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Student Service Members/Veterans on Campus:
Challenges for Reintegration
Brian Borsari
San Francisco Veterans Affairs Medical Center
University of California—San Francisco
Ali Yurasek and Mary Beth Miller
Brown University
James G. Murphy
and Meghan E. McDevitt-Murphy
The University of Memphis
Matthew P. Martens
University of Missouri
Monica G. Darcy
Rhode Island College Kate B. Carey
Brown University
Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a
meaningful career and financial stability. Evidence suggests that student service members/
veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of
this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts
to facilitate their retention and academic performance. With a focus on SSM/Vs attending
colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published
between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature,
and the empirical research tends to be limited by cross-sectional design and small sample sizes.
SSM/Vs encounter significant personal and environmental challenges when transitioning from
the military to college campuses. A variety of services have been developed to address the needs
of the SSM/V population, but the efficacy of these services remains largely unknown. In
conclusion, there is a clear need to provide education to faculty, students, and staff regarding the
experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engage-
ment in mental health services would also be beneficial, as would improved availability of and
SSM/V access to academic support. All future programs designed to address the unique
challenges of SSM/Vs in the academic environment should also be systematically implemented
and evaluated.
Supplemental materials: http://dx.doi.org/10.1037/ort0000199.supp
Recent military operations in Iraq (Operation Iraqi Free-
dom, OIF; Operation New Dawn, OND) and Afghanistan
(Operation Enduring Freedom, OEF) represent the most
sustained ground combat operations since the Vietnam era. As
over 2.5 million OIF/OEF/OND veterans return home, many are
attending college using benefits provided by the U.S. government.
The post-9/11 GI Bill is an educational program offered through
the Department of Veterans Affairs (VA) that provides support for
tuition, books, and housing to encourage student service members/
veterans (SSM/Vs) to pursue higher education (Sander, 2012). As
of February 2013, over 877,000 SSM/Vs had used the post-9/11 GI
Bill to enroll in college courses at over 6,000 institutions (Sander,
2013). As college graduates tend to gain more consistent employ-
ment, earn more money, be more active citizens, and lead healthier
lifestyles than those who do not attend college (Baum, Ma, &
Payea, 2013), college retention and graduation can be important
elements of successful adjustment to civilian life for SSM/Vs
(Armstrong, Best, & Domenici, 2013).
The largest study on SSM/V retention and performance in
higher education to date examined 898,895 veterans over a span of
10 years (Million Records Project; Cate, 2014) and found that,
although SSM/Vs earn postsecondary degrees (from vocational to
doctorate) at rates similar to other students (51.7%), it takes them
Brian Borsari, San Francisco Veteran Affairs Medical Center, Depart-
ment of Psychiatry, University of California—San Francisco; Ali Yurasek
and Mary Beth Miller, Center for Alcohol and Addiction Studies, Brown
University; James G. Murphy and Meghan E. McDevitt-Murphy, Depart-
ment of Psychology, The University of Memphis; Matthew P. Martens,
College of Education, University of Missouri; Monica G. Darcy, Feinstein
School of Education and Human Development, Rhode Island College; Kate
B. Carey, Center for Alcohol and Addiction Studies, Brown University.
Correspondence concerning this article should be addressed to Brian Bor-
sari, Department of Psychiatry, University of California—San Francisco,
Building 8, Room 108 San Francisco VA Medical Center (116B) 4150
Clement Street San Francisco, CA 94121. E-mail: brian.borsari@va.gov
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
American Journal of Orthopsychiatry © 2017 American Orthopsychiatric Association
2017, Vol. 87, No. 2, 166–175 http://dx.doi.org/10.1037/ort0000199
166
longer to do so. This slower completion rate is particularly trou-
bling because the GI bill only covers up to four years of education,
which may not provide enough time for SSM/Vs to obtain a
degree. Also, because higher education institutions receive tuition
and fees directly under the GI Bill, SSM/Vs may be particularly
susceptible to exploitation by for-profit institutions (Riegel, 2013).
