Alcohol Abuse (Armed Forces)
The next item of business is a members’ business debate on motion S4M-02321, in the name of Paul Wheelhouse, on addressing alcohol abuse in Scotland’s armed forces. The debate will be concluded without any question being put.
Motion debated,
That the Parliament recognises the work of veterans in Scotland and the sacrifices that they have made during their time in the armed forces; understands that there is a reportedly high level of substance misuse, particularly involving alcohol, among not only veterans, but also serving personnel; expresses concern at what it sees as the limited action that has been taken to support those with such problems; notes that the organisation, Combat Stress, has argued that many addiction problems are linked to self-medication for mental health problems; understands that research by Poppyscotland suggests that veterans in Scotland are more likely to experience alcohol misuse and homelessness than those from the rest of the UK; notes that 13% of serving personnel who responded to a King’s College Centre for Military Health research study said that alcohol misuse was a problem for them and that 26% of these respondents were under 25; further notes the evaluation of the Gateways for Veterans pilot scheme in Inverclyde, which claimed that “vulnerable veterans in Scotland may be at particular risk of abusing alcohol due to the exacerbating factor of a culture of drinking in Scotland”; supports the Inverclyde initiative and other similar work, including that carried out by Veterans Scotland, its member organisations and other groups that provide support for veterans on matters such as substance abuse, homelessness and employment opportunities and in tackling the drinking culture that it believes exists in the armed forces; recognises the work of organisations such as the NHS that aim to provide the necessary support to armed services personnel who leave the forces with a substance misuse problem, and notes the calls from veterans’ organisations to the Ministry of Defence to provide greater welfare support to veterans and serving armed forces personnel to significantly reduce the incidence of alcohol abuse and its subsequent impact on the lives of veterans once they have completed their service.
12:32
I thank members who signed my motion and those who will stay in the chamber during lunch time to hear the debate. In particular, I thank Opposition members for the support that has enabled the debate to be heard. I also thank Veterans Scotland—Bob McFarlane in particular—and Poppyscotland for their support in my endeavours to secure the debate.
People who are part of a generation the majority of whom—unlike the minister—have had the good fortune never to have to go to war and experience all its horrors can only imagine what our servicemen and women go through. I put on record my support for all our serving armed forces personnel and all our veterans. The debate focuses on the alarming levels of alcohol misuse in the armed forces, but I do not want that to detract in any way from the vital importance of the armed forces’ work or from the courage, heroism and professionalism that members of the forces demonstrate daily while they are conducting duties on our behalf.
Indeed, my admiration for our forces inspired me to join the cross-party group on armed forces veterans. The origins of the motion were heartfelt pleas by non-MSP members of the cross-party group, who asked MSPs on the group to seek a debate to raise awareness of the scale of the problem and to encourage the Ministry of Defence to confront the issue.
When I approached Veterans Scotland to indicate that I was willing to take the matter up on the organisation’s and others’ behalf, I was made aware of a key study on alcohol misuse, which was undertaken by Dr Nicola Fear, from the King’s centre for military health research. The study, which is one of several that link alcohol and drug abuse to combat stress, revealed stark and alarming figures. The researchers undertook an extensive survey of 9,990 service personnel, and in the region of 13 per cent of respondents said that misuse of alcohol was a problem for them, either during or after their service. Further, the research indicated that the number of armed forces personnel who are misusing alcohol might be higher in Scotland than it is elsewhere. That is also indicated in the evaluation of the gateways for veterans pilot in Inverclyde, which I mentioned in the motion.
The King’s centre for military health’s study highlighted that, during the period from 1998 to 2004, eight of the worst 10 local authority areas in the United Kingdom for alcohol-related deaths were in Scotland, with the average death rates in Scotland almost double those for the UK as a whole. I do not want to cover ground that has already been widely debated in the chamber to do with the cultural problem that we have in Scotland, so I will leave the analysis of that there. However, I noted that the surgeon general himself cited wider societal change as a factor that influences alcohol consumption in the services. It is my opinion that the unique pressures that are faced by forces personnel fan the flames caused by societal practice.
Even more concerning is the fact that the study’s figures show that 26 per cent of respondents aged under 25 felt that alcohol misuse was a problem for them. The figure rises from 11 per cent of those who have not been deployed to combat to 23 per cent of those of all ages who have served in a combat role.
