Ashira MorrisPeer networks work to overcome the stigma that student veterans face in accessing care
Since 2009, more than a million veterans have used their Post 9/11 GI Bill benefits to attend colleges and universities across the country. That number is only expected to increase in the coming years as more military personnel return from tours of duty in Iraq and Afghanistan, seeking degrees to bolster their civilian careers.
For many, the transition from military to campus life can be challenging for a host of reasons, including the fact that a large percentage are returning with physical and non-apparent disabilities acquired during training and in combat. These conditions, along with other challenges related to re-entry, have prompted schools to step up their efforts to support those who have served.
The question now is how to create an environment where student veterans will access the services that are becoming available to them.
Peer networks may be the answer.
Ten years ago, Adam LeGrand was on his final deployment as an Air Force medic in Qatar when a serious accident led to a medical discharge for the resulting back injuries. After going back and forth between dead-end jobs and suffering a debilitating panic attack that set him back emotionally, he heard about the veterans support program at Syracuse University and immediately applied to the school.
The private school in upstate New York has had a large veteran presence since the original GI Bill in 1918 brought nearly 800 vets to campus. Like many colleges, it has a Student Veterans Organization and a veteran’s lounge. It’s also home to the Institute for Veterans and Military Families (IVMF), the first interdisciplinary academic institute of its kind, and an active chapter of Student Veterans of America, a national network for student veteran groups on campus. (The current president of SVA earned a degree at Syracuse and came to the presidency from the IVMF.)
LeGrand was accepted at Syracuse and started classes last August. Since arriving on campus, he has been deeply connected with the veterans organizations on and off campus. Because of these relationships and his candid approach to his own disability, the SVA named him one of the first Disabled Veteran Disability Services Liaisons (DSL) as they pilot the program.
In this role, LeGrand is the link between fellow student veterans, the office of disability services, the veterans recruiting office, the Veterans Administration (VA), and academic campus departments, ensuring fellow vets receive the health services and classroom accommodations they need.
It’s a critical link. An estimated 20 percent of student veterans have post-traumatic stress or depression. Nineteen percent have a traumatic brain injury (TBI). According to a national survey by Syracuse’s IVMF, nearly half of the student veterans were thinking about suicide; twenty percent had a plan.
Encouraging help-seeking behaviors in student veterans is one of the biggest challenges advocates like LeGrand face. After spending years on a regimented military schedule, campus life can be disorienting and open-ended.
“You don’t take care of yourself when you’re in,” said Dan Standage, Director of Disability in Education for SVA. “You take care of yourself last. [A supervisor] tells you when you go down to medical. When you get out, that mentality still prevails. You’re waiting around for someone to tell you what to do.”
On a college campus, the onus is on the student to seek out the health services they need; for student veterans, who also carry the military’s “tough-it-up” attitude toward mental health into the civilian world, coming forward and asking for help can be a tall order.
Veterans are physically and psychologically in a different place than most freshmen who show up straight from high school.
They have often lived overseas; some have seen combat.
They are in their mid-20s or older. Many have families.
They joined the military after high school in good health, then may have acquired a disability – physical or mental or both – during their service. The stress of a military deployment, even without seeing combat, can be enough to lead to mental health issues.
While veterans often don’t transition out of the military in time for orientations that begin weeks before classes, most issues aren’t because of poor communication about what’s available. Stigma is a much higher mountain to climb.
“The culture around disability for veterans is weakness,” Standage said. “That culture and pride gets in the way of student veterans getting the help they need, and that’s assuming they even know the services exist.”
The VA reports that 38 percent of all veterans returning from Post-9/11 missions have a disability and as many as 20 percent have a mental health condition.
Yet only 14 percent of veterans who are eligible for services on campus are using them. Considering 51 percent of student veterans report having some kind of service-connected disability, and 80 percent of those reported that their disability has a negative impact on their academics, these statistics are concerning, especially since veterans with disabilities are using higher education to transition into civilian society.
“We’re teaching veterans that ‘disability’ doesn’t mean ‘broken’,” Standage said. “It just means you have to do things a little differently.”
“Differently” can mean going to a psychiatrist or a peer-counseling group specific to student veterans. It also can mean asking for accommodations, such as additional testing time, different testing locations, and note takers – all of which can have an enormous effect on a student veteran’s success.
Just sitting in a classroom can be hard, as veterans tend to constantly scan the room for danger and feel uneasy sitting with their backs to the door. Concentration can be difficult, especially if they have an untreated TBI. For infantry soldiers who have experienced combat, the sound of students walking through the halls in flip-flops can sound like a machine gun.
For veterans who return with a physical disability, pain and other symptoms associated with their injuries can make their attendance in class less consistent. They also may be on pain medicines that affect their ability to concentrate and take notes.