Increased awareness of SSM/V attrition rates has been accom-
panied by greater understanding of the factors that affect SSM/V
enrollment, retention, and academic performance in the college
setting. A recent review (Barry, Whiteman, & Wadsworth, 2014)
of 13 peer-reviewed studies on SSM/Vs found higher rates of
health risk behaviors (e.g., substance use) and psychological symp-
toms (e.g., PTSD) among SSM/Vs relative to peers without mili-
tary experience, as well as difficulties in adjusting to campus life
and interacting with faculty and students. The authors highlighted
the lack of research conducted with SSM/Vs as well as the large
number of non-peer-reviewed documents addressing the issues
faced by this population. As there has been over a fourfold increase
in the literature on SSM/Vs over the past 5 years, the current
review aims to identify the unique challenges that SSM/Vs face in
the higher education setting. We conclude with recommendations
for facilitating the successful integration of SSM/Vs on campus.
Method
Search Strategy and Selection of Studies
PRISMA criteria (Moher, Liberati, Tetzlaff, Altman, & the
PRISMA Group, 2009) were applied to review published docu-
ments that examined the experiences of OEF/OIF/OND veterans
and/or the challenges they face as they transition from the military
to college. Searches were conducted via PsycINFO, PubMed,
CINAHL, Google Scholar, and ERIC using combinations of terms
[(military OR veteran OR deployment OR service member OR GI
Bill) AND (postsecondary education OR student OR university
OR college OR higher education)]. Searches were confined to
“Title” and “Abstract” fields for all databases except Google
Scholar.
Inclusion/exclusion criteria. The review included both
peer-reviewed and “gray” literature. Peer-reviewed literature was
defined as quantitative and qualitative articles published in peer-
reviewed journals (including special editions). Gray literature in-
cluded non-peer-reviewed articles including book chapters, theses/
dissertations, conference proceedings, organizational reports, and
commentaries (Alberani, De Castro Pietrangeli, & Mazza, 1990).
Reports published between 2001 (the start of OEF) and August,
2015 were eligible for inclusion. Ancestry (i.e., obtaining docu-
ments that are cited in an eligible or relevant manuscript) and
descendancy approaches (i.e., obtaining documents that cite an
eligible or relevant manuscript) were also employed. Studies were
excluded if they were not available in the English language.
Search Results
The online database search identified 16,514 articles, and the
descendancy search identified an additional 10 articles. After re-
moving duplicates, 14,048 unique articles were identified. When a
manuscript provided the same data as a previous conference pro-
ceeding, we included the published manuscript in the review. After
screening, 189 articles (n⫽87 peer-reviewed and n⫽102 gray
literature) underwent full-text review to determine eligibility. We
omitted manuscripts that did not address the transition to higher
education (n⫽25) or that focused on non-SSM/Vs (n⫽27),
non-OEF/OIF/OND SSM/Vs (n⫽3), military schools (n⫽2),
employment (n⫽1), and naturalistic change (n⫽1). Of the
130 articles that met all eligibility criteria, 57 were peer-
reviewed manuscripts and 73 were gray literature publications
(see online supplemental materials for detailed descriptions for
each publication).
Unique Characteristics of Student Service
Members/Veterans
Although the number of SSM/Vs varies widely from campus to
campus, recent national surveys indicate that the majority of
SSM/Vs are male (73%–79%) and Caucasian (60%), with lower
prevalence of African American (18%), Hispanic (13%), and
Asian (3%) racial and ethnic backgrounds (Cate, 2014;Walton-
Radford, 2009). SSM/Vs tend to be older than typical college
students, with only 20% between 17 and 23 years in age. They are
also more likely than traditional students to be married (47%),
have children (47%), or be single parents (15%; Walton-Radford,
2009). Most SSM/Vs enroll in public 2-year institutions (43%),
followed by public 4-year institutions (21%), private nonprofit
4-year institutions (13%), and private for-profit universities (12%;
Walton-Radford, Wun, & Weko, 2009). Enrolled SSM/Vs com-
plete a wide range of terminal degrees, including bachelors (48%),
associate (29%), masters (16%), and doctoral (2%) degrees (Cate,
2014). Overall, SSM/Vs are more likely to major in engineering,
applied sciences, and social sciences than in the arts or commu-
nications (Durdella & Kim, 2012).
