This topic area covers statistics and information relating to veterans in Hull including local strategic need and service provision.
Headlines
- The 2021 Census in England and Wales was the first to ask people if they had previously served in the UK armed forces. 4.7% of Hull’s 16+ population recorded that they were veterans – 10,079 people. Of the 331 local authorities in England and Wales, Hull has the 109th highest levels of people who recorded themselves as being veterans.
- Overall, 8.2% of 16+ aged males in Hull identified as veterans, whilst only 1.3% of 16+ aged females did so. Whilst 1.0% of aged 16 to 24 years males in Hull identified as being a veteran, this increased considerably to 21.5% for those aged 65 years and over.
- In Hull, if you are a veteran, you are more likely to live in rented accommodation whether social rented accommodation (owned by the local authority or another body) or privately owned, than compared with the Yorkshire and the Humber region and England averages.
- Veterans below the age of 65 are more likely to be economically active than compared to non-veterans.
- In 2022, there were 3,740 people and their dependents recorded as veterans on the clinical systems of Hull’s GPs – this would appear to be significant under-recording.
- In a national survey across Great Britain, self-reported health (excellent to very poor) was similar for veterans and non-veterans, but more veterans reported a health problem lasting or expected to more than 12 months than non-veterans for both those aged 16-64 and 65+ years. Among those aged 16-64 years, compared to non-veterans, veterans were more likely to have long-term health problems with their arms or hands, legs or feet, and back or neck, and among those aged 65+ years, veterans were more likely to have long-term health problems that were related to difficulty seeing and hearing compared to non-veterans. Veterans were also more likely to have ever smoked, and whilst they were equally likely to be employed than non-veterans they were less likely to have management roles and more likely to be process, plant or machine operatives. Veterans were also less likely to have a degree.
- A survey conducted across Hull in 2017 identified mental health, employment / employability, and housing as priorities for Hull’s veterans and their families. This was reinforced by a further survey in 2022.
- A local survey was conducted in 2009 with veterans, and whilst the 53 veterans who participated were not necessarily representative of all veterans living in Hull, they did provide some insight into veteran health and wellbeing, and the issues some veterans faced. The majority had problems with mental health or emotional wellbeing, two-thirds had physical health problems, and one in six stated they smoked too much, drank too much, or ate unhealthily to help them deal with stress. The majority felt their mental and physical health, and lifestyle behaviours were related to their service. Compared to similarly-aged residents (participating in Hull’s general adult Health and Wellbeing Survey also conducted in 2009), veterans had much poorer general health and emotional wellbeing, but similar prevalence of 5-A-DAY and alcohol (although 17% of veterans stated that a relative or friend, doctor or health professional had been concerned about their drinking or suggested they cut down), fewer veterans smoked, and a higher percentages fulfilled the then national guidelines for physical activity. Sixteen of these 53 veterans also provided more information as they participated in in-depth interviews.
The Population Affected – Why Is It Important?
A veteran is defined as anyone who has served for at least one day in Her Majesty’s Armed Forces (Regular or Reserve) or Merchant Mariners who have seen duty on legally defined military operations. A service leaver is a term for someone who is in transition from or has ceased to be a member of HM Armed Forces. The term service leaver is typically used in legal documents, as understanding and use of the term veteran does vary, and not least among those who have served. Many former Armed Forces personnel in the UK do not define themselves as a veteran.
The Armed Forces Act 2021 introduced a new requirement for some public bodies, local authorities, and the NHS, to pay due regard to the principles of the Armed Forces Covenant when carrying out specific public functions in the areas of housing, healthcare and education. This came into force on 22 November 2022. The new legislation aims to prevent service personnel, veterans and their families from being disadvantaged when accessing essential services.
Some veterans have specialist health care needs, and this could be either in relation to physical health care needs, or mental health care needs, or both.
