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Question: Do we understand soldiers’ traumas better than we used to?

Nancy Sherman: Well we’re doing better in that we’re sending mental health clinicians out to the field.  And at Uniform Services University, which is on the campus of Bethesda Naval Hospital, I sometimes teach some of these folks who are going out to the field.  So, they’re deploying with the troops and they’re going to be available, and they make themselves known in advance, and some of them do like warrior resilience training.  I’m here, this is what a healthy soldier can expect to see, helping commanders know that they’re there, so if some of their troops are involved in incidents or they lose buddies or they kill civilians, they know where to go afterward and have touched base beforehand.  So, there’s much more of that.  We have more chaplains going out and being trained in these areas.  We also now are using medical corpsmen to help fill these roles, so they’re not just dealing with first aid and physical wounds, but rather psychological wounds.  So, we’re doing a lot better.  It’s still stigmatizing to come home and seek help and self-medication is one of the first things that lots of folks do, sadly, which is alcohol or drugs. 

And what we’re not doing enough of, I think, is really getting support to the families.  The families served too, in a way, as I said, they go to war in a sense with their soldiers because they’re in such close communication.  They can email their war theater and home theater are not so separated, and when they come home, they’re often limited in resources.  How do you deal with a soldier, male or female, who comes home and just retreats inside, or can’t begin to talk, and also unemployment rates are much higher for returning veterans than they are for those—for civilians. 

So, we’re getting better, but we still have this enormous yawning military/civilian divide.  And the families in a sense are civilian families, of course, but they’re military families because their loved ones have served and they feel society often isn’t supporting them enough.

Question: What new solutions or interventions would you propose?

Nancy Sherman: Certainly more money into the VA, stronger benefits, more robust programs for seeking jobs, making sure that the military hospitals are not themselves shaming places.  Walter Reed had a very big scandal about three years ago in mismanagement and it was a bullying place where soldiers would come home and they were still kept in holding units where they would be ready as if to deploy, but most of them knew they weren’t because they had such severe injuries, yet they still had to go outside for 6:30 a.m. formation, and stand in formation and whatnot.  Though many had been on very heavy medications at night, or might not fall asleep or drift into sleep until 4:30 in the morning, and if they were on leave for awhile, they didn’t get back in time, they were really bullied.  So, making sure that our environments are healthier.  We’ve done a lot to clean those up with something called Warrior Transition Brigades.  Soldiers themselves helping other soldiers move through this passage. 

But I would say, one thing we can do, and I’m involved in this to some degree.  If you’re on a teaching campus, talk to those veterans that have come home and try to break down the barriers, and make them understand that they don’t have to feel it’s only those that have been to war and come home that can really be talked to, that we really want to understand and listen.  And similarly those that are about to go to war who are part of ROTC programs.  Make sure they are not feeling marginalized in class, or afraid to say that I’m going to be serving in a year’s time, or whatnot, and really trying on a person-to-person basis to break down some of the barriers in our local communities.  I think that’s really critical.  In addition to large scale policies of more resources in the VA, having the VA talk to the military hospitals more smoothly.  We’re working that out right now with unified computer systems. 

And also understanding that multiple deployments have an attrition; a psychological attrition on the mental health of soldiers.  Resilience is sort of supposed to be, you bounce a ball and it for a while continues to hold its bounce, but then balls after awhile they keep bouncing and bouncing and bouncing and the bounce gets lower and lower and lower.  And a little bit like that with troops.  You send them three and four and five times to war and their resilience just doesn’t hold up the same way as in the first round.  Stresses on families as a result, high divorce rates.

Question: Are some of these stresses unavoidable in an all-volunteer army?

Nancy Sherman: It’s an Army that wasn’t designed to fight two wars at the same time for 10 years.  If you think about it, I teach 18- to 22-year-olds, half of their lives have been exposed in a very indirect way, but nonetheless, that’s the background factor to war.  That’s a long time, longer than exposure during World War II.  So, yes, big debate, certainly about draft versus volunteer.  I don’t think we will go back to a draft easily.  There’s not enough support for that in Congress.  But we certainly could have more service of various sorts, national service and making military service one of those options so that those that go into military service aren't the only ones who are doing compulsory national service.

More from the Big Idea for Monday, April 26 2010

 

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