This is an excerpt from testimony before a House Veterans Affairs Subcommittee on Health hearing held February 28, 2008, regarding the Iraq War’s mental health impacts of Iraq War on the families of Guard/Reserve veterans.
I am the author of “When the War Came Home: The Inside Story of Reservists and the Families They Leave Behind.” I am currently separated from my husband, a National Guard soldier who served one year in Iraq in 2004-05. Just as we are beginning to find our way back together, we are starting the countdown for a possible second deployment. Two of my cousins by marriage have also served in Iraq, one with the MN Guard, a deployment that lasted 22 months, longer than any other ground combat unit. My other cousin, active duty, was killed in action.
My family members have spent more time fighting one war – the war in Iraq – than my grandfather and uncles did in WWII and Korea, combined. When the home front costs and burdens fall repeatedly on the same shoulders, the anticipatory grief and trauma – secondary, intergenerational and betrayal – is exponential and increasingly acute. Nowhere is that more obvious than in Guard and Reserve households.
Same Duties, Less Training
Our Guardsmen and Reservists perform the same duties as regular active troops when they are in theatre, but they do it with abbreviated training and, all-too-often, insufficient protection and aging equipment. It was a National Guardsman who asked then-Secretary of Defense Donald Rumsfeld what he and the Army were doing “to address shortages and antiquated equipment” National Guard soldiers heading to Iraq were struggling with.
Guard families experience the same stressors as active duty families before, during, and after deployment, although we do not have anywhere near the same level of support, nor do our loved ones when they come home. Many Guard members and their families report being shunned by the active duty mental health system. Army National Guard Specialist and Iraq War veteran Brandon Jones said that when he and his wife sought post-deployment counseling, they were “made to feel we were taking up a resource meant for active duty soldiers from the base.” One Guardsman’s wife was told that “active duty families were given preference” when seeking services for herself and her daughters while her husband was in Iraq.
The nearly 3 million immediate family members directly impacted by Guard/Reserve deployments struggle with issues that active duty families do not. The Guard is a unique branch of the Armed Services that straddles the civilian and military sectors, serves both the community and the country. The Guard has never before been deployed in such numbers for so long. Most never expected to go to war. During Vietnam, some people actually joined the Guard in order to dodge the draft and avoid combat. Today’s National Guard and Reservists are serving with honor and bravery, each and every time they’re called. But when the Governor of Puerto Rico called for a U.S. withdrawal from Iraq at the annual National Guard conference, more than 4,000 National Guardsmen gave him a standing ovation.
These factors are crucial to understanding the mental health impacts of the war in Iraq on the families of Guard/Reserve veterans, and tailoring programs and services to support them.
Several weeks after my husband got the call he was mobilized. There was very little time to transition from a civilian lifestyle and employment to full-time active duty. The Guard didn’t have regular family group meetings, and I couldn’t go next door to talk to another wife who was going through the same things I was, or who had already been there, done that. Most Guard/Reservists live miles away from a base or Armory, many are in rural communities. We are isolated and alone.
At least 20% of us experience a significant drop in household income when our loved one is mobilized. This financial pressure is an added stressor. The majority of citizen soldiers work for small businesses or are self-employed. Some have lost their jobs or livelihoods as a direct result of deployment. The possibility of a second or third tour makes it difficult to secure another one. Guard members have reported being put on probation or having their hours cut within a few days of being put on alert status for deployment. Some of us have to re-locate. Some of us go to food shelves. Where we once had shared parenting responsibilities, the spouse left behind is now the sole caregiver, without the benefit of an on-base child care center.
Secondary Traumatic Stress Disorder
During deployment, we withdraw and do the best we can to survive. Anxious, depressed, and alone, we attempt to cope by drinking more, eating less, taking Xanax or Prozac to make it through. We close the curtains so we can’t see the black sedan with government plates pulling into our drive. We cautiously circle the block when we come home, our personal perimeter check to make sure there are no Casualty Notification Officers around. Every time the phone rings, our hearts skip a beat. Our kids may act out or withdraw, get into fights, detach or deteriorate, socially, emotionally, and academically. There are no organic mental health services for the children of National Guard and Reservists, even though they are more likely to be married with children than active duty troops.
There are a growing number of military families with what psychologists are beginning to recognize as Secondary Traumatic Stress Disorder. Secondary Trauma may occur when a person has an indirect exposure to risk or trauma, resulting in many of the same symptoms as a full-blown diagnosis of PTSD. These symptoms can include depression, suicidal thoughts and feelings, substance abuse, feelings of alienation and isolation, feelings of mistrust and betrayal, anger and irritability, or severe impairment in daily functioning.
One woman wrote, “My husband is a Reservist and, foolishly or not, we did not expect him to be activated and sent to Iraq. During my husband’s deployment I had anxiety, depression, loss of appetite, difficulty sleeping, and hair loss from the stress. I had to cut back on my work hours because I couldn’t concentrate.”
Higher Risks
When our soldiers come home, they are given a perfunctory set of questions about their mental health status, and then they are given back to us. Half of the Guard/Reservists who have served in Iraq suffer post-combat mental health issues, and the government has known for decades that Reservists are at significantly higher risk.
