Real Help for At-Risk Veterans

We all intuitively know that returning veterans have a difficult time transitioning to civilian life, but most of us don’t appreciate just how difficult it can be. Anywhere from 11 to 20% of all veterans who served in Iraq and Afghanistan have PTSD in any given year. An average of twenty-two veterans commit suicide every day. “Couch-surfing” is a form of homelessness common among those who have recently returned due to the inability to pay rent.

Why am I writing about this on a website called Thinking Moms’ Revolution, you ask? Well, a surprising number of our readers are either in the military themselves or married to someone in the military. Given that most of the people who find their way to us either have chronic health issues or children with chronic health issues, you can read into that what you will. In any event, veterans’ concerns are directly applicable to the lives of those readers, and forestalling or alleviating such challenges is a topic of great interest. So, today on Veterans Day, we address some ways to do just that.

Yesterday’s blog about the Evolution of Medicine mentioned an app by Manish Shah and Navin Gupta called PeerWell that is designed to match people with others going through similar health challenges, creating an electronic form of peer-to-peer community support intended to alleviate some of the many difficulties people face when making the life changes necessary to regain their health. Today, PeerWell is launching a new implementation of their app designed to help returning veterans, those whose mental health is most at risk, transition to civilian life with as few hiccups as possible.

PeerWell created this version of their app in collaboration with Swords to Plowshares, a not-for-profit organization in the San Francisco Bay Area whose mission is helping returning vets get the support they need to live successful civilian lives. Their motto is “When their service ends, ours begins.” Returning vets can download the PeerWell app and get a free code from Swords to Plowshares that will unlock the functionality they will require.

As you might imagine, given that the Department of Veterans Affairs (VA) is a branch of the federal government, returning vets have to navigate a thick tangle of bureaucratic red tape in order to receive the benefits to which they are entitled. When they leave the service, veterans are handed a stack of paperwork laying out the details of all the things they need to do to receive the benefits they are due, but for people who have spent their recent years in military operations that stack of paper can be extremely intimidating, and many returning vets end up forfeiting very important benefits that could be of enormous help in their transition. The Department of Defense, veterans’ ex-employer, is a separate entity from the VA, and the two do not share information. In addition, the VA itself is divided into three sections: the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and the National Cemetery Administration (NCA), which also do not share information. Veterans need to file paperwork for both the VBA and the VHA when they get out. Returning veterans are entitled to six months of unemployment, but the clock on that six months starts immediately after they leave the service whether they apply for it (through the VBA) then or not. So every week that the application is not filed is a week of unemployment pay lost forever. Veterans are also entitled to five years of free healthcare through the VBA. Given what we know of long wait times for doctors’ appointments at the VA, the sooner a vet with significant health issues files, the better.

Swords to Plowshares has published a 27-page Transition Manual available in PDF form outlining what many veterans wish they had known when they came out, and telling newly returning vets what they should be doing, and when and how they should be doing it. The manual is a wonderful thing, but one of the most important factors in successful transition cannot be attained through a manual: peer-to-peer support. Studies have shown the value of peer-to-peer support in reducing symptoms of depression, and veterans who have taken on the task of creating veteran peer-to-peer networks say that they are saving lives. One of PeerWell’s main goals is to make such a life-saving network available to any returning vet.

The veteran-specific implementation of PeerWell is intended to help mitigate the complexities of governmental bureaucracy. There is a one-item-per-week checklist that includes things like “File for unemployment” with a link or other information specifically instructing the user how to do so. One of the benefits of the app becomes apparent when you realize that from time to time the government agencies can and do change the links to the specific information veterans require. Some of the links in the Transition Manual have been changed two or three times since the manual was last published in 2012. By the time a vet finds the stack of paper given to him or her at discharge and wades through it to the appropriate page or packet, the information could already be out-of-date. The information driving the PeerWell app is kept on PeerWell’s own servers and can be changed dynamically. Whenever government information is revised, PeerWell will be informed, and all vets using the app will be able to access the correction information easily.

Since returning vets are at high risk of depression and PTSD, the app contains a mood assessment so that users can easily determine their level of risk. When the mood drops too low, the app will prompt the user with specific action suggestions like checking in with a local mental health center, and if it gets really low, it will direct the user to the veterans’ suicide prevention hotline.

The most important feature of the app may be, however, the peer-to-peer matching. The app matches male vets with up to nine other males at about the same stage of transition. Statistics show that women will be chattier on social media, so their groups tend to be smaller, topping out at a total of eight in a peer group. The group is sent text updates when someone checks something off their list. And peers will be able to check in with each other and as a group make sure no one falls through the cracks. I asked Kevin Miller at Swords to Plowshares whether there was any concern that there were veterans who couldn’t use the app because they don’t have smartphones. Miller says that it’s a rare veteran these days who doesn’t at least carry a phone that can receive texts. While the current implementation is strictly for the iPhone, an android version is on its way as well as a text-only version.

This implementation of the app is aimed at transitioning veterans. Statistics show that most suicides occur within three years of discharge, so this is the group most at risk. The earlier the intervention and the greater the support, the smoother the transition and the lower the risk. But what of veterans who returned long ago, and may have already fallen through those cracks? Their needs are generally quite different from those of the recently discharged vets. Gupta says that there are plans in the works to expand PeerWell’s functionality in the future with a version more suitable to the needs of long-time vets.

Given the sometimes overwhelming difficulty veterans have returning to civilian life after their military service ends, I’m really glad to hear about this innovative new way to help veterans get the best possible support in real time. Personally, I’m hoping that PeerWell marks the beginning of a new era marked by a significant downward trend in the veteran suicide and homelessness rates. After serving their country, traumatized veterans don’t deserve to live in poverty and despair because they couldn’t figure out the bureaucracy all on their own.

If you know any veterans recently discharged or contemplating a discharge, please make sure they know about the PeerWell app. It could save a life.

~ Professor

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