Boots to Books: Are Campuses Prepared for Veterans?

William Smith has done an amazing amount of important research that as a former soldier is very important to him and to our returning young members of the armed forces. --Sarah

First, what makes me qualified to write this article? I am a Veteran, I utilized the Montgomery GI Bill, I use VA for my health care and I have worked in Higher Education for the past nine years as a Public Health Educator. Since June 1989, I have been and will always be an American soldier. Like many Veterans, I enlisted for military service because of my sense of pride and duty to my country. I was assigned to the famed 1st Infantry Division — the Big Red One (BRO) at Ft. Riley, Kansas. Furthermore, I was assigned to one of the oldest units in the Army: Headquarters & Headquarters Battery, 1st Battalion, 5th Field Artillery Regiment —- Hamilton’s Own.

One November day in 1990, the BRO was called to duty as part of Operation Desert Shield. My unit deployed to Saudi Arabia at the end of December 1990 and returned to Ft. Riley at the end of May 1991. I was awarded the Bronze Star for my service during Desert Storm.

I received an Honorable Discharge from the U.S. Army in June 1992 and enlisted in the Army Reserve in October 1992. I remained in the Reserve until December 1997.

Soon Veterans will be able to begin utilizing the Post-9/11 Veterans Education Assistance Act or as it is more commonly referred to as the GI Bill for the 21st Century. This new GI Bill is a significant improvement to the Montgomery GI Bill which helped pay for my undergraduate education – well barely, it helped with living expenses but not for tuition and books. The GI Bill for the 21st Century will enhances one of the most fundamental benefits for Veterans aside from eligibility to utilize the Veterans Administration (VA) Health Care System. For more information about the GI Bill for the 21st Century, click here.

The question that Administrator’s in higher education need to begin asking themselves is, are our country’s college and university campuses prepared for the estimated 580,000 next generation of Veteran’s of the wars in Iraq and Afghanistan? Are our campuses prepared to address the unique needs that these students will bring to campus – different life experiences than traditional students, increased mental and physical health issues, increased utilization of campus disability services, support networks and organizations for students who are Veterans, etc.?

Let’s look at the current profile of all Veterans and what the potential issues faced by college campuses:
Basic Facts About Veterans (click to make larger)

Based on this FY 08 data there is the potential of approximately 65.5% of those receiving educational benefits are also being compensated for PTSD.

Looking at the number of amputees from the current VA data, there is also the potential from theses veterans to seek higher education on our campus and Disability Offices in concert with Counseling Services will need to position themselves to accommodate their needs.

Now let’s look specifically at OEF/OIF Veterans
Profile of Service Members Currently Deployed

Total number currently deployed includes all branches of service
Profile of Service Members Currently Deployed

It is estimated that there are 1.8M OIF/OEF Veterans to date since 2001.

Profile of Service Members Currently Deployed

It is projected that approximately 580,000 Veterans will take advantage of the GI Bill for the 21st Century. This was signed into law in 2008 by then President Bush and significantly increases the educational benefits to Veterans from the previous Montgomery GI Bill.

Current research on students who are Veterans is limited. Most of the research is dated from the post Vietnam era. I was able to find one qualitative study that was conducted by Dr. DiRamio – assistant professor of higher education administration at Auburn University; Dr. Ackerman – associate professor in the College of Education at the University of Nevada, Las Vegas; and Regina Mitchell – doctoral candidate in education leadership at Central Michigan University. Their study is titled, "From Combat to Campuses: Voices of Student-Veterans" () and was published in the NASPA Journal in 2008.

What they found is that students who are Veterans typically move through four transitional periods in the course of their initial enlistment, deployment to a combat zone, coming home, and transitioning to campus life. These are classified as Military Moving In, Moving Through, Moving Out, and Campus Moving In stages. It is a great article to read (PDF).

The common issues that OIF/OEF Veterans will bring with them to college campuses are high rates of mental health disorders (PTSD, depression and increased alcohol use); increased rates of suicide and suicidal ideation; learning issues as a result of Traumatic Brain Injury (TBI); and physical disabilities. PTSD is the result of any event that inspires fear, helplessness, and threat of annihilation.

Personnel in combat zones are exposed to high levels of stress and threat every day. Tours of duty typically last 12 months and current rotations have troops doing repeated tours of duty. This can have a significant impact on troop’s ability to manage this high level of stress over time. Combat related PTSD may include the following: recurrent recollections or dreams about war; flashbacks that cause the veteran to relive various trauma; avoiding any reminders of combat; emotionally numbing; hyper-arousal (feeling of being on edge and alert for new threats). PTSD and depression are often times linked among Veterans.

It has been reported that nearly half of veterans with PTSD were also depressed. Depressed veterans often times feel: worthless and profoundly sad; have poor concentration; have a lack of interest in social activities; have feelings of hopeless and helpless; experience a change in appetite; have difficulty sleeping or over sleeping; are irritable; and experience suicidal thoughts or attempts.

An article in the LA Times emphasizes the need to be mindful that

"some service members may actively avoid a diagnosis of a mental health problem, fearing the negative consequences of being diagnosed with a stress disorder or depression….these troops are worried that their career could be hurt or co-workers would have less confidence in them after a diagnosis."

This article also noted the need for

"thousands more mental health professionals – both government hospitals and the civilian health care systems – are needed to meet the need of troops and veterans, and new training is needed for current medical professionals."

According to the article Bringing the War Back Home

"the youngest group of OEF/OIF veterans were at the greatest risk for receiving mental health or PTSD diagnosis compared to veterans 40 years or older."

