The Use of Peer Support Interventions for Veterans Facing Community Reintegration Challenges

Background and Purpose

Veterans often struggle with community reintegration after military life, facing challenges including job insecurity, relationship difficulties, anxiety, social isolation and depression.  Post-traumatic stress rates for Veterans are as high as 60%, and approximately 22 U.S. Veterans per day die by suicide.  Innovative service programming is required to help Veterans forge pathways out of isolation.  Peer support interventions, delivered by and for Veterans, can improve reintegration outcomes, improve outreach and reduce Veteran suicides.  This paper presents data from a multi-site program evaluation, offering insight into the lived experience of Veterans receiving peer support.

Methods

A phenomenological qualitative design was used to examine the experience of reintegration and use of non-clinical peer support services for Veterans spanning multiple eras.  In-depth, semi-structured interviews were conducted with 100 Veterans providing or receiving peer mentorship services from ten distinct programs.  Audio recordings were transcribed, coded and analyzed for themes with Atlas TI software.  Template Analysis was used to analyze data in partnership with a team of Veteran research consultants.

Results

Data analysis yielded 110 codes, clustered into 6 primary categories, then classified into secondary and tertiary codes, and organized into themes.  Participants faced a highly complex set of reintegration challenges, with significant negative impact upon functionality and community living.  Participants described multiple losses (of structure, camaraderie, perceived life value, military culture, and mission/purpose), lack of preparation for reintegration, survivor’s guilt, emotional and physical isolation, and feeling misunderstood by civilians.  Stigma regarding mental health services was a universal theme, with tremendous distrust of traditional providers.  Participants instead sought to engage in non-clinical interactions with peers/other veterans.  The resulting peer mentorship relationships were described as more genuine, mutual, and meaningful than those with professional providers.  Many characterized their peer support experiences as life-saving, preventing social isolation, and offering positive role modeling opportunities.  Peer mentor relationships were conceptualized by Veterans as “battle buddies”, replicating the intensity and intimacy of close military relationships within combat units.  The recreation of unit-like dynamics and social camaraderie appears to have significant benefits for Veterans.  The positive impacts of social connections and peer support are essential to overcoming reintegration challenges, and can lead to life-changing personal growth following military service.

Conclusion

This study has implications for social work practice, education, research, and social policy related to Veterans.  Consistent with the profession’s Grand Challenge of reducing social isolation, peer support interventions meaningfully engage Veterans in prosocial activity, offer valuable meaning, and provide positive hopeful relationships.  The shared experience and identification found in peer support replicates military social bonds, and eases resistance to help-seeking.  Programs and social workers serving Veterans must incorporate better knowledge of reintegration challenges and assist in the development of peer support interventions.