At the most recent meeting of the CPG in April, I was grateful to the surgeon general, Vice Admiral Philip Raffaelli, for joining the meeting to hear the concerns addressed by my motion and to attempt to allay them. The surgeon general and Jon Parkin, head of veterans services at the Service Personnel and Veterans Agency, suggested that early leavers from the armed forces often have the most problems with alcohol misuse, which coincides with the evidence of the high proportion of young people with that problem.
If that is the case, it is all the more important that the MOD steps up its efforts to identify problem drinkers in the recruitment process, provides a stronger hand in deterring the adoption of a macho drinking culture during service and provides ever-greater support and signposting advice to individuals to get help. That could avoid the wastage of losing highly trained professional service personnel to problem drinking and the behavioural changes that come with it. Indeed, alcohol may well be a strong contributory factor to many early departures.
Also at the CPG meeting were a number of CPG members who are serving, ex-serving and associated armed forces personnel, and representatives of agencies such as First Base Agency in Dumfries and Galloway. They raised concerns about the easy availability of cheaply priced alcohol in on-base messes and other facilities, and expressed concern about the effect that subsidised alcohol and the ability to buy alcohol on a mess bill, rather than with cash, had in helping to encourage a binge drinking culture in the forces. Although the days of rum tots in the navy are long gone, the inherent drinking culture remains—a point recognised by the surgeon general. From anecdotal evidence, we believe that alcohol consumption is often encouraged as a means of decompression for those coming back from combat.
Although I accept that a degree of responsibility must be shouldered by people such as MSPs who are actively making laws to protect vulnerable people, MOD bases are in effect off-limits to us, to civilian licensing authorities and to health professionals. The bases have their own policing, health and disciplinary procedures. I therefore strongly urge the MOD, as the body responsible for the mental and physical wellbeing of our serving forces personnel, to review the support that it gives to serving forces personnel and to train more senior officers and non-commissioned officers to deal with and support their charges for whom alcohol misuse has become a problem.
I encourage the MOD to do more to control the use of cheap alcohol and promotions, if not to remove alcohol from barracks altogether, which would not make us very popular. Also, I encourage the MOD to do more to educate personnel properly on the risks that they face in adopting a heavy drinking culture.
The motion encourages the national health service and the MOD to work together to provide even greater welfare support to veterans. We recognise that various veterans organisations have a strong role to play in addressing the risk of mental health issues in our forces.
Alcohol, when it is consumed irresponsibly, can destroy lives and prospects for relationships, getting a home or a job. Ultimately, it can destroy people’s health. Anyone who heard the recent BBC Radio Scotland phone-in on “Call Kaye” will have heard first-hand experiences of today’s veterans and their families, who feel that they were inadequately prepared for life outside the forces.
While serving, forces personnel benefit from a heightened sense of community, and the support of their comrades in arms is a great comfort while they are deployed. That runs alongside the close network of families left at home, often living in quarters and providing an alternative family for each other. However, it is almost unimaginable for civilians to appreciate the sense of loss that many feel when they leave the armed forces, even when they have not lost close comrades in combat.
The King’s study indicates that there is quite a sharp rise in alcohol misuse problems among those who come back from combat roles. I suspect that many combat stress cases go undiagnosed and the sufferers may end up self-medicating with alcohol, having learned while they were in the forces that that is an accepted way of decompressing.
In February, the UK Government responded to the House of Commons Defence Committee’s report “The Armed Forces Covenant in Action”. The response recognised the work done to provide medical treatment to wounded, injured and sick service personnel in theatres of operation and during rehabilitation at home. I hope that that work will continue. I highlight the “Fighting Fit” report from 2010, which says:
“alcohol abuse is significantly associated with service in the Armed Forces and there is evidence that it is more common among combat veterans. Mental illness is a root cause of both homelessness and involvement in the criminal justice system.”
The MOD proposes to allow serving personnel to carry forward an NHS number through their military career—traditionally, when people join the forces, they have given up their NHS number, which has made it difficult to track them once they leave. It proposes to implement that policy in England, and will enter discussions with the Scottish Government as well. That will improve our tracking of veterans and give us a better understanding of their medical history.
The motion discusses those who find alcohol misuse a problem while still serving as well as after they have left active service. I want to draw attention to that, because it is not just a problem of veterans—the problem starts while people are in the forces.
