Many U.S. military veterans have mental and physical disabilities that can increase their risk of substance abuse, social isolation, unemployment, and homelessness. The wars in Iraq and Afghanistan have made it urgently necessary to address these issues once again as the nation faces “the largest wave of returning veterans with disabilities in recent history.” One in four veterans of these conflicts reports a service-connected disability, and unemployment among the youngest subset of veterans is particularly high.
Veterans with disabilities need quality programs to help them get on a path to work and reintegrate into their communities. But there is limited evidence about what interventions can effectively help them do so. Past research suggests that symptoms and impairments explain only a part of what prevents people with disabilities from working, and that people with disabilities’ own beliefs and attitudes about their conditions often keep them from gainful employment. Similarly, researchers at the U.S. Department of Veterans Affairs (VA) have suggested in personal interviews that disabled veterans’ attitudes and beliefs about disability present at least as big a barrier to their ability to return to work as their actual physical or mental conditions.
Drawing on its experience in disability, behavioral, and employment research, MDRC began testing the Progressive Goal Attainment Program (PGAP) for Veterans in 2012, in collaboration with the VA Connecticut Healthcare System. PGAP is a behavioral intervention for people struggling with a wide range of physical and mental health conditions. The program complements clinical services for the treatment of disabilities by specifically targeting psychological and social behaviors that contribute to pain, disability, and inactivity. The goal is to help those with disabilities resume daily activities and get them on a path to work.
The PGAP demonstration in the VA Connecticut Healthcare System was designed to explore how feasible it is to implement the program in a veteran service setting. In the coming year MDRC will also test PGAP for Veterans in several locations in Houston, Texas, including the VA hospital and two local community providers.