The defence world is not like the real world that most people live and work in, and many veterans find it particularly difficult to transition from the defence force to civilian society.
One thing I hear from veterans repeatedly is how they pushed through their injuries to do their duties, lest they be seen as a 'slacker'. The consequences can be dire: instead of healing and rehabilitating thoroughly, their injury becomes a huge problem later in life. By battering their bodies at a young age, many end up with long-term disabilities. It affects you when you see a 28-year-old young man using a walking stick and having to avoid crowded places, missing out on family activities and a healthy social life when he had invested so much in serving his country.
While the physical challenges of integrating into civilian life can be great, the mental challenges are often greater. Sometimes it’s PTSD-related; sometimes it’s living without the structure that the defence force provides; sometimes it’s simply a case of veterans preferring solitude. A lot of vets chose to live in rural areas. Unfortunately, this isolation can eventually become a problem, making integration back into civilian life less likely, and often compounding mental health problems. That space may be healthy when they first leave the defence force, but the lack of support can come back to cause them problems.
At Konekt WorkCare we aim to provide the support they need, helping veterans reintegrate through work or psychosocial activities.
How occupation rehabilitation works
Some of the veterans I work with have been out of the force for a long time. They are often fine for a while, enjoying civilian employment, until something throws them for a loop. It is usually the case that their injuries begin to play up as the veteran gets older, and physical issues can often trigger mental issues, which may have been well controlled or manageable for some time. Some end up self-medicating, turning to alcohol or drugs. These issues then get in the way of their ability to participate in work and participate in psychosocial activities. Frequently the injuries and other issues start to impact their ability to do their jobs and the time comes for them to seek an alternative, more suitable career path. That’s when I get involved.
When a veteran comes on board, either for the reason already given or because they have recently separated, I begin with a thorough assessment. As an occupational therapist, I’m trained in physical health and mental health – I can look at their injuries and have a sense of the prognosis and what treatment may benefit them, and I can talk to them about their mental health issues. The veteran still consults with doctors, psychologists and psychiatrists, whom I often help them source and connect with, with myself monitoring treatment outcomes and progress.
With the veteran I formulate and submit a rehabilitation plan and then aim to meet every fortnight – ideally face-to-face – focusing on the activities we’ve set based on our goals, which usually fall into the categories of medical, psychosocial and vocational management. These meetings can be quite casual, as my initial goal is to build a rapport with the veteran and gain their confidence and trust. The better our rapport, the more trust they have in me, and the more positive the results.
The program is flexible – new goals and activities can be added and completed ones closed off. Finishing an activity quickly can be a real confidence builder. Often the results take some time to realise, and extra encouragement and support are needed.
Veterans helping veterans
The major hurdle that many veterans face is finding and defining their purpose and their value. I run them through a gamut of assessments designed to determine their interests, passions, likes and dislikes. I help with setting things up, sourcing information and opportunities, and connecting them with other people, often fellow veterans.
I work with one young veteran who runs a martial arts combat gym. I have another guy who is passionate about martial arts, but who can’t participate because his injuries are so limiting.
I was so glad he told me. I spoke to the girl who runs the gym and suggested he could be a spotter during class, checking people’s form and technique, or just help by taking the payment before class or selling the merchandise. He doesn’t care what he does – he just wants to be around people who are passionate about martial arts. There are plenty of other examples, like the two veterans who are supporting each other in studying law at their local university.
Who better to help a veteran than a veteran? They understand the mental health implications of being in the defence force and empathise with each other. While not a veteran myself, I can still bring a level of understanding, and provide education to help them put some perspective around their challenges. I try and be as responsive and realistic as I can.
One highlight for me was being invited to an exhibition wheelchair basketball game by a veteran I had organised weekly taxis for so she could get to her games. So I went to the game and cheered her on.
Returning to work isn’t for everyone
These days most employers do a pre-employment assessment. The need to disclose injuries makes things difficult for veterans, because it has a huge impact on people’s perception of what you can and can’t do.
I’ve had people turned down based on their pre-employment assessment, even though the job was suitable and their GP had said that they can do the job. If the veteran has a family to provide for, failing to secure work can have a huge impact on their mental health. This seems to affect men more than it does women – while this belief is slowly changing in society, for the most part men still expect to be the breadwinners, and if they are not, it impacts their sense of worth.
Sometimes returning to work isn’t appropriate, at least in the short-term. It’s my job to assess whether a veteran goes back to work or not. If it is not a feasible option, a psychosocial program may be offered instead. Sometimes my view differs from the view of the veteran’s GP – I might say they’re unfit to work, the GP might say they are, or vice versa – and we have to work towards an agreement while being guided by the veteran’s personal goal. Volunteer work can be a useful bridge back into work.
If we agree a veteran can return to work, at least one of the goals we set has to be vocational, though it doesn’t necessarily have to be short-term. A goal could simply be to determine three medically suitable and sustainable options for future employment. Once that’s achieved, we can move onto reviewing and engaging in one of those three options. Perhaps they undertake worksite visits, do a work placement or volunteer at a local organisation that supports the chosen option, which can be a precursor to employment.
A diverse, challenging and rewarding career
An OT is dually trained, having both a mental health and a physical health skillset, which enables them to support and assists veterans to achieve their goals. It’s challenging, but the diversity of the work is interesting, and the results make it incredibly rewarding. You also have the confidence of knowing that there are always specialists available to assist, and being a specialist yourself gives the veteran increased confidence in your role in their life.
When contemplating my role as an OT in veterans’ vocational rehabilitation, I think I often have to be the holder of hope until they can hold hope for themselves.
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