Cover Story Article

It seems likely that our nation will be involved in military conflict somewhere in the world for the next several years—if not decades. Intellectually, our citizens realize that we have been at war since 9/11, but we as a country seem uncomfortable confronting what this means for our nation, specifically for those citizens who bear the burden of war.

We have the most powerful military force in history. We have the most well equipped fighting force and arguably the most brilliant military minds in the world. We are clearly up to the task of carrying out the campaigns required of our armed forces. We are not, however, prepared to carry out the critical task of caring for those who serve our country once they return home to our communities.

Nearly 2 million men and women have served in Iraq and Afghanistan over the last six years. A conservative assessment suggests that 10 family members are directly affected for each member of the armed forces who serves. Thus, approximately 20 million Americans are coping with the acute and long-term consequences of deployment and reintegration. Not everyone who serves is severely affected by the experience of combat. Not everyone sustains a physical injury. Not everyone develops post-traumatic stress or suffers a traumatic brain injury. But everyone is affected. To imagine otherwise ignores a growing body of evidence. More important, to imagine otherwise perpetuates a view that prevents those in need of assistance from asking for or receiving proper care.

Once we accept the premise that everyone is changed by the experience of combat and that families and loved ones are directly and significantly affected by deployments and reintegration, we can begin to comprehend the enormity of the task at hand. First, we must ponder the issue of breadth—just how many areas of life are affected by one’s experience of war. Next, we must think about depth—how such experience affects someone over the course of his or her lifetime. By understanding the breadth and depth of the issue, we can begin to construct a comprehensive system of care for the men, women, and families who give so much and ask so little.

Clearly, every area of someone’s life can be affected by the experience of combat. This is especially true if the experience results in a physical injury or an invisible wound like post-traumatic stress or traumatic brain injury.

On a recent train trip, I sat across from a strapping young man who looked to be in his mid-twenties. He was tall, with broad shoulders, strong, muscular legs, chiseled facial features, and a prosthetic arm. He wore a cap with a slogan indicating that he was a veteran. I was first struck by the reaction of the crowd on the train. Everyone noticed him (how could you not?). People stole glances, seemed uneasy, but no one approached. The young man himself seemed unapproachable, with his head buried in a newspaper and no chance for eye contact.

I then began to think about the impact of his sacrifice. I wondered about the circumstances of his injuries. Were his buddies injured too—did some die? Was he unconscious for a period of time? Did he suffer a traumatic brain injury in addition to the physical injury that was easier to see? I assumed—rightly or wrongly—that he might be dealing with post-traumatic stress. Whatever the circumstances that resulted in the loss of his arm, it is hard to imagine they weren’t traumatic. I wondered how his post-traumatic stress might be affecting his interpersonal relationships with his family and friends . . . I wondered about his intimate relationships. I saw no wedding ring and assumed he wasn’t married and wondered whether he would be able to comfortably and successfully navigate the complexities of the dating world. Perhaps he was experiencing other perfectly understandable mental health concerns associated with his service. Was he getting the assistance he needed? Did he know how to access mental health care? Did he have the resources to cover the expense? Was he aware of all the free services available to him through organizations like Give an Hour™, the Soldiers Project, and SOFAR?

I began to wonder about his present and his future. Was he going to school, did he want to go to school? If he did want to go to college, what would that experience be like for him? The majority of the young men and women who populate our college and university campuses are vastly different from this young man with respect to life experience and other critical factors that affect their sense of self and identity. I wondered if he knew about the organization Student Veterans of America, which was established to help veterans as they head to the classroom.

If he wasn’t in school, had he found a job that suited his experience, his interests, and his life goals? Did his employer provide the appropriate level of support for him, given that his life had been forever changed because of his willingness to risk everything in service to our country?

If not employed, where was he living? I wondered. Was his family able to provide assistance? Was that putting a strain on them—financially, emotionally? Who took care of him during the many months of recovery and rehabilitation he must have undergone. Did his mother or father give up their job to stay in one of the Fisher House’s to be near him while he tolerated multiple surgeries? Did they have a job to return to when they went back home? If his family was not able to assist with support, would he too become one of the many homeless veterans that try to survive on our streets?

And then I took step back. What will this young man need from me, from our country, over his lifetime? I asked myself. We owe him all that we can provide to ensure that his sacrifices are recognized, his service valued, and his life honored. Unfortunately, we have not quite figured out how to do pay this debt. We put “Support Our Troops” stickers on our cars and minivans, but do we actually provide ongoing and necessary support to the men and women coming home? Not yet.

In addition to creating a system that will respond to the multitude of needs across the life span of those serving, we also face the challenge of creating a process that brings together the myriad organizations that have formed to fill gaps in care. Thousands of organizations throughout the country are offering services to the men, women, and families within our military community. One DoD leader has referred to this collection as a “sea of good will.” Indeed, most of these efforts reflect a genuine wish to care for these deserving soldiers, marines, sailors, and airmen. The problem is that while well-intentioned, some organizations may not be very effective, and others may duplicate services already available. The result is one of confusion and clutter for those in desperate need of clarity and organization.

Fortunately, progress is under way. An important technological tool, the Network of Care (www.networkofcare.org) will soon be available throughout the country to help service members, veterans, and family members locate services in their communities. Other organizations are stepping forward to develop metrics to assist in the important goal of identifying organizations that actually provide the services they offer. Finally, a number of well respected, successful, and capable organizations including the USO, Blue Star Families, Civic Enterprises, Be the Change, the Tug McGraw Foundation, Operation Homefront, Student Veterans of America, Veterans for Common Sense, Give an Hour™, and a host of others are joining forces to develop a structure for collaboration and coordination. Indeed, there seems to be wonderful momentum building toward the goal of cooperation among community-based organizations.

What else do we need? Continued leadership from the White House, from Chairman Mullen, from Secretaries Gates and Shinseki. The message needs to be consistent and constant: that our nation will do everything necessary to ensure that those who serve come home to the comprehensive and long-term care they need and deserve for the rest of their lives. There is reason for optimism and for hope but the task is huge. Our commitment must be unwavering, and our action must be effective.

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. 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.