An interview-based approach was taken for the research study to ascertain the needs of veterans in North East Lincolnshire.
This used the Camberwell Assessment of Need – Clinical Version (CAN-C; Phelan et al., 1995), with demographic information gathered along with a quantitative measure of current psychological distress as measured by the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM; Evans et al., 2002).
The project recruited 51 veterans in total.
2.1 Demographics
A breakdown of the demographic details of participants can be found in Table 1.
The majority of the sample of 51 veterans were middle-aged males. Over half of the sample were either married or in a civil partnership, which aligned with the recent census data. Moreover, the proportion of females within the study is representative of the number of female veterans within the country.
The veteran who identified as transsexual within the study had transitioned from male to female; they reported that they were open about their sexual identity following changes in rulings that LGBTQ+ personnel should be able to serve openly without discrimination.
Most participants had served in the army, followed by the RAF and navy; one participant had served in both the army and the RAF.
Table 1. Demographic information of the sample
| Variable | Range (M) / % (N) |
|---|---|
| Age (in years) | 27-77 (52) |
| Gender | |
| Male | 85% (43) |
| Female | 14% (7) |
| Transsexual | 2% (1) |
| Marital status | |
| Single | 33% (17) |
| In a relationship | 10% (5) |
| Engaged | 2% (1) |
| Married | 51% (26) |
| Civil partnership | 2% (1) |
| Widowed | 2% (1) |
| Length of service (years) | 3-37 (16.3) |
| Branch of Military | |
| Army | 51% (26) |
| Navy | 12% (6) |
| RAF | 35% (18) |
| Combination | 2% (1) |
2.2 The Camberwell Assessment of Need - Clinical Version
The Camberwell Assessment of Need (Clinical Version) assesses the needs of people with mental health difficulties during the past month, across 22 domains of life.
The CAN-C records user (interviewee) and professional (interviewer) perceptions as it acknowledges that these can differ.
The CAN was designed to assist local authorities to fulfil their statutory obligations under the National Health Service and Community Care Act 1990 to assess needs (clinical and social) for
community services (Phelan et al., 1990).
The CAN-C measures whether a need exists and if so, if this need is being met or unmet through the provision of support, which could be formal (support services) or informal (friends, family, partners,
children).
Initial analysis of the CAN-C data indicated that clinicians typically
perceived more unmet needs in the sample, compared to the participants themselves (see Table 2). The data suggests that veterans tends to have more needs met than unmet (ratio of 3:2), although the high standard deviation values indicate a lot of variation in the data.
Table 2. Mean and standard deviation values for met and unmet needs as rated by participants and clinicians on the CAN-C.
| CAN-C | Participant Rating M (SD) | Clinician Rating M (SD) |
|---|---|---|
| Met Need | 3.18 (2.35) | 3.02 (2.13) |
| Unmet Need | 1.80 (2.83) | 2.10 (3.06) |
2.3 Clinical Outcomes in Routine Evaluation – Outcome Measure
The Clinical Outcomes Routine Evaluation – Outcome Measure (CORE-OM) is a 34 item self-report questionnaire that measures psychological distress across four domains (subjective wellbeing,
problems/symptoms, functioning, risk).
Participants were asked to rate a series of statements on how relevant they have been over the past week, providing a score out of 136 with higher scores indicating more distress.
The tool has been validated for use in primary and secondary care services (Barkham et al., 2005).
Table 3 displays the distribution of distress as measured by the CORE-OM. The majority of veterans experienced mild or low levels of psychological distress.
Approximately a third of participants had higher levels of psychological distress and thus may require access to secondary care psychological therapy services.
Table 3. Distribution of scores on the CORE-OM
| CORE-OM Distress Level | N (%) |
|---|---|
| Severe (85+) | 5 (9.8%) |
| Moderate to Severe (68-84) | 3 (5.9%) |
| Moderate (51-67) | 8 (15.7%) |
| Mild (34-50) | 9 (17.6%) |
| Low level (21-33) | 11 (21.6%) |
| Healthy (1-20) | 14 (27.5%) |
| No distress (0) | 1 (1.96%) |