SAN FRANCISCO - Veteran enrollment has been increasing dramatically at City College of San Francisco, but Keith Armstrong, LCSW, director of mental health social work at the San Francisco VA Medical Center (SFVAMC), noticed the students were having a difficult time getting across the city for mental health appointments at the facility.
Identifying the veteran students as a distinctly underserved population, Armstrong championed a program that brought services to the City College of San Francisco following the 2010 establishment of a veterans’ task force there. His efforts recently were recognized with the 2013 American Psychiatric Association Silver Award.
“There had been a good deal of talk about the need for VA to not just sit and wait for our veterans to come to us but for us to go to them,” Armstrong recounts.
The task force, which included a group of students, enlisted the help of the school’s football coach, George Rush, who contacted Armstrong. “When they approached me about getting me an office on campus, I said, ‘Absolutely.’ I then went to our directors and asked what they thought,” he says.
VAMC management was “incredibly supportive,” Armstrong recalls. “We put together a cracker-jack team, including an unbelievable psychiatrist, and we were rocking.”
Many Services Offered
The program office, which is in a suite that includes academic counselors and the certifying official at City College, enables student veterans to walk in and request services ranging from checking on their VAMC appointments to setting up new appointments to determining eligibility.
“On campus, we provide medication management, individual and couples therapy, and an array of social work services,” notes Armstrong. In fact, he adds, the menu of services is not outlined “in a box” but is the result of responses to student requests.
“We want to make sure to communicate — especially to the younger veterans — that VA is useful to them and will respond to their changing needs,” Armstrong explains. “We are the face of VA. If our work is good we help create a relationship with VA in these younger veterans that will last their entire lives. If it’s bad, they may decide never to go to VA again.”
Career Almost Wasn’t
Armstrong has been with VA for 29 years, but it almost didn’t happen. “I did an internship here when I was in social work school, and I left thinking I will never work for that organization because the bureaucracy would drive me crazy,” he says. “But soon after that there was a job opening, and I thought ‘Folks certainly love veterans, so why not give it a shot?’”
Four years later, he faced a life-changing event that would shape his future VA career. “My best friend was killed in a bike accident and that shook me up tremendously,” Armstrong shares. “A couple of years later VA started operating outpatient PTSD programs. Although I was on the inpatient side, I applied, and I’ve now worked in that area for about 20 years.”
At the same time, he adds that he started doing a great deal of family therapy work. He co-authored two books, one of which — Courage after Fire — was a bestseller. (It was designed to help servicemembers and their families after deployment.) He followed up with Courage after Fire for Parents. “People don’t talk too much about parents, and I really wanted to acknowledge their sacrifice to the country,” Armstrong explains.
As for the program’s future, Armstrong says he is looking forward to more expansion. “I really believe in the college model and will help to spread that in the Bay Area personally as well as doing all I can to help other places get their programs up and running across the country,” he notes, pointing out that, in one college alone, the veteran population has grown from a few hundred to 1,300 in just a few years. “Leadership in Washington, DC, is very supportive of what we do — and we’ve shown with data that it is effective,” he adds.
Armstrong says he “could talk forever” about what he finds rewarding about treating veterans. “It’s so wonderful if I can help a family member express the pain they’ve gone through in war and help their partner hear that and be present for them and improve their bond — it’s a real high,” he shares. “There are moments in doing therapy when it feels like there’s no better place to be than where I am right there and then. The feeling you get from really helping, and having people leave the office feeling better can’t really be described; it’s almost a spiritual experience.”