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2015 HSR&D/QUERI National Conference Abstract

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3087 — National Guard/Reservist Recommendations On Improving Linkage to Treatment and Treatment Programming

Curran GM, COIN North Little Rock; Abraham T, COIN North Little Rock; Drummond K, COIN North Little Rock;

Objectives:
Problem alcohol/drug use is highly prevalent among National Guard (NG) service members and Reservists but help-seeking is low. This qualitative study is investigating pathways to problem alcohol/drug use and factors influencing help-seeking both during and after service in the NG and Reserves. Participants are also offering recommendations on how to better link service members with care and improve substance use disorder (SUD) treatment programming.

Methods:
A combination of advertisements, key informants, and respondent-driven sampling techniques are being used to recruit participants for in-depth qualitative interviews. We have thus far conducted 53 interviews with current/former NG service members and Reservists with a history of substance use problems. Doctoral level qualitative researchers are analyzing the data using inductive and deductive methods.

Results:
Many participants recommended changing how the NG and Reserves "reach out" to service members while deployed and after. We heard recommendations to "debrief and educate" about substance use and mental health issues before leaving a deployment area and to stop screening (as they currently do) during the brief "demobilization" period upon first arriving back in the US (where they retain soldiers longer if they come forward with problems). Participants also recommended changing punitive policies around testing positive for substances, having NG and Reserves pay for treatment services, and that key personnel (e.g., Squad Leaders) be trained in how to approach services members and confidentially screen and refer for care. They also recommended increased outreach from the local VA during drill weekends and other events, and using "battle buddies" or other peer counselors to assist in treatment engagement and improving treatment staff's knowledge of the "military mind."

Implications:
This sample expressed a number of concerns about how SUDs are discussed, assessed, and addressed within the NG and Reserves context. They recommended changes in the screening process and offered numerous suggestions to reduce stigma and improve the likelihood of help-seeking for SUDs.

Impacts:
These recommendations will be compiled and presented to a group of National Guard Leaders, VA and community treatment personnel, and researchers as part of a prioritization process. Next, the investigators will develop and test the Veteran-originated strategies.