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Recent data suggest that just over 50% of U.S. veterans use VA benefits for which they are eligible, yet research disproportionately draws on VA samples, excluding almost half of the population including those most at risk of social isolation. Typically run by veterans themselves, community-based peer support programs offer a non-stigmatizing, trauma-informed resource with social connection as the centerpiece, offering meaningful alternative to VA participation. However, the successful implementation of such programs requires creativity, innovation, non-traditional engagement, and an increasingly complex array of community partnerships. This qualitative study examines the challenges and barriers facing effective program implementation for such programs, offering insights for social workers invested in ensuring all veterans have access to life-saving services.
Methods
A qualitative research design embedded within a larger evaluation study was used to elicit the lived experiences of program directors running veteran peer support initiatives. Purposive sampling yielded a diverse group of veteran participants. Qualitative video interviews (N=15) were held using a semi-structured interview guide and online video technology. All interviews were audio-recorded and transcribed verbatim. Data were also triangulated using monthly service delivery reports from a larger sample of programs, each describing unique barriers and challenges. All data were collaboratively coded and analyzed using Atlas-TI software. The research team used a phenomenologically driven approach to content analysis, using King’s (2011) template analysis method to develop themes.
Results
Analysis of the interview transcripts and monthly data responses yielded 35 primary codes, which were then categorized by domain. Analysis revealed the following key themes: the challenge of navigating complex administrative systems, the importance of fiscal autonomy and decision-making authority, resource challenges related to serving rural veterans, the need for appropriate and comprehensive staff supports, difficulties reaching subgroups of vulnerable veterans, and the value of inclusive welcoming environments. These themes highlight common struggles faced by program directors and demonstrate that implementing peer support programs is a complex endeavor requiring strong organizational capacity and sustained external support.
Conclusion and Implications
The findings here offer practical guidance for social workers and other stakeholders interested in veteran well-being. Peer support programs are a viable and meaningful alternative to traditional care and a potential bridge into formal systems for veterans not currently engaged with the VA. These programs help reduce social isolation and foster connection, purpose, and community among veterans. Program directors described navigating highly complex local and state systems while facing numerous challenges. Understanding the barriers to peer support program administration within the veteran community can provide social workers with valuable knowledge as they link individuals to resources and seek to support veterans. Social workers are well-positioned to advocate for peer support initiatives, contribute to policy efforts that sustain them, and engage in collaborative research within veteran-focused programs. Finally, peer support settings provide rich training opportunities, helping social workers develop the relational and cultural competencies essential for ethically and effectively serving veteran communities.