Sharing the Burdens of War

Special to Veterans Advantage

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

I sat in a meeting yesterday and heard a painful yet familiar tale. A military spouse recounted the challenges she faced in her effort to obtain appropriate comprehensive and integrated care for her husband, who suffered a serious head injury while deployed three years ago. This young woman was fierce in her dedication to her husband and extremely capable and competent. She told of the frustration of numerous hospital visits and of seeing multiple medical residents, most of whom seemed overwhelmed, while others were unhelpful. She told of having to repeat a history that was clearly documented in the chart no one seemed to read, and the lack of continuity of care between services offered by the Department of Defense (DoD) and those offered by the Department of Veterans Affairs (VA). She told of the painful decision she made to leave her teaching position—because she had no one to assist her with the day-to-day needs of her husband—and the serious economic ramifications this decision has had for her family.

We know that our military community - those who serve and those tasked with caring for our service members and their families - is stretched thin in so many ways. We know that many service members and their families have seen multiple deployments and are trying to cope with the physical and invisible injuries and consequences of combat stress. Many DoD and VA service providers dedicated to giving care are weary, if not exhausted. These physicians, mental health professionals, and case workers are overextended and underresourced. Programs continue to be developed, by both DoD and VA, in an effort to address what we all see—that the experience of war has a prolonged and pronounced effect on those who fight and their families.

Other government agencies have joined the effort. Programs specifically focused on military personnel, veterans, and their families have been developed by a host of federal (SAMHSA, the Department of Labor, the Department of Health and Human Services), state, and local agencies. Similarly, the nonprofit and veterans service communities have rallied to respond to the needs. And yet, after nearly eight years of war, we continue to play catch-up. There are still so many in need, so many falling through the cracks, so many continuing to struggle and suffer as the war continues to come home.

There is no need to place blame; it is neither appropriate nor helpful. When our country was attacked on September 11, 2001, we had no idea that we would be at war for the next decade. Although veterans of previous wars and many within the mental health profession knew that the consequences of war are serious and long lasting, we had no idea that so many would be placed in harm’s way for so long. And our civilian population certainly had no idea that those who serve and their families would need care and support far beyond what the Pentagon and our government can provide for years following their separation from the armed forces.

Now we see that those economic factors affecting our country over the last several years will soon have a significant impact on those who serve and their families, as well as those tasked with their care and support. Defense Secretary Robert Gates announced on January 6 that the Pentagon will cut projected spending by $78 billion over the next five years, which will result in a decrease in troop strength for both the Army and the Marine Corps. Beginning in 2015 the Army—with approximately 569,000 soldiers on active duty—will reduce its numbers by 27,000. The Marine Corps—with approximately 202,000 on active duty—will be decreased by 15,000−20,000. These reductions will save a projected $6 billion and are planned to coincide with the troop withdrawals from the war in Afghanistan.

Secretary Gates, Admiral Mullen, and many other top officials at the Pentagon have been clear, consistent, and determined in their support of those who serve and the families that share the burden of war. Our military leaders understand the pain of those affected. They have worked tirelessly to support military families. There is no reason to believe that these leaders will look to cut programs or efforts designed to care for returning troops or their families. Still, cuts will be made and programs will be forced to do more with less. In addition, new and creative efforts may not receive the attention or support they deserve. New opportunities may not be explored and programs that serve subgroups within the larger community may not be feasible.

Furthermore, it is clear that the stigma associated with seeking and receiving mental health care still exists within the military community; many who are in need of treatment fail to receive the care they need and deserve as a result. Significantly more outreach and education must occur in order to reach those in leadership roles, for it is the leaders who set the tone and the example for those in need of care. Unfortunately, it is hard to imagine that it will be possible to maintain the amount of time and energy allocated to this important effort up to this point as leaders struggle to ensure that our fighting force is well equipped and combat ready. While many of us would argue that providing appropriate mental health education, support, and treatment is a critical element in ensuring a strong and capable force, there are still many who don’t quite see it that way.

Given this reality, what can we do to ensure that those in our military community seek and receive the care and opportunities that they want, need, and deserve, as they return from war and for the rest of their lives? We can do what effective families, neighborhoods, and communities have always done. We can take care of our own. We can educate ourselves as well as those who are unaware of the needs of our military community. We can create employment, educational, and volunteer opportunities for those who serve as they return to our communities. We can park our egos at the door, roll up our sleeves, and learn to coordinate and collaborate with others who share the belief and the commitment that we all have a part to play in this war effort.

Recall the young spouse who spoke so eloquently about her ongoing journey through her husband’s injuries, his care, and his recovery. She has clearly become the advocate that her situation demanded. But how can we be sure that all of the spouses, parents, and partners have the skills and the resources to do the same for their loved ones? We must be prepared to add our voices and our expertise to theirs. They need to know that they are not alone as they navigate their own journey home.

Give an Hour, providing free mental health services to military personnel and their loved ones, at www.giveanhour.org.

Editors Note: Give an Hour is a strategic partner of Veterans Advantage. Learn more about our partnership with Give an Hour.

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