A report into Early Service Leavers (ESLs) who were dismissed from the Armed Forces as a result of a positive Compulsory Drug Test (CDT) is the first of its kind in the UK to shed light on their experiences and outcomes.
The results were shared at The Veterans’ Mental Health Conference, held on Thursday 25th March by King’s Centre for Military Health Research (KCMHR) at King’s College London, and funded by Forces in Mind Trust (FiMT).
The Conference focused on a group of reports, also funded by FiMT, into addiction and substance misuse in the Armed Forces. The reports include a series of recommendations, particularly for the MOD and NHS, to improve support for current and former Service personnel with addiction and substance misuse issues and their families.
The report, “Fall Out”: Substance misuse and service leavers: a qualitative investigation into the impact of a Compulsory Drug Test (CDT) discharge, was led by Galahad SMS and Anglia Ruskin University.
The research states that between 600 and 770 serving personnel return a positive CDT result each year, with cocaine cited as the most commonly reported drug used. However, for the research participants there was little evidence of a clear protocol for referral onto pathways for treatment and support. Many experienced anxiety and uncertainty, and some reported harsh and humiliating treatment compounding feelings of vulnerability, isolation and shame. Very few participants received psychological, social or transition support, and two thirds perceived a decline in their mental health following discharge, whilst the majority continued using drugs and alcohol.
The report outlines some pre-Service indicators among the participants in the study such as mental health diagnoses, adverse childhood experiences and drug use prior to enrolling. Many participants saw the military as an opportunity to escape these environments and distance themselves from substance misuse.
Following the completion of the study, the MOD has confirmed that personnel discharged as a result of a CDT will now be entitled to resettlement support. Resettlement support was not available to participants of this research and it is hoped that this change in policy will better prepare CDT discharges in future for the transition into civilian life. The report also highlighted opportunities for intervening earlier to help such individuals.
All participants spoke positively of their time in service, although there were also challenging circumstances which some had struggled with including bullying, poor treatment and not fitting in, which reportedly led to substance misuse. Participants also reported barriers to support, such as the stigmatization of mental health.
The report suggests that alcohol, which was perceived to be an integral part of service life, inadvertently encouraged other forms of intoxication, which is consistent with other research which will be presented at the conference. A study on mental health and treatment needs of veterans from King’s College London’s KCMHR and Liverpool University found that personnel who served in Iraq and Afghanistan were more likely to report hazardous drinking than civilian personnel, while an additional study from the same researchers found that two thirds of serving and ex-Service personnel who self-reported an alcohol problem had not sought help.
“The army and alcohol go hand in hand. If you’re not working, you’re drinking.” – A participant in the “Fall Out” report.
Other research which will be discussed at the conference includes a study into the use of Performance and Image Enhancing Drugs (PIEDs) and research into the experiences of families of veterans with substance use issues.
Ray Lock CBE, Chief Executive of FiMT, said:
“By recruiting people with pre-service vulnerabilities, the Armed Forces, and particularly the British Army, are taking on a moral duty to ensure such vulnerabilities are managed and overcome. The offer of an escape from a life of deprivation is a key attraction in recruitment that spans centuries. It is therefore reasonable in a modern society to expect the Armed Forces to prevent in-service triggers, and to provide better access to appropriate care.”
“The group of reports which will be discussed at the conference provide an evidence base to call on the government to ensure that veterans are no worse off than non-veterans, and that there are effective services available to them. Forces in Mind Trust recommends improving awareness of mental health and substance misuse problems, ensuring access to treatment and support, a change in the conversation about alcohol in the military context and more support for families of veterans with substance misuse problems. This report adds to the recommendations that those who have been discharged with positive CDT should be appropriately supported and clearly signposted to mental health and substance support services.”
Simon Bradley from Galahad SMS said:
“That the Forces have the right to discharge personnel who are in violation of policy is not in question; none of the participants would contest this fact either, although many in the study felt themselves to have been highly proficient in their military roles and felt that they were deserving of a second chance. The issue is how the discharge process is managed to minimise further harms and ensure that it does not exacerbate underlying problems.
“Having shared preliminary findings with the MOD at various stages of the research process we hope that our work has contributed in some way to recent policy updates and approaches (as outlined in JSP100 & JSP534v19) seeking to improve and broaden access to health, well being and transition support for service leavers.”