Endless Potential for Veteran Research: Forces in Mind Trust Research Centre

Bios taken from FiMT Research Centre Website:

Dr. Mary Keeling is a Chartered Psychologist who has worked in the field of Military Health Research since 2010, both in the UK and the US. Dr. Keeling’s research has aimed to understand the psychological and social impact of military service on military personnel, Veterans, and service-connected families. Mary joined RAND Europe as Research Leader in Defence and Security to take on the role as Research Manager of the FiMT Research Centre in August 2022.

Kirsty Dimond has worked in research study management and delivery across a broad span of clinical areas within the NHS since 2016, during which time she completed an MSc in Clinical Research at University College London. Her professional focus has been promoting the inclusion of stigmatised and under-represented groups in research and championing research accessibility. Kirsty joined the King’s Centre for Military Health Research, King’s College London, to take on the role of Deputy Research Manager, in November 2022.

Forces in Mind Trust Research Centre (FiMT) is an internationally renowned centre of research excellence, coordinating and curating high-quality, influential research. Funded by Forces in Mind Trust and operated by a consortium of RAND Europe and Kings College Military Health Research, the centre curates a free and accessible evidence base of research into ex-Service personnel and their families. It provides an accessible and authoritative evidence base exploring transition from military to civilian life, that will inform policy and practice affecting ex-Service personnel and their families in the United Kingdom (UK)(Forces in Mind Trust Research Center, n.d., About).

The interview that follows is a discussion between myself (SC) and Mary Keeling (MK) on her interest in the field of veterans studies, her scholarly contributions, and her commitments to continuing this research and working for FiMT Research Centre. Additionally, this interview examines current issues with veteran populations in the UK, and how the FiMT Research Centre is working to distribute research to benefit veteran populations and the general community. Kirsty Dimond (KD) adds some introductory, supplemental perspective as the Deputy Research Manager for FiMT Research Centre, as she sat in on the interview.

SC

Why are you both interested in veterans studies? Do you have any personal ties to the military?

KD

So, for me, the main draw was continuing to work with and research a population that I previously worked with closely when I was a physiotherapy assistant. When I was first starting out in the National Health Service (NHS), I worked in Lincolnshire, which is known for being home to many people serving in the RAF [Royal Air Force] and a lot of the patients I was working with were veterans. Also throughout my NHS research career I have enjoyed working with populations that are generally overlooked and underserved. I find this work incredibly fascinating; my interest continues to grow and there is much more complexity to the veteran’s research space than I was previously aware of.

MK

My dad was in the Marines for a brief time; he’d be classed as an early service leaver, but his Marines mug was always on our mantelpiece. I’m from North Nottinghamshire, and it’s quite a deprived area. I saw a lot of my friends get recruited into the military between the ages of 16 and 18, and then go to Kosovo, and I experienced firsthand what happens when the infantry recruit from low-socioeconomic status areas. This is probably what first interested me and drew me to this area of work. When I saw the PhD advertised to come to Kings College and work with Professor Nicola Fear and Professor Simon Wessely around military romantic relationships, I just thought, wow, how fascinating, and now it’s been 13 years later.

I find it really interesting. There’s such a disconnect between the military and the civilian population, and I think that continues to grow. When I first started this work my friends asked me, “what are you doing? You’re a hippie. You’re completely antiwar.” But it’s not about the players, you know, the players, those who serve, are part of the process, and we need the military, as you know. The reality of existence of how the global north or the world essentially works is that apart from Costa Rica; we have militaries and so that’s not going to go away. And so should at least try and support those who choose to support and serve their countries.

SC

What do you enjoy the most about working for the [FiMT] research centre?

MK

For me it’s an opportunity to pull together all the work that I’ve done. Not just the outputs of the research projects that I’ve worked on, but the building of relationships, and the variance of the work. My role at the centre allows me to draw on all the skills I’ve developed professionally and academically so far and use them to hopefully make a positive impact for veterans, their families, and the Armed Forces community.

KD

I love the potential that I see in the research centre. A lot of the time, especially with the variety of things that we’re developing, it feels like we’re standing on the doorstep of this huge, almost nebulous thing. But it’s going to be really beneficial, not just for veterans and their families, but the whole community. We want to become an interactive, integrated community hub and it feels satisfying, finding these connections, and utilizing the expertise of those around us and knowing that we have the opportunity to build something from the ground up. We’ve got 5 years to watch this develop and I really hope that this centre can benefit people across so many different levels.