Social connection and identity. SSM/Vs often report
difficulty connecting socially with traditional students, who are
less likely to have firmly established vocational, social, and family
roles. Beyond the perception that traditional students are just
“kids” (Smith-Osborne, 2012), the military has been a way of life
for SSM/Vs, and the less structured role as student may not be as
familiar (Hopkins, Hermann, Wilson, Allen, & Malley, 2010).
Difficult social connections may be due in part to unpleasant or
intrusive interactions with civilian peers, who may convey little
knowledge or concern about the current conflicts overseas, ask
inappropriate questions (e.g., if s/he had killed someone while
deployed), or express a lack of military appreciation (e.g., lack of
observance of Veterans Day). Indeed, civilian students have sig-
nificant misperceptions about OIF/OEF/OND and U.S. foreign
policy (Dunwoody, Plane, Trescher, & Rice, 2014) and as a result
it may be uncomfortable or unappealing to integrate into the
typical student lifestyle.
These issues appear to lead to a form of identity challenge for
some SSM/Vs, who may perceive themselves as at a different
stage in their lives than the typical student and may prefer to spend
time with other veterans (e.g., DiRamio, Ackerman, & Garza
Mitchell, 2008;Ellison, Mueller, Smelson, et al., 2012;McBain,
Kim, Cook, & Snead, 2012). SSM/Vs may downplay their role as
veterans when interacting with non-veteran members of the cam-
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167
SSM/V REVIEW
pus community (Jones, 2015). In doing so, they experience the
push and pull of two identities— one as a veteran with unique
experiences and a skill set different than that of the traditional
student, the other as a student trying to integrate and adapt in the
college (Darcy & Powers, 2013;McCaslin, Leach, Herbst, &
Armstrong, 2013;Messina, 2015;Ureno, 2015). This struggle
between wanting to be accepted (and recognized) as a veteran
versus wanting to assimilate and develop an identity as a “typical”
college student may be an important issue for veterans and college
communities to address.
Mental health. SSM/Vs meet criteria for a range of mental
health (MH) diagnoses, including posttraumatic stress disorder
(PTSD), anxiety disorders (e.g., generalized anxiety disorder), and
depression, but findings within the peer-reviewed and gray litera-
tures are mixed regarding whether these disorders occur at signif-
icantly higher rates among SSM/Vs than non-veteran students
(e.g., Canfield & Weiss, 2015;Glover-Graf, Miller, & Freeman,
2010;Grossbard et al., 2014;Hopkins et al., 2010;Kanel, 2015;
McCaslin et al., 2013;Rudd, Goulding, & Bryan, 2011). That said,
these psychological disorders may manifest themselves uniquely
in the SSM/V population. For example, SSM/Vs who have been
diagnosed with PTSD tend to engage in a significantly greater
number of physical fights (Widome, Kehle, et al., 2011), demon-
strate more hostility and strain in intimate relationships (Johnson,
Graceffo, Hayes, & Locke, 2014), experience more alcohol related
problems, and report greater alienation on campus (Elliott, Gon-
zalez, & Larsen, 2011) relative to SSM/Vs without PTSD. Simi-
larly, increased symptoms of depression, anxiety, anger/aggres-
sion, and PTSD are associated with less identification with campus
and lower social support among SSM/Vs (Quigley, 2015;Weber,
2012). There is some evidence that anxiety and depressive symp-
toms are also inversely related to academic persistence among
SSM/Vs (Grossbard et al., 2014;Quigley, 2015;Weber, 2012).
Not surprisingly, qualitative studies with SSM/Vs have docu-
mented the desire for special accommodations in classroom set-
tings to help mitigate the impact of these symptoms (e.g., Ellison,
Mueller, Smelson, et al., 2012).
