For military spouses, the joy of reuniting with their wife or husband can quickly be replaced by distress during a bumpy readjustment back into civilian life. It may feel like the service member has returned a different person who may be irritable or seem unwilling to play with his or her children.
“Families are affected by military service,” explained Irina Komarovskaya, Ph.D., clinic director of the Steven and Alexandra Cohen Military Family Clinic at NYU Langone Medical Center. “The family serves as well.”
At the New York City clinic, Dr. Komarovskaya and her colleagues try to help spouses and children of service members understand and adjust to the changes that their loved one experienced. The clinic, which opened in July 2012, also works with the veterans coping with these changes and trying to readjust to civilian life. These services are free and complement other existing services for veterans. The clinic also receives referrals from programs that provide housing and other services to veterans experiencing homelessness.
Extending Mental Health Services to Military Families
“We saw there was a gap in the mental health system for military families,” Dr. Komarovskaya said. She explained that the Department of Veterans Affairs (VA) is the main provider of mental health services for veterans, but the services available to family members are limited. Sometimes veterans may choose to or need to seek services outside the VA system—some veterans are not eligible for VA care or some families may prefer to seek care in a different setting.
With support from numerous philanthropic organizations, Charles Marmar, M.D., chair of the Department of Psychiatry at NYU Langone Medical Center, and his colleagues created the Military Family Clinic.
“Our mission is to try to remove any possible barriers to care,” Dr. Komarovskaya said. “It’s a safe, confidential place where veterans and families can talk about anything they are going through.” Dr. Komarovskaya explained that, in the military, failure to adhere to the structure or failure of any member of the unit to fulfill his or her role may be life threatening. Transitioning from this highly structured military lifestyle into less structured civilian life can be a challenge.
“That transition often doesn’t go very smoothly,” she said. “There is so much flexibility [in civilian life] that it can feel chaotic or unsafe [to a veteran]. We try to support [veterans] as they cross that bridge.”
Why Veterans’ Need Specialized Care
For many veterans, these understandable feelings may be exacerbated by posttraumatic stress disorder (PTSD), anxiety, depression, and other mental health issues. For example, a veteran with PTSD working as a security guard may be hypervigilant and may overreact to perceived threats on the job.
The clinic’s multidisciplinary staff—including psychologists, licensed clinical social workers, psychiatrists, and former veterans—are trained to understand military culture and to provide evidence-based care. The clinic has recently added specialized care for veterans who have developed co-occurring disorders, meaning they are experiencing both substance use and mental health issues. “Substance use often goes hand in hand with other struggles,” Dr. Komarovskaya said.
Sometimes care for a veteran begins when a spouse or other family member reaches out for help. Dr. Komarovskaya explained that the fear of exclusion associated with asking for help among service members may deter them from directly seeking mental health care. But they may be willing to seek couples counseling or other services if their spouse insists.
Help for Military Spouses and Children
The clinic’s staff can help spouses or other loved ones understand how their service member’s stress and trauma affects them and their relationships and can help them work through their own mental health concerns. They also work with children of service members who may be experiencing behavioral, academic, or other difficulties during the family’s readjustment. Access resources on child trauma for military families and their caregivers.
One key to the clinic’s approach to care for military families and veterans is to ensure that staff are well versed in military culture and well trained in trauma-sensitive care, Komarovskaya said. The staff is active in local veterans’ communities and in advocacy for veterans and their families.
“For this population, it is hard to build trust,” she said. “The more you can be competent in all these areas, the better it will go.”
This article was originally published to highlight the May 2015 theme of Children and Families. Learn more about critical issues facing veterans and military families and the challenges they face reintegrating into civilian life.
Access more behavioral health and homelessness resources.