Buddy‐to‐Buddy, a citizen soldier peer support program to counteract stigma, PTSD, depression, and suicide

Abstract

Citizen soldiers (National Guard and Reserves) represent approximately 40% of the two million armed forces deployed to Afghanistan and Iraq. Twenty-five to forty percent of them develop PTSD, clinical depression, sleep disturbances, or suicidal thoughts. Upon returning home, many encounter additional stresses and hurdles to obtaining care: specifically, many civilian communities lack military medical/psychiatric facilities; financial, job, home, and relationship stresses have evolved or have been exacerbated during deployment; uncertainty has increased related to future deployment; there is loss of contact with military peers; and there is reluctance to recognize and acknowledge mental health needs that interfere with treatment entry and adherence. Approximately half of those needing help are not receiving it. To address this constellation of issues, a private-public partnership was formed under the auspices of the Welcome Back Veterans Initiative. In Michigan, the Army National Guard teamed with the University of Michigan and Michigan State University to develop innovative peer-to-peer programs for soldiers (Buddy-to-Buddy) and augmented programs for military families. Goals are to improve treatment entry, adherence, clinical outcomes, and to reduce suicides. This manuscript describes training approaches, preliminary results, and explores future national dissemination.

Provider and Nonprovider Sources of Mental Health Help in the Military and the Effects of Stigma, Negative Attitudes, and Organizational Barriers to Care

“…Recently, military efforts to emphasize and incorporate these sources of help have been suggested, such as a "collaborative intervention" model that promotes the merging of expertise between medical officers and chaplains to treat psychological problems (22). Other programs that incorporate peer support (23)(24)(25) or family support (26) show promise to provide effective and favorable options for returning soldiers. Barriers to care affect soldiers' decisions to seek help (13,20).…”

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

“…Among these are disproportionate rates of posttraumatic stress disorder, mood disorders, suicide, substance abuse, and chronic health problems. PS has been an acceptable strategy to promote treatment entry and adherence and to improve clinical outcomes (45). In Vet-to-Vet, a PS program for veterans with chronic mental health problems, program satisfaction and recovery orientation were associated with duration and frequency of program participation (5).…”

Peer Advisors for Veteran Education (PAVE): Implementing a sustainable peer support program for student veterans on college campuses

“…Decreasing stigma is of special relevance to student veterans for whom concerns about being weak or needing help may get in the way of asking for assistance, which is crucial to successfully transitioning to academic life after leaving the military. (Greden et al, 2010;Dalack et al, 2010). Recognizing the increasing numbers of veterans returning to civilian life and entering college, and noting the emerging issues with transition challenges, in 2012 the M-SPAN Team consulted with subject matter experts and reviewed recommended literature to further delineate issues and gaps in services specifically for student veterans.…”