Veterans and Their Families as Multiple Service Consumers
The Unique Role of Social Workers in Uncovering Hidden Needs of Clients
Roger J. Sherwood, DSW, Associate Professor, Hunter College School of Social Work
The Afghanistan and Iraqi wars spill across our televisions nightly, however here at home veterans represent a hidden population whose needs and problems pervade social work practice. They are hidden because they rarely identify themselves as veterans nor do professionals often think to inquire about military service. This may be even more likely if the veteran is a woman.
As social workers, what should our role be in relation to veterans seeking services at any agency? As with all clients, we need to start where they are and ask what they are seeking from us. Concurrently, we need to gain an understanding of the role military experience has in relation to the presenting concern or request. Our assessment may lead us to identify and work with veteran-related issues as a component of the agency’s work, or it may be appropriate to refer the individuals to agencies specializing in services to veterans.
World War II veterans were part of a war that involved the entire nation. Nearly everyone had a family member, co-worker, friend or neighbor directly involved in the military. Korea saw reduced national involvement, and Vietnam, while having much involvement, had many conflicting subgroups. Other conflicts up to the Persian Gulf, Desert Shield and Desert Storm were smaller and affected fewer people. Afghanistan and Iraq involve international forces but a very small proportion of Americans are directly affected. Roughly one half of one percent of the American population are in the military. This small group carries the direct impact of these engagements and are often required to do so in multiple deployments.
Unless social workers are aware of the veteran population and skilled in exploring related questions, returning veterans or family members of deployed veterans, may remain underserved and below the radar. Veterans and their family members are consumers of services in every setting that employ social workers from schools to nursing homes. When the veteran is deployed, a number of people are affected including parents, siblings, partners, children and friends. Children may exhibit behavioral changes in school that precipitate a referral to a social service program. Without the understanding and knowledge of the parent’s deployment, critical information and connections to presenting problems can be missed.
In their task of transitioning from military life to civilian life, veterans returning from the military face issues in relation to employment, education, and reintegration back into their social networks. Others are required to continue their military service as citizen soldiers, members of the National Guard or Reserves, in order to receive their educational benefits. They remain vulnerable to being recalled to active duty and redeployed.
Social workers and agencies first need to be aware that this population may be utilizing their services. A single question on an intake form asking: ”Have you or any member of your family ever been in the military?” may help identify potential need. Once we have identified a veteran or family member of a veteran, we need to explore the impact of military service. It is not uncommon for veterans to have challenges re-integrating into a markedly different civilian life from the one left behind at the time of deployment, with repercussions for them and their families. For example:
Mary, a mother of four lively school age children, had struggled to take over family responsibilities when her National Guard husband was suddenly called up for a tour in Iraq. While it had been a stressful time, she had adjusted and even secured a part-time job in a hospital. A year after his return, her husband seemed remote and drank more than usual. Things had changed at his job and he had missed a promotion while deployed. Financial pressures were increasing, marital conflict developed and their twelve year son was having problems in school. Mary sought help from the social worker in the Employee Assistance Program but did not connect the current problems to their readjustment after military deployment.
Many of our troops have been exposed to traumatic experiences and/or high stress events. Combat veterans may be at higher risk for substance abuse as they seek to self-medicate anxiety and sleep disturbances. We also need to assess whether they are experiencing residual effects ranging from Post Traumatic Stress Disorder (PTSD) to Traumatic Brain Injury (TBI). Post traumatic stress disorder manifests as intrusive thoughts, flashbacks, high anxiety, sleep disturbance, nightmares, or trouble concentrating, etc. Other veterans who were exposed to improvised explosive devices (IEDs) in Iraq and Afghanistan may have experienced concussions that, in varying degrees, have led to traumatic brain injury (TBI).
As Mary’s social worker explored more about her husband’s exposure to stressors in Iraq, it became known he had been exposed to multiple blasts and may be at risk for traumatic brain injury. A referral to the local veterans hospital was made and the veteran was also able to see a social worker in a veterans outreach center who involved him in a group for combat veterans.
Another area in which we can assist veterans transitioning from the military is with their educational benefits. As of July 2008 returning veterans from Iraq (Operation Iraqi Freedom or OIF) and those returning from Afghanistan (Operation Enduring Freedom or OEF) became eligible for the New York State Veterans Tuition Award which pays for up to $4,286 toward tuition at any college in the State of New York. In August 2009 the new federal GI bill will begin, and it will provide money for tuition, books and a living allowance.
Hunter College School of Social Work received funding to start an outreach program within the City University of New York for returning veterans. Currently, there are more than 1700 veterans receiving educational benefits while attending one of the 23 campuses. Project for Return and Opportunity in Veterans Education (PROVE) started September 2007 and is now in its second year. Social work interns are tasked with reaching out to student veterans, engaging and assisting them in linking to medical care, additional educational benefits, peer support and counseling. Interns also connect student vets to other student vets via student veteran clubs. Social workers bring critical skills in assisting veterans as they navigate complex bureaucracies while simultaneously building upon and maximizing the multiple strengths that veterans bring to their campuses.
Social workers’ education and training prepares them to be highly responsive to the range of issues veterans may present. Regardless of the setting, social workers can provide assistance by thanking veterans for their service, promoting connection with other veterans and their social/familial networks, validating and supporting their interests, talents and specialties, and linking them with appropriate veteran-related services and agencies.
Editor’s Note: Dr. Sherwood treats veterans with Post Traumatic Stress Disorder. He is one of the initial organizers for the annual conference
on the “Still Hidden Clients: Veterans and Their Loved Ones,” which started in 1983.