‘Armed
Forces Champion’ to act as a focal point for implementing the Covenant across its areas of
responsibility.122
However, many of the successes of this Covenant have been achieved by just one
part of the ‘modern trinity’ - the government or public sector.
Conversely, in the US, the third and private sector appear to have taken the lead on
improving community relations with veterans and military families. The Mission Continues is one
such example, where a non-profit organisation is supported by Goldman Sachs, Boeing and others
to identify opportunities for veterans to tackle pressing local community issues, thus allowing them
to ‘continue their service to America’.123
Team Rubicon is another, which provides an opportunity for
veterans to utilise their skills and experiences to aid first responders both in the US and abroad.124
It
taps into the sense of service and helping others that is innate in many veterans. Got Your Six is
another non-profit organisation that aims to, “bridge the civil-military divide and start a new
conversation that sees veterans and military families as leaders and civic assets.”125
It partners with
other non-profit organisations across six key pillars of veteran reintegration: jobs (Hiring Our
Heroes), health (Give an Hour), family (Blue Star Families), education (Student Veterans of
America), housing (VA) and leadership (The Mission Continues), with metricised and tangible
progress in each pillar. In conjunction with Be The Change, Inc,126
it utilises the entertainment
industry and globally known actors, such as Tom Hanks, Michael Douglas, and Sarah Jessica
Parker to drive awareness and support.127
Some of the US initiatives may be starting to appear in the UK. A recently launched charity,
Serve On, seems to be inspired by Team Rubicon and is not only employing veterans, but also
former emergency service personnel and potentially local youths looking for meaningful
opportunities.128
Whilst it may fall more naturally under the Community Covenant, it is possibly also
an example of the current UK government’s ‘Big Society’ idea, which aims to support and develop
talent, innovation and enterprise to deliver positive social impact.129
The model of using veterans to
lead community projects or coherently assist disaster response efforts – to continue to serve – is yet
to really gain traction in the UK. If the UK were to take some of the aforementioned US approaches
to using media organisations, philanthropic companies and charities, it would generate the potential
to further develop the reach and impacts of both the Corporate and Community Covenants.
Leveraging existing relationships with the entertainment industry to utilise events such as The Sun’s
120
http://www.lockheedmartin.co.uk/us/news/press-releases/2012/march/hiring-heroes.html accessed 19 Apr 14.
121
http://www.cnbc.com/id/46839121 accessed 19 Apr 14.
122
https://www.gov.uk/government/policies/fulfilling-the-commitments-of-the-armed-forces-covenant/supporting-pages/armed-forces-
community-covenant accessed 14 Apr 14.
123
https://www.missioncontinues.org/about/ accessed 19 Apr 14.
124
http://teamrubiconusa.org accessed 22 Apr 14.
125
http://www.gotyour6.org/about/history/ accessed 19 Apr 14.
126
http://www.bethechangeinc.org accessed 19 Apr 14.
127
See the 2013 Official Celebrity Public Service Announcement at: http://www.gotyour6.org/media/ accessed 19 Apr 14.
128
http://www.serveon.org.uk and http://www.thesun.co.uk/sol/homepage/features/5560064/serve-on.html accessed 22 Apr 14.
129
http://www.thebigsociety.co.uk/about-us/ accessed 22 Apr 14.
21. 16
Annual Military Awards (a.k.a. the Millies) or high profile stars such as David Beckham or James
Blunt, could aid the evolution of the national narrative and radically develop society’s relationship
with the armed forces community.
22. 17
CONCLUSION AND RECOMMENDATIONS
The aim of this paper was to identify UK/US best practices and propose measures to
improve the balance of Clausewitz’s trinity at a time when societal, and possibly public sector,
support and understanding of the Armed Forces Community is declining. The Armed Forces
Covenant is fundamental to this, but even across the community it is designed to help, it is not
particularly well understood.130
There is no shortage of good intentions, but unless they are routinely
driven, propounded and analysed by senior leaders, in close conjunction with the private and third
sectors, they will struggle to deliver the coherent effect that is intended. There remains a great deal
that can be learned between the UK and the US. A closer relationship in the area of Service
personnel, veterans and their families could easily reinforce the wider Special Relationship and
benefit in other, non-military, areas which are important to the national leadership, such as
international trade and prosperity.
Lord Ashcroft and the Covenant Reference Group have made similar recommendations to
some of those laid out below, which have been grouped in accordance with the shared issues and
best practice section of this paper. Before considering these recommendations it may be worth
reiterating the first two maxims proposed in the Introduction:
Just because a policy exists on paper one cannot assume that it is being implemented well on
the ground, therefore, accurate metrics are essential to properly understand whether the
intended effect is being achieved;
Leadership and passion count. At the national level, at the departmental level and at board level,
policies and initiatives work best when they are actively and regularly driven by senior leaders;
Key Recommendation
The one key recommendation of this paper is the creation of a dedicated and accountable
Veterans’ Champion, operating under the Prime Minister’s authority, whose sole focus is to
cohere and balance the ‘modern trinity’ of relevant government departments, charities and the
private sector. This appointment must be reinforced by a small staff, possibly outside of
government to remain apolitical, who support, but are not subordinate to, the Cabinet’s Armed
Forces Covenant sub-committee and the work being conducted by Lord Ashcroft in this area.