Suicide attempts and ideation are of particular concern among
SSM/Vs: Between 7% and 8% reported a past suicide attempt and
14% to 35% reported suicidal thoughts with a plan (Bryan, Bryan,
& Clemans, 2015;Ray-Sannerud, Bryan, Perry, & Bryan, 2015;
Rudd et al., 2011). Some research has indicated that these rates are
significantly higher than those in non-veteran college samples
(Rudd et al., 2011), although a recent national survey did not find
differences in past-year suicidal ideation, plan, or suicide attempts
between SSM/V and traditional students (Pease, Monteith, Hostet-
ter, Forster, & Bahraini, 2015). SSM/Vs with a history of same-
gender sexual partners (Ray-Sannerud et al., 2015), victims of
military sexual trauma (Rolbiecki, Pelts, & Albright, 2015),
women with premilitary sexual abuse, and men who have experi-
enced military sexual trauma (Bryan, Theriault, & Bryan, 2015)
may be particularly vulnerable to suicidal ideation.
Substance abuse is also a significant issue among returning
OEF/OIF/OND veterans. A recent survey of SSM/Vs revealed
higher levels of heavy episodic drinking and alcohol-related risky
behaviors (e.g., fighting, riding in car with an intoxicated driver)
compared with their civilian peers, even after controlling for
differences in gender and age (Widome, Laska, Gulden, Fu, &
Lust, 2011). Both deployment status (Grossbard et al., 2014) and
use of alcohol for coping (Whiteman & Barry, 2011) have been
linked with problematic drinking in SSM/Vs. Little research has
focused on other drug use among SSM/Vs, although one study
found that SSM/Vs were less likely than non-veteran peers to use
marijuana and more likely to use cigarettes and smokeless tobacco
(Widome, Laska, et al., 2011). One area of particular relevance and
concern is the diversion/misuse of prescription drugs, given the
number of veterans who may be prescribed these medications for
psychological and/or physical symptoms (Boynton Health Service,
2012;Glover-Graf et al., 2010).
Physical disabilities. Because of the nature of warfare
encountered by OEF/OIF/OND personnel, prevalence estimates of
combat-acquired traumatic brain injury (TBI) in OIF/OEF/OND
veterans ranges from 12% to 23% (Church, 2009), and SSM/Vs
may not be fully aware of their disability until confronted with the
demands of the classroom. These often unseen injuries can inter-
fere with the SSM/V’s ability to succeed academically by impair-
ing his or her ability to learn and self-regulate. For example, the
effects of TBI and/or spinal cord injury may lead to difficulty
completing writing, computer, and lab tasks as well as difficulty
with prolonged seating and ambulation to and from classes (Hop-
kins et al., 2010). These physical conditions may also contribute to
fatigue, impulse control, and irritability. Moreover, SSM/Vs with
these injuries may have social and communication deficits that
interfere with their ability to correspond with peers and faculty
(Church, 2009).
Redeployment. Students who still have active duty, Na-
tional Guard, or Reserve commitments may experience risk for
deployment while enrolled in college (Livingston & Bauman,
2013). This may lead to disruptions in education, loss of course
work/credit that was already completed for that semester, and loss
of scholarships (Ackerman, DiRamio, & Garza Mitchell, 2009).
Following such deployment, reenrollment and reintegration into
the academic environment is yet another challenge (Ford,
Northrup, & Wiley, 2009;Hopkins et al., 2010;Johnson, 2009;
Livingston & Bauman, 2013). Some attempts have been made to
address deployment during the academic year, with 82% of insti-
tutions refunding tuition for activations and deployments and
providing assistance with educational benefits (Cook & Kim,
2009;McBain et al., 2012). However, more persistent, long-term
efforts and support will be required to encourage SSM/Vs to
complete their degree following a deployment-related interruption.
Environmental Challenges Encountered by
SSM/Vs in Higher Education
Both the peer-review and gray literatures consistently indicate
that SSM/Vs find the logistic challenges of the transition from
military to college overwhelming (Allen, Armstrong, Saladiner,
Hamilton, & Conard, 2014;DiRamio et al., 2008;DiRamio, Jarvis,
Iverson, Seher, & Anderson, 2015;Griffin & Gilbert, 2015;Mes-
sina, 2015;Ureno, 2015). Because a large number of SSM/Vs
enlist in the military as emerging adults and spend a number of
years in the strict and structured environment of the military, they
may be less skilled at navigating available services outside the
context of the military setting (see Messina, 2015).