Medical services are delivered to servicemen and women by the Ministry of Defence, the NHS, charities and welfare organisations, and all serving personnel receive their mental health care through the Ministry of Defence commissioned services. Everyone leaving the Armed Forces is given a summary of their medical records, which they are advised to give to their new NHS doctor when they register with them. Veterans should be flagged with their GP as veterans within their NHS medical notes to help to ensure that they are able to access dedicated services for those who have served in the UK. A rigorous handover process – known as the Seriously Injured Leavers Protocol – is in place for veterans with any condition that may have been caused during service. The veterans personalised care programme is also in place for anyone who has a complex and lifelong health condition. Veterans can access all NHS services, including those services set up to meet the needs of veterans, like prosthetics and mental health which include treatments available to help people with the psychological consequences of exposure to traumatic events. As families and carers can be seriously impacted when their loved ones are injured, they can also be supported to access services that may help them.
The National Picture
Census 2021
The 2021 Census in England and Wales was the first to ask people if they had previously served in the UK armed forces. People aged 16 years and over were asked whether they had previously served in the regular or reserve UK armed forces, or both. People currently serving in the UK armed forces and those who had never served were both advised to tick “no”.
People who have previously served in the regular or reserve UK armed forces are often known as the veteran population and form part of the armed forces community (along with those who currently serve in the armed forces or Merchant Navy and their families). The question on UK armed forces veterans was added to better meet the needs for service providers and others who support veterans, in line with the Armed Forces Covenant.
Over three-quarters of UK armed forces veterans residing in England and Wales had previously served in the regular armed forces only (1.4 million, 76.3%), while 361,000 (19.5%) had served only in the reserve armed forces. The remaining 79,000 (4.3%) had served in both the regular and the reserve armed forces.
Of the UK armed forces veteran population in England and Wales, 98.0% (1,816,299) lived in households and 2.0% (36,813) lived in communal establishments. This is similar to the breakdown for the population as a whole; 98.3% of usual residents in England and Wales lived in households and 1.7% lived in communal establishments.
1,745,078 households in England and Wales had at least one person who had previously served in the UK armed forces in 2021 (7.0% of all households in England and Wales).
Of these households, the vast majority (almost 1.7 million households, 96.0% of all households with at least one veteran) included only one veteran, 68,000 (3.9%) included two veterans, and the remaining 2,000 (0.1%) included three or more veterans.
The proportion of UK armed forces veterans was higher in Wales (4.5% of the population aged 16 years and over, 115,000) than it was in England (3.8%, 1.7 million).
Of the UK armed forces veterans population in the two countries, there were similar proportions of those who had served in the regular forces only (76.3% in Wales, 76.3% in England), the reserve forces only (19.3% in Wales, 19.5% in England), and both the regular and reserve forces (4.5% in Wales, 4.3% in England).
Within England, the regions with the highest proportion of veterans were the South West (5.6%, 265,000 people) and the North East (5.0%, 109,000 people). These were also the regions that had the highest percentage of households with at least one veteran (10.1%, 247,000 households in the South West; 8.8%, 104,000 households in the North East).
By contrast, London had both the lowest proportion of UK armed forces veterans (1.4%, 101,000 people) and the lowest proportion of households with at least one veteran (2.8%, 96,000 households).
The Hull Picture
Census 2021
Across England and Wales, the local authorities with the highest proportion of veterans include Gosport (12.5%), North Kesteven (10.2%) and Richmondshire (9.5%). The local authorities with the highest proportion of households with at least one veteran were very similar; Gosport (21.2%) and North Kesteven (17.8%) were first and second, and Fareham was third (16.7%).
4.7% of Hull’s 16+ population recorded that they were veterans – 10,079 people. This compares to 4.2% of the Yorkshire and Humber 16+ population and 3.8% of the 16+ population of England and Wales. Of the 331 local authorities in England and Wales, Hull has the 109th highest levels of people who recorded themselves as being veterans. This places in in the top third of local authorities in England and Wales.
The 2021 Census asked people whether they had served in the regular or reserved services, or both. In Hull 3.4% of the 16+ population stated that they had served in the regular forces (7,347 people), 1.0% in the reserve forces (2,189 people), and 0.3% had served in both (543 people). All these percentages are greater than both the Yorkshire and Humber figures, as well as the England and Wales figures.
