Defining Veteran Peer Support: Representing the Voices of Veterans in New York State

Background and Purpose

The high rate of veterans dying by suicide is a well-known social problem without a simple solution and unmet mental health needs are a major contributor. Peer support is a powerful intervention that can reduce suicide rates. However, veteran peer support is not well-described nor is it understood among non-military communities. Further, it is unclear how peer support for veterans may differ from peer support within other populations. Cultural differences between military/veterans and non-military civilians may contribute to the disconnection between veterans and providers in community settings who have little knowledge of military culture. Incorporating veteran peers in mental health settings can bridge this gap if providers understand peer support and can learn from veterans. This study asked: How do military veterans define peer support? The results of this research have changed the way in which peer services are provided to military veterans.

Methods

This exploratory study used qualitative description to define veteran peer support according to veterans participating in peer programs. Participants included 154 military veterans involved in veteran specific community programs across New York State. The sample included women (22%), diverse ethnicities (African Americans 17%, Latinx 6%, and Native Americans 1%), and different military branches (Army, Navy, Air Force, Coast Guard, Marine Corps). There was great variation in era, number of deployments, types of deployments, and length of time in service. Verbatim transcripts from semi-structured interviews were analyzed and coded for aspects of peer support. Veterans were asked to define peer support based on their involvement in the peer programs.

Results

Peer support was broadly defined as “a veteran assisting another veteran based upon their shared connection of military experience.” Key elements to veteran peer support include an experiential understanding of military culture (rather than theoretical knowledge), instant connection or trust with the peer, less hierarchy than clinical relationships, non-directive tone, increased social support, and a source of education/knowledge. Veteran peer support took many forms that included one-on-one support, group formats, and social/recreational settings.

Conclusions and Implications

While most participants described veteran peer support in similar ways, definitions were nuanced. For example, most participants defined anyone who had ever served in the military as a potential peer, however, a few veterans found branch/type of service, ethnicity, gender/sex, years of service, generation/era, and combat deployment to be factors influencing “peer-ness.” Discovering how an individual veteran views peer support allows veterans to find better matched peer relationships.

This study has implications for social workers who practice with veterans or organize community programs for veterans. Social work practitioners who understand the role of veteran peer support will more effectively meet their client’s needs. Program managers can use these findings to design spaces that are conducive to peer support. These environments would encourage natural connection (i.e. recreational, social, and relaxed), eliminate hierarchies, build trust, and be non-directive. Data from this research has been used to educate social work students and guides the continued implementation of veteran programs in New York.