Soldier To Civilian: The Journey Home

Author:
Andrew Cramb
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Imagine losing your identity, your job, and your purpose – all on the same day.  It might sound like an absurd prospect to civilians, but for our service personnel it is the reality that some feel confronted with as they discharge from the Defence Force and transition into civilian society. In this article, Gallipoli Medical Research Foundation provide an insight into the direction of their most recent research project.
 
Service is no longer viewed as a ‘life-time career’, with many leaving aged in their thirties or forties after having enlisted shortly after high school. This is leading to an increase in practical, psychological, and even cultural adjustments required for the transition to civilian life.

But what happens when this ‘new life’ seems to go against every bit of your experience and training? There is a lack of consideration of the psychological impact of reintegration, and the result there is a substantial proportion of veterans struggling with the transition process. A recent U.S investigation found that up to 56% of Iraq and Afghanistan veterans receiving Veteran Affairs medical care reported significant difficulties with reintegrating into community life including “participating in activities”, “getting along with my partner” and “finding and keeping a job”. The authors also reported that 96% of the sample expressed interest in services to help readjust to civilian life (Sayer et al, 2010).
RSL Queensland provide support to all current and ex-serving ADF members during their transition to civilian life.Image Source: RSL News
 
The Gallipoli Medical Research Foundation (GMRF) is partnering with RSL Queensland to develop knowledge and strategies that can bridge the reintegration gap for our veterans. GMRF’s Veteran Mental Health Initiative (VMHI) conducts translational research which aims to have a measurable and meaningful impact in the lives of veterans, both now and for future generations.

The First Step: The VHMI Reintegration Study

Reintegration is a complex issue which spans a broad range of aspects of everyday life. These include employment, finances, activity levels, family relationships, social functioning, and community involvement. Compounding this are fundamental aspects of military versus civilian culture which many veterans find are unable to be integrated which can lead to issues with social and relational functioning as well as mental health difficulties. 
 
The first stage of the VMHI Reintegration Study, which was launched in April this year, is ‘Soldier’ to Civilian: A Qualitative Analysis of Cultural Reintegration and Psychological Adjustment to Civilian Life Following Military Service. The study is providing a comprehensive look at the issue, incorporating the experiences of veterans, their partners, and health professionals from a range of disciplines, such as psychology, psychiatry, and social work.
VMHI Project Lead and Clinical Psychologist, Dr Madeline Romaniuk says the ease of recruiting is a clear sign of just how important the issue of reintegration is for the veteran community.

“We have had overwhelming support for this project from the veteran community so far, demonstrating the importance of addressing reintegration difficulties through research. I cannot thank our participants enough for their time – their experiences and interviews will shape the way we understand and manage the complexities of transitioning out of the military.

“We must do better for ex-service personnel who struggle to adjust to civilian life, and this is the first step,” Dr Romaniuk says.

This research would not be possible without the support of RSL Queensland and their commitment to evidenced based research for improvement in transition practices and policy.
 
The VMHI Reintegration Study is unique as it is the only qualitative research study being conducted in the area of reintegration and transition from the ADF. It has given veterans and their partners the chance to have their voices heard on this issue – in many cases, for the first time.

“Our participants have certainly appreciated the fact that their participation has really just been about sitting with somebody who listens, having a conversation about their experiences, and not feeling forced into a check-box,” Dr Romaniuk says.

To an outside observer, Dr Romaniuk’s interviews may just look like casual conversations, but therein lies their value. They provide a more in depth look at an issue by allowing participants to expand on their responses rather than ticking a box or rating an issue on a scale of one to ten.

“We needed to start with qualitative research because we didn’t properly understand the area of transition, reintegration and the lived experiences of our ex-service personnel. No one was listening to the people who had transitioned so we didn’t know what it was like – yet there was emerging evidence indicating that for some, the process of transitioning out of the military is extremely challenging. But how do we improve this, if we don’t really understand what is occurring?”