Whilst overall 4.7% of Hull’s 16+ population recorded that they were veterans, there is considerable difference with regards to gender and age. Overall 8.2% of 16+ males in Hull identified as veterans, whilst only 1.3% of 16+ females did so. There is considerable difference in the percentage of veterans when divided by age category. Whilst 1.0% of aged 16 to 24 years males in Hull identified as being a veteran, this increased considerably to 21.5% for those aged 65 years and over. To a lesser extent this larger figure will be due to military service during World War II, although the greater reason is likely due to National Service which saw males who were born before 1 October 1939 being liable for two years military service, being called up at some point between the ages of 17 and 21 years of age. The last of the National Service men left the military as recently as May 1963. And another reason will be the decrease in the size of the British military in recent history a fewer people joining. In 1964 (the year after National Service ended) there were 417,000 personnel in the British military – by 2022 this had decreased to 148,000 personnel.
| Age Group | Hull Observation (Persons) | Hull % | Yorkshire and the Humber % | England % |
| Aged 16 to 24 years | 227 | 0.7% | 0.6% | 0.5% |
| Aged 25 to 34 years | 798 | 1.9% | 1.6% | 1.2% |
| Aged 35 to 49 years | 1,700 | 3.3% | 2.6% | 2.2% |
| Aged 50 to 64 years | 2,702 | 5.5% | 4.5% | 4.1% |
| Aged 65 years and over | 4,655 | 11.4% | 9.1% | 8.9% |
It is to be expected that as Hull has a larger percentage of veterans who are usually resident here than compared to the Yorkshire and the Humber region and to England as a whole the percentage of household in which a veteran lives is also higher in Hull. Whilst 8.0% of Hull households have 1 person who is a veteran, this is 7.2% in the region and 6.7% in England. There is little difference in those households with two or more veterans, with Hull, the region and England all recording 0.3%.
| Hull Observation (Households) | Hull % | Yorkshire and the Humber % | England % | |
| 1 person in the household previously served in UK armed forces | 9,253 | 8.0% | 7.2% | 6.7% |
| 2 or more people in the household previously served in UK armed forces | 318 | 0.3% | 0.3% | 0.3% |
| No people in the household previously served in UK armed forces | 105,901 | 91.7% | 92.5% | 93.0% |
In Hull, if you are a veteran, you are more likely to live in rented accommodation whether social rented accommodation (owned by the local authority or another body) or privately owned, than compared with the Yorkshire and the Humber region and England averages, and therefore less likely to live in your own home which you either own outright or have a loan/mortgage and share ownership with someone else.
In Hull, those who are not veterans are more likely to be economically active than those who are not veterans.
Broken down by age, it is only in the aged 65 years and over age group that it is more likely non-veterans are economically active compared to veterans. Otherwise, in all the age groups below that, it is more likely that a veteran will be economically active.
| Age Group | Economically active: In employment (including full-time students) | Economically active: Unemployed (including full-time students) | Economically inactive | |
| Veterans | Aged 16 to 24 years | 69.0% (156) | 7.1% (16) | 23.9% (54) |
| Aged 25 to 34 years | 81.6% (653) | 4.9% (39) | 13.5% (108) | |
| Aged 35 to 49 years | 82.5% (1,403) | 4.3% (73) | 13.2% (224) | |
| Aged 50 to 64 years | 71.0% (1,918) | 3.4% (92) | 25.6% (692) | |
| Aged 65 years and over | 7.4% (343) | 0.5% (22) | 92.2% (4,288) | |
| Non- Veterans | Aged 16 to 24 years | 44.6% (14,091) | 10.6% (3,344) | 44.8% (14,144) |
| Aged 25 to 34 years | 73.3% (29,511) | 6.1% (2,456) | 20.6% (8,274) | |
| Aged 35 to 49 years | 74.1% (36,382) | 4.8% (2,344) | 21.1% (10,387) | |
| Aged 50 to 64 years | 64.5% (30,109) | 4.0% (1,865) | 31.5% (14,718) | |
| Aged 65 years and over | 8.9% (3,221) | 0.3% (117) | 90.8% (32,833) |
Other Estimates of the Number of Veterans
In the Annual Population Survey 2017, it was estimated that there were 2.4 million UK Armed Forces veterans in Great Britain making up an estimated 4.7% of household residents aged 16+ years. With the Second World War and subsequent National Service which ended in 1960 with the last National Servicemen released from the Armed Forces in 1963, and as white males have continued to be more likely to join the UK Armed Forces since then, it is not surprising that veterans are predominantly white (99%), male (89%) and/or aged 65+ years (60%). It is estimated that 8.5% of men and 1.0% of women are veterans, and it is estimated that 5.3% of the White and 0.5% of the Black, Asian and Minority Ethnic group population are veterans.
