Serving Together: Using Peer Navigators to Enhance Veterans’ Health and Well-Being Sally Koblinsky, PhD*, Katie Hrapczynski, PhD*, Suzanne Randolph, PhD**, Stefanie Moreno, MS***, Jessica Fuchs, MS***, & Ernest Spycher, SGT, Ret.*** *University of Maryland, College Park **MayaTech Corporation ***Serving Together, Mental Health Association of Montgomery County

Need for Service Veterans and military families: a top national priority More than 2.6 million American service members deployed to Afghanistan and Iraq Approximately 1.6 million of these troops now veterans Increasing demand for civilian professionals and communities to serve veterans and their families

Mission Serving Together: A collaborative partnership to coordinate and strengthen community-based health/mental health, education, employment, housing and other support services for service members, veterans, and families in Montgomery County, MD

Support Robert Wood Johnson Foundation: 4 year grant Montgomery County Government 10 National Capital Area Foundations Other Local Donors

Montgomery County, MD Almost 50,000: Total Veterans 8,000: OEF/OIF/OND 500: Wounded Warriors Walter Reed National Military Medical Center National Intrepid Center of Excellence Within 1 hour: Ft. Meade, Ft. Detrick, Andrews Air Force Base, Coast Guard Yard, Baltimore

Peer Navigation System Assists veterans, service members and families of all war eras Builds partnerships with community agencies Provides extensive outreach to potential clients Conducts referral and follow-up vs. duplicated case management Tracks client outcomes Identifies gaps in service for community agencies and policymakers

Three Additional Peer Navigation Systems Serving Veterans Charlotte Bridge Home (North Carolina) Augusta Warrior Project (Georgia) AspenPointe Peer Navigator (Colorado)

Serving Together’s Peer Navigator Veteran with counseling skills Orientation to project and county’s military/veteran serving agencies Trainings ▫ Mental Health First Aid ▫ American Association of Suicidality ▫ Mental Health Association Case Management Training

Peer Navigator Services Information Services Short-Term Consultation and Referrals: ▫ < 2 weeks Long-Term Assistance: ▫ 2 weeks to a year

Client Use of Peer Navigator June 1, 2013 through May 31, 2014 Type of CaseNumber of Cases % of CasesNumber of Contacts Information Services 3830%38 Short-term Consultation and Referrals 2722%54 Long-Term Assistance 6048%475 Total:125100%567

Demographics of First Year Clients Cold War veterans (40-50 years): largest group OEF/OIF veterans: 33% Equal numbers of men and women Family members: 21% Veterans: 60%, Active Duty & Reserves: 40%

Requests for Assistance Client Interviews Most Prevalent Concerns ▫ Financial challenges ▫ Employment issues ▫ Housing insecurity & homelessness ▫ Behavioral health conditions (e.g., PTSD, alcohol abuse) ▫ Veterans benefits ▫ Education

Client Evaluation Survey ItemMean Prompt return of your call/ 3.50 Listening skills3.50 Understanding of your needs3.25 Knowledge of available resources/services3.00 Usefulness of information provided (good advice, referrals, answers to your questions) 3.25 Courtesy of response3.75 Likelihood of recommending Serving Together’s Peer Navigator to others 3.50 Overall satisfaction3.25 Likert Scale: Excellent = 4, Good = 3, Fair = 2, or Poor = 1

Qualitative Client Feedback Strengths of Peer Navigator System 1.24-hour Navigator response to initial contact 2.Empathy/support from a fellow veteran 3.Navigator’s in-depth knowledge of local resources 4.Personalized, “one-stop” referrals to community agencies

Behavior Change Following Peer Navigator Assistance Examples: ▫ Researched local companies in my job search ▫ Revised resume to be more “civilian-friendly” ▫ Identified remaining educational benefits ▫ Modified/improved my compensation claim ▫ Found low-cost rental and obtained free furniture ▫ Filed a hardship waiver ▫ Entered a counseling program ▫ “Gave me hope…a light at the end of the tunnel.”

Agency Feedback Increased client attendance at appointments Earlier treatment of behavioral health problems Enhanced ability of police department to provide appropriate referrals for veterans in crisis (versus taking them to the police station) Improved client coping and self-sufficiency Successful coordination of resource use from multiple sectors

Challenges Outreach to OIF/OEF veterans Branding of the program linked to the Montgomery County Mental Health Association Engagement of business and faith communities Insufficient resources to address housing for veterans without a mental health or substance abuse diagnosis Large number of cases with multiple problems requiring long-term assistance Difficulty in reaching clients for evaluation

Lessons Learned Clear need for Peer Navigator ▫ Number of cases ▫ Complexity of cases Accessible, “high-touch,” comprehensive services Partnership/systems integration with service providers Targeted outreach for OIF/OEF veterans Additional program evaluation needed on Peer Navigator intervention for military/veteran families

Program Replication Planning Grant to Expand Serving Together to Fairfax County, Virginia

Thank you! For more information: Jessica Fuchs Project Director, Serving Together (301) Ernie Spycher Peer Navigator, Serving Together (301) Sally Koblinsky Program Evaluator (301)