Monthly Archives: March 2017

16Mar/17

Policy Brief Regarding the Improvement of Services for Veterans with Substance Misuse Disorders or Veterans in Recovery on College Campuses

There is a PDF form of this on my website as well. You can access it here.

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Policy Brief Regarding the Improvement of Services for Veterans with Substance Misuse Disorders or Veterans in Recovery on College Campuses

March 16, 2017

The Substance Abuse and Mental Health Services Administration (SAMHSA) held a two day conference in Washington, D.C. on March 13-14, 2017, that brought national college leaders together to discuss how to increase the population and improve outcomes of diverse and underserviced populations. I was brought in to facilitate the conversation regarding veterans with substance misuse disorders (as well as veterans in recovery) on college campuses. In addition to veterans, this brief also applies to military service members who attend college while in the National Guard or Reserves.

Challenges:

  • Veterans often only want to associate with other veterans.
  • Veterans that report having positive military experiences are far more likely to access services than veterans who report having negative military experiences. Those that report negative military experiences usually have greater need of services.
  • Veterans and service members often use their military experiences as a cudgel to resist therapy and other forms of assistance by uttering lines such as “you weren’t in (or there) so you wouldn’t understand” or “unless you lived it, you can’t help me.”
  • Veterans are more likely to be older and have families than traditional students. There is a lack of services for their spouses and children.
  • Because they are often older, veterans and service members sometimes report feeling “behind in life.”
  • A lack of coordination between veteran services and other departments on college campuses.
  • Lack of housing for veterans.
  • Lack of ability to identify and treat PTSD on campus.
  • Military and veteran culture usually encourages and normalizes heavy alcohol consumption.
  • Tuition remission, VA payments, and GI Bill moneys are frequently delayed, causing financial hardships which result in late payments to college which results in deregistering from classes
  • Campus professionals have a lack of knowledge of outside services available to service members and veterans.

 

Solutions:

  • Collaborate with veterans center or services on campus. Set up in person meetings between professional staff at least once a semester. You will need to go to them.
  • Approach veterans and service members as if they are in precontemplation on the stages of change model. Provide outreach and educational training on stress and how service members often use negative ways to cope (eating, shopping, gambling, substance misuse, fighting, sex).
  • Currently, 42 college and universities have Peer Advisors for Veterans Education (PAVE) on campus (paveonecampus.org). Start a chapter on your campus.
  • Work with veterans services or center on campus to develop a program that supports families. Using peer support for veterans’ families is cost effective and efficient. Syracuse University has a robust program called the Institute for Veterans and Military Families (IVMF).
  • Use the experiences of veterans and service members to your advantage. Encourage them to engage in your community by putting them in leadership positions, and/or asking them to be of service to other students: they can lead activities such as hikes or captain intramural athletic teams; they can help students with physical fitness; they can tutor others; they can lead service events to soup kitchens and organize clothing drives; and those in recovery can take other people to meetings.
  • Offer yoga (and other services) in your wellness or recovery centers that veterans and service members can attend without signing in. Getting them into your building anonymously will expose them to your building and professionals and may lead to rapport and trust.
  • Having a veteran in your college recovery community will open the doors for more veterans and service members, much like other under-represented populations in CRCs.
  • Work with admissions to identify service members and veterans. Reach out multiple times throughout the school year.
  • Do not allow veterans and service members with substance misuse disorders (and/or mental health disorders) to use their military experience to push away therapists and professionals. This is enabling them. One does not need to have military experience to break through their resistance, but one should get some basic training on military and veteran structure, culture, and issues. Let’s call it Military Cultural Competency.
  • Have a list of on campus and off campus housing options (including for families) handy for those that need it.
  • Talk to the professionals at the veterans service program (if there is one on campus) about not providing alcohol nor normalizing its use.
  • Ensure the counseling and medical professionals on campus are trained in adequate substance misuse disorder and PTSD screening. Ensure that new hires are trained in these areas. Be aware of local services that screen and treat Traumatic Brain Injuries (TBI).
  • Work with financial aid and the registrar’s office to smooth over financial problems that are related to delayed paperwork from military units, VA payments and late GI Bill checks. This is the most common problem that veterans and service members in college and universities complain about.
  • Be aware of local and national services and organizations that can assist veterans and service members. I have compiled a list of vetted services at http://greenagel.com/for-soldiers-and-veterans/

 

 

Frank L. Greenagel II

MPAP, MSW, LCSW, LCADC, CASAC, ACSW, ICADC, CJC, CCS

Adjunct Professor – Rutgers School of Social Work

Instructor – Center of Alcohol Studies

NJ Governor’s Council on Alcoholism & Drug Abuse

1st LT – PA Army National Guard

FLG2@aol.com

greenage@rci.rutgers.edu

15Mar/17

Don’t Hit Governor Christie on Healthcare, Medicaid and Trumpcare

The Newark Star Ledger released a blistering editorial on Gov. Christie this morning. They argue that while Gov. Christie dedicated 66% of his recent State of the State address to addiction, has appeared in numerous commercials about drug treatment, and has tried to set himself up as a national figure on addiction, he has stayed silent on Trumpcare and the Medicaid rollback. Drug policy experts and the Congressional Budget Office (CBO) have stated that 1.3 million Americans were able to access drug treatment only after the Medicaid expansion that was part of the Affordable Care Act (ACA).

Gov. Christie was among a handful of Republican Governors (including John Kasich, R-OH) who decided to take the Medicaid Expansion. Last August, Gov. Christie said that “the naysayers were wrong” and that over 500,000 NJ residents became insured under the ACA, most of them from the Medicaid Expansion. When he ran for President in 2015-2016, he touted his record on drug treatment and his willingness to split from the standard Republican position of total rejection of the ACA.

President Trump, Secretary Price and Speaker Ryan recently introduced the American Health Care Act (AHCA). Mr. Trump has said, “We have come up with a solution that’s really, really I think very good,” but both moderate Republicans and Democrats have cited independent and partisan studies that state that over twenty million people will lose coverage in the next 10 years and that this will have a potentially disastrous effect on the heroin and opioid epidemic. Republican Governors such as Mr. Kasich (Ohio), Bruce Rauner (Illinois), and Brian Sandoval (Nevada) have come out strongly against the AHCA. Despite Mr. Christie’s previous praising of the ACA and Medicaid expansion and the examples set by the other Governors, he has not uttered a word about the AHCA.

Here’s the rub: it makes sense for Gov. Christie to remain quiet. He has less than a year left in office, and his best (and last?) hope for a future political position is in the Trump Administration. While there are examples in American history of a President appointing someone who blasted them, it is rare. The passage or defeat of the AHCA will not be impacted at all by Christie’s opinions. While a critique of the AHCA and the Medicaid Rollback would momentarily please newspaper editors and drug policy experts, it makes absolutely no political sense.

I value loyalty. Very highly. I have worked for a couple of excellent bosses/supervisors. We have usually marched in tune together, but there have been rare occasions in which we disagreed on some issue or policy. I never broke with them publicly (those reading this may think about all of my criticisms leveled at Gov. Christie and other politicians that I have worked with, but I have never directly worked for them). On the same vein, I have always wanted subordinates to question and even challenge me, but only behind closed doors. I very much doubt that I would hire someone who publicly challenged or attacked me on a position or issue. Nor would almost anyone else. There is much to hit Governor Christie on, but his failure to criticize President Trump is not one of them.