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'Where Soldiers Come From' in Context

Reintegration and Recovery

The U.S. Department of Defense and the Department of Veterans Affairs have implemented numerous programs, interventions and other services to support veterans suffering psychological health problems, including post-traumatic stress, depression and anxiety, as well as TBI.



Government Response to TBI and Psychological Health

The U.S. Department of Defense and the Department of Veterans Affairs have implemented numerous programs, interventions and other services to support veterans suffering psychological health problems, including post-traumatic stress, depression and anxiety, as well as TBI.

After receiving an order from Congress in 2007 to set up a national center to deal with soldiers coming home with TBI and PTS, the Department of Defense established the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, which are meant to collaborate with the Department of Veterans Affairs, civilian agencies, community leaders, advocacy groups, experts and academic institutions to expand and maximize services for veterans and their families. The goal is to unify systems of care, from point of injury to stateside treatment facilities. In addition, the centers of excellence undertook a campaign to encourage "help-seeking behavior" for returning service members with post-traumatic stress or TBI, with a focus on building resilience to help facilitate recovery. According to the U.S. Government Accountability Office, however, the centers' mission, funding and activities have not been clearly defined or communicated to Congress.

Both the Department of Veterans Affairs and the Department of Defense have publicly acknowledged shortcomings, and much criticism has been directed at the two departments for inadequately supporting the needs of service members. A November 2010 policy brief from the Center for a New American Security reports that a new paradigm for veterans' care will require a dramatic reprioritization in the allocation of federal funds and fundamental changes to the relationship between the Department of Veterans Affairs and the Department of Defense and between these two organizations and nonprofit organizations working on similar issues. Nonprofit organizations have been serving primarily to interface between government agencies and service members.

In a May 2011 decision in the case Veterans for Common Sense v. Eric K. Shinseki, the United States Court of Appeals for the Ninth Circuit ruled that "unchecked incompetence" by the Department of Veterans Affairs had led to poor mental health care and slow processing of disability claims for veterans. The court noted that veterans had died while waiting for the Department of Veterans Affairs to provide health care and benefits.

After the court's ruling, Veterans for Common Sense released a statement saying that recent war veterans had filed more than 550,000 disability claims and that the Department of Veterans Affairs still had no plan for handling new patients and claims. While the department has set a 120-day goal for initial processing of a disability claim, it was found that it takes, on average, 394 days for it to process a service member's claim — and in some cases had taken several years.

The department's resource request for 2012 is $132.2 billion, which includes almost $61.9 billion in discretionary resources and nearly $70.3 billion in mandatory funding. According to the department, this discretionary budget request represents an increase of $5.9 billion, or nearly 10.6 percent, over the 2010 enacted level, and a 23% increase in its discretionary budget since President Barack Obama took office in 2009.

View the full Presidential 2012 Budget and Announcement

Resiliency: Before, During and After Deployment

Many government and non-government deployment and reintegration programs have focused on building resiliency and coping strategies for stressful situations faced during wartime. Resiliency refers to how an individual reacts and adapts to a traumatic event, usually bouncing back to his or her level of functioning before the traumatic event.

The idea of "resiliency" as related to the military is to adopt a set of positive actions and attitudes that prepare veterans and families to adapt to challenging situations, establishing a "new normal" and realizing potential for growth. In the case of combat veterans, training is focused on the strengths of the soldiers — things that make soldiers better at what they do and how they do it within a given extreme environment. During reintegration, resiliency training is used to help veterans focus on what they want for themselves in the future, rather than focus on their deficits and the past trauma that occurred.

Photo caption: Dom and Cole pose in front of Dom's mural.  Credit: Heather Courtney
Sources:
» Berglass, Nancy. "America's Duty: The Imperative of a New Approach to Warrior and Veteran Care." Center for a New American Security, November 2010.
» Dao, James. "Court Backs Veterans' Complaints on Mental Health Services." The New York Times, May 11, 2011.
» Maze, Rick. "Senators Blast DoD, VA for Bad Coordination." Army Times, May 18, 2011.
» U.S. Army Medical Department. "Resilience Training."
» Van Dillen, Thomas A. "Resilience Related to TBI in the Military: An Overview." Brain Injury 7, No. 3.



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