I dedicate this members’ business debate to those who have given their lives for us and, crucially, to those who return from serving their country. Many of them continue to fight their own private battles once the guns have gone silent, and they deserve our full support.
12:41
I declare an interest, as I am a member of the William Simpson’s home trust, which I will refer to in my speech.
I congratulate Paul Wheelhouse not only on securing the debate but on his excellent analysis of the problem. I am sorry that I have not been able to attend meetings of the cross-party group on armed forces veterans, which I attended in the previous session.
Our soldiers are exposed to the most horrific scenes and situations while taking part in combat to protect our country. On return, some find the memories and flashbacks that are caused by their time in battle unbearable and turn to alcohol in an attempt to forget the tragedies that they have seen. We need to have a better support unit in place, to identify not only the tell-tale signs of the mental scars of war but also, as Paul Wheelhouse said, the initial signs of alcohol problems, which develop before that stage and which can be fundamental to our understanding of the situation.
We need to offer packages that deliver not only effective medical care, in general physical terms—things have improved in that regard—but more extensive psychiatric and psychological care. Because of the line of work that they were involved in, many people who have served in the armed forces feel that it is a weakness to admit to having a problem. We must do more to ensure that those brave men and women are able to come forward and speak about their problems.
Recently, I worked as a consultant addictions psychiatrist in West Lothian, which showed me something of the extent to which alcohol and drug use covers up post-traumatic stress from conflict, going back to the Falklands conflict, which I know that the minister was involved in, and to both Iraq wars and Afghanistan. I found that the expert help that I was able to get for some of those veterans at Hollybush house was invaluable. I know that the Government has given support to that care home, and I hope that it will continue to do so.
There are some fine examples of other organisations and individuals who have created packages to support current serving personnel and veterans. One that I have been engaged with is Gardening Leave, a charity that was founded by Anne Baker Cresswell, which provides current and former servicemen and women with gardens in which they can grow plants and fruit in a safe and relaxed environment while contributing as much or as little as they choose. That might sound rather simplistic, but therapeutic gardening is critically important as a measure across Scotland not only for this group but for others. Trellis in Perth in my constituency co-ordinates 160 such therapeutic gardening projects. Gardening Leave is developing more centres and I hope that, where those centres do not operate, the Scottish Government will consider talking to Trellis about engaging with veterans, because some of them benefit enormously from those projects.
Another supportive organisation in my constituency is the William Simpson’s home in Plean, which I mentioned earlier. It has existed for more than 100 years and looks after people with alcohol-related brain damage. More than 50 per cent of those individuals are veterans. Supporting them is important. The home is trying to raise capital to fund a new development programme to modernise its facility. Unfortunately, we have been unable to garner any Government support for that yet. I know that the economic situation is difficult, but I suggest that the minister might want to consider giving it some support.
I acknowledge the work of the Government in Scotland, previously in partnership with the UK Labour Government, which is reflected in the joint meeting of the veterans and mental health cross-party groups in the previous session of Parliament, where work was taken forward to ensure that those coming out of our armed forces are supported, that problems are identified at an earlier stage—and indeed in service—and that treatment and support are offered.
The work of charities such as Help for Heroes has an important role to play and they need to be engaged in the process.
12:45
As convener of the cross-party group on armed forces veterans, I am delighted to be able to take part in the debate. As other members have done, I commend Paul Wheelhouse for bringing the motion to the chamber. I know that he put a lot of work into getting the wording of the motion right and being careful not to point the finger of blame too accusingly in any particular direction. I commend him for that—he is right not to do so because, although it is easy simply to blame this or that Government, this or that theatre of war or this or that regiment, it will do nothing to solve the problem that is so accurately highlighted in the motion.
The truth is that this is not about Governments, fields of war or regiments but about people. It is about people who have signed up to a job of work that may very well demand that they put their lives on the line in our defence, and it is about how we treat those people while they are undertaking that job of work and, perhaps even more important, as they prepare to return to civilian life—indeed, to a civilian life that offers none of the protection, camaraderie or peer support that they will most likely have come to depend on as servicemen and women.
