Exploring the role of social factors in a Veteran service organization to improve mental health outcomes

Abstract:United States (US) military veterans with mental health conditions such as posttraumatic stress disorder (PTSD) or moral injury often experience significant interpersonal challenges leading to isolation and difficulties with social reintegration (Drescher & Farnsworth, 2021; Price et al., 2013). Moral injury has emerged as a construct that more comprehensively captures symptoms of shame, anger, selfhandicapping behaviors, spiritual problems, and social alienation that result following a transgression to an individual’s moral system (Currier et al., 2015). The impacts of social isolation nationwide were strikingly evident following the 2019 worldwide Covid pandemic. Veterans with a larger social network were less likely to experience increased distress as a result of the pandemic, whereas veterans that reported more loneliness at the outset of the pandemic had increased distress (Hill et al., 2023). Furthermore, recently separated veterans with PTSD, in combination with a physical comorbidity (i.e., sleep disturbance, or chronic pain), were particularly likely to experience poor social functioning which is associated with suicidal ideation (Shor et al., 2022). However, veterans who engage in Veteran Service Organizations (VSO) might experience reduced social isolation and improved connections with others (Russell & Russell, 2018). Strong social support systems can contribute to restoration of wellbeing in veterans (Blais et al., 2021; Chen et al., 2020; Ren et al., 1999; Zalta et al., 2021), while PTSD symptoms can contribute to deterioration of social relationships (Bomyea & Lang, 2012). The current study examined the role of social functioning factors in improvements in mental health outcomes across two time points in a VSO. A total of 46 veterans participated in a spiritual journey to Israel and completed surveys one month before and six months after the journey. Results indicated that 65% of the sample exceeded the cutoff for PTSD symptomatology at baseline and 59% exceeded the cutoff at follow-up. Social determinants of posttraumatic adjustment were inversely correlated with mental health outcomes at baseline and follow up. Additionally, veterans demonstrated an improvement in both mental health outcomes and social factors across the two times points. Interaction effects were examined but not found to be significant. Findings from this study support the social-functional perspective of moral injury (Drescher & Farnsworth, 2021) and demonstrate a potential pathway for recovery of moral injury. Clinically, these findings demonstrate the need to assess veterans’ perceived social support, social self-efficacy, and ability to participate in social roles and activities when identifying potential goals in trauma-focused treatment.

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