Amid growing public knowledge of the challenges soldiers face in Iraq and Afghanistan, there is increasing awareness of the challenges families and friends must confront. As the wars continue, the need for mental health services outside the military system is growing.
On Long Island, a new division of The Soldiers Project works to connect military service members of the Iraq and Afghanistan wars with mental health therapists willing to volunteer time and psychological services to them and their families. The Long Island division of The Soldiers Project has 20 therapist volunteers. They include psychiatrists, psychologists, social workers, family therapists, and clinical nurse specialists in psychiatric and mental health nursing. Therapist volunteers agree to treat military service members and their loved ones in a private setting, free of charge. The Soldiers Project is a private, nonprofit group and is not government-affiliated.
Susan R. Cohen, RN, PhD, CS, co-chairwoman of the Long Island division, says military service members face issues such as post-traumatic stress disorder, substance abuse, unemployment, disruption of family dynamics, depression, traumatic brain injuries, and suicide. She says these issues spill out into the community because family and friends of returning soldiers are similarly affected. She believes additional mental and social problems surrounding combat stress are yet to be understood.
Any therapist presented with a patient should ask the question, Is someone in your family in the military? Cohen says. We are only at the beginning of understanding the ramifications of all of this. There is a huge ripple effect. You drop that pebble in the pond, and it keeps moving. She says all healthcare professionals should ask patients the same question, just as questions regarding different types of abuse and addiction are asked.
The U.S. government provides mental health services for active service members and veterans, but the treatment is limited to treatment of the soldier, Cohen says, not his or her family or significant others. In addition, she says, the stigma attached to mental health therapy may prevent many soldiers from seeking assistance from the government. By offering services outside the governmental system, soldiers and their families treated through The Soldiers Project are assured privacy and confidentiality.
Judith Ehrenfeld, RN, PhD, CS, is a therapist volunteer with The Soldiers Project. She has a private practice on Long Island and has treated veterans from World War II and the Vietnam War. According to Ehrenfeld, it is estimated 18% of Iraq veterans and 11% of Afghanistan veterans struggle with PTSD. She says there will be a profound impact on mental health clinicians as they are presented with a veteran population with a wide range of serious and emotional problems.
The experiences that result in the long-term diagnosis of PTSD are unique when these experiences are a consequence of war and battle, says Ehrenfeld. Even re-entry to normal life presents challenges for the veteran and [his or her] family and friends.
John Javis, director of special projects for the Mental Health Association of Nassau County and chairman of the Veterans Health Alliance of Long Island, says the Soldiers Project of Long Island is part of the 80-member Veterans Health Alliance, which includes mental health and substance abuse providers, the Veterans Affairs Administration, VET Centers, veterans organizations, elected officials, and local universities. Javis says there are 174,000 veterans on Long Island. This number includes veterans from all wars, not just Iraq and Afghanistan. On Long Island, 1,500 to 2,000 National Guard and Reserve Troops are set to rotate home between January and June.
The military does a great job of preparing people to go to war, but not such a great job of preparing people to be veterans, Javis says. He says multiple deployments, short military-to-civilian transition times, and nonconventional warfare used in the current conflicts account for high levels of PTSD, substance abuse, traumatic brain injury, and suicide among Iraq and Afghanistan veterans.
The VA offers a variety of mental health services, but according to Javis, six out of 10 veterans do not use the VA for these services. He says in addition to the stigma attached to seeking mental health therapy, many veterans fear it might have an impact on their current or future careers if it were revealed they had sought mental health attention. Transportation and distance to access services are other issues. On Long Island, only one VA hospital exists. Javis says groups like the Soldiers Project offer veterans and their families a free and valuable resource.
As Long Island division co-chairwoman, Cohens focus is on outreach and funding. She has a private practice but scaled down her caseload to volunteer additional time to The Soldiers Project. She says outreach includes reaching soldiers and their families, but also includes informing the community that each time soldiers are deployed and return home from war families are disrupted. She says all nurses especially school nurses, ED nurses, and visiting nurses are the front lines of healthcare and need to be aware of the stressful impact these situations have on soldiers and those surrounding them.
For information, e-mail [email protected] or call 877-576-5343.