| Age | Estimated number of veterans in GB (thousands) | Percentage of veterans |
| 16-19 | 3 | 0.1 |
| 20-24 | 19 | 0.5 |
| 25-29 | 48 | 1.1 |
| 30-34 | 57 | 1.3 |
| 35-39 | 70 | 1.7 |
| 40-44 | 82 | 2.1 |
| 45-49 | 144 | 3.3 |
| 50-54 | 170 | 3.8 |
| 55-59 | 192 | 4.8 |
| 60-64 | 167 | 4.8 |
| 65-69 | 160 | 4.8 |
| 70-74 | 169 | 5.7 |
| 75-79 | 289 | 13.0 |
| 80-84 | 448 | 28.9 |
| 85-89 | 258 | 30.3 |
| 90+ | 126 | 32.5 |
| Aged 16+ | 2,401 | 4.7 |
| Aged 65+ | 1,449 | 12.8 |
Estimated number of veterans and percentage of veterans in GB, 2017
There was some further information on geography, with an estimated 2,041,000 veterans aged 16+ years living in England (4.6%), and 218,000 living in Yorkshire and Humber (5.0%). Among those aged 16-64 years, it was estimated that there were 93,000 veterans in Yorkshire and Humber representing 2.8% and 125,000 veterans aged 65+ years living in the Yorkshire and Humber region representing 12.9%. The information was also presented for counties for those aged 16+ years, and it was estimated that there were 34,000 veterans living in East Riding of Yorkshire (6.9%), 59,000 living in South Yorkshire (5.3%) and 69,000 living in West Yorkshire (3.8%).
In 2020, it is estimate that Hull has 206,892 residents aged 16+ years, and if 4.6% (prevalence estimate for England) were veterans this would equate to approximately 9,500 veterans living in Hull.
A more detailed estimate could take into account the estimated prevalence for Great Britain by age, and apply that to Hull’s population. It would also be possible to apply an adjustment to Hull’s figure adjusting upwards by 1.48 if it assumed that the prevalence in East Riding of Yorkshire is 6.89% is higher than the prevalence across Great Britain of 4.68% (6.89 divided by 4.68 gives 1.48). Using this method, it is estimated that there are around 8,800 veterans when applying the prevalence for Great Britain to Hull’s population and an estimated 13,000 veterans living in Hull when further applying the adjustment for the increased prevalence in East Riding of Yorkshire.
| Age | Veterans in GB (%) | Hull’s population 2020 | Estimated number without adjustment | Estimated number with adjustment* |
| 16-19 | 0.1 | 11,603 | 14 | 21 |
| 20-24 | 0.5 | 20,135 | 92 | 136 |
| 25-29 | 1.1 | 21,262 | 231 | 342 |
| 30-34 | 1.3 | 20,807 | 277 | 410 |
| 35-39 | 1.7 | 17,435 | 296 | 438 |
| 40-44 | 2.1 | 14,408 | 305 | 451 |
| 45-49 | 3.3 | 15,441 | 504 | 745 |
| 50-54 | 3.8 | 16,049 | 609 | 900 |
| 55-59 | 4.8 | 16,364 | 782 | 1,156 |
| 60-64 | 4.8 | 13,951 | 671 | 992 |
| 65-69 | 4.8 | 11,608 | 555 | 820 |
| 70-74 | 5.7 | 10,934 | 621 | 918 |
| 75-79 | 13.0 | 6,887 | 898 | 1,328 |
| 80-84 | 28.9 | 5,405 | 1,561 | 2,309 |
| 85-89 | 30.3 | 3,114 | 944 | 1,396 |
| 90+ | 32.5 | 1,489 | 485 | 716 |
| All 16+ | 4.7 | 206,892 | 8,844 | 13,077 |
| 65+ | 12.8 | 39,437 | 5,063 | 7,486 |
Estimated number of veterans in Hull – applying national prevalence estimates to Hull’s population (*adjusting figure upwards assuming same relative increased prevalence in Hull as East Riding of Yorkshire).
