For Veterans, Road to Mental Health May Begin at the Bar

Connecting struggling veterans to the mental health services they need is an ongoing challenge. Now, a new study finds that the process could start with a sympathetic bartender.

The exploratory study found that bartenders at Veterans of Foreign Wars (VFW) clubs could help identify veterans in trouble and direct them to mental health professionals. Brief and inexpensive training for these bartenders would widen the safety net for veterans in need of care, said study researcher Keith Anderson, a professor of social work at Ohio State University.

"We found that the VFW bartenders were quite close to the veterans," Anderson told LiveScience. "In many cases they saw the veterans as both friends and even like family."

Bartending gatekeepers

More than 23 million veterans live in the United States, according to 2009 data from the Department of Veterans Affairs. Veterans are at higher risk than the general population for depression and post-traumatic stress disorder (PTSD), a fact that has led the Veterans Health Administration to intensify its focus on mental health services. But many veterans still fall through the cracks.

That's where community members can come through, Anderson said. Doctors may miss symptoms, because they typically only see patients once a year, he said. In contrast, a grocery store clerk or a mail delivery person may see the veteran weekly or daily.

"Bartenders, we tend to look at them as confidants and counselors in certain instances, so I naturally thought of them as someone who could serve as a gatekeeper" to mental health services, Anderson said.

To find out how prepared and willing VFW bartenders might be, Anderson and his colleagues sent out questionnaires to 300 VFW halls. Seventy-one bartenders from 32 halls responded.

Because VFWs are private clubs where regulars are common, 54 percent of the bartenders reported feeling "close" to their clients. Another 18.6 percent said they were "very close." On average, the bartenders had worked at their VFW hall for seven years, and 73 percent said they felt as though the veterans were family.

"It's not just a job here; it is a second home with an extended family," one bartender wrote on the survey.

About 55 percent of bartenders said their clients shared problems with them often, and another 15.5 percent said they "always" heard about veterans' struggles with family, work, finances and other personal problems. Slightly more than 65 percent of bartenders ranked themselves as moderately able to identify signs of depression, and 42.8 percent said they were moderately familiar with symptoms of PTSD. Another 34 percent said they were highly familiar with depression symptoms, and 14 percent said they were well acquainted with PTSD symptoms.

Willing to help

Bartenders weren't as comfortable with the services offered by veterans' hospitals. Only 43 percent were familiar or very familiar with the types of mental health benefits available to veterans. But the key, Anderson said, was that 80 percent of respondents were willing to refer veterans to professional help, and 60 percent were willing to get extra training to help them do so, according to the study detailed in the current issue of the Journal of Military and Veterans' Health.

The goal isn't to turn bartenders into social workers or psychiatrists, Anderson said, but a 20-minute online training mandated by the VFW could give workers the information they need to identify and refer struggling veterans. The idea is "beginning to work its way through some of the bureaucratic levels" of the VA and VFW, Anderson said.

There's no telling when such a program might be implemented, but Anderson says the idea is cheap, easy and has potential.

"If it helps one veteran, then it's cost-effective," he said.

You can follow LiveScience Senior Writer Stephanie Pappas on Twitter @sipappas.