From the interviews, Dr Romaniuk and her team will collate the experiences and identify patterns based on recurring issues raised by participants.
 
A clash of cultures

In addition to psychological and practical adjustments, the research will examine the issue of cultural reintegration. The aim is to understand the differences between military and civilian culture as experienced by ex-service personnel, and how these differences impact the reintegration process.

Transitioning from military to civilian life can lead to experiences of ‘culture shock’ which can take an enormous psychological toll. This has been evident in a number of the research interviews in which participants highlight that the Military emphasises the importance of structure, order, discipline and direct communication, compared to a civilian system which is often perceived as inferior in comparison.

Dr Romaniuk recalls one clinician stating as part of their interview, “A patient was asking me the question, "What do I do because they taught me a lot of things; they trained me but they did not ‘untrain’ me?  So I don't know how to adjust in this world again." Struggling to reintegrate culturally can have a significant impact on the practical transition to society. A common experience Dr Romaniuk has observed from her interviews with veterans is the difficulty in finding - and retaining - employment.

“Maintaining a job in a civilian setting can be an issue. This seems to be due to difficulty relating to others in the workplace in terms of communication, sharing a common experience, feeling part of a team or genuine comradery – and on top of that feeling frustrated and angry that the civilian system is inefficient and flawed,” Dr Romaniuk says.
 
The untold impact on families

The impact of a veteran struggling with reintegration is not just felt by the individual. From Dr Romaniuk’s conversations with the partners of veterans, many have been left feeling forgotten. The help and support that is available seems to be geared around the individual ex-service person rather than the family unit as a whole.

“Something I’ve noticed as an early pattern from this study is often the partner takes on the role of teaching the person how to behave in civilian life again. There can be a tremendous burden on the partner. In a lot of cases the care and the responsibilities fall on the partner when the veteran is struggling to function with day-to-day life. It’s the partner who often has to get them through.

“I am interviewing partners of veterans as part of the study, and something I’m hearing a lot is partners actually feel at times they may been the only thing keeping their spouses alive, as they were the only ones helping them to navigate the outside world. So, we’re really seeing the importance of partners in this process.  More research is needed around this area of how the family unit operates through reintegration,” Dr Romaniuk says.

Where to from here?

GMRF has always taken pride in its focus on translational research which has real-world application. Put simply, this is not research for the sake of academics; rather, it identifies a significant issue affecting our veteran community and aims to address it.

“As a clinician treating individual veterans, you see a lot of areas of need within the larger healthcare/training systems. The reason I’m doing this research right now, and not clinical work, is because I want to have an impact on the system and improve policy as a whole. This will potentially help so many more people, and hopefully prevent the difficulties I see occurring on an individual basis within the next generation of ADF members.”

The VMHI Reintegration study may be in its early stages, but it already has a clear goal in place for improving the transition process for service personnel. The final stage of the study will be to develop a training program to help with reintegration to civilian life. This program will be informed by the results of the qualitative study as well as evidence-based cognitive and behavioural strategies. Through this, GMRF aims to improve former ADF members’ readiness for civilian life by providing education and training about what to expect and how to operate successfully in a civilian setting.

“The program will be unique as the interviews we are conducting now will be used to inform how the program is delivered as well as the content of the program. We are using people’s own experiences– both poor and successful transition.  

“Understanding the common factors between people who transition well compared to those who do not, gives us valuable information that we can share with others and build into a training program. This way, as a psychologist, I’m not simply saying what I think will help - instead we are using the experiences of people who have been through transition to inform the program in a scientific manner.”

Stay tuned for more updates from GMRF’s VHMI Reintegration Study as they continue to work with RSL Queensland to support the men and women who have served this country. While the transition process will no doubt continue to be an enormous adjustment for veterans and their families, we are committed to ensuring no one faces this journey alone.




Research and article by the Gallipoli Medical Research Foundation. 

Visit www.gallipoliresearch.com.au for information about Veteran Mental Health and other research being undertaken at Gallipoli Medical Research Institute.