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168 BORSARI ET AL.
Enrollment and benefits. SSM/Vs are often unaware
that they are eligible for a number of potentially helpful services,
ranging from the Veterans Benefits Administration (VBA) to
community programs. Even when SSM/Vs are able to access these
services, they often struggle to effectively coordinate and make use
of the various programs (Ackerman & DiRamio, 2009). For ex-
ample, managing education-related finances is often a significant
challenge: Although educational benefits cover tuition, various
fees are often not included. Furthermore, SSM/Vs often have to
pay out of pocket for tuition and other benefits until paperwork is
correctly filed and processed, which may take months, placing the
SSM/Vs under significant financial distress. Academic credit can
also be a complicated issue. Although many SSM/Vs complete
academic coursework and applied training during their military
service (Cook & Kim, 2009;Steele, Salcedo, & Coley, 2010),
some institutions do not award school credit for military training.
Some schools also offer amenities such as tuition and financial aid
assistance counseling, discounts, and scholarships specifically for
veterans and military students (McBain et al., 2012).
Even after SSM/Vs overcome these and other barriers to enroll-
ing in college (e.g., applications, benefit eligibility, admission
testing), emerging evidence indicates that retention in school may
be a problem. For example, one survey found that 37% of part-
time and 16% of full-time SSM/Vs dropped out within 9 months of
enrollment (Walton-Radford et al., 2009). Furthermore, despite the
high levels of academic engagement characteristic of SSM/Vs (as
measured by active participation in class and interaction with
faculty in and out of the classroom), veteran status is negatively
associated with GPA (Durdella & Kim, 2012). There are several
possibilities why this may be the case: SSM/Vs may have more
demands on their time and attention, as they are more likely to be
married, have children (15% are single parents), and work full-
time or part-time; these competing commitments may also impact
academic performance and degree completion (e.g., Choy, 2002;
Johnson, 2009). As discussed, mental health symptoms and
combat-related injuries might interfere with academic achieve-
ment. In addition, SSM/Vs are typically older, and hence, some of
their basic math, science, writing, and study skills may have
eroded (Cunningham, 2012;DiRamio et al., 2008;DiRamio &
Jarvis, 2011;Rumann & Hamrick, 2010;Steele et al., 2010).
School environment. SSM/Vs often experience diffi-
culty adapting to a civilian world after the hierarchical environ-
ment of the military, sometimes reflected in an unwillingness to
ask for assistance and difficulty managing time and responsibili-
ties. SSM/Vs frequently report experiencing difficulties in the
transition from a military style of technical learning and hierarchi-
cal organizational structure to a university learning environment
that is less structured and more informal (Messina, 2015). Specif-
ically, the military often uses a standardized, stepwise, and “hands-
on” approach to teaching a skill, which is different from the more
autonomous approach typically used on college campuses. Fur-
thermore, different departments and individual professors often
vary in their approaches to grading, teaching, and class require-
ments, whereas instruction and evaluation in the military tends to
be more consistent across settings. Perhaps for these reasons,
SSM/Vs have reported that they view the campus environment as
more chaotic, confusing, and less ordered than the military envi-
ronment (Durdella & Kim, 2012). Adapting to this environment
may result in struggles and drop-outs among SSM/Vs.
Recommendations for SSM/V Services
The needs of SSM/Vs range from financial assistance to dis-
ability services to psychological interventions. Programs (pro-
posed or implemented) that are designed to retain and integrate
SSM/Vs in the academic setting include establishing Offices of
Veterans and Military Services (Abel, Bright, & Cooper, 2013)
and/or student veterans organization (Hawthorne, Bauman, & Ew-
ing Ross, 2013). Other approaches include designated space for
SSM/Vs to socialize (e.g., vet lounges), providing counselors and
personnel with expertise in assisting SSM/Vs, and establishing
SSM/V groups and learning communities. Programs have also
been developed by counseling centers dedicated to SSM/Vs and
their families (e.g., Danish & Antonides, 2009), and those that
work with SSM/Vs have been trained to be sensitive to their
experiences and unique needs (Sorrells, Wills, Reagins-Lilly, Cate,
& Moe, 2015). These efforts suggest specific strategies regarding
academic, health, and campus services.