There is a remarkable charity called Southwest Scotland RnR, which is run by a constituent of mine called Jennefer Tobin. Jennefer comes from a military background and she knows what soldiering entails. Some years ago, she was struck by the bland, somewhat uncomprehending faces of the troops she saw returning from Iraq and Afghanistan and decided, in her inimitable fashion, that some of those returning soldiers needed what she calls a jolly good holiday. She contacted the regiment, converted her home in Dumfriesshire, cajoled, persuaded and attracted a veritable army of local volunteers, and built up an incredibly effective means of getting returning servicemen and women, all of whom are wounded—sometimes physically but more often mentally—back on to the straight and narrow.
I once asked Jennefer how she measured the success of the exercise, and she said that if they are sleeping a full night’s sleep and laughing naturally by the end of the week, it has worked. It was not until I met one of the groups that had arrived for her unique form of treatment that I saw exactly what she meant. They were clearly a group of young people—in this case men—in a very fragile state of mind. They were young lads just back from Afghanistan, who were almost all from difficult and challenging backgrounds and who had quite possibly signed up to escape from those backgrounds. What they had signed up to was probably a heck of a shock to them.
That will, I am sure, be replicated throughout the military. When they are sent into action, those brave young people will naturally seek comfort and reassurance with their mates over a few cheap subsidised drinks in the safety and security of base camp at the end of the day—comfort and reassurance that quickly becomes a daily habit and probably just as easily becomes a dependency. It is not hard to see how someone like that—and there will be many of them—will have the greatest difficulty when they are thrown back into the bear pit of civilian life.
At the most recent meeting of the cross-party group, we heard of the considerable efforts that are being made in the armed forces to address the problems early. Those efforts are commendable, yet there clearly remains a huge dichotomy between what the military thinks it is returning to civvy street and what the numerous charities that pick up the pieces know is being returned to civvy street. There remains a great deal to be done. We owe it to those incredible servicemen and women to do everything that we can to ensure that it is done. Ending that dichotomy is our challenge. I suggest that it is also our duty.
12:49
I thank my colleague Paul Wheelhouse for lodging this important motion for debate.
We owe a huge debt to the service personnel who put themselves at great risk to keep us safe. The risk of death in the Army is 150 times higher than the risk for the general working population, and the loss of life in the armed forces is a debt that we will never be able to fully repay. Although a lot of good work is being done, we need a more concerted effort to ensure that when those in the armed forces return from the field, they are better supported in their transition back into civilian life.
As the motion states, there is a wealth of evidence that links alcohol and drug misuse in veterans to self-medication for mental health problems, and we need to examine our attitudes and responses to both those issues. We know from the huge number of studies in that field that alcohol and drugs have historically been used by military personnel to cope with the intense stress of battle and as a way of mediating the transition from the heightened experience of combat to “normal” routine life, which is a transition that many of us cannot envisage.
Coupled with that change is the culture of drink in the armed forces that existed in the 1980s and 1990s, when alcohol was used as an aid to team building and there was an element of the train hard, play hard mentality. It is no coincidence that the service personnel who were in the armed forces at the height of that culture are now the ex-service personnel who are seeking help.
That situation is exacerbated by Scotland’s relationship with alcohol. As the motion mentions, the Inverclyde pilot scheme referred to Scottish veterans being at particular risk because of Scotland’s attitude to drinking. There are members in the chamber who are doing all that they can to ensure that Scotland’s relationship with alcohol changes. We are all aware that, too often, already vulnerable groups in Scotland are being drawn to alcohol misuse as a self-medication tool. While that culture exists, we as a society have a duty to help those brave men and women on their return to civilian life.
There is evidence that that armed forces mentality has changed to some degree. There is far less tolerance of alcohol intake during the week than there was previously, and there is zero tolerance on tour. If the mentality can change within the armed forces, it can surely change outwith them.
Whether we like it or not, there is still an underlying shame and stigma attached to the mental health issues that often go hand in hand with alcohol and drug misuse by veterans. That is highlighted by the fact that, on average, it takes 13 years from leaving the service to getting in contact with organisations such as Combat Stress, Veterans Scotland or—more locally to me—Glasgow’s Helping Heroes.
However, although society could do more to break the taboo on mental health and not allow substance abuse to be so readily seen as the answer, there are groups, such as those that I have just named, that are working tirelessly to help veterans to acclimatise to civilian life again. Glasgow’s Helping Heroes is one such group, which acts as a one-stop referral service for serving personnel, veterans and their dependants or carers. Of the many areas in which it helps veterans, providing information on local services to treat the underlying issues causing substance abuse is an extremely important one.