The more alienated veterans feel for making the requests they need, the less likely they are to set themselves up for success. Conversely, Standage notes, veterans want to help their peers out and can be the key to normalizing help seeking.
LeGrand understands this. As a veteran himself, his encouragement carries more weight than a recommendation from an administrator who hasn’t been in a conflict zone. He is conscious of providing the best approaches for 23-40-year-olds who have life experience but might be embarrassed of their disability or don’t feel they deserve testing accommodations.
“Some students perceive the counseling center as a place where an 18-year-old goes when their pet dies, not a place where their service-related, post-traumatic stress can be addressed,” Standage said.
This semester, LeGrand helped out one recently enrolled veteran with a diagnosed learning disability due to a brain injury. He talked him through the process of how to access accommodations on campus, then walked with him to the VA to help set up medical services.
“Adam has the pioneering spirit that defines servant leadership, the genetic code of the DSL,” Standage said. “He’s using leadership to reframe disability in the student veteran space. Mentorship is instinctive to veterans, and Adam is bringing that familiar element to a place [disability in education] that is largely unfamiliar to veterans.”
LeGrand also leads by example: He is upfront and public about his own post-traumatic stress and traumatic brain injury. He brings his service dog, Molly, a Yellow Lab/Golden Retriever/Wolfhound mix he received from the K9s for Warriors program, wherever he goes on campus.
He mentors student veterans in the process of being admitted to Syracuse so they know where to go from day one. It’s not only a lesson in how to access care, but also, implicitly, a statement that it’s okay to do so.
“I can’t be a combat medic anymore, physiologically and emotionally, but I can still take care of my veteran family,” LeGrand said. “My duty is to continue the mission.”
As the programs at private universities like Syracuse have proven, veteran peer networks are a powerful way to support student veterans. The same is true of community colleges, where over 30 percent of veterans using Post 9/11 GI Bill benefits go for their degrees. But for these schools, encouraging student veterans to access help is only part of the problem.
Community colleges face challenges to provide health services for any of their students: They tend not to have fully staffed counseling centers or robust help-seeking cultures. For a veteran already reluctant to seek out services on his or her own, this can be detrimental.
This spring, Ann Cheney co-authored the first published study on the mental health concerns of veterans enrolled at community colleges. It surveyed 11 community colleges in rural regions throughout Arkansas.
“Community colleges are already underserved and under-resourced,” said Cheney, now an assistant professor at the University of California-Riverside. “We wanted to talk to student veterans at these schools about their mental health burden and their ideal models for care.”
The study’s authors listened to stories from veterans whose trauma led to sleep disturbance, hypervigilance, irritable or aggressive behavior, and difficulty concentrating.
“Our findings underscore the need for supportive services in higher education to integrate student veterans into campus communities and refer them to mental healthcare resources [to help them work] toward improving their academic success,” Cheney said.
Despite the need, a scant 12 percent of community colleges have a psychiatrist or other licensed prescriber on staff or contracted to provide services. Most do not provide suicide prevention resources. This means that student veterans have to seek out care from community services, usually the VA. In rural areas like the ones Cheney studied, the students needed to drive to access care.
“Even with VA benefits, they may not have the gas money to get there,” she said. “It becomes low on their priority list.”
Many veterans struggle financially, and they often don’t see their personal mental health as a direct concern. But they do recognize the stress that comes from a tight budget. Like many community college students, veterans often need to work a job in addition to attending classes. On a daily basis, they are juggling roles as an employee, student, partner, and parent.
On top of that, Cheney said, there’s also their history of combat or general exposure to violence, which exacerbates mental health issues and stigma. Like Standage, she notes that the military culture toward help-seeking carries over when they transition into the civilian world. They still see it as a weakness, still adhering to a “suck it up and get through it” mentality.
One of the combat veterans Cheney interviewed in Arkansas told her that his experience in combat is his “cross to bear,” and that it was his duty to suffer from it.
Throughout the interviews, the veterans consistently listed a peer-led model as their preferred way to connect with information and care. Cheney and her team worked with the student veterans, administration, and the community to create the suggested peer-to-peer system. They established peer advisors and had strong support from the school administration.
In the schools with institutional and community support, the program took hold. But others died after the research team left. Because of the high turnover rates at two-year programs, maintaining traction in a peer program can be a challenge.
This, Cheney said, is where SVA and other national organizations can make the difference: their institutional support is consistent even as students and staff turn over.
The SVA’s Disability Services Liaison has the potential to carry forward the peer model with national, institutional backing.
Although the program is currently in a pilot phase, of the 11 schools that current have the toolkit, three have been especially active: Syracuse and two community colleges, Riverside City College and Pima Community College.
This fall, Adam LeGrand will be a senior at Syracuse, a year away from completing his degree in communications and rhetorical studies. He’ll continue serving as the school’s SVA Disability Services Liaison, meeting other student veterans peer to peer, soldier to soldier.