Provide faculty, staff, and students with educa-
tion on SSM/Vs’ experiences. Trainings for the campus
community were commonly recommended in both the peer-
reviewed (46% of studies) and gray (49%) literatures, and it is
recommended that thoughtful consideration be given to the content
and delivery of these efforts. Although universities and programs
have begun such trainings, some researchers are concerned that
these trainings focus too much on SSM/V issues such as TBI or
PTSD and may create a SSM/V stereotype that impedes rather than
facilitates understanding and connection (Canfield & Weiss, 2015;
Glover-Graf et al., 2010;Hart & Thompson, 2013;Hawthorne et
al., 2013;Messina, 2015). Fortunately, excellent resources are avail-
able to enhance understanding of SSM/Vs, such as the VA Campus
Toolkit (http://www.mentalhealth.va.gov/StudentVeteran) and the
Vet Success Program (www.vetsuccess.gov/vetsuccess). Some ev-
idence suggests that virtual training, in which users role-play
difficult situations with virtual SSM/Vs, increases users’ military
cultural competence and self-efficacy to manage classroom dis-
cussions, talk with SSM/Vs about their service, and make appro-
priate referrals (Cate & Albright, 2015). In addition, there are
several current efforts to enhance online mentoring and advising
for SSM/Vs, although these efforts have yet to be formally eval-
uated (see Abel et al., 2013;Cass & Hammond, 2015). Initiation of
a Veterans Advisory Council (composed of key faculty and staff
from the veterans service office, admissions, the campus counsel-
ing center, multicultural or diversity offices, the athletics depart-
ment, career services, the graduate college, legal services, and
campus veteran organization) may also facilitate integration of
services for SSM/Vs.
Increase engagement with health and wellness
services. There is a clear need for continued efforts to engage
SSM/Vs in health services and treatment. In most communities
there is a variety of health services available for SSM/Vs. For
example, honorably discharged veterans with a history of combat
service are eligible for cost-free health care from the Veterans
Health Administration (VHA) for five years post discharge, re-
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169
SSM/V REVIEW
gardless of the role their military service may have played in the
development of the physical or psychological condition. Faculty
and staff are strongly encouraged to become aware of the health
services available to SSM/Vs on campus and to communicate
these opportunities to SSM/Vs when appropriate. Such an appro-
priate instance may be when medical (e.g., TBI; Church, 2009)or
psychological (e.g., PTSD; Bernard-Brak, Bagby, Jones, & Sulak,
2011) symptoms may be hindering student success.
It may be important to consider the provider’s experience work-
ing with military populations when making treatment referrals.
Students enrolled in college have access to treatment at student
counseling centers and hospitals as well as through private pro-
viders; however, these providers may lack specific expertise in
treating veterans (Canfield & Weiss, 2015). To address the need
for these services, campuses are providing either (a) on-campus
counseling services for SSM/Vs and their families or (b) assistance
in finding appropriate services (Cook & Kim, 2009;Danish &
Antonides, 2009). Institutions with larger SSM/V populations are
more likely to train staff on working with military issues (see
Wurster, Rinaldi, Woods, & Liu, 2013). Approximately 84% of
campuses provide assistance for PTSD, 55% provide assistance
with physical disabilities, and 35% assist with brain injuries
(McBain et al., 2012). Some programs have also implemented
SSM/V-specific counseling groups to help with the transition to
the academic setting (Selber, Chavkin, & Biggs, 2015) or with
stress and sleep difficulties (Wisner et al., 2015). However, only
7% of SSM/Vs who obtained mental health treatment in the last
year received treatment at campus counseling or health centers
(Boynton Health Service, 2012). Thus, data suggest that many
SSM/Vs choose not to use the free or low-cost counseling services
typically available on college campuses (DiRamio et al., 2015;
Johnson et al., 2014;Kanel, 2015;Steele et al., 2010). As an
alternative, there have been promising efforts to bridge VHA and
campus services (VITAL; Sorrells et al., 2015) or even implement
a VHA clinic on campus that may facilitate treatment engagement
in SSM/Vs (McCaslin et al., 2013). However, detailed evaluation
of these efforts have yet to be done.
