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Readjustment issues affect 44% of combat vets

Mar. 26, 2013 - 01:28PM   |  
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Nearly half of the 2.4 million Americans who deployed to Iraq and Afghanistan have problems readjusting to life at home — troubles compounded by a lack of understanding on the part of the Defense and Veterans Affairs departments, a new government report concludes.

About 44 percent of U.S. troops who took part in Operations Enduring Freedom and Iraqi Freedom have issues integrating into civilian life, including reconnecting with family, finding jobs or going to school.

And while the government offers help, not all veterans get it, according to a panel of scientists.

“The federal government, in particular DoD and VA, is actively seeking to understand the scope of readjustment challenges,” the report states. “In many cases, however, the response does not match the magnitude of the problems and many readjustment needs are unmet or unknown,”

The report, “Returning Home from Iraq and Afghanistan,” was released today by the Institute of Medicine, an arm of the nonprofit National Academy of Sciences.

The IOM was contracted by DoD under a congressional mandate to produce the report.

The panel, composed of academicians and researchers, found “sparse information´” about the effectiveness of hundreds of DoD and VA medical and social programs for the military and veteran populations.

“The number of people affected, the influx of returning personnel as the conflicts wind down, and the potential long-term consequences of their service heighten the urgency of putting the appropriate knowledge and resources in place to make re-entry into post-deployment life as easy as possible,” said Committee Chair George Rutherford, vice chairman of epidemiology and biostatistics at the University of California, San Francisco.

Most service members who deployed to the war zones — 56 percent — found their military service “rewarding” and had favorable outcomes after leaving the service, the report found.

But 44 percent reported readjustment challenges, 48 percent said they had family strain, 49 percent reported post-traumatic stress symptoms and 47 percent had angry outbursts.

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Because deployment-related health and personal problems often peak decades after service, DoD and VA must take steps now to prevent an avalanche of future challenges, the report said.

Among the recommendations, one touches on a hot-button issue: The report urges DoD and VA to align their treatment policies with accepted standards in the civilian community, to include restricting access to firearms for troops and veterans considered at-risk for suicide.

Other recommendations:

• Develop policies to eliminate military sexual trauma, which is associated with poor health and readjustment outcomes.

• Adjust policies and programs to support and strengthen military families, to include broadening the definition of “family” to serve all in need, including nontraditional families.

• Evaluate programs such as the Transition Assistance Program and the Post-9/11 GI Bill to reduce unemployment and ensure that education benefits serve those who need them.

• Continue and enhance efforts to reduce the stigma of seeking psychological or substance abuse treatment.

DoD spokeswoman Cynthia Smith said officials are reviewing the report and are coordinating with VA to provide a response to Congress by June.

“We are committed to taking care of our people, and that includes doing everything possible to develop the best physical and mental health programs for our service members and their families,” Smith said.

VA spokesman Mark Ballesteros said the report will help improve care for young Iraq and Afghanistan veterans, 56 percent of whom have sought VA health services.

“Greater collaboration with DoD in the areas of research, treatment and clinical outcomes will further enhance continuity of care as service members transition from active to veteran status,” Ballesteros said.

VA faces ongoing criticism for not providing timely health care for patients. A recent report found that more than half of first-time patients couldn't get an initial appointment within 14 days and waited an average of 50 days to see a primary care provider.

Wait periods for specialized mental health care are even worse: VA's inspector general said veterans wait more than two months, on average, for behavioral health appointments.

DoD has its own challenges treating service members in need. In 2011, 301 troops committed suicide and more than half sought mental health counseling or guidance before they died.

Of the 301 suicides, 172 were completed using a gun — 141 with privately owned firearms, 31 with military-issued weapons.

However, 60 percent of the active-duty troops who died by suicide in 2011 had never deployed, and 83 percent had no combat exposure.

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