Veteran Transition: What can an occupation-focused perspective contribute to understanding the impact of transition to civilian life on veteran health

In the UK there are an estimated 3-5 million veterans, defined as individuals who have served in the Armed Forces for at least one day (MOD, 2015). On completion of service the majority transition successfully to civilian life, yet a substantial number experience difficulties (12.5%; Iverson et al, 2005). This proposal sets out to explore the experience of veterans transitioning from service in the armed forces to civilian life. It applies an occupation-focused perspective to this, and explores what this approach can contribute to the understanding of transition.

The study addresses transitions as dynamic events, which may be triggered by a discontinuity in the personal life space (Blair, 2000; Adams, 1979). The nature of transitions may vary: for some they may be welcome, yet for others, unwanted or unexpected, e.g. due to injuries or redundancies or injury. Transitioning successfully is defined as having the skills and attributes to move successfully between one context and another (Piggott and Houghton, 2007). Successful transition from the Armed Forces into civilian society is commonly "measured" through employment, having a family and engaging with society (CSJ, 2014; Castro et al, 2014). Unsuccessful transition has been linked to homelessness, unemployment, alcohol abuse and a risk factor for social isolation (Thompson and Bridier, 2013; Elliot, 2011).

This study takes an occupation-focused approach it investigating how the health and wellbeing of veterans can be supported during transitions. 'Occupations' are defined as activities performed by an individual which contribute to their overall health and wellbeing - this may include self-care, roles, responsibilities and employment. In this context 'health' is the balance between physical, mental and social status, including engagement in occupations. 'Wellbeing' is how satisfied individuals are with that status and/or balance. Occupational therapists are professionals who support people to perform occupations contributing to health and wellbeing; i.e. adapting occupations or using occupation as a therapeutic tool.

Veteran transitions have been addressed in Occupational Science, the scientific investigation into bases of occupational therapy practice occupation and the value of occupation in promoting health and wellbeing (Yerxa, 1990). Plach and Sells' (2013) suggest that regardless of physical or mental health injury, transition from the Armed Forces, causes disruption to daily life as occupational participation is affected. In addition, van Hoorn and McKay (In Press) have identified common occupations veterans participate in whilst serving in the Armed Forces and during their transition from it. Beyond this there is currently limited understanding of veterans' changes in occupational engagement from an occupational therapy/ science perspective within the UK. As Occupational Therapists do work with veterans who are transitioning, it is appropriate to explore the transition journey through an occupational perspective in order to directly inform and support the occupational therapy role with veterans.
The aim of this research is to apply an occupation-focused perspective to the analysis of veteran's health and wellbeing during and following transition to civilian life.
The research will consist of two phases of data collection. Stage one will be qualitative, veterans will be asked to record their transition experience through photo-narrative: a method using photographs to document experience and prompt narrative accounts of experience. These accounts will be thematically analysed and meaningful themes collated in preparation for stage two, the quantitative survey component of the PhD. Stage two would consist of a short survey distributed to wider military and civilian populations; questions would ask participants to rate their level of agreement with themes suggested in order to identify commonalities within the transition experience.