Final Report, March 2021 “Fall Out”: Substance misuse and service leavers: a qualitative investigation into the impact of a Compulsory Drug Test (CDT) discharge. 2 Fall Out, Final Report − March 2021 Authors • Simon Bradley, Research Associate at Galahad SMS Ltd, Director of the Social Issues Research Centre (SIRC) • Lorraine Khan, Research Associate at Galahad SMS Ltd, Director Loraine Khan Solutions • Matt Fossey, Associate Professor and Director, Veterans and Families Institute for Military Social Research at Anglia Ruskin University • Dr Anne Fox, Director Galahad SMS Ltd • Dr Nick Caddick, Senior Research Fellow, Veterans and Families Institute for Military Social Research at Anglia Ruskin University • Dr Lauren Godier-McBard, Research Fellow, Veterans and Families Institute for Military Social Research at Anglia Ruskin University This document was written by the staff, advisors and consultants of Galahad SMS Ltd (Galahad) and the Veterans and Families Institute for Military Social Research at Anglia Ruskin University. All opinions expressed in this document are solely those of the authors and do not necessarily reflect the views of the Forces in Mind Trust (FiMT), research participants or stakeholders. Acknowledgements This report is the culmination of a two-year programme of research conducted by Galahad and the Veterans and Families Institute for Military Social Research at Anglia Ruskin University. It has been made possible by the support, contributions and input provided by individuals and organisations. We are grateful to the Forces in Mind Trust (FiMT) for funding and supporting the project. We would also like to extend our sincere thanks to the many ex-military personnel who participated in the research and for their openness, honesty and candour. Re-living these significant life events was an emotional and difficult experience for some of the participants and we hope that we have been able to summarise their contributions accurately. We are grateful too for the individuals, organisations and experts in their field who gave up their time to talk us. 3 Fall Out, Final Report − March 2021 Table of Contents FOREWORD .....................................................................................................................................................5 EXECUTIVE SUMMARY .....................................................................................................................................7 1 INTRODUCTION ..................................................................................................................................... 17 1.1 STRUCTURE OF THE REPORT ........................................................................................................................ 19 2 METHODS, SAMPLE & STUDY LIMITATIONS........................................................................................... 20 2.1 LITERATURE REVIEW.................................................................................................................................. 20 2.2 QUALITATIVE RESEARCH WITH ESLS ............................................................................................................. 20 2.3 RECRUITMENT ......................................................................................................................................... 21 2.4 PROFILE OF INTERVIEW PARTICIPANTS........................................................................................................... 22 2.5 CONSULTATION WITH SUBJECT MATTER EXPERTS ............................................................................................ 23 2.6 ANALYSIS AND REPORTING ......................................................................................................................... 23 2.7 ETHICS ................................................................................................................................................... 23 2.8 STUDY LIMITATIONS .................................................................................................................................. 23 3 PRE-SERVICE EXPERIENCES .................................................................................................................... 25 3.1 MOTIVATIONS FOR JOINING THE ARMED FORCES, CHALLENGING ENVIRONMENTS AND VULNERABILITIES .................... 25 3.2 EARLY EXPERIENCES OF SUBSTANCE MISUSE ................................................................................................... 26 3.3 KEY POINTS ............................................................................................................................................. 29 4 IN-SERVICE EXPERIENCES ....................................................................................................................... 30 4.1 FRIENDSHIP BONDS ................................................................................................................................... 30 4.2 OPPORTUNITIES ....................................................................................................................................... 31 4.3 EXPECTATION VERSUS REALITY .................................................................................................................... 31 4.4 BELONGING & FITTING IN........................................................................................................................... 33 4.5 BULLYING ............................................................................................................................................... 33 4.6 MENTAL HEALTH ..................................................................................................................................... 33 4.7 DEVELOPING A CULTURE OF PEAK MENTAL FITNESS.......................................................................................... 35 4.8 KEY POINTS ............................................................................................................................................. 36 5 IN-SERVICE SUBSTANCE MISUSE ............................................................................................................ 38 5.1 DRUGS ................................................................................................................................................... 38 5.2 ALCOHOL ................................................................................................................................................ 40 5.3 DRIVERS OF SUBSTANCE MISUSE .................................................................................................................. 41 5.4 IMPACT OF IN-SERVICE SUBSTANCE MISUSE .................................................................................................... 43 5.5 ADDRESSING DRINKING CULTURE ................................................................................................................. 43 5.6 EARLY DETECTION AND INTERVENTION .......................................................................................................... 43 5.7 DETERRING DRUG AND ALCOHOL MISUSE ...................................................................................................... 45 5.8 KEY POINTS ............................................................................................................................................. 46 6 CDT & DISCHARGE EXPERIENCES ........................................................................................................... 47 6.1 ZERO TOLERANCE ..................................................................................................................................... 47 6.2 PARTICIPANT’S PERCEPTIONS OF CDT........................................................................................................... 47 6.3 CDT TO OBTAIN A DISCHARGE ..................................................................................................................... 48 6.4 SUBSTANCE MISUSE PRIOR TO CDT .............................................................................................................. 49 6.5 CDT PROCESS .......................................................................................................................................... 49 6.6 RECEIVING NOTIFICATION OF CDT RESULT ..................................................................................................... 50 6.7 POST-CDT TEST DISCHARGE EXPERIENCE ....................................................................................................... 52 6.8 DISCHARGE ............................................................................................................................................. 54 6.9 INCONSISTENT AND DAMAGING DISCHARGE PROCESSES .................................................................................... 54 6.10 SUPPORT AND ADVICE ............................................................................................................................... 55 6.11 KEY POINTS ............................................................................................................................................. 58 4 Fall Out, Final Report − March 2021 7 TRANSITION .......................................................................................................................................... 59 7.1 TRANSITION SUPPORT ............................................................................................................................... 59 7.2 EMPLOYMENT ........................................................................................................................................