Practice Title: VetSET: LHDs readying communities to serve Veterans and their families
Department: Nebraska Association of Local Health Directors (NALHD) VetSET Nebraska is a collaboration between the members of Nebraska’s SACCHO, the Nebraska Association of Local Health Directors (NALHD). The jurisdictions of NALHD’s 21 members cover all 93 of Nebraska’s counties and the Winnebago Tribal Health Department. Each local health department (LHD) in Nebraska is locally-governed with distinct management, structure, and programs. Each serves a jurisdiction of from 1 to 11 counties that are collectively home to the entire state population (1,934,408). Approximately 124,500 United States Military Veterans plus their families live in these jurisdictions. Since 2015, NALHD has been implementing the unique, statewide VetSET program that applies public health approaches—and leverages the unique position and expertise of LHDs as Chief Health Strategists—to support connection, resiliency, and wellbeing of Veterans and their families. VetSET broadly defines a Veteran as one who served or is currently serving in the United States Military. The public health needs of Veterans and their families are frequently overlooked and unknown, in part because public health demographic data typically does not identify these populations. National data suggests that, when compared to the general population, Veterans and their families disproportionately suffer from negative risk factors and health outcomes that impact overall community wellbeing—including suicide and behavioral health issues. These health issues, when addressed, are often being addressed in local communities. Many Veterans and most of their family members are not eligible for VA services and those who are often choose to use services close to home. Therefore, Veterans and their families make up a significant proportion of the target population across all programs in every LHD in Nebraska—and across the country. 2016 Nebraska BRFSS data suggest that over 50% of adult Nebraskans are Veterans or Veteran-connected family members. Additionally, 23% of school aged children report their parent or guardian is connected to the military. These data are not readily available nationally. Veteran-connected family members—who are often the first responders when Veterans and Service Members are in crisis—deserve and need the attention of local public health systems. Nebraska’s recent BRFSS data show that spouses and partners of Veterans have significantly more poor mental health days and are more likely to have been told that they have depression than the population as a whole. Also, Nebraska students with a military connection (through their parent or guardian) are significantly more likely to report that they considered attempting suicide, attempted suicide, and engaged in self-harm. They are also more likely to use alcohol, tobacco, and prescription drugs. (see: Students_from_Military_Families_07_06_2020.pdf (unmc.edu)) To address these concerning statistics, Veterans and their families need to be surrounded by whole communities of cross-sector organizations that are broadly aware of and working to address their challenges. VetSET Nebraska works toward this with these overarching goals: 1. Build capacity within and collaboration between military-serving and civilian-serving partners in LHD jurisdictions and statewide. 2. Support a range of LHD-specific activities that engage and serve Veterans and families in their local communities. 3. Build LHDs’ suicide prevention ability, especially to reach Veterans and their families. 4. Develop sustainable mechanisms for collecting, synthesizing, and sharing surveillance data on Veteran and families’ health and wellbeing. These data provide direction for local policies and programs. Through VetSET, LHDs have made military cultural competence part of the foundational skillset of the public health workforce in Nebraska. Statewide, LHD staff participate in various Military 101 Training and other awareness-raising training events (see 2017 Model Practice, VetSET Nebraska). Staff at the LHDs apply this knowledge in developing new community partnerships, with the purpose of serving Veterans and families. Partner organizations also participate in VetSET trainings, thereby improving military cultural competence across the public health system—among military-serving and civilian-serving providers. These partnerships are supported at the SACCHO level by the VetSET Program Director and her facilitation of a state-level Task Force. VetSET work makes Veterans and their families more visible across the public health system. Initially, VetSET LHDs encouraged community partners to ask their employees, students, and clients if ‘they or a family member ever served in the military’. This grass roots initiative cascaded into formalizing additional questions (Military Connection Screener) on Nebraska's 2016 (and later the 2018) BRFSS (Behavioral Risk Factor Surveillance System). A similar screener was permanently added to the Nebraska Risk and Protective Factor Student Survey (NRPFSS) in 2018. These demographic questions, for the first time, allow LHDs to understand and monitor how Veteran-connected family members disproportionately experience a range of mental health issues when compared to other groups. These findings help to guide community organizations to better serve their Veteran-connected clients/patients/students. Funding partners recognize the opportunity in the unique LHD-driven approach to serving this population. Since 2015, VetSET Nebraska has engaged and has been supported by local, state, and federal entities in the public health and Veteran spaces (including: the Veterans Administration [VA] Office of Rural Health, the Prevention Institute/Movember Foundation’s Making Connections program, the Behavioral Health Education Center of Nebraska [BHECN], Center for Disease Control [CDC] Foundation, The Nebraska Departments of Health and Human Services and of Veterans Affairs, local community foundations, and others). Nebraska’s Veterans and their families (a previously underserved and somewhat invisible subpopulation) today are more likely encounter a local public health system that better-understands the opportunities and challenges of military life. VetSET is an important aspect of Nebraska LHDs’ broader efforts as Chief Health Strategists. https://nalhd.org/our-work/vetset/
Size: Medium (Population of 50,000-499,999 people)
State: Nebraska
Summary of Practice:
VetSET: LHDs readying communities to serve Veterans and their families
Category
Behavioral Health
Description