Engaging Veterans and Families to Enhance Service Delivery

Table of Contents

I. Executive Summary
II. Serving Today’s Veterans
III. Veteran Engagement and Service Delivery

• Military Cultural Competency
• Effective Outreach and Engagement
  • Outreach Challenges
  • Maximizing Traditional Outreach to Veterans
  • Outreach to Veterans in the Digital Age
  • Connecting with Veterans, Families, and Friends
• Enhancing Service Delivery
  • Understanding Trauma-Informed Care
  • Addressing Traumatic Stress
  • Online Therapy

IV. Citations
V. Resources

I. Executive Summary

The return of our men and women in uniform serving in Iraq and Afghanistan will rival the scale of World War II demobilizations in some communities. Our federal government agencies and their community-based organization grantees are engaged in a commitment to end veteran homelessness within five years led by President Barack Obama and Secretary of Veterans Affairs General Eric Shinseki. These events underscore the urgent need to expand veteran services and improve their effectiveness for returning troops, many of whom have sustained physical and psychological injuries.

We can and must improve the effectiveness of informing veterans and their family members about the full range of available government and community-based resources. We must also address the very real barriers that limit access and use of these vital programs and services.

To enhance support for veterans and their families, and increase the use of government and community-based services, The National Center on Family Homelessness (The National Center) with funding from the Walmart Foundation, created Engaging Veterans and Families To Enhance Service Delivery: A Tool Kit for Community-Based Organizations. This publication offers tools, resources, best practices, lessons learned, and cutting-edge research to improve the effectiveness of community-based organizations’ staffing, program design, delivery, and outreach and engagement of veterans and their families and friends.

Among the resources in this publication, readers will learn:

• How “texting campaigns” can reach veterans anywhere. How you need to change your intake process to support texting campaigns, and how to learn more.
• How to locate “invisible” veterans such as women who do not self-identify as veterans, and what to ask to discover an individual’s military service history.
• How to understand and use “trauma-informed” care (a nonmedical method of providing emotional support) and how it can improve the effectiveness of veterans’ services in all areas (employment, housing, substance use treatment, and mental or physical health care).
• How community organizations serving veterans can mitigate staff burnout and lower staff turnover rates.
• How to identify cutting-edge models of service delivery that address the significant barriers to providing treatment to veterans, while engaging their families and friends.

The purpose of this publication is to improve the effectiveness and impact of the ever increasing number of non-governmental and community-based organizations working to meet the needs of veterans, especially those recently separated from military service. We urge you to share this Toolkit with other individuals or organizations. For additional information, other veteran resources or electronic copies please contact: The National Center on Family Homelessness 617-964-3834 or www.familyhomelessness.org/resources.

II. Serving Today’s Veterans

The number of returning veterans from Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) is expected to surge in correlation with President Barack Obama’s announced withdrawal date of December 2011 from Iraq. Returning veterans will need specialized services from government and community-based organizations to ensure they do not fall through our nation’s social safety net. Of the veterans who have returned, over one-third have been screened as being at-risk for Post Traumatic Stress Disorder (PTSD) and other mental health conditions.¹ PTSD is an “injury to the mind” in which a traumatic event causes lasting anxiety.² Despite the risk of developing PTSD only one-half of at-risk veterans will pursue any form of mental health assistance for their condition.³ Another common psychological injury suffered by veterans is Traumatic Brain Injury (TBI), which is a noncongenital “insult” to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.⁴ Together, PTSD and TBI can cause significant disruption to a veteran’s life when he or she returns to civilian life.

The “new normal” of the Global War on Terror (GWOT) that includes the conflicts in Afghanistan (OEF) and Iraq (OIF) means an increasing number and length of deployments, greater reliance on National Guard and Reserve service members, and new roles for women in the military. The type of warfare in OEF/OIF increases the susceptibility of veterans to mental health problems. With the enemy potentially anywhere at any time, service members need to be continuously on guard. This pace and type of warfare cause service members to be constantly stressed, frequently exposed to trauma and have minimal control of their surroundings. Successful in-theater medical treatment saves lives but increases the number of veterans with both physical and emotional wounds.⁵

Veterans with PTSD or TBI have an increased chance of developing emotional problems and substance abuse, and committing intimate partner violence (IPV).⁶ With the recent economic downturn, many veterans are struggling to find jobs. This is reflected in the June 2010 veteran unemployment rate of 11.5%, which is two percent higher than for civilians.⁷ More disturbing, OEF/OIF veterans are becoming homeless at a faster rate than any previous group of new veterans.⁸

While there is heightened attention to the impact of PTSD and TBI on returning military service members, health and mental health services provided by the U.S. Department of Veterans Affairs (VA) are designed primarily for the veterans. Despite a growing body of research that shows how a veteran’s social network supports a successful transition to civilian life, VA mental health services have only recently begun to include veterans’ spouses.⁹ Current services do not consider the needs of all family members such as parents, siblings, romantic partners or friends, who are often the veteran’s only supports. Services provided by community-based organizations, particularly mental health services, have been negatively impacted by reduced tax revenues to state and local government. The capacity of existing community programs (and the ability to develop new programs) to support both veterans and a broader definition of “family” can be improved and benefits from philanthropic funding, although the amount and availability of these funds are also negatively affected by the uncertain economic climate.¹⁰

In response to the lack of services for veterans’ family members, and lower than optimal utilization of government and community-based services, The National Center on Family Homelessness (The National Center), with funding from the Walmart Foundation, created Engaging America’s Veterans and Their Families To Enhance Service Delivery. Community-based organizations play an important role in expanding the social safety net to help ensure that veterans are able to get and keep jobs and do not turn to substance abuse, violence, or become homeless as they transition to civilian life. This publication offers tools, resources, best practices and lessons learned to improve the effectiveness of community-based organizations’ staffing, program design, delivery, and outreach and engagement of veterans and their families and friends. Our goal is to strengthen the impact of the ever increasing number of non-governmental and community-based organizations working to meet the needs of our veterans.

See the whole publication.