We encourage campus faculty and staff to eliminate as many
barriers to mental health treatment among SSM/Vs as possible.
Active duty service members who have returned from deployment
commonly report concerns about the stigma associated with treat-
ment (e.g., being perceived as weak, which may harm their future
careers), uncertainty about where or how to get help, frustration
with the difficulty of scheduling an appointment, and inadequate
transportation to or time for treatment (Kim, Thomas, Wilk, Cas-
tro, & Hoge, 2010). SSM/Vs have demonstrated that they value
education and the opportunities that a college degree can deliver.
Thus, it may be fruitful to engage SSM/Vs collaboratively to
explore ways their MH and/or physical symptoms are creating a
barrier to academic success, and, importantly, to elicit intrinsic
(e.g., military experience, training, personal characteristics such as
perseverance and commitment) and extrinsic (e.g., school, com-
munity, and Veterans Affairs Medical Center (VAMC) programs;
family and social support) resources that can assist them in achiev-
ing their goals. This collaborative approach, focusing on personal
resilience rather than deficits (e.g., Callahan & Marks, 2009),
might increase motivation to engage in services and obtain
treatment.
Faculty and staff might be best able to facilitate this process if
they are made aware of the unique barriers to SSM/V education
success, the personal strengths many of these students possess, and
the resources available in the campus and larger community. That
said, we acknowledge that it may be a considerable challenge for
faculty and staff to venture into a conversation addressing engage-
ment in services for psychological or medical issues, even if they
think they know what to say or have an understanding of the
services that could address the difficulties a veteran might reveal.
Currently, the majority of faculty/staff may not necessarily have
knowledge, interest, or time to ask about SSM/V-specific issues,
which is understandable given the unique needs of their other
advisees. Furthermore, faculty and staff also run the risk of the
SSM/V not giving much credence to a civilian providing the
suggestion. Innovative ways to enhance the awareness of how
integrated and successful SSM/Vs can add to the campus environ-
ment may enhance the motivation of faculty and staff to learn
about SSM/Vs on campus.
For mental health providers, brief interventions that address
alcohol and other substance use (marijuana, prescription drug
misuse) in the broader context of academic and career goal pursuit
may be especially helpful for veterans (Murphy et al., 2012;
Yurasek, Dennhardt, & Murphy, 2015). Brief interventions have
been effective in addressing alcohol use in veterans (McDevitt-
Murphy et al., 2014) and in general student populations with
mental health symptoms such as depression (Murphy et al., 2012)
and PTSD (Monahan et al., 2013). Brief interventions delivered by
phone, which have been shown to increase treatment engagement
in returning veterans (Seal et al., 2012), may also enhance engage-
ment in MH treatment and improve outcomes for SSM/Vs with
MH symptoms. Furthermore, although SSM/Vs may use the VHA
or other providers for long-term or specialized care, SSM/Vs may
be more willing to engage in on-campus services that are geared
toward students (e.g., a campus-based psychiatrist or counselor
who will be sensitive to integrating their treatment and/or medi-
cations with their college demands). However, the efficacy of
these approaches have yet to be formally evaluated.
