Joe Klein’s cover story, How Service Can Save Us in last week’s Time, identifies several critical issues that must be further explored and better understood if we are to more successfully engage and support the men, women, and families who serve our country.
First and foremost, not all who come home from war are suffering from post-traumatic stress. Indeed, although some reports indicate that as many as one-third of all of those exposed to combat will experience significant mental health symptoms, this suggests that two-thirds will not.
This does not, however, mean that the two-thirds who are not “diagnosable” are unaffected by their experience of war.
They most certainly are.
In addition, post-traumatic stress exists on a continuum. Not all veterans with PTS exhibit the same symptoms or are affected to the same degree. Just because someone is suffering from post-traumatic stress, depression, anxiety, or a traumatic brain injury doesn’t mean that they are unable to heal, recover, or manage their symptoms. Nor does having a diagnosable mental health condition suggest that someone is unable to be a great employee, successful student, effective parent, or wonderful partner. The ride may be a bit bumpy at times—but this is true for all who experience trauma in their lives or manage a mental illness.
Furthermore, one size doesn’t fit all: not all veterans need or respond to traditional forms of treatment. But for some veterans and family members, traditional therapies can and do save lives. Some veterans are in search of finding meaning and their next mission in life, while others are struggling with moral injuries resulting from actions they did or didn’t take that make them question whether they want to continue living at all.
The Department of Veterans Affairs offers excellent care for many—but so do community-based programs. We must work to create options, and we must encourage service members, veterans, and their families to keep trying until they find the kind of treatment or care that fits their needs. A recent study by Blue Star Families found that for those members who sought marital counseling, it didn’t matter whether they sought care through the Department of Defense or from a community-based provider. Both groups reported a high level of satisfaction with more than 70% of each group finding it helpful to seek treatment.
There is little doubt that engaging in service can have a powerful and positive effect on those who serve. And creating a national service movement and strategy could help us address many of the social issues that plague communities across our nation.
But the relationship between service and mental health is a complicated one.
This is especially true when we look at populations engaging in service that may be vulnerable or at risk. While many veterans who join disaster relief efforts will benefit tremendously from the teamwork and sense of purpose they experience as they assist devastated communities, we need to be very careful to provide appropriate support for those who want or need it. By the way, we should provide appropriate support to all who work in disaster situations. We are all vulnerable to experiencing psychological pain, distress, and injury in the face of devastation and suffering.
Given that being exposed to further trauma may be distressing for some veterans who join disaster relief efforts, should we discourage veterans from participating in such efforts or engaging in other forms of service in their communities? Not at all.
But we do need to be thoughtful and well prepared as we move forward. We need to be certain that we have appropriate resources in place, and we need to ensure that we provide a range of service opportunities for those who are interested in pursuing service as an option. Just as in mental health care, one size doesn’t fit all when it comes to service opportunities. Some veterans will choose disaster relief if they have that option. Others would benefit from the opportunity to work with a nonprofit as a Mission Continues Fellow, and still others would choose to join one of the many programs offered by the Corporation for National and Community Service if they have the chance. All opportunities are of tremendous value for those who want to continue to serve their communities and their nation.
Finally, we need to remember that there is no single answer, no simple solution when it comes to providing the support and opportunities that our service members, veterans, and military families need and deserve. No one effort, approach, organization, or agency has the answer, nor can any one approach address all that ails those who come home carrying the memories and experiences of war. And why would we think that it would? There are many similarly complicated societal issues affecting many populations. We have been working on these challenges—homelessness, poverty, domestic violence—for decades and have yet to find a simple solution.
But we are making progress: many well-respected organizations who engage and support veterans and the military community are working collaboratively to combine efforts and approaches. And this coordination is benefiting those coming home and the communities they live in.
Perhaps this generation of veterans and military families will lead our nation to develop a strategy for national service for all Americans. Perhaps their leadership and involvement in developing this strategy will help us address some of the other seemingly intractable challenges that face nation.
And just perhaps our nation will finally move a bit closer to closing the military-civilian divide as a result.
Dr. Barbara Van Dahlen is a Washington, D.C.-area psychologist who founded Give An Hour, a private non-profit group that pairs volunteer mental-health professionals with U.S. military personnel back from war.