Local People’s Panel Survey 2017
Hull City Council’s Business Intelligence Team undertake regular surveys – the People’s Panel – across Hull. The survey is open to people who live or work in Hull and includes a small proportion of people who live in East Riding of Yorkshire. In November 2017, a survey was undertaken examining the Armed Forces Covenant. The People’s Panel are members of the general public, and not specifically in the Armed Forces, but the survey was extended in November 2017 to include North Lincolnshire and North East Lincolnshire and partners targeted Armed Forces organisations to obtain information from veterans. In Hull, responses were obtained from 1,209 Hull residents of which 2.2% currently served in the Armed Forces, 16.7% previously serviced in the Armed Forces and 81.1% had never served in the Armed Forces. Overall, 7.9% of responders living in Hull had one (or more) current member of the household or close family serving in the Armed Forces or cared for someone who was currently serving, 31.8% had a member of the household or close family who had previously served in the Armed Forces or cared for someone who had previously served in the Armed Forces, and 60.4% stated that there were no members of the household or their close family or people that they cared for who were current or previous members of the Armed Forces.
Veteran’s Registered with Local General Practices
A total of 3,740 people and their dependents were registered as veterans on the GP clinical system in Hull for Hull’s Clinical Commissioning Group in 2022 (2,003 men and 1,737 women). For each age group except those aged 71+ years, there were more men than women, and the largest numbers occurred in the older age groups in particular among those aged 51-60 years. Given the results of the 2021 Census, these figures would appear to show that significant numbers of veterans are not recorded as such on Hull GPs’ systems and the numbers are far higher than this.
Health of Veterans
National Survey 2017
Across Great Britain, in the Annual Population Survey 2017, there was no difference between the self-reported health (very good, good, fair, bad or very bad) of veterans or non-veterans among those aged 16+ years and those aged 65+ years, but there was a significant difference in the percentage reporting a health problem lasting or expected to last more than 12 months among those aged 16-64 years (40% in veterans and 36% in non-veterans) and among those aged 65+ years (71% in veterans and 65% in non-veterans). Among those aged 16-64 years, veterans were statistically significantly more likely compared to non-veterans to have long-term health problems with their arms or hands (22% versus 17%), legs or feet (33% versus 25%) and back or neck (30% versus 23%). Among those aged 65+ years, veterans were statistically significantly more likely compared to non-veterans to have long-term health problems that were related to difficulty in seeing (11% versus 7%) and difficulty in hearing (23% versus 16%).
In the same national survey, veterans were more likely to have ever smoked with 55% having done so compared to 44% of non-veterans among those aged 18-64 years and this was also the case among those aged 65+ years (66% versus 56%). This was also the case for males (56% versus 45%) and females (51% versus 39%) with veterans more likely to state they had previously smoked than non-veterans.
There was no difference between employment in the 2017 survey with identical percentages employed (79%), unemployed (3%) and inactive (18%) for veterans and non-veterans among those aged 16-64 years, although veterans tended to have fewer management roles. Among those aged 16-64 years, fewer veterans were managers or senior officials compared to non-veterans (12% versus 15%), had professional occupations (15% versus 21%), although more veterans had associate professional and technical occupations (19% versus 14%) and were process, plant and machine operatives (15% versus 10%). There were statistically significant differences between these four occupations, but there was no differences for administrative and secretarial (6%), skilled trade occupations (16%), personal service occupations (5%), sales and customer service occupations (4%) and elementary occupations (9%) where the percentages were identical between veterans and non-veterans. Among those aged 16-64 years, fewer veterans had a degree or equivalent (21% versus 30%).