Interestingly, when the organisation was set up, it was generally those who fall into the combat stress average who were attending. They were male and in their mid-to-late 40s, and predominantly had been in the Army for less than 10 years and had undertaken at least one operational duty. Many of those self-medicating with alcohol were—and still are—homeless.
Age is certainly a factor. Among the younger veterans who are now attending, there is a lower incidence of alcohol misuse—although the figures are still too high—which correlates to the change in culture in the armed services. One therefore hopes that the tide is turning.
However, there is, and will continue to be, a huge demand for veterans centres. The Scottish Government has set up the Scottish veterans fund, which recently announced that more than £80,000 has been awarded to 11 groups countrywide to offer support and services to our veterans. The UK Government has also set aside money to help to provide and improve veterans services.
In my constituency, Cathcart old parish church, led by the Rev Neil Galbraith, is working with Glasgow’s Helping Heroes and other veterans organisations to create its own veterans centre in the church to offer services to ex-service personnel in the south of the city. The minister has already visited the project. The venue is ideally placed, with the Territorial Army stationed close by as well as great transport links and a local college that is keen to get involved in supporting veterans. Once the centre comes to fruition—the group is meeting today to move that forward—it will be a huge resource that veterans can use to get the help and support that they might need.
I am proud to serve in a Parliament for a party that has such close ties with its veterans. We must all work together to ensure that all the help and support that is needed is available. With great organisations throughout the country such as Combat Stress, Veterans Scotland, Poppyscotland and Glasgow’s Helping Heroes, that help is slowly but surely being provided.
12:54
I, too, congratulate Paul Wheelhouse on securing this debate on what is an important issue and am gratified to see members’ attempts at being as consensual as possible. I realise that there are a number of very important public policy and resource allocation issues to address but, from my discussions with veterans organisations and veterans themselves, I can tell the chamber that they appreciate the united front that the Parliament has often displayed on veterans’ issues. I also welcome members’ speeches, which illustrate their very clear interest in the issue and their determination to focus support and assistance on those with alcohol and drug problems.
Dr Richard Simpson will know that I am well aware of the William Simpson’s home, as it was previously in my constituency, which he represented before me. Last night, I received a communication from a former MSP, Dennis Canavan, asking me to attend an abseiling event on Sunday. I am tempted to say to Richard Simpson, “If you do, I will, too,” but, in any case, my association with the home and its redoubtable chief executive will continue. The home, whose origins are steeped in the military—it was founded by the parents of a returning naval officer—does tremendous work and I will continue to advocate its case in its efforts to raise funds.
In response to Paul Wheelhouse’s important point about NHS numbers, I point out that substantial work is being carried out on that matter. Officials are developing arrangements in partnership with the MOD to allocate numbers to all military personnel in Scotland to facilitate the provision of an NHS record for every serviceperson and the eventual migration of military and health details on to that record. Paul Wheelhouse was quite right to highlight an important issue that many veterans have mentioned directly to me.
I am also delighted to confirm that the Scottish veterans fund, which members have mentioned, has provided support to Gardening Leave to allow it to expand its services into Dundee and that I will be visiting its facility at the Tayforth centre in the very near future.
I know that this issue was discussed in detail at a recent meeting of the Scottish Parliament cross-party group on veterans, which heard from the MOD surgeon general, Vice Admiral Philip Raffaelli. As members have pointed out, it is the responsibility of the armed forces themselves to tackle alcohol and substance misuse by serving personnel. As employers, the three services have put in place clear and unambiguous rules that must be obeyed under pain of court martial. James Dornan suggested that, historically, the armed forces have had a reputation for a work hard, play hard culture. That is understandable and, to some extent, inevitable. However, as Mr Dornan made clear, that culture is changing for the better. Alcohol consumption by service personnel is permitted, provided that it happens in controlled circumstances and off duty. Soldiers, sailors and airmen and women have the armed forces’ reputation to maintain—which they do, with pride and honour.
