Cover Story Article

Special to Veterans Advantage

Many efforts are currently under way to assist the men and women who serve as they return home and confront the realities of reintegration into our communities. On March 25, a bill was introduced by Senator Max Baucus of Montana. If passed, this legislation could be instrumental in ensuring that those returning warriors who need and deserve mental health support are identified and provided with appropriate care as quickly as possible.

	Barbara V. Romberg, Ph.D. is a licensed clinical psychologist and the founder and president of Give an Hour

The Post-Deployment Health Assessment Act of 2009 can be viewed when you (click here). This bill would require the completion of face-to-face screenings before deployment, upon return home, and every six months after that for two years for all military personnel deployed to combat environments. The Baucus Bill grew out of an impressive program in Montana spearheaded by Matt Kuntz. Mr. Kuntz lost his step-brother, a member of the Montana National Guard, two years ago to suicide following his return from deployment. The events surrounding his brother’s death led Mr. Kuntz, along with Governor Brian Schweitzer and the Montana National Guard, to develop one of the premier programs in the country for providing care for National Guard members suffering from post-traumatic stress. President Obama honored Mr. Kuntz for his efforts by inviting him to join the Obamas on their Whistle Stop Tour to the inauguration in Washington D.C. (Click here to read an article)

Barack Obama with Matt Kuntz, whose stepbrother Chris Dana committed suicide after returning from Iraq. With Kuntz are his wife Sandy and their child, Fiona. Photo: James Woodcock Billings Gazette

The Post-Deployment Health Assessment Act of 2009 includes three key elements critical to providing necessary mental health care to those who serve. First, the proposed legislation requires that all men and women who serve undergo face-to-face screenings by health care professionals trained to recognize the signs of post-traumatic stress as well as other mental health concerns. By asking that ALL who serve engage in these screenings, we will begin to chip away at the stigma that prevents many from seeking care. By providing face-to-face contact, we will greatly increase the number of individuals who are properly identified as being in need of assistance. I have spoken with many returning warriors who openly admit to shading the truth on the questionnaire that is currently completed upon return.

Our returning troops are tired, they want to see their families and they want to go home, so they are often less than honest in their responses to the Post Deployment Health Assessment questionnaire (PDHA) they are asked to complete upon return from deployment. It is much more difficult to avoid the truth about symptoms and difficulties during a live interview than it is on a questionnaire. The opportunity to acknowledge one’s pain and struggle to an interested human being is an incredible gift to offer those who give so much to our country. Over 40 percent of the individuals who have completed the Montana face-to-face screenings asked for help in addressing their combat stress injuries.

A second key element of the bill is that it requires face-to-face screenings during the period of time leading up to deployment. This is essential in order to identify men and women who may be exhibiting signs of emotional distress above and beyond what we expect under these circumstances. No one is well served—not the individual, not the members of a military unit, not our country—by sending warriors into battle who are incapable of performing their duties. By identifying individuals prior to deployment who need mental health care, we have the opportunity to provide necessary intervention. Perhaps an individual identified as needing care will be able to deploy following appropriate treatment. Perhaps he or she will be assigned a different role within their service that allows them to continue to serve our country. Or, perhaps some individuals will leave the military because service may not be possible for them. Regardless, these alternatives are far more desirable than placing someone with a severe mental health concern in a situation where he or she may endanger his or her own life as well as the lives of others.

Finally, the Baucus Bill requires that mental health screenings continue for a period of two years after a warrior returns from deployment. Current screenings end six months following the start of reintegration. Many of the issues that affect those who serve in war time do not surface during the initial weeks and months following their return home. Many of those who come home feel relief and appreciation that they made it back. There is a bit of a “honeymoon” experienced by service personnel and their families. But then, real life settles in. For many, this is when difficulties start to surface. The warrior who can’t find a job or the one who returns to his or her job but feels bored, restless, and distracted may begin to notice that something just isn’t quite right. In addition, symptoms of post-traumatic stress—nightmares, hypervigilance, insomnia, depression—may surface weeks, months, or years after trauma is experienced. Similarly, family relationships that seemed intact at the start of the reintegration process begin to erode under the weight of the cumulative strain caused by a warrior who is struggling. Further, men and women who initially felt fine upon return may fail to understand that the symptoms they experience a year after they come home may indeed be related to their combat duty. We need to follow those who return for at least two years to educate and provide care when needed.

Many within the Department of Defense are very supportive of the approach suggested in the Post-Deployment Health Assessment Act of 2009. Most notably, Admiral Mike Mullen, Chairman of the Joint Chiefs of Staff, has been advocating for mental health screenings for all those who serve in combat. (Read article by clicking here). Some within the military, however, are concerned that the cost of conducting these screenings is prohibitive and that there aren’t enough health care providers available to do the work required. Fortunately, community based organizations like Give an Hour and others stand ready to assist the military in this effort. With nearly 4,000 mental health professionals already in our network, Give an Hour can work with DoD and the VA to ensure that all who need care receive it. In addition, all of the major mental health associations in our country support Give an Hour’s mission and will step up to assist with this critical task.

Approximately 1.9 million men and women have served in the conflicts in Iraq and Afghanistan. We owe them the best care that we can provide. In this case, the best care that we can offer means following each one of them throughout the reintegration process to ensure that they receive appropriate services and interventions. The members of our military community deserve to lead productive and meaningful lives. They deserve our respect, our understanding, and our commitment to leave no one behind.

Editors Note: Give an Hour is a strategic partner of Veterans Advantage. For more on our partnership, click here.

Veterans Advantage is also hosting a special online PTSD Transition Center for its members, with customized news and resources to help in this vital area.