Local People’s Panel and Armed Forces Covenant 2022 Surveys
As mentioned above, the People’s Panel in November 2017 included questions on the Armed Forces Covenant. As well as the 1,209 responses from members of the general public in Hull, there were a further 185 general public responses from people who lived in East Riding of Yorkshire, and 114 and 31 responses from people living in North East Lincolnshire and North Lincolnshire respectively of whom the majority were currently serving or had previous served in the Armed Forces (57.0% and 74.2% respectively). In September 2022 a further survey about the Armed Forces Covenant just for Hull residents was conducted.
In the earlier survey, among the people living in Hull, 60.3% thought it most useful to focus on housing, 9.9% on adult education, 63.6% on employment (including self-employment and training), 5.6% on care (including childcare and care at home), 23.7% on money matters, benefits, etc, 28.8% on physical health and 75.7% on mental health. Among all survey responders across all four local authorities, people who currently served in the Armed Forces placed thought more focus should be placed on adult education, money matters, and physical and mental health compared to people who had never served in the Armed Forces. People who had previously served in the Armed Forces also thought that more focus should be on adult education, money matters and mental health, but additionally that focus should be on employment compared to people who had never served. Only a slightly higher percentage of people who had previously served also thought that the focus on physical health compared to those who had never been in the Armed Forces, in contrast to those who were currently serving.
In the latest survey a similar picture was seen in the areas respondents wished attention to be focused for veterans.
| Area of Focus | 2017 Survey | 2022 Survey |
| Housing | 60% | 60% |
| Adult Education | 10% | 23% |
| Employment (including self-employment and training) | 64% | 58% |
| Care (childcare, care at home etc.) | 6% | 12% |
| Money matters, benefits etc. | 24% | 42% |
| Physical health | 29% | 25% |
| Mental Health | 76% | 65% |
| Other | 1% | 0% |
Local Armed Forces Covenant Surveys: 2017 and 2022
The findings suggest that the priorities should remain the same Mental Health (65%), Housing (60%), Employment, Training and Self Employment (58%) However there was a significant increase in the number who felt Money matters, benefits etc should be an area to focus on – from 24% in 2017 to 42% in the latest survey.
Local Survey 2009
In 2009, Hull’s Veteran’s Health and Wellbeing Survey was undertaken. Veterans were defined as those who had served in and left the Armed Forces in 1970 or afterwards. The local radio stations were used to advertise the survey as well as local groups which helped veterans, and as a result it is likely that veterans with health and other problems were more likely to participate in the survey. This means that the veterans who participated in the survey are probably not representative of all veterans living in Hull. Nevertheless, the survey can examine some of the health and other issues faced by this group of veterans.
Overall, 53 veterans participated in the survey and 16 of them participated in in-depth interviews. An analysis was completed for those who completed the questionnaire and the results were compared with survey responders who participated in Hull’s adult Health and Wellbeing Survey which was also conducted during 2009.
- Only a half of Veterans (48%) knew about the ‘fast-track’ service (as it was known in 2009; a more comprehensive offering is available currently).
- Overall, 43% felt they did not have access to all the services they needed and 14% stated that they were reasons why they might not want to engage with local health services mainly as civilians did not understand (although total numbers not wanting to engage were very small). There were comments about the delays in receiving care, and a hope that this would not be ‘just another survey’.
- Just under a half stated that they had depression or anxiety and the majority (87%) of these stated that this was related to their service.
- Around one in four stated they suffered from post traumatic stress disorder (PTSD) and all thought this was related to their service.
- One-quarter had problems controlling violence with the majority (83%) of these stating it was related to their service.
- One-third had difficulty obtaining or maintaining a job and the majority (63%) of these stated that this was related to their service.
- One in six stated they smoked too much, drank too much alcohol or ate unhealthily to help deal with stress and the majority of these felt that this was related to their service.
- Two-thirds had physical health problems (but this could be associated with age for many), and 79% of these with health problems stated that they felt these problems were related to their time in the Armed Services.
