“I’m Coming Home, Tell the World I’m Coming Home”. The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans

Abstract

This study explored the journey of American armed forces personnel from their decision to join the service, through their service in an active military conflict and how these factors may be associated with potential resistance for mental healthcare. The data came from qualitative interviews with 46 OIF/OEF/OND active-duty military, reservists, and discharged veterans of the average age of 25 years, who presented for a new episode of mental health treatment to a large Veterans Affairs Hospital (VAH) in Northeastern United States in 2011-2012. Qualitative analysis of veterans' perceptions revealed several major themes describing how a mental health diagnosis would negatively impact both their sense of identity and pragmatic career-building goals: enlisting as a career-building avenue, 'noble superhero' identity, escaping from hardship, and mental illness as a career-killer. Findings suggest that factors making young veterans resist mental healthcare may be reduced by partnering VAH psychiatrists with career counselors, and by enhancing military leadership's awareness and understanding about how to support soldiers with emotional and mental health needs, with a goal to eliminating stigma.

Psychotherapy Utilization and Retention in a National Sample of Veterans With PTSD

“…Veterans from the OIF/OEF service era were much more likely to initially engage in psychotherapy, a finding that somewhat conflicts with previous work showing low mental health care utilization rates for these Veterans (Garcia et al., ; Hoerster et al., ; Rozanova et al., ). They received a similar number of individual sessions, but 29% less group therapy sessions compared to Veterans from other service eras.…”

“…When left untreated, PTSD can become a chronic and debilitating condition, with significant costs to individuals, their families, and society (McCrone, Knapp, & Cawkill, ; National Institute for Clinical Excellence, ). Despite ongoing efforts to engage Veterans in mental health treatment, service utilization rates remain remarkably low, particularly among Veterans from recent conflicts such as Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND; Garcia et al., ; Hoerster et al., ; Rozanova et al., ).…”

“…Masculine gender socialization tends to include beliefs about emotional issues as a sign of weakness (Addis & Mahalik, ; Green, Emslie, O'Neill, Hunt, & Walker, ; O'Neil, ). Military culture emphasizes and reinforces masculine values of strength and stoicism, and individuals who serve are often exposed to explicit and implicit messages about shutting off their emotions and “toughing out” any problems that might arise (Harpaz‐Rotem, Rosenheck, Pietrzak, & Southwick, ; Rozanova et al., ; Sherman, ). Male Veterans are thus exposed to multiple levels of socialization that run counter to help‐seeking behavior and a primary goal of psychotherapy itself–acknowledging and expressing one's emotional experience.…”

Why People Who Inject Drugs Voluntarily Transition Off Methadone in Ukraine

“…The third theme was voluntarily discontinuing MMT as a transition toward “normal life.” This theme adds to a nascent body of qualitative health research examining how patients’ views on “normalcy” and “being normal” are significant drivers of their health behaviors and choices to engage or not in treatment (Rozanova et al, 2016; Smith et al, 2016). In our study, participants enumerated attributes constituting, in their view, a “normal life.” Having adhered to MMT for several years (and likely having endured the issues described in the previous two themes), participants wished to progress in recovery.…”

Thank You for Hearing My Voice – Listening to Women Combat Veterans in the United States and Israeli Militaries

“…The continuously expanding body of knowledge on the implications of military service and armed conflicts for the lives of men and women combat soldiers spans a range of disciplines from psychology and other health sciences through critical security and military studies to political science and international relations. These disciplines both embody and reflect the events that influence the physical and emotional well-being of combat soldiers and veterans—men and women ( Solomon and Flum, 1988 ; Harpaz-Rotem and Rosenheck, 2011 ; Daphna-Tekoah and Harel-Shalev, 2014 ; Rozanova et al, 2016 ; Grimell, 2018a ). Just as the literature on veterans lies at an interdisciplinary junction, so, too, do the veterans themselves constitute crossroad protagonists in the negotiation of relations between politics, the state, the military, and society.…”