Vets Battle Modern Issues When Returning Home

Michael Kilpatrick discusses the Millennium Cohort Project during ‘Treatment of the Returning Military Veteran' Friday.

Michael Kilpatrick discusses the Millennium Cohort Project during ‘Treatment of the Returning Military Veteran’ Friday.

In this era of the modern military, with females in combat theaters and multiple deployments to combat zones, veterans face new issues as well as long-established challenges when leaving home and returning. Speakers at a symposium Friday focused on those issues and data now being collected to develop treatment strategies.

Symposium #2, “Treatment of the Returning Military Veteran” featured a detailed presentation about how combat in the Middle East has affected members of the military and their families, as well as efforts to learn more about the long-term effects of combat.

Offering the perspective of a health care professional, as well as personal experience because her former fiancé served in the Middle East, was Susan A. Storti, Ph.D., RN, CARN-AP. Dr. Storti is an investigator at McLean Hospital, Harvard University, Boston, and a research associate at Brown University Medical School.

“You need to look at them from a holistic perspective,” she said of returning military members. “They could not only have wounds from combat, but there could be issues in the home that play a role in alcohol abuse or psychiatric disorders.”

Of the 2.2 million military members deployed to Iraq and Afghanistan, 52 percent are ages 18 to 25, and 24 percent are ages 25 to 30, Dr. Storti said. While effective treatment for these traumatized veterans should require 12-16 sessions, “this group will not stick around,” she said. “They will have two or three sessions, then disappear.”

Military members and their families face an emotional cycle of deployment that includes:

Initial intense fear and worry
Detachment and withdrawal as deployment nears
Loneliness and sadness soon after the military member leaves
An adjustment period
Reunion issues
Effects of pre-existing difficulties

Instead of getting closer to their family and friends as they near deployment, military members often become more solitary, which causes more problems when they return home if issues already exist, especially in a marriage, Dr. Storti said.

During deployment, family members must cope with limited communication and frightening news reports, she said.

When the military member returns home, everyone must learn to adjust to a changed family structure — from spouses to children to parents. Mothers returning home from duty increasingly find that their children act out, sometimes leading to legal issues, Dr. Storti said.

Other factors to consider when treating returning military members are that they feel out of place and often translate their coping techniques from combat to their homes. In addition, individuals also face physical problems, such as loss of limbs, traumatic brain injury, loss of hearing, musculoskeletal disorders, combat trauma, and stigma.

“Military members are often afraid to seek assistance, especially if they want to make the military a career,” Dr. Storti said.

Complicating readjustment can be abuse of alcohol, narcotics, benzodiazepines, marijuana, stimulants, and steroids, she said, adding that more military members now use “spice,” a chemically treated herb that is legal and similar to marijuana.

Dealing with these issues may eventually improve because military and political leaders are finally recognizing the need to collect data and develop plans to help these returning veterans.

Michael Kilpatrick, M.D., FACP, a longtime member of the military and now a civilian, has studied deployment issues for the past 10 years. Veterans are now being surveyed in-depth three to six months after returning home, instead of answering a few questions immediately after returning home.

In addition, the Millennium Cohort Study is examining the long-term effects of military life on service members. The study began in 2001 and new members are enrolled every three years, so more than 150,000 have been sampled.

“This data will provide important indicators that will lead us to understand what other studies need to be done,” Dr. Kilpatrick said. “It is fertile ground for more research.”