Campus Counseling Centers must become mindful of the unique conditions these students will present in terms of their exposure to trauma in the combat zone. They must be prepared to address the potential increase of students seeking services. Clinicians will need to be prepare to address the trauma of combat – high combat stress situation and loss of comrades. Campus clinicians must also become familiar with the resources that are available to Veterans and how to refer them to the VA or Vet Center‘s for treatment and care.

The use of alcohol among Combat Veterans as a means of self medication to cope with PTSD, depression, or social anxiety disorders is also of concern.

"In 2003, there were an estimated 25 million veterans comprising roughly 11.5 percent of the 217 million non-institutionalized civilians aged 17 or older in the United States. Approximately 93 percent of veterans are male, and 8.4 percent were between the ages of 17 and 34. (SAMHSA, 2008).

"An estimated 56.6 percent of veterans used alcohol in the past month compared with 50.8 percent of their nonveteran counterparts in 2003. Heavy use of alcohol also was more prevalent among veterans, with an estimated 7.5 percent of veterans drinking heavily in the past month compared with 6.5 percent of their nonveteran counterparts" (SAMHSA, 2008).

"An estimated 13.2 percent of veterans reported driving while under the influence of alcohol or illicit drugs in the past year compared with 12.2 percent of comparable nonveterans"(SAMHSA, 2008).

The VA has approximately 94 alcohol dependence treatment program (ADP) and 42 drug dependence treatment programs (DDTP). Each ADTP and DDTP provides services that include intervention support activities, emergency medical services including detoxification, clinical and vocational assessment, consulting liaison, ambulatory/out-patient and after-care services.

Again, campus clinicians need to become familiar with the resources that are available to Veterans and how to refer them to the VA or Vet Center’s for treatment and care.

Many Veterans have become victims of Traumatic Brain Injuries as a result of the employment of IED or road side bombs. TBI is the result of sudden trauma that causes damage to the brain when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. The victim may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms may include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, or attention.

Some of the consequences resulting from TBI include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

This type of injury, along with other injuries that result in physical disabilities such as amputation may bring an increased demand for the utilization of campus Disability Services. Again, these services should become familiar with the services provided by the VA to assist students who are Veterans. One program at my local VA hospital provides veterans with PDA’s and GPS’s to assist with calendar and task reminders and with direction finding.

The Student Veterans of America (SVA) is a coalition of student veterans groups from college campuses across the United States. The SVA was founded in January of 2008 and works to develop new student groups, coordinate between existing student groups, and advocate on behalf of student veterans at the local, state, and national level. SVA has published a guide for college campuses to use to prepare them for an increase of Veterans attending their schools. Key points from the guide are as follows:

• Survey student veterans for their needs and concerns.
• Work with student veterans during registration periods to ensure they are able to quickly enroll in classes.
• Develop easy to use procedure to notify institution (all parts of it to include professors, departments, programs, support offices) in the event they are called to duty. Ensure point of contact is promoted and easy to find.
• Keep in mind that Department of Veterans Affairs benefits and programs do not cover all the needs of student veterans.
• Consider developing institution specific scholarships, programs and other student veteran’s resources.
• Evaluate the admissions process to ensure veterans are not disadvantaged. Student transitioning out of active service face a host of admissions difficulties.
• Be mindful that Veterans have dramatically different life experiences, especially younger veterans, that their counterpart traditional students.
• Do not treat them the same as you do student straight out of high school or other first time students.
• Develop veteran specific orientation programs. Partner with local veterans organizations and military units for presentations and assistance.

In the end, the important thing to remember is that our Service Members have volunteered to provide service to their country. Whether their motivation to enlist was the result of a sense of patriotism, a duty to country, or as a way to pay for higher education they have earned the benefits they receive once their enlistment obligation has been met. It then becomes the obligation of Institutions of Higher Education to ensure that the unique needs of these students will be met on college campuses in order for our Veterans to be successful students.

It is the Army Core values that I learned in Basic Training and throughout my tour of duty in the Army that continue to guide me today and have proven to be useful in all aspects of my life – loyalty, duty, respect, selfless service, honor, integrity and personal courage. Our colleges must be prepared to take on the needs of these returning service men and women.

Resources for Veterans

Transition Assistance Program
Department of Veteran Affairs
Iraq and Afghan Veterans of American
After Deployment
Military Health System

See Works Cited below the jump

Contingency Tracking System. Profile of Service Members Currently Deployed(as of June 30, 2008). Prepared by the Defense Manpower Data Center on July 21, 2008
Contingency Tracking System. Legal Residence/ Home Address for Service Members Currently Deployed (as of June 30, 2008). Prepared by the Defense Manpower Data Center on July 21, 2008

Department of Veterans Affairs (2008). VA Benefits & Health Care Utilization. (http://www1.va.gov/vetdata/docs/4X6_summer08_sharepoint.pdf)

DiRamio, David, Robert Ackerman, Regina L. Mitchell. “From Combat to Campus: Voices of Student-Veterans.” NASPA Journal 45.1 (2008): 73-102

Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). “Alcohol Use and Alcohol-Related Risk Behaviors among Veterans”. 10 NOV 2005. 25 SEP 2008 (http://www.oas.samhsa.gov/2k5/vetsAlc/vetsAlc.pdf)

Seal, Karen H., Daniel Bertenthal, Christian Miner, Saunak Sen, Charles Marmar. “Bringing the War Back Home”. Arch Intern Med 167 (2008): 476-482.

Traumatic Brain Injury information Pate. National Institute of Neurological Disorders and Strokes. 25 SEP 2008 http://www.ninds.nih.gov/disorders/tbi/tbi.htm

This has been cross posted to Everyday Citizen and Future Majority.