Improve availability and access to academic sup-
port services. One consistent recommendation in the peer
reviewed (42%) and gray (62%) literatures was the need for
SSM/V-only services. SSM/Vs need access to support services to
facilitate their adjustment to college and foster connections with
other students and faculty at their institution. At the most basic
level, research suggests that the majority of civilian and SSM/V
students derive benefit from the use of a “degree map,” or a plan
of study in which the list of courses they need or plan to take is
outlined at the beginning of their education. Large classrooms and
other contextual factors, such as timed test-taking and group as-
signments, may pose challenges for SSM/Vs suffering from med-
ical and/or psychological issues. As such, it is recommended that
college campuses implement academic (e.g., specialized tutoring,
SSM/V study groups) and library (e.g., orientation) services as
well as veteran benefits and certifications that specifically address
these barriers to campus engagement among SSM/Vs, Approxi-
mately 60% of SSM/Vs utilize such veteran-specific programs
when they are available (Lang & Powers, 2011), and SSM/Vs who
utilized more campus programs and services in general (not spe-
cific to veterans) endorsed greater intentions to maintain enroll-
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
170 BORSARI ET AL.
ment (Weber, 2012). The 2007 founding of the Student Veterans
of America (SVA), a national organization, may also increase the
availability of support services across U.S. college campuses
(Summerlot, Green, & Parker, 2009). Currently, the SVA has
suggested services such as single-credit orientation classes, intra-
mural sports teams for SSM/Vs, and assigning individual mentors
to each SSM/V. Given the multiple family and life demands and
the presence of debilitating injuries that many SSM/Vs face, uni-
versities could also consider implementing and evaluating in-
person counseling and advising services with regular follow-up
contacts (perhaps via phone, Skype, email, or text).
Systematically implement and evaluate SSM/V
programs and services. Perhaps the most troubling theme
to emerge from the peer-reviewed and gray literatures is the
absence of systematic implementation and evaluation of any pro-
grams designed to help the SSM/V population. Many of the
qualitative interviews conducted with SSM/Vs revealed a desire
for veteran-only classes, veteran online courses, lounges, orienta-
tions, and other programs. For example, learning communities,
composed of groups of students sharing thematically linked expe-
riences inside and outside the classroom (Smith, 1993), have been
proposed as a way to keep SSM/Vs together by incorporating a
curriculum that has been adapted for their needs (Minnis, Bondi, &
Rumann, 2013). These programs are designed primarily as an
adjunct to classes, rather than an integrated SSM/V curriculum.
However, few of these recommendations have been implemented,
and none have been empirically evaluated. Therefore, it remains
unclear whether such segregation would result in better academic
outcomes. From their experiences teaching SSM/Vs, Hart and
Thompson (2013) discussed veteran-only, veteran-focused, and
veteran-friendly writing courses, acknowledging mixed reports on
the success of these courses. Any benefits were equally matched
with drawbacks, such as the isolation of SSM/Vs rather than their
immersion into the larger campus community. In addition, veteran-
only writing courses appeared to be difficult to sustain because of
low enrollment rates. Similarly, the proposal of online courses
specific to veterans might reinforce social withdrawal that can be
characteristic of those suffering from PTSD and/or depression. As
a result, these veterans may be deprived of personally connecting
and identifying with other SSM/Vs on campus, which has been
consistently described as beneficial by SSM/Vs (e.g., Cunning-
ham, 2012;DiRamio et al., 2008;Osborne, 2014). Therefore,
programs that are currently implemented should be systematically
evaluated to determine whether they have the intended impact on
academic indicators such as GPA and retention as well as the
quality of SSM/Vs’ educational experiences. Many SSM/Vs may
benefit from a graded approach to full integration, with the avail-
ability of consistent veteran-only support structures required for
the initial transition to campus, followed by increasing integration
within campus academic and social milieux.
Conclusion
The strengths and needs of the SSM/V population have been
detailed extensively in the past 14 years, and there have been some
programs designed to assist SSM/Vs’ adjustment to their academic
environment. Unfortunately, there remains a dearth of research
examining the effectiveness of these programs, highlighting a clear
need for comprehensive and theoretically based programs to facil-
itate college success. It is our hope that thoughtful implementation,
evaluation, and refinement of current and future efforts will en-
hance the retention and academic success of the thousands of
veterans who decide to seek higher education.
Keywords: veteran; higher education; mental health; SSM/V;
treatment
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