Apart from the very dangerous work that they carry out, service personnel have to work with heavy, sophisticated and dangerous equipment and must do so in full control of their faculties. Everyone is aware that, under such circumstances, no serviceman or woman can be under the influence of alcohol, so we must welcome the fact that the services have programmes for and training on sensible and responsible drinking. Drug use is also strictly forbidden. The armed forces routinely conduct random drug tests and those caught using drugs are dismissed.
It is important to stress that, when they leave the armed forces, the vast majority of service personnel return to civilian life and live quietly and successfully in their communities. No one should take from the debate the idea that service inevitably leads to problems with alcohol, drugs or mental health. However, we recognise that, for some people, problems will arise and might lead to heavy drinking or drug use. That is a tragedy for the individuals concerned and, as has been made clear in the debate, it often leads to other problems such as family breakdown, a lack of employment opportunities and perhaps even homelessness.
Many types of support are in place to help those with alcohol and drug problems. Naturally, the armed forces are considering better and quicker ways of identifying those who might be at risk of falling into alcohol and drug dependency and that work will, in itself, lead to improved and tailored interventions.
As members have said, a number of service charities offer a range of support packages and I applaud them for their selfless work in support of veterans. They offer invaluable assistance in myriad settings across Scotland, some of which we have heard about today. That is why the Scottish Government has set up the Scottish veterans fund and allocated more than £400,000 to projects of direct support to the veterans community.
The armed forces are a reflection of the society from which they recruit. It is inevitable that some individuals will become involved in problem alcohol or drug use. That can manifest itself in a number of ways. However, despite all that has been said, it is important to recognise that problem alcohol or drug use are no more prevalent in the armed forces than they are in an equivalent demographic profile within wider society. The national alcohol strategy, “Changing Scotland’s Relationship with Alcohol: A Framework for Action”, sets out a broader agenda and adopts a whole-population approach, which is augmented by guidance for the provision of effective alcohol treatment and support services.
The “Quality Alcohol Treatment and Support (QATS)” report from 2011 outlines 14 recommendations that, if embedded in practice, will help to better identify and respond to the specific needs of people, including veterans and those in the armed forces.
I understand entirely what the minister said about the statistics on dependency in the armed forces reflecting those in normal society. One of the earlier speakers mentioned decompression, or coming away from the highly stressful situation of modern service and modern warfare and going back into civilian life. Does the minister accept that that is an issue? Given that the backgrounds from which many people come into the armed services allow potential problem cases to be identified, does he also accept that much more work could be done to identify potential problem cases, and to follow those people through the decompression stage and back into civilian life?
The member raises two distinct issues, one of which is decompression. Nobody would dispute that that happens. From my limited experience a long time ago of going through a traumatic event, I know that the experience of decompression that happens afterwards was almost always associated with alcohol. One report called it self-medicating. It is obviously a problem. The heightened levels of stress that are associated with serving for long periods of time in Afghanistan or, in the past, Northern Ireland are bound to have an effect, and alcohol comes into that picture.
I do not want to apportion any blame, but it is also true that some have said that the armed forces cannot be held responsible for the people they recruit if they have a pre-existing propensity to be involved with social problems, if I can put it as generally as that. I do not accept that that is the case. For centuries, the armed forces have harvested people from their communities and they have a responsibility to those people. From what I am hearing now from the armed forces and the MOD, they are taking that responsibility seriously. They should continue to do that.
The Alcohol etc (Scotland) Act 2010 came into force on 1 October 2011 and is a significant step in the battle against Scotland’s unhealthy relationship with alcohol. The main measures in the act are a ban on quantity discounts in off-sales that encourage customers to purchase more than they might otherwise, a restriction on material promoting alcohol, and the involvement of health boards in licensing issues, notwithstanding Paul Wheelhouse’s point about the limited ability of civilian organisations to involve themselves with what goes on on MOD bases.
There is a substantial range of legislation in place, which I mention to point out that the general issue is certainly being taken extremely seriously by the Government. We are aware of some of the particular issues that present themselves in relation to serving service personnel and veterans, which is why we see the breadth of assistance that is available. I do not think that we are at the end of that. We are about to do a refresh of our veterans strategy, and this is one of the issues that will be covered.
I am grateful that the issue has been raised and for the work that has been done by the cross-party group. Raising these issues is the best way of ensuring that we improve our response to dealing with such problems.
13:04
Meeting suspended.
14:15
On resuming—