- Overall, of the 51 Veterans answering these questions, 10 (20%) stated that they did not have any of the above health or lifestyle issues and 11 (22%) stated that they had “physical health problems” but none of the health or lifestyle issues.
- Similar percentages attributed these health and lifestyle issues to other people they know who used to be in the Armed Services with the exception of lifestyle issues with much higher percentage attributing these factors to others.
- All were registered with a GP and many had used local health services within the last year; 94% had seen a GP, 62% a practice nurse, 23% a community psychiatric nurse, 26% attended physiotherapy, 38% attended counselling, 31% attended a psychologist appointment, 71% attended a dental appointment, 19% had been to A&E, 53% had had an outpatient appointment, 39% a daycase appointment and 19% had been an inpatient.
- Veterans were asked if they had sought help or advice from a professional within the last year or more than a year ago with regard to the various health and lifestyle issues above. Within the last year, 61% had sought help or advice for physical health problems, 36% for depression or anxiety, 33% for PTSD, 23% for problems controlling violence, 13% for employment problems, 23% for problems with family relationships and few had sought help or advice for lifestyle issues.
- 53 completed questionnaires for post-1970 Veterans with wide age range (23 to 88) with mean age of 54 years, serving between 1-38 years (mean 16 years).
- Compared to similarly-aged local Health and Wellbeing Survey responders, much poorer general health and mental health status for Veterans, but similar prevalence for 5-A-DAY and alcohol although 17% stated that a relative or friend, or a doctor or other health professional has been concerned about their drinking or suggested they cut down. Fewer Veterans smoked and a higher percentage of Veterans exercised to national guidelines compared to the Health and Wellbeing Survey responders.
Local In-Depth Interviews 2009 Learning Points
From the 16 in-depth interviews the following learning points were noted:
Learning Point 1: Responses from veterans and professionals suggested that the survey results might not be an accurate representation of the proportion of ex-military personnel actually suffering from the physical impacts of military service due to the sample profile. Whilst there was overall recognition of the association of drinking, smoking and poor diet with the lifestyle of service personnel, this was thought to be countered to some extent by the fitness regime that existed in the services.
Learning Point 2: Alcohol (and drug) misuse was attributed throughout by veterans and professionals alike to the cultural pressures of service life and to the alleviation of stress suffered when military service was at an end. There is a need for health professionals in primary healthcare to recognise that such behaviour or symptoms may well be masking other much deeper serious problems. There is an immediate need for the development of improved education (about the long-term physical effects of heavy consumption) and accessible (prompt) counselling to assist veterans using alcohol and other substances to alleviate stress and anxiety, this should be a priority.
Learning Point 3: The impact of military service on family life was widely acknowledged. Assimilation into the family was often a problem after long absences and behavioural problems and unrealistic expectations exacerbated difficulties. There appears to be a general need for family counselling facilities and speedy access (particularly for partners) to advice and guidance at the point when difficulties arise. An information pack for families and a help-line number should be considered.
Learning Point 4: The need for resettlement advice, particularly in respect of employment and training was expressed frequently. Preparation for employment and civilian responsibility appears to be absent from the experience of most veterans. There is a need for more support for those seeking employment, advice and guidance might be encompassed within a counselling service.
Learning Point 5: These two points alone (and there are others) show that the health needs of veterans are not simply a health service provider’s problem but are instead a city wide problem, involving stakeholders in all areas of provision: education; social services; employment; counselling; support groups; etc
Learning Point 6: Publicity and education increases demand for services and can help servicemen overcome the stigma that they feel exists in revealing illness and weakness related to service. Promotional work should be sustained.
Learning Point 7: Military personnel should be encouraged (both in and after service) to address their problems quickly and there should be clear routes to support. The development of an information pack provided before discharge from the army is essential. This should also be made available through doctors’ practices for all Veterans registering for general medical services after leaving the military.
Learning Point 8: The existence of the ‘macho’ culture, and its attendant expectations of service men and women, was a major obstacle to seeking help for psychological problems. Mental illness was viewed as something that would be perceived as weakness by others. Health professionals should have further training to improve investigation of presenting symptoms and behaviours that might be treated superficially but often mask more serious underlying conditions. It is essential that those service providers seek understanding of problems not only from the veterans themselves but also from their spouses/dependents.
