Summary: Group Therapy Among OIF Veterans

Hundreds of thousands of United States veterans are not able to leave the horrors of war on the battlefield (“Forever at War: Veterans Everyday Battles with PTSD” 1). Post-traumatic stress disorder (PTSD) is the reason why these courageous military service members cannot live a normal life when they are discharged. One out of every five military service members on combat tours—about 300,000 so far—return home with symptoms of PTSD or major depression. According to the Rand Study, almost half of these cases go untreated because of the disgrace that the military and civil society attach to mental disorders (McGirk 1). The general population of the world has to admit that they have had a nightmare before. Imagine not being able to sleep one

Over the last decade, the wars in Afghanistan and Iraq have drastically increased the need for effective mental health services and treatment for U.S. veterans and service members, especially those suffering from Posttraumatic Stress Disorder (PTSD). Nearly 1.5 million American service members have been deployed in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) since the attack on the Twin Towers in September 2001 (Price, Gros, Strachan, Ruggiero, & Acierno, 2013). Approximately 25% of soldiers and wounded warriors returning home from OEF/OIF present with mental illness due to combat-related violence and other trauma exposure (Steinberg & Eisner, 2015). According to Price and colleagues (2013), OEF/OIF soldiers and veterans are at greater risk for developing mental illness compared to others who served in past military operations.

There is concern about military service members receiving stigma about getting or needing treatment in the area of mental health. Stigma occurs when individuals view others negatively because they have been labeled or identified as having a deviant behavior against societal norms; deviant behaviors such as mental illnesses or diagnoses uncommon or harmful to others. How does that impact the military? Military men and women alike are termed heroes, warriors, and survivors; this is quite the reputation to keep up. Military members go to war or deploy to hostile combat environments, which many come back with severe mental illnesses and diagnosis that need immediate care. At this point they may not feel like a hero. The terms psychological, mentally ill, PTSD, and behavioral health has gained a reputation as having or being a problem. Being labeled a problem is not what service members want. Many studies are trying to pinpoint the problem and resolve the stereotypes associated with getting treatment. Consequently, an individual’s attitude toward mental health treatment is thought to be affected by other people’s views on mental health care (Held & Owens, 2012).

Rates of trauma and mental illness are reported to be disproportionately higher among American veterans, especially those of the recent wars in Iraq and Afghanistan. The barriers to care after civilian reentry further disadvantage this already vulnerable population. The wars in Iraq and Afghanistan have been the longest sustained US military operations since the Vietnam era, sending more than 2.2 million troops into battle and resulting in more than 6,600 deaths and 48,000 injuries. Veterans are at risk mental health challenges, as well as family instability, elevated rates of homelessness, and joblessness. Veterans have disproportionate rates of mental illness, particularly posttraumatic stress disorder (PTSD), substance abuse disorders, depression, anxiety, and military sexual trauma.

Both articles identify the issue of providing mental health services for veterans with an extra emphasis on those that served in Afghanistan and Iraq (OEF/OIF veterans). It is no surprise that returning veterans suffer from both visible/invisible (physical and mental) wounds. Most veterans have this “high” expectation that they are going to receive quality care from both the DoD and VA. Unfortunately reality steps in where veterans are slapped in the face because they are receiving a lack of poor quality care all while jumping through Beuracractic hoops. The challenges faced to access these services include resistance, stigma, lack of professionalism, and geographic and/or regional disparities in the distribution of services resources and/or benefits, and the system simply refusing to change.

For many years, the VA has offered health care to the men and women who have surrendered a large part of their lives to protect our nation. The VA has made great stride in providing specialized services to veterans such as Traumatic Brain Injury (TBI), Military Sexual Trauma (MST), and Mental Health treatment. In fact, the VA is leading the field on Post-Traumatic Stress Disorder (PTSD) research, but now that many of our men and women are returning home from war, the commitment that the VA made to provide accessible health services and a smooth transition from military life back to civilian life to these heroes and their dependents are not being granted in a timely manner. Studies show that suicide among veterans is the number one leading cause of death in the United States and

“The Veterans Health Administration (VHA) is home to the United States’ largest integrated health care system” (Mason e.t. al 2016). Because of technological and medical advancement, surviving injuries from war has lead to a greater need for post deployment and discharge care. I often hear the phrase “Freedom is not free”; the mental health of our active duty soldiers and veterans is one area that ends up costing America. Some lose time with their families, some are injured physically and mentally, and some lose their lives.

According to Connor, Jones, Watts, Shiner, and Stecker (2013), “[o]nly about one quarter of active duty troops with psychiatric disorders actually receive treatment services” (p. 280).These researchers conducted a study using a qualitative analysis method by means of an intensive cognitive-behavioral telephone interview lasting approximately forty-five to fifty minutes. The participants consisted of approximately 300 service members who were recruited within a three year time frame, beginning in November 2009 and ending in January 2012.  The makeup of the participants included: 84% percent male, 67% Caucasian, 13% African Americans, and 9% Latinos. The sample identified participants from forty-eight to fifty states including veterans from all branches of military service. Research findings revealed four primary reasons veterans do not seek treatment for PTSD symptoms: concerns about treatment (40%), emotional readiness for treatment (35%), stigma (16%), and logical issues (8%) (p. 282-283). Overall, the research concludes that if there is an increase in veterans seeking treatment for PTSD after serving military time then the primary care physician should emphasize to the veterans upfront certain expectations. These expectations include

This link was made most evident in the veterans who returned home from service in the Gulf and Iraq Wars due to them suffering from a wide variety of behavioral and physical issues, including PTSD, injuries sustained from blast exposure, chronic joint pain, substance abuse, long term effects to substances used in biological warfare, injuries from working with chemicals and machinery during their time of service (Heady, Gale). These issues are made worse for veterans living in rural areas due to the lack of access to VA healthcare.

Therefore, Spelman, Hunt, Seal, & Burgo-Black (2012) recommend that the best practices for care should consist of an interdisciplinary approach involving integrated teams of primary care, mental health, and social work providers which can normalize and de-stigmatize mental health treatment. Recognizing that co-located, interdisciplinary care may not be feasible for many providers, they suggest utilizing local resources and facilitating interagency collaboration with local Veteran Centers or with the VA (Spelman et al., 2012).

Today's veterans offten return home and find themselves experiencing PTSD symptoms as a result of combat-related stress and signfigant amount of exposure to traumatic events. Post-traumatic stress disorder (PTSD) among United States Veterans has risen to great numbers in recent years due United States involvement in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) thus far within the last 10 years 1,400,000 military service members have been engaged in these conflicts. Once Unitied States troops were deployed and participated in Operation New Dawn (OND) numbers began to rise over 2.5 million troops. (Rosenthal, J. Z., Grosswald, S., Ross, R., & Rosenthal, N. 2011) The veteran population will face exclusive types of stressors

Veterans have a heightened need for medical and mental healthcare compared to the general population, and rural veterans have proven be in significantly more need of such care (Weeks, et

Other people—spouses, children, family members, friends, or co-workers—often are more aware of the veteran's emotional distress than he is himself.(Scurfeild, 1993)

Lunney, Schnurr and Cook, (2014) compared the severity of PTSD symptoms in treatment-seeking older and younger U.S. veterans with PTSD. The study uses a wide number of participants, which provides credibility to the research and can be relied upon on information regarding the effective treatment of PTSD. The researchers

Many challenges still remain as Iraq and Afghanistan veterans seek available access to mental health care. These challenges include the resistance and stigma to seek care, lack of