People who work with Service Members, Veterans and their Families (SMVF) to prevent, treat and support recovery from addictions find that understanding the particular cultural context of military service increases their ability to engage and establish rapport. According to the Department of Veterans Affairs, in 2014, there were 379,772 Massachusetts living veterans between the ages of 18 and 84, about two-thirds of them aged 45 and older. You might not know that you are working with someone who served or a family member.
According to SAMHSA, 20% of active duty personnel meet criteria for heavy use of alcohol, which is more than 3 times the general population, and the post-9/11 military has experienced triple the prior rate of prescription drug abuse. Each era of service has particular experiences (for greater detail, see the Practice Guidance: Engaging Veterans in Treatment).
First contacts for immediate questions:
1. Veterans’ Crisis Line (Federal)
- Phone: 800-273-8255
- Web: www.veteranscrisisline.net (Confidential online Chat available)
- Text: 838255
- TTY: 800-799-4889
These services are free, confidential, and available 24/7/365 to any Veteran and their loved ones, even if they are not registered with Veterans Administration (VA) or enrolled in VA health care.
2.The Statewide Advocacy for Veterans' Empowerment (SAVE) Team (Massachusetts)
- Phone: 888-844-2838 - press '2' for SAVE
- Web: Statewide Advocacy for Veterans' Empowerment (SAVE)
Resources in the Library (left sidebar) have additional phone numbers, links to documents, and contact information for organizations that provide services for SMVF and people who work with them. At a high level, information relates to several key topics:
- Normalize asking “the question”: Ask people who come to your practice or program, “Have you served in the US Military?”
- Battlemind: being combat-ready is ingrained during training, and this involves mental toughness, emotional control and sharing information only on a need-to-know basis. This may be interpreted as “resistance” in a clinical setting unless the counselor is familiar with military culture.
- Family: Service members and their families experience and prepare for unexpected and long absences.
- Trauma: many service members have experienced trauma, and may have undiagnosed Post-Traumatic Stress Disorder and/or Traumatic Brain Injury.
Resources also provide suggestions for specific adaptations to help engage SMVF. Changes in approach, or even small changes in how furniture is arranged, can make a huge difference in engagement. For example:
- After a training on military culture, a substance use and addictions clinician switched the location of her clients' chair so that clients could see the door, rather than have their back to it. This change allowed clients with a service background to feel more comfortable, and engage.
- Motivational Interviewing is an evidence-based practice for working with substance use and addictions, but for many people with Traumatic Brain Injury (TBI), it is too abstract. A program which works with patients who have substance use disorder and TBI adjusts the use of Motivational Interviewing, depending on the extent of the injury, employing more concrete approaches where needed.
Massachusetts now has Veterans Treatment Courts, which are designed to handle criminal cases involving defendants who have a history of military service through a coordinated effort among the veterans services delivery system, community-based providers, and the court, thereby improving public safety while dealing with the underlying issues of posttraumatic stress disorder, traumatic brain injury, and military sexual trauma. Abstinence from drugs and alcohol, mandated treatment, swift accountability, and weekly interaction with the court are requirements of the Veterans Treatment Court.
Other sections of the Careers of Substance website have information on how Service Members, Veterans and their Families can start or advance a career in substance use and addiction-related work (see Peer Support/Recovery Coaches, Jobsearch Tips and Links); and how organizations can benefit from hiring people who have served in the US Military (see Recruitment and Retention). Such resources may be helpful to SMVF who have sought treatment, as they progress in their own recovery.
The Attorney General's Veteran's Resource Guide (https://www.mass.gov/files/documents/2016/10/vl/vets-guide.pdf) compiled by the Attorney General’s Office describes certain federal and state laws protecting the rights of veterans and service members in the United States Military, including the National Guard or Reserves, such as those protecting against discrimination in employment, helping to avoid credit or foreclosure problems, and maximizing healthcare, disability, and education benefits.
Battlemind Training: Transitioning from Combat to Home: is a brochure from the Walter Reed Army Institute of Research, describing the ‘battlemind’ and the challenges of transition.