SC

What do you feel, or what have you found, are the most pressing issues currently facing UK service members as they transition out of the armed forces?

MK

I don’t feel as though there is one singular answer. I think it’s multifaceted, and I think that really depends upon the veterans. I think we’re really prone to see veterans as a homogeneous group, whereas of course they’re actually a really diverse group and we need to remember that when we’re talking about research. I think there’s evidence in the UK that indicates some groups are at higher risk of having challenges: early-service leavers—those who only serve less-than-4-years; women, because we know less about their needs and experiences, and we don’t know what the impact of those are; and previously hidden populations—maybe the wounded, injured and sick, especially those who were injured, nondeployment related—I think maybe sometimes get a little bit overlooked.

Then in the UK, we also have the Commonwealth population, those who are from the Commonwealth countries or Northern Ireland or the Gurkhas—we also know less about them. So, it’s not necessarily that they have the most pressing issues, it’s just we don’t really know. We’re just starting to research those groups, similar to minoritized ethnicity groups in the military, they’ve been previously overlooked. There’s a huge space there to be filled in terms of research.

Additionally individuals leaving the military right now are entering into a cost-of-living crisis, a housing crisis, and job-market issues. A situation that’s not particularly good for anyone. Whether or not veterans would experience problems over and above those that the general population are, is to be determined. In terms of cost of living and the general economic climate, it’s possible that less money is being put to services that support them, so maybe support services are going to decrease because there’s not the funding capacity to maintain third sector, charitable-funded organizations. Maybe. But there’s also emerging evidence that shows those who are less prepared for transitioning, which would mean maybe those who are early service leavers and/or those that get discharged for reasons out of their own control, or because of injury, will have a more difficult transition. If a veteran is not prepared to transition out of service, there is evidence that shows that will have a huge impact on their success. Some individuals don’t know what they are getting themselves into when they leave, and so their expectations aren’t being managed very well; preparedness is definitely a key factor when we think about transition success. On our website for the [FiMT] research centre, it’s broken into 9 themes. Those themes represent broad transition outcomes. They are: education, employment, finance, housing, physical health, mental health, families and relationships, well-being, and justice. Depending upon the individual, they’re going to be more or less at risk of having problems in those areas.

SC

There is such a diverse population of veterans, there are so many different things to consider within various veteran populations. Do you feel as though certain roles and jobs they had while they were active, for example, a combat role or noncombat role, has made their time transitioning out of the service more difficult?

MK

We don’t have a huge amount of evidence on that. I think in terms of combat, we know that combat exposure increases the likelihood of reporting mental health difficulties and if a veteran reports mental health difficulties, it increases the likelihood of having transition difficulties. So, I think there is a kind of mediated or moderated, whichever way impacts combat through mental health on transition outcomes, but I would say that the jury’s still out on that. Some work that Howard Burdett (King’s Centre for Military Health Research) did that was funded by the FiMT a few years ago did indicate that those who were deployed were less likely to experience a positive economic change, so less likely to sort of have upward social mobility essentially on leaving service. But I don’t know whether you could really say for certain if that’s because of the deployment experience or whether that’s because those who are deployed are more likely to have infantry roles and therefore may have lower education. The report Change in Socioeconomic Status & the Role of Transition among those who have left the UK Armed Forces (Serfioti et al., 2021) shows that preparedness and initiative during and after transition is the biggest key factor.

This research (Serfioti et al., 2021) investigates veteran socioeconomic stability during active duty and after transitioning to veteran status, highlighting income, education, financial management, housing, social support, and personal relationships.

SC

It’s interesting that you mentioned the possible correlation between infantry and less education; have you seen that as well in your research or in the research FiMT has published?

MK

I think there’s research out there that shows that those in other ranks, not in commissioned officer ranks and not in the noncommissioned officer ranks, but those who join as a private into the infantry roles, probably have GCSE’s [General Certificate of Secondary Education], as a minimum education and maybe less likely to have a degree. Many individuals join the armed forces at the age that others would be going to university and while these individuals may go on to get a degree while they are serving, thus increasing their success for social mobility, earning potential is historically lower without a degree or some sort of higher educational training.

