Public-Academic Partnerships: Working Together to Meet the Needs of Army National Guard Soldiers: An Academic-Military Partnership

The collaboration between MIARNG and MSU was the result of a graduate student's (LG) interest in military families. Her research interest was supported by faculty from the Departments of Human Development and Family Studies, Epidemiology, and University Outreach and Engagement. A conference meeting in 2005 between MIARNG leaders and MSU faculty and graduate students led to a collaboration to develop and deliver programming during weekend reintegration events that followed unit demobilization and to develop referral options for community resources where needed. Activities like these are part of the military's Yellow Ribbon program to support soldiers and their families throughout all phases of the deployment cycle.

MIARNG launched its first two-day reunion and reintegration workshop for soldiers and their supporters in 2006. These workshops were implemented with a small staff from the state family program office, chaplain support, faculty and clinical interns from MSU, and volunteers from the private sector. These two-day events, held at a retreat location approximately 45 days after the MIARNG soldiers' return home, aim to assist soldiers and their supporters with reintegrating back into civilian work, family, and community life. Attendance is mandatory for soldiers and optional for family. Programming includes education about depression, suicide, PTSD, addictions, traumatic brain injury, and information about community resources and entitlements. In facilitated process groups, soldiers and their families have an opportunity to talk openly about their reintegration experiences.

In 2007, with the support of an internal MSU grant, survey data were collected at these weekends to understand how MIARNG soldiers and their families were faring postdeployment. These data were summarized and discussed with MIARNG leadership to guide and change programmatic efforts. Further input came from members of the MIARNG-MSU collaboration, who were all actively involved in delivering programs. Additional input was gained from two Vietnam veteran advocates who were active in reintegration weekends and provided informal peer outreach to soldiers.

UM Medical School faculty, several of whom also had appointments with the VA Ann Arbor Healthcare System, became involved with the MIARNG and MSU faculty in the summer of 2008. UM activity was spurred in 2007 by a U.S. philanthropist with ties to the UM. His initiative ("Welcome Back Veterans" [WBV]), sought to involve the general population in a nationwide campaign to support Centers of Excellence in developing and providing services for returning OIF and OEF veterans. WBV partnered with Major League Baseball and the McCormick Foundation to administer procured funds through its gift and grant process.

UM-VA faculty initially planned to develop an inventory of current service activities extant in 2007 for veterans in Lower Michigan. The information gathered made UM-VA faculty aware of the broad array of community initiatives that were already in place but not accessible in a centralized location.

These efforts were aided by the liaison activities of a UM psychiatry fellow (RL) who was also a member of MIARNG. Through him, UM-VA project leaders became aware of MIARNG's work with MSU and the reintegration workshops. MSU colleagues and MIARNG leadership were consulted about their programming preferences, and a grant was funded through the WBV-McCormick Foundation initiative, which provides important seed monies to develop a more systematic peer-outreach program and additional family initiatives for MIARNG veterans.

UM-VA and MSU combined evaluation activities to further inform intervention development. They documented baseline symptoms and services used by sequential waves of MIARNG soldiers. Surveys also asked about soldiers' treatment preferences, assessing to whom soldiers turned when they experienced mental health symptoms or other life difficulties. These data informed programming needs and allowed MIARNG to obtain funding for services from higher National Guard echelons.

A comprehensive compilation of community agencies and providers was developed, including information about experiences and expertise in treating military populations, fees and insurances, and types of treatment offered. This guide was distributed to National Guard personnel.

Family programs that focused on parenting, family reintegration, and dealing with stress were offered at reintegration events. Additional predeployment programming was included to prepare families for their loved one's deployment and to connect them to services, providers, and other families with similar experiences.

Based on MIARNG programming preferences and the military culture that supports "leaving no one behind," a proactive, systematic peer-outreach and linkage program, called Buddy-to-Buddy, was developed. Peer outreach was thought to be well suited to address the stigma associated with treatment seeking. A UM-VA faculty member (MV) with expertise in developing peer support programs with veterans and other populations led the planning. Also involved were the two Vietnam veteran peer advocates. Their prior activities and influence throughout the MIARNG helped the new program gain acceptance. Buddy-to-Buddy was implemented in January 2009 for returning MIARNG soldiers. Each returning soldier is assigned a first-tier Buddy (Buddy One) from within the same unit. Buddy Ones are trained in communication techniques and systematically telephone returning soldiers in their panel to identify those who may benefit from further evaluation. Soldiers and Buddy Ones also are able to access second-tier Buddies, who are volunteer veterans trained in motivational interviewing techniques, are well versed in VA and other local mental health resources, and receive regular supervision by UM staff. Buddy Two volunteer veterans help soldiers who might be ambivalent about care, have difficulty accessing treatment resources, or require more complex treatment coordination.

After services projects were implemented, a joint research agenda began to be developed. On the basis of the collaborative's priorities, research applications to more rigorously evaluate the Buddy-to-Buddy program were submitted and funded by the VA Health Services Research and Development office.