This toolkit (see http://www.mentalhealth.va.gov/communityproviders/#sthash.n79i1eOO.dpbs) was released in summer 2015. It is a website that provides information on connecting with VA, understanding military culture and experience, as well as tools for working with a variety of behavioral health conditions. On-demand trainings are available, such as a Military Culture Course (see https://deploymentpsych.org/military-culture-course-modules). In addition, there are "Mini-Clinics" with overviews and tools for specific considerations, such as Substance Use (see http://www.mentalhealth.va.gov/communityproviders/clinic_sud.asp#sthash....)
Wiliam James College (formerly the Massachusetts School of Professional Psychology) offers Masters and Doctoral degrees which can have a specialization in Military and Veteran Psychology.
One has the goal of helping people who have not served in the US Military to provide culturally competent services to those who have (https://www.williamjames.edu/academics/counseling/clinical-mental-health...).
Another is a Train Vets to Treat Vets special program (https://www.williamjames.edu/academics/centers-of-excellence/military-ve...)
The College participates in the Yellow Ribbon Scholarship program to support veterans in obtaining education.
The Massachusetts Department of Veterans' Services provides resources on Domestic Violence
The Massachusetts Department of Veterans' Services provides resources on Families
The Massachusetts Department of Veterans' Services (https://www.mass.gov/orgs/massachusetts-department-of-veterans-services) provides information and contacts for Veterans to access benefits and services, from health services to education and employment training and much more.
The MassVetsAdvisor webportal (https://massvetsadvisor.org/) is an online resource created by the Commonwealth of Massachusetts that strives to serve the nearly half-million Veterans living in Massachusetts, and their Families, as a bridge to the many benefits that they have earned. It combines state and federal benefits, as well as non-profit resources into one tailored online search. Access to financial, education, and housing benefits that once took hours to research are now just one click away.
MassVetsAdvisor is a collaboration between the Massachusetts Broadband Institute, the Massachusetts Department of Veterans’ Services, the Red Sox Foundation and the Massachusetts General Hospital Home Base Program.
This Technical Assistance Package from SAMHSA provides a comprehensive yet concise summary of many of the elements of military culture of which every civilian counselor, clinician or other support personnel should be aware.
The mission of the National Guard Family Program of Massachusetts (https://https://www.massnationalguard.org/index.php/resources/family-pro...) is to establish and facilitate ongoing communication, involvement, support and recognition between Guard families and the Guard in a partnership that promotes the best in both. The Family Program notifies family members about various benefits, entitlements and special services available to Guard members and their families during times of deployment and non-deployment; and offers an opportunity for Guard family members to interact and network with other families. The Family Program also has a Facebook Page (https://www.facebook.com/Family-Program-Massachusetts-National-Guard-156...)
The Massachusetts Department of Public Health's Bureau of Substance Abuse Services developed a Practice Guidance on working with Service Members, Veterans and their Families, which also has an extensive listing of links, documents and organizations which provide support to SMVF and also those who support them. It is downloadable athttps://www.mass.gov/files/documents/2018/05/25/care-principles-guidance..., and also from the attached PDF.
The Massachusetts Department of Veterans' Services provides resources on Post-Traumatic Stress Disorder and Military Sexual Trauma: https://www.mass.gov/veterans-programs-and-services.
The Professional Section of the Veterans' Administration PTSD webpage (http://www.ptsd.va.gov/professional/index.asp) has many resources for professionals.
The Massachusetts Department of Veterans' Services provides resources on Traumatic Brain Injury (TBI): https://www.mass.edu/forstufam/veterans/health.asp
The home page for the US Department of Veterans' Affairs (https://www.va.gov) links to far more than Addiction-related information, and is provided here as a convenience. Links to relevant subpages are provided separately.
Veterans' Laws and Benefits (https://www.sec.state.ma.us/cis/cisvet/vetidx.htm) is a document from the Massachusetts Secretary of the Commonwealth. This link is to the eighth edition which provides a compilation of resources regarding major state benefits in the areas of education, employment, housing, motor vehicles, property taxes, and medical assistance, as well as information regarding employment rights and federal burial benefits.