SC

How is the research gathered and organized by the research centre, and then shared with organizations to help and assist veterans?

MK

We have 5 core functions and within those core functions lots of tasks to do. We want to make sure that decisions around policy and practice are informed by the most up-to-date evidence. We are currently reconstructing our website to ensure it holds as much information, research, and evidence that is relevant to veterans transitioning out of the armed forces in the UK. You can search the repository by keyword, theme, author, year, and country. We are also going to start providing summaries, which will present all the evidence on one chosen topic and write a synopsis of that evidence. We hope those summaries will inform relevant policy making and decision making. The first topic we are going to cover is justice. We are doing this work collaboratively with other people working in the veteran community who are experts in the justice area specific to veterans, and we’ll be doing a call to organizations to say “if you have a policy within your organization, which is relevant to justice and veterans, then share it with us because then we can know what the current context is.”

It is a big undertaking. We think it’s going to take us 3 to 4 months to do each one, and it is going to be a slow process. We are probably only going to be able to work on 2 a year. Our hope is as we get into the momentum of things, hopefully that will pick up and then it will just be a matter of updating rather than going from scratch each year. But that’s another way of essentially trying to make the evidence digestible to the people who might need it. It takes time because they are produced in a methodical and thorough way.

In addition to that, we have a research page which has a research community page, this is a growing resource, because we’ve only been doing this 6 months. In theory it will eventually become a comprehensive directory of everybody who is doing research within the veteran space in the UK and the ongoing research page will be a comprehensive list of all research that is currently actively being conducted in the UK around veterans and will hopefully help people start working together. For example, researchers may start collaborating on, and service providers and policymakers can understand who’s who and who’s doing what, so they can start thinking about adding to their services or thinking about policies. We’re hoping this resource will help people find the “experts.”

SC

It sounds like it will be an amazing resource.

MK

It’s a work in progress. We also hosted a conference this year; the FiMT Research Centre Conference (2023). We just had it earlier this month. Moving forward we’ll be hosting a conference every year, which we hope we be a lovely space for disseminating research and hopefully bringing together policymakers, researchers, and practitioners to learn from each other. The research centre provides advice to FiMT as our funder. Our role is to provide advice mostly around the rigor and robustness of methods. When people send in applications for funding, but also just generally, we have our ear to the ground of what’s happening and what research is being done. We are knowledgeable and can share that information. We are also connected with the Office of Veterans Affairs, and we meet with them regularly, so we share information back and forth. We also meet with Ministry of Defence, often with The Confederation of Service Charities (COBSEO) who’s kind of an overarching organization, looking at the charities that provide services, we will also be connecting with the devolved nations including the Veterans Commissioners in Wales and Scotland and Northern Ireland. It’s an ongoing, two-way interactive process that we’re learning what other people are doing and we’re making sure other people know what we’re doing, and that there’s this resource that exists, and by the very nature of us being in these different spaces, we will be holding some upper-level understanding of who’s doing what that we can hopefully help bring people together.

SC

Is the conference that you hold an international conference? Or is it only for people who are doing research in the UK?

MK

In terms of the presentations, they’ve been UK centric. Whether that continues that way is to be determined. We just ran it and hosted it for the first time this year, so we have a meeting next month to discuss how we want it to look.

I think we would definitely want international delegates to come, and I think maybe in time, it may grow to have international presentations and maybe we’ll think about having one of the sessions focus on what we can learn from our colleagues in other countries.

SC

Has the research centre compiled any new research that discusses the current involvement with Ukraine and Russia?

MK

No; the UK military isn’t on the ground in Ukraine. So, while most European countries have their troops in training for the worst-case scenario at the moment, there aren’t any UK troops, to my knowledge, or public knowledge, in Ukraine. When the Ukraine war first broke out a year ago, there was lots of news articles about UK veterans going over to support the fight. I don’t know if anybody has started to investigate those veterans, because that would be quite interesting.

SC

There is evidence that points to the fact that depending on the veteran-specific-situation, and possibly the conflict involvement, there would be different needs for those populations. For example, according to Olenick et al. (2015), “Varying military service branches and varying military experiences among the veteran population is unique. Varying wartime eras and health-specific issues associated with those eras are unique among the veteran population” (p. 635). I’m wondering if there is research or any initiative to look at generational needs?