Numerous studies conducted in the 1980s and 1990s on the impact of combat deployments in citizen soldiers found that “Being a reservist, having low enlisted rank, and belonging to a support unit increased the risk for psychiatric breakdown. [And] Loss of unit support [post-deployment] was considered a potential major factor for PTSD … In a study of National Guard reservists … nearly all subjects reported one or more PTSD-specific symptoms 1 and 6 months after returning from the Persian Gulf area.
After being denied care, having their symptoms dismissed, or put on waiting lists of up to half a year, dozens of Guard/Reserve veterans have committed suicide, including Jonathan Schulze, Jeffrey Lucey, Chris Dana, Tim Bowman, and Joshua Omvig. Given the documented failure of the Veteran’s Administration to track and disclose veteran’s suicide rates in a timely and forthright manner, and the fact that they don’t monitor Guard and Reserve, it is extremely likely that the actual number is in the hundreds, if not a thousand or more.
Families Need More Support
One of the most critical elements in promoting the short- and long-term wellness of the combat veteran is the military family. Yet, Guard and Reserve families are generally left to fend for themselves during and after deployments. In order for the Veterans Health Administration (VA) to genuinely care for America’s veterans, it must attend to the needs of the families who are left behind during combat deployments, enduring the stress, trauma, violence and grief of war, struggle with marriage and family cohesion and reintegration, and serve as the first line of support for the soldier during deployment and for the veteran upon his/her return.
However, within the Veterans Health Administration, treatment benefits are tied to the veteran. Military spouses cannot access services at the VA until their soldier has acknowledged his/her trauma, registered with the appropriate agency, and provided paperwork/given permission for the spouse to receive assistance or attend a support group, which may or may not be available at that time.
The majority of the affected families/loved ones (parents, children, siblings, significant others, etc.) are beyond the scope and scale of mental health care and services provided by the military, the Veterans Administration, and Vet Centers. Military ONE Source allows for a maximum of six visits and Guard/Reserve families, extended family members, siblings and unmarried partners and significant others of the soldier’s family often do not have private insurance, cannot afford the co-pay or out-of-pocket expense, and are unable to find an adequate mental health provider. Few accept TRI-CARE (military medical plan); fewer still have the experience, training and awareness to address the particular needs of the military community during a time of war. Such inadequacies put the health, well-being and future of military family members and their veterans at risk.
How to Really Support the Troops
Beyond supporting the VA, increased attention to PTSD, and providing proper training, the following initiatives should be implemented in an attempt to fully support the troops and their families:
The Military Citizens Advisory Panel (MCAP): Modeled after Citizens Advisory Boards and Commissions, which are a staple of local, county and state government, and similar to the Iraq Study Group established at the urging of Congress, the proposed 9-12 member non-partisan panel would be comprised of an independent group of credible and diverse military family members and veterans with direct connections to the United States Armed Forces during the Iraq War, and the war on terror. Real support for veterans and their loved ones cannot be achieved without the perspectives of those who are directly affected by combat deployments. It is critical that the expertise and experience of military citizens, i.e. family members from all branches of services, retired active duty and reserve, combat and non-combat veterans, etc., who are able to speak about the realities of being a veteran, the effects of combat deployments, and the battles that begin when the war comes home, is brought into the policy, program and oversight processes of the Veterans Affairs Committee.
The MCAP would be commissioned to provide Congress with independent assessments of the current and prospective situation of deployed troops, veterans and military families; publish briefing papers, policy analysis and status reports on available services and emerging issues faced by veterans and their loved ones; identify near- and long-term consequences for the status of veterans care and the Armed Services, and offer recommendations for improvement.
Because they are the people they represent, the Panel members primary concern is for service men and women, their families and communities, and the veterans of the Armed Forces. They know first – and most accurately – what is occurring with our veterans, the shortfalls in care and services, emerging issues, suggestions for improvement.
Peer-to-Peer Support Groups: Peer counseling prior to/during/after deployment by wives of combat veterans/military families/parents/combat veterans.
Implement Adopt-A-Family program: Involve community members in taking a Guard/Reserve family under its wing thoughout all phases of combat deployment.
Conduct Home Visits: Many Guard/Reserve families lack transportation or cannot easily travel to Guard Armories and approximately 40% of veterans live in rural areas.
Fund Community-Based Weekend Retreats/Experiential Programs & Non-Clinical Services, including:
- Veteran Mentoring/Peer Counseling;
- Family Group Counseling;
- Off post readjustment/reintegration counseling for families of wounded warriors;
- Grief Counseling for Gold Star families;
- Developmentally-appropriate play therapy for children;
- Respite & Bereavement Support: Taking care of the caregivers; and,
- Outdoor/Experiential Programs
Develop & Implement Family-Systems Theory Programs/Services
By definition, a family system functions because it is a unit, and every family member plays a critical, if not unique, role in the system. As such, it is not possible that one member of the system can change without causing a ripple effect of change throughout the family system. (Source Unknown) “The entire family suffers when a Veteran’s mental health needs are not acknowledged and resolved; it can strain even the strongest of marriages … the longer the problem is not treated, the complicated the treatment becomes due to complications that arise from the lack of treatment. As a result, our families suffer through crisis on a daily basis.” (LTC Carol Seger, WAARNG State Family Programs Director, August 20, 2007)
When America chooses war, knowing that with that choice comes the intentional, inevitable infliction of suffering on its veterans and their loved ones, this nation enters into a covenant with the troops and their families. That covenant has been betrayed.