Marina Kukla, PhD; Nicholas A. Rattray, PhD; Michelle P. Salyers, PhD

1. Mixed methods study examining work reintegration experiences from perspectives of Veterans with mental health disorders Marina Kukla, PhD; Nicholas A. Rattray, PhD; Michelle P. Salyers, PhD

2. Aim • Address gap in literature regarding work reintegration for Veterans and explore perspectives of Veterans with mental health disorders about work reintegration and successful transition into civilian workplace. • Relevance • Reintegration into civilian life can be challenging for Veterans. Work reintegration is a particularly crucial area of study. Veterans struggle with vocational functioning. Many Veterans report work problems, including job loss upon returning from deployment. This is especially problematic among those Veterans who have sought mental health care.

3. Methods • Mixed methods study examined work perspectives of 40 Veterans receiving VA mental health care. Background information, ratings of factors influencing work success/failure in community, and narratives of work experiences were collected through in-person interviews and written survey. Reintegration experiences that emerged in narratives were examined through ratings of factors affecting work success. • Participant background characteristics: sex, ethnicity, educational attainment, mental health diagnosis, marital status, disability status, income level, residential status, and military background. Work history: work status (competitively employed or unemployed), average number of hours worked per week, and wage rate worked during past 6 mo. • Survey consisted of 20 items probing degree to which factors played a role in Veterans’ work success. Narrative interviews asked participants to tell a story about a time when they felt they were successful in employment and maintained a competitive job for at least 6 mo and then tell a story about a time when they struggled to find or keep a competitive job in the community.

4. Results • Sample: 40 Veterans, 21 with military combat experience and 19 without combat experience. • Veterans who served in combat experienced significantly more total work barriers than those who did not. • Veterans with combat experience reported significantly more physical health and cognitive problems that interfered with work success. • Combat and noncombat groups did not significantly differ on the number of perceived facilitators to work success. • No significant differences in total barriers or total facilitators between Veterans who served during Persian Gulf war and those who served during previous service eras.

5. Conclusion • Reintegration after leaving the military involves multiple transitions that must be managed simultaneously and is related to a variety of factors that influence way Veterans think about themselves, other people, and their ability to succeed in civilian world. Assisting Veterans to assimilate military/combat experiences into their changing self-concept and connecting and engaging these Veterans with effective mental health services is essential. • Providing further guidance and resources as Veterans navigate the process of transitioning from military to civilian world is critical, especially with regard to translation of military skills/experiences to civilian workplace. • Veterans who perceived greater difficulty attributed to their mental/physical illnesses may need a higher level of preparedness and more assistance; these Veterans carry the burden of adjusting to both new mental and physical ailments as well as transitioning back into society. • Findings regarding stigmatizing employer attitudes toward persons with mental health disorders are consistent with conclusions drawn in prior studies; further investigation of this issue and effective ways to prepare employers to properly work with and accommodate Veterans is urgently needed.