MK

Of course, we see differences by the very nature of different conflicts. Starting with World War II we see a difference between a Conscription National service compared to a now all volunteer force. Fast-forward to Northern Ireland and that’s very different to other conflicts with people fighting and being at war on their own community spaces, which at the time was challenging, and then in the aftermath has huge implications as well. There are also various legal issues around the Northern Ireland conflicts, so then the conversation turns to peacekeeping and peace-enforcement missions. For my generation I think about Kosovo and Bosnia, and they’re often overlooked as a cohort of veterans, even though actually, although they weren’t in an active fighting war, they most certainly saw things that could impact their well-being potentially. I don’t think we necessarily look at them and their experiences, which are obviously very different. And then post-9/11 conflicts and the fact that they didn’t necessarily end as successfully as intended. All of these different conflicts have different nuances, which are going to have different impacts on the individual veteran on how they adjust and transition afterwards. I think in recent years, of course a lot of the focus has been on post-9/11. I think the area of veteran research really is new, isn’t it? At least in the UK?

SC

Oh, very new, absolutely.

MK

There is definitely more work to do. Beverly Bergman, who is based in Scotland at University of Glasgow, has investigated some of these issues. She did a project funded by FiMT titled Trends in Scottish Veterans’ Health (Bergman et al., 2022)

I think there are differences depending upon the era of which [sic] people served. I think we’re growing and understanding that, but I definitely think that we could do more; especially those in the Falklands generation, which was a relatively short conflict, but potentially has a lasting impact on those people who served during that time, which was very political as well. What we do see in the UK, at least from my experience, is recruiting veterans of other service eras as research participants is really hard. Researchers doing studies around post-9/11 get responses, but when you start trying to look for Falklands veterans, those who served in Northern Ireland, those who served in the peacekeeping operations, such as Kosovo, it’s harder to reach them and find them and I’m not totally sure why; I think maybe because they feel it’s not for them that when we talk about military ex-personnel, everyone’s mind goes to Iraq and Afghanistan because that’s what was in the news most recently. There could also be a whole lot of reasons why that might be, but I think there’s definitely a gap to be filled, but I think it will come with recruiting challenges.

SC

So, maybe not surprisingly, I just recently learned about the Falklands Conflict (see Imperial War Museums, 2023). I was in Scotland a few weeks ago, and we stopped at a Falklands Memorial, on our way to Skye.

MK

Before our interview I reached out our team at the centre to talk to them about what we know about veterans of different generations and different wars, and Professor Simon Wessely, wisely shared a favourite quote of his which is, “Once you’ve experienced one war, you’ve experienced one war.” They’re all so different and because you’ve gone and served and deployed doesn’t mean that the next experience is going to be the same.

SC

Right. That’s very true.

I’m aware you have done a lot of research with service members and quality of relationships. Do you see an issue that surrounds veteran service members and their quality of relationships?

MK

There has not been a lot of research in the UK that has looked specifically at romantic relationships. I think there is a huge gap in research there. When I did my PhD research from 2010 to 2013 in the UK, there had been no specific study looking at relationships of people in the military. At that time there had been questions that had been asked in previous studies, but there had been no specific directed study that asked about relationships with people who serve, and specifically about those who deployed to Iraq and Afghanistan. At that time the news over here was suggesting the military and deployments were ruining people’s relationships. I remember thinking—based on what evidence? The bottom line is relationships are hard per se. But in the military, for example, some relationships handle separation and deployments better than others. If a couple/family has strong support, stable finances, and good communication, they will fare better than those who do not. However, there’s also a group of people who maybe accelerated their relationship quite quickly. They maybe haven’t known each other very long, and then the deployment got announced. They were like, let’s get married because then we get the on-barracks housing, they get all of the support, but they’ve only had this relationship for 6 months. That could apply to anyone really. It’s going to be really difficult because they don’t have the foundations of a strong relationship. There is a lot of evidence that shows if a person deploys for more than 13 months in a 3-year period, that has a negative impact on any relationship. But the bottom line is relationships are hard. The vast majority do fine, but they have to work at it. I did a comparison of divorce statistics between our military data and our census data in the UK, and from that comparison, across age and gender, it essentially showed that people in the military are less likely to be divorced than the general population.