Learning Point 9: Psychological well-being was affected badly by a lack of forward planning and an absence of advice and guidance in respect of resettlement. Personnel leaving the service without qualifications or plans for employment were often defeated and developed feelings of guilt and inadequacy. Signposting towards possible/suitable career paths with associated, relevant further education would reduce the impact of losing a lifestyle, camaraderie and a steady income. Partnership working between health, education and other providers should be considered in order that a holistic safety net is developed.
Learning Point 10: Whilst there is a general acceptance amongst many veterans that anger and aggression develop in service personnel, there is evidence, inherent in the interviews that where education and life opportunities are available this impact is managed more effectively after discharge from the military. For many individuals with low academic and/or skills attainment and associated limited life/career opportunities, a ‘macho’ life where training for combat and institutional management, replace education and social development is likely to reinforce or exacerbate tendencies for anger and aggression that already were part of their characters. It is therefore essential that education, training and career planning for post-service lives are an integral part of military service and linked to further development in civilian situations. From a mental health perspective there should be the potential for referral to career advice, guidance and training initiatives.
Learning Point 11: Associated with the general requirement for more information about services, easy access to support and the development of understanding by staff within primary care services was the frequently identified requirement to have ex-military providing care in civilian settings. It is desirable that staff recruited to health service and health education roles, to give care and guidance to ex-service personnel, are either recruited on the basis that they have military experience and personal insight or are trained extensively to improve their understanding of the issues that impact upon veterans.
Learning Point 12: It was clear that, once accessed, there were generally good levels of satisfaction with services that existed. The main problems existed in the primary contact and referral to appropriate services, understanding of the problems faced by veterans, the information available and the links to care following discharge from the armed forces. It is essential that health and social welfare information is provided more promptly and disseminated to service personnel and veterans more effectively. Health and social service workers need improved training to give them added insight into the problems and needs of veterans. Local networks with opportunities for virtual (internet based) and face to face discussions would be a valuable resource for veterans suffering social and economic isolation.
Local Survey Reports
Further information is available within the local Veteran Health and Wellbeing Survey report. Details of the questions asked of the veterans is also available as well as the report detailing the findings of the in-depth interviews.
VeteransInterviews2009MainReport
VeteransSurvey2009Questionnaire
Strategic Need and Service Provision
Specialist dedicated services are available at a local and national level for veterans who have physical and/or mental health needs as a result of their service in the Armed Forces. Veterans who are not flagged as a veteran on the NHS medical records, should be encouraged to inform their GP that they are a veteran so that they have access to these services.
The Veterans’ Mental Health Transition, Intervention and Liaison Service (Part of Ops Courage) is a local dedicated out-patient service for service personnel approaching discharge from the Armed Forces and veterans who are experiencing mental health difficulties.
Additional support is available for veterans and their spouses from the Armed Forces Community Hub at the Octagon such as specialist employment support, money advice from the Citizen Advice Bureau (CAB) Armed Forces Project or support to complete housing applications from Hull4Heroes.
Resources
Office for Veterans’ Affairs. Veterans Factsheet 2020.
NHS. How armed forces healthcare works. www.nhs.uk
Office for National Statistics. Annual Population Survey: UK Armed Forces Veterans residing in Great Britain, 2017.
Hull’s Veteran’s Health and Wellbeing Survey 2009
Hull City Council. Support for Armed Forces personnel and veterans. https://www.hull.gov.uk/benefits-support-and-welfare-advice/welfare-advice/support-armed-forces-personnel-and-veterans
Hull Clinical Commissioning Group. Veterans’ mental health services. https://www.hullccg.nhs.uk/mental-health-and-wellbeing/veterans-mental-health-services/
UK Armed Forces Veterans: Census 2021 in England and Wales. Office for National Statistics, 2022. https://www.ons.gov.uk/releases/ukarmedforcesveteranscensus2021inenglandan
Updates
This page was last updated / checked on 24 May 2023.
This page is due to be updated / checked in August 2023.