International perspective highlights complexity of veterans' issues
CEO of Veterans Aid (left) Dr Hugh Milroy meets 97-year-old Professor Zbornik Radova, former partisan, soldier and distinguished military historian at the 30th World Veterans Federation Assembly in Belgrade, Serbia | Credit: Veterans Aid
CEO of Veterans Aid Dr Hugh Milroy's recent interactions on the international stage have caused him to reflect on both the universality and complexity of individual nations' post-service problems - and the need to take a 'bottom up' approach to resolving them.
I have been working with veterans in crisis for 28 years during which time I have been fortunate enough to have engaged with veterans and veteran support organisations around the globe. In March, at the World Veterans Federation Congress in Belgrade, I spent a week in the company of ex-servicemen and women from 60 countries. They spoke different languages, were focused on discrete issues and had varying degrees of support from their respective governments - but all were there because they belonged to organisations dedicated, in some way, to the wellbeing of their country's veterans. Since then, I have been engaged with six agencies from overseas who are seeking an effective working model for solving veterans’ problems.
Interestingly, the formalisation of 'wellbeing' as a conference theme was new, but it seized the collective imagination like wildfire because it resonated with everyone: perhaps because it transcended language and nationality barriers?
And it occurred to me that while the word translated as different things to different people, it was gratifying to see such widespread and immediate buy-in to a model Veterans Aid has been advocating for years. It also crystallised for me the need to challenge even more vigorously the customs and practices that prevail here in the UK.
We have multiple initiatives in the sector yet there are repeated cries for more to be done. I'm now acutely aware of how much this mirrors the situation in the multinational veteran community. Virtue signalling is widespread, but it isn't translating into delivery of services that effectively address complex needs.
By and large, we still present veterans as victims, to whom we provide 'top-down' support . We still react to circumstances that provoke pity and outrage - and we still throw ad hoc tranches of money at solutions to problems that some (not necessarily veterans!) have identified. The impact of seeing ex-servicemen and women from such a narrow perspective spectacularly fails to address the complexity of veterans' lives and almost always ignores the wider context that is responsible for so many problems. The result is that some veterans remain invisible. Their needs remain unmet, and they fall through the cracks.
The plight of a recent Veterans Aid client illustrates this well - a former sailor who, through a set of circumstances beyond her control, was forced to sleep in her car while working as a teacher. Each morning she used service station toilets to get ready for work. She was utterly desperate and rang a major service charity for help. They refused because the money she was earning took her over their income threshold for assistance. She called Veterans Aid whose team immediately placed her in hotel accommodation. Within three days we moved her into a flat and provided all she needed to make it a home.
The very large service charity that declined to help saw her only in monetary terms. To me this represents, in microcosm, what has gone wrong with veterans' care in the UK. In a triumph of marketing, we have confused money with practical help - and provision of 'charity' in its widest sense.
There are too many organisations invested in signposting roads to non-existent destinations; services that raise hopes, only to leave those in need feeling angry, abandoned, despairing and disenfranchised. I can't believe that any serving member of a ship's company, presented with the scenario above, would consider leaving a struggling veteran to sleep in her car acceptable.
Setting up filters of exclusion that deny aid to those in clear need is morally repugnant. To do anything less than what we did smacks of counterfeit care. Using process as a way of denying support cannot be right when there is clear evidence of suffering.
Ethics aside, how much more sensible would it be to expand the Veterans Aid model - as indeed the Dutch Government now appear to be doing - and build on identified needs rather than perceived ones. Our work also has resonance in Australia where a parallel interest in ‘wellbeing’ rather than ‘welfare’ has brought us into close contact with academics and ex-service organisations committed to building resilience and exploring what veterans most need in the 21st Century.
The common denominator today is clearly poverty, in its myriad manifestations and effects. It creates new problems and exacerbates existing difficulties, but as there is no swift or universal panacea for such a widespread ill, and as funds are scarce, the smart solution must surely be to target only the issues that individual veterans demonstrably need.
The knee-jerk impulse to spend millions on housing, for example, assumes two things: that the biggest problem facing veterans is homelessness and that all those who are homeless can have their issues resolved by provision of accommodation. I'm over-simplifying of course, but one only has to 'follow the money' to see where most of it has been spent in recent times. Ironically, by spotlighting the wrong issues, these well-meaning highly publicised initiatives disguise the numbers of invisible veterans whose often complex, multiple and highly personal problems remain unaddressed.
The 'bottom up' pathway described in our Welfare to Wellbeing© model is one that assumes nothing. Of course, it prioritises immediate provision of basic needs like hunger and shelter (if they are evidently needed), but its focus thereafter is on discovery - not automatic channelling into often spurious services that 'assume' conditions like PTSD, service-related injuries and single-cause crisis triggers. The team at Veterans Aid have sometimes stopped adversity dead in its tracks simply by listening and investing time in unpacking underlying issues.
Welfare to Wellbeing© is a genuine post-modern working model of veteran support which places the veteran centre stage and allows clients to move forward and flourish on their terms.
It aims to build their capacity so that veterans can sustain their own lives with dignity and not be objects of pity. Context is relevant, but the methodology accepts that everyone is unique; it requires us to look at the emotional, physical, psychological and financial needs of the individual.
The strategy of moving away from a top-down 'issue-fixated' approach that suits a welfare methodology, to one that equips individuals to be the best they can be is one that has universal resonance, whether the veteran's primary need is a house, a prosthetic, a job or bespoke support.
We can’t change history, and we can’t remove contextual problems in the future, so our aim must be to allow veterans to flourish regardless. Using this methodology, the key to looking after a much wider group of struggling veterans is to ensure that individual veterans get into a wellbeing position regardless of issue and context. It won't solve all problems in all scenarios, but I believe that it will achieve a quantum leap forward in terms of helping many whose needs were previously unmet.
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