Bringing Them Home: Addressing the Behavioral Health Needs of Veterans and Their Families

By Kay Hart, MPAff Candidate
Lyndon B. Johnson School of Public Affairs
The University of Texas at Austin

No one leaves war unchanged and those changes may include both physical and mental trauma that adversely affects the quality of life for those who serve in the military and the families that love and support them. Nationally, 1.5 million soldiers have served in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) and 60% of these soldiers are married and/or have children. With the third largest population of resident veterans and 14 major military bases, Texas is deeply impacted by issues affecting military personnel and their families.

In many ways, especially those related to mental health, the impact on military personnel serving in OEF/OIF and their dependents is unprecedented. For example, half of those serving have been Reservists or members of the National Guard. These service men and women do not deploy from or return to regular military bases. Thus, they and their families often do not have the support that comes from living in a community of people who share their experiences.

Another unprecedented aspect of OEF/OIF is the number of deployments faced by many in the military. Nearly 500,000 service men and women have been deployed for more than one tour with four and five tours being common. Being deployed more than once increases the exposure to trauma for military persons, and lengthy and frequent separations increases the stress experienced by their loved ones.

Also, unlike previous conflicts where the typical soldier was a young, single male, 20% of those serving in Iraq and Afghanistan are female and most soldiers have families. In fact, 23,000 of those serving in OEF/OIF are single parents with custody of their children. Dual military families, where both spouses serve, are also a significant factor in the military. As a result of these changing demographics, 2 million children have been directly affected by the deployment of a parent and 40% of these under 5 years old.

All of these factors combine to produce significant mental health risks for active duty military personnel, veterans, and their families. It is estimated that 30-40% of Iraq veterans will face depression, anxiety, or Post Traumatic Stress Disorder (PTSD). In addition, 320,000 OIF/OEF veterans have experience Traumatic Brain Injury (TBI), a physical injury to the brain that is associated with symptoms similar to PTSD.

The family also faces mental health risks associated with both the deployment and reunion phases of military service. With so many infants and young children experiencing separation from one or both parents, mental health workers are concerned about attachment issues and negative impacts on brain development. Furthermore, adolescents with a deployed parent are more likely to participate in risky behavior, such as teen pregnancy and substance abuse. These are compounded by troubling evidence that the stress of loneliness and worry experienced by the caregiving spouse results in an increased risk for child maltreatment during periods of deployment. Even after the return of the military family member, difficulties in adjustment and mental or physical health issues faced by the veteran can result in increased anxiety and depression in their children.

Promoting resilience in the families of veterans and service personnel offers hope that behavioral health issues can be avoided in the long-run. People with resilience are able to harness inner strength, access external help, and rebound more quickly from setbacks. Without resilience, people turn to unhealthy coping mechanisms such as substance abuse and may develop significant mental health problems. The task of helping military families develop greater resilience rests with the entire community.

An important first step in promoting resiliency is recognizing the warning signs of mental illness and knowing what treatment options are available. The National Center for Posttraumatic Stress Disorder provides excellent information about warning signs and treatment options for PTSD and other mental health conditions. They also provide information for the family about coping during deployment. This information is helpful not only for families affected by deployment, but for those who want to support them during this time.

Promoting resiliency and offering support to veterans and their families can happen in a variety of ways. For example, a group in California offers Surf Camp to the children of wounded or fallen service members. There are numerous organizations like this and it is important to connect them with members of the community that want to help and veterans and their families that need help. TexVet: Partners Across Texas (TexVet P.A.T.) is a collaborative effort of various local, state, and federal entities and programs to ensure the availability of a system of resources and referrals for members of our military service, veterans, and their families. The TexVet website provides valuable information that helps provide those connections.

While no one leaves war unchanged and the burdens of war are born by even the children of those that serve, those burdens do not have to be born alone. Bringing our service men and women home to stable families, strong communities, and a committed mental health care system can provide the best outcomes for everyone affected by the trauma of war.
For more information

* The National Center for Posttraumatic Stress Disorder
http://www.ncptsd.va.gov/ncmain/information/
* Coping When a Family Member Has Been Called to War
http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/familycoping.html?opm=1&rr=rr116&srt=d&echorr=true
* Surf Camp
http://www.ourmilitary.mil/Content.aspx?ID=45009891
* TexVet
http://www.texvet.com/