This team could be created for an initial period of between three and five years in order to prove
its utility, focussing initially on purely veterans’ issues but accepting that over time it should
evolve to cover the wider Armed Forces Community, including families. One significant corollary
to this construct will be the positive effect it will have on generating wider support and
understanding of British Reservists, who are increasingly vital to the overall delivery of Defence
outputs. This office should be configured as follows:
130
As evidenced by CDS’s recent missive to the Armed Forces. See: http://www.aff.org.uk/linkedfiles/aff/20140314-
armed_forces_covenant_and_you-u.pdf accessed 21 Apr 14.
Veterans'
Champion
Policy Coherence
Health and
Wellbeing
Transition and
Employment
Community
Engagement
Strategic
Communication
Deputy /
Executive Officer
23. 18
National Leadership
Launch a proactive and enduring media campaign to amend the national narrative from one of
sympathy to a better understanding the value of veterans in both the workplace and the
community. This should include better use of social media, in a similar fashion to General
Dempsey’s regular postings on Facebook, to draw in and engage ‘digital natives’131
both within
and outside the military.
Create an annual reporting mechanism for the UK/US Taskforce on Service Personnel,
Veterans and their Families to inform the national leadership of achievements to date and future
plans.
Consideration should be given to offering time-limited tax concessions to employers to take on
veterans, especially when Defence conducts major redundancy programmes. Consideration
should also be given to introducing a ‘veteran preference’ scheme for public sector jobs to allow
veterans to continue to serve their country.
Support to Families
The US Joining Forces Initiative has been so successful that it should be emulated in the UK.
Identification of a suitable lead will be key, and given their previous engagements in this space,
ideas should be sought from the Royal Foundation of the Duke and Duchess of Cambridge and
Prince Harry.132
Initiatives such as the Sesame Street programme should be further investigated as one of a
number means to address the increasingly disaggregated Service family population, including
those of Reservists.
Support to Wounded, Injured and Sick (WIS)
Maximise the efforts to keep WIS in the public eye to reinforce the enduring importance of the
Armed Forces Covenants. This must be done without exploiting the individual or extracting
sympathy, and should demonstrate that the efforts of the government, military and society are
appropriate and coherent. This should also robustly counter the mis-conceptions held by the
public regarding the prevalence of mental health and PTSD issues.
Optimise, in conjunction with COBSEO, the coherence of Service charities to ameliorate
‘philanthropic fratricide’ and ensure that those in need of their support are able to utilise an initial
single point of contact and have their case co-ordinated and managed professionally.
Transition and Employment
Proactively engage with the multiple trans-Atlantic companies who are already supporting US
transition and employment initiatives, and export their knowledge and support to the UK under
the Corporate Covenant.
Engage British academia to encourage the creation of a similar entity as Syracuse University’s
IVMF programme in order to support decision-making across the modern trinity.
Community Engagement
131
‘Digital natives’ is an expression used to encompass people who have grown up with an intimate understanding of consumer
technology and social media. They are generally younger than ‘digital immigrants’ who were already adults when consumer technology
and social media began to proliferate.
132
http://www.royalfoundation.com/our-work/armed-forces/ accessed 21 Apr 14.
24. 19
Strengthen the public engagement with Armed Forces Day under the Communities Covenant.
This could include relevant activities in schools in conjunction with local authorities and the
Department of Education in order to ensure a better understanding of the needs of Service-
connected children, and getting CEOs and business leaders to publicise internally and
nationally, their reasons for supporting veterans and their families.
Encourage more engagement from the third and private sector to proactively support the use of
veterans and possibly reservists in community projects.
Develop and leverage contacts within the UK entertainment industry to better depict veterans on
movies and on television shows, and use celebrities to strengthen the spotlight on veterans’
issues. This could include expanding the remit of existing Forces entertainment organisations,
such as Combined Services Entertainment or the British Forces Foundation.
As over a decade of the UK and US fighting side by side draws to an end, both nations’ militaries
have to reset their relationship with society and with each other. The UK and US have so much in
common in this area, that working together on Armed Forces Community issues is an easy way to
maintain and strengthen bilateral relationships, with concomitant benefits to employers and wider
society. In order to ensure that these societies recognise the commitment that has been made by
their Armed Forces Communities, all militaries, government, charities and the private sector must be
encouraged to work together to deliver coherent support for those affected by the conflicts, and
earlier generations of veterans.
_______________________________________
25. BIBLIOGRAPHY - 1
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