There is a trend that those who are younger in the military are more likely to get divorced from compared to the same age group of civilians, but that could be due to an accelerated relationship. But I think there’s more to it, isn’t there? Arguably, maybe in the military, people stay in relationships longer than they would because of benefits. Considering social exchange theory, people in relationships balance the pros and cons of the relationship and consider alternatives; we need to be careful when we talk about divorce rates because we shouldn’t assume that everybody who ends a relationship is unhappy about it, and that everybody in a relationship is happy about it. There are a lot of new nuances in terms of veteran’s relationships. We don’t really know that much.

There’s a study happening in the UK right now called the UK Veteran’s Family Study and is a collaboration between Kings College London and Queens University Belfast, Glasgow Caledonia University, Anglia Ruskin University, and Cardiff (one of the Welsh universities), which is looking at factors associated with mental health and well-being among veteran families. But I know that in that study they have the Dyadic Adjustment Scale and they ask about relationship status and some other relationship questions, but they’ve just finished data collection so I’m not totally sure what they’re going to do with those relationship questions, and I’m not totally sure when that data is going to be released. It is FiMT funded, and it’s about to be complete.

SC

The university’s data collection sounds huge.

MK

Yes, very large. There’s a gap we need to know more about relationships and families and the partners.

SC

I was really excited when I saw your article, “Military spouses transition too! A call to action to address spouses’ military to civilian transition” (Keeling et al., 2020). I am curious if you know of any ongoing research, or even if you feel it’s still as important of a topic now in 2023 as it might have been just a few years ago?

MK

Thank you. We wrote that when I was doing my postdoc in the US [United States]. We wrote that in collaboration with other authors who were dotted around the US and some expertise in various areas that contributed to different sections. It is translatable to the UK as well. I think it’s 100% as relevant, if not more so, by the fact that that paper is 5years old and we were writing in 2018.

My dream study is to do a longitudinal study following the family, pre-discharge/post-discharge at various time points. Looking at them in in their own entity because I think so often we see family members as careers of those who have been wounded and sick, or supporting the veteran as they transition and not thinking about how that spouse or family member is going through their own transition, as are the children. We recently published “Families transition, too! Military families transition out of service: a scoping review of research from the Five Eyes nations” (Dodge et al., 2022). The aim of the paper was to investigate and identify what is known about military families across the Five Eyes Nations [FVEY; Australia, Canada, New Zealand, the United Kingdom, and the United StatesN]. There are a lot of assumptions and stereotypes about military families, and in reality, we know very little about them; we’ve also historically not been very good at including the male partner, plus other ethnicities, plus other sexual orientations, plus other family dynamics, because actually maybe the person’s family is their sibling or their cousin or their aunt or, somebody else, like, we shouldn’t assume, especially not in this day and age.

SC

So, while I was in Edinburgh, Scotland, I walked past Scottish Veteran Residences (n.d.) and I can’t think of anything that exists like that in in the States. I was wondering if this is a continued area of research and consideration for veteran populations in the UK?

MK

I think it follows a “housing-first” model, which gets veterans into housing and then helps them deal with the rest of the issues. It’s fantastic that we have those. We have some great charitable organizations like Haig Housing, and the Minister for Veterans’ Affairs, Johnny Mercer, has pledged no homeless veterans by the end of 2023, and the UK’s first dedicated homelessness pathway for veterans, Op Fortitude was announced last December (see Cabinet Office et al., 2023). After we’ve done our justice summary, we will hopefully be doing a housing summary early next year, so we would compile the evidence base that exists so far on homelessness and veterans.

SC

Since the FiMT Research Centre current grant expires in 2027, what is the plan moving forward?

MK

Our fifth core function is sustainability planning. The idea and hopefully the reality will be that we will be self-funding by 2027.

We’re looking at ways to bring in funding to support us. We just literally started those conversations recently and there’ll be different avenues and different ways that we’ll be looking to do that.

Funding for FiMT is also due to expire by 2030. The initial idea is that the research centre will live on as the legacy because we share the same vision, which is that all veterans make a sustainable and successful transition to civilian life, which for the FiMT research centre is centered around research and evidence.

SC

Do you think the name of the research centre would change?

MK

I think that’s up for grabs. That’s to be determined.