Returning Veterans and Behavioral Health
In the conference keynote address, Ms. Power emphasized the importance of educating both the military and civilian communities, as well as providers, about the true nature and effects of trauma. “The experience of trauma is not a disease but a public health issue,” she explained.
In recent years, SAMHSA has worked to elevate the visibility of trauma and is providing tools for understanding and dealing with its effects, she added, noting that many more models for trauma care exist now than even 10 years ago. The need for trauma awareness and trauma-informed care, which incorporate knowledge about trauma and minimize retraumatization, is especially central in dealing with today’s veterans, Ms. Power said.
The long and repeated deployments to conflict areas lacking clear front lines expose service members to trauma and extreme stress, and exacerbate the risk of mental health and adjustment issues among both service members and returning veterans. Service members may also suffer military sexual trauma arising from violence and harassment. Ms. Power added that between 13 and 30 percent of female service members suffered rape, which often goes unreported.
Normal reactions to trauma vary widely among individuals, Ms. Power said. Many people show resilience, but responses such as PTSD, depression, anxiety, and suicidal thoughts are common. These are not signs of underlying mental illness, Ms. Power emphasized, but rather results of traumatic experience. A third of the 1.64 million individuals who have deployed in the current conflicts have suffered from depression, PTSD, or TBI, she noted. Substance abuse is highly comorbid with these conditions.
“The range of efforts underway to help shows that assisting veterans as they return home involves preparing our communities to do more than have parades and release confetti. We must not only celebrate service but facilitate reintegration,” said H. Westley Clark, M.D., J.D., M.P.H., Director of SAMHSA’s Center for Substance Abuse Treatment (CSAT).
Recovery is not only possible, but highly likely with appropriate help, Dr. Clark said. Treatment for trauma’s effects is improving, and large clinical trials are coming that will evaluate treatment methods.
Dr. Eric B. Broderick (left), SAMHSA’s Acting Administrator, stops for a photo with Carol Graham (center) and Brigadier General Loree Sutton (right).
Although many individuals experience post-traumatic growth as positive changes take hold, he said, only half of service members or veterans who need help actually obtain it.
In addition to raising awareness, another conference goal was to build partnerships among the broad range of agencies and organizations serving veterans. One example, cited by Dr. Katz, is the SAMHSA–VA collaboration on the veterans suicide helpline, which has received over 60,000 calls, 30,000 of them from veterans themselves, since its launch in July 2007 (see SAMHSA News online, July/August 2008). “It’s a major success,” Dr. Katz said.
Dr. Katz mentioned a new Uniform Mental Health Services Handbook projected for publication by the end of 2009. The VA handbook will define which services must be provided and will give guidance on methods of addressing service gaps caused by distance and other factors, he said. Approaches include increased use of both telemental health and community services.
Attendees at the Paving the Road Home conference visit the exhibit area.
The U.S. Department of Defense (DoD) will also, as part of its transformation initiative, soon launch a major public information campaign on mental health emphasizing recovery and reintegration, General Sutton said.
“Service members have a very strong identification with strength,” said plenary speaker Marine Sergeant Dan Taslitz, who suffered accidental brain injury in Iraq from carbon monoxide after Marine combat and reconnaissance service. “My identity was shattered. I was no longer a strong athlete and leader,” Mr. Taslitz explained. But resilience was a strong element in his recovery. “It opens the door to support,” he added.
“The Army’s new guidance is to make it a sign of strength, not weakness, to come forward to seek mental health care,” General Graham said.