A study from the Minneapolis VA, finds anger, substance abuse, social difficulty, shows the need to treat behaviors as much as symptoms.
A study by Minneapolis VA researchers finds that as many as 56 percent of returning Iraq and Afghanistan combat veterans report readjustment problems ranging from dangerous driving to increased alcohol, drug use and anger problems.
The national study of 754 veterans, most of whom have been discharged for at least three years, is one of the first to look at how combat veterans fare once they return home, resume civilian work and attempt to reenter society. The lead researcher of the study says the results show a need for more community-and family-based programming to address the adjustment issues.
Left unattended, the study warns, the problems could affect not only veterans, but also their families and communities. Also, VA mental health providers could be swamped by surging demands for services. More than half of the veterans surveyed reported anger-control problems and nearly one-third had engaged in behaviors that put themselves or others at risk, such as dangerous driving or drug or alcohol use.
The study suggests that greater use of the Internet and other, nontraditional, methods of outreach to combat veterans could be effective in easing the pressures of shifting from a military to a civilian environment.
"We can focus on symptoms at the expense of focusing on function. When you talk to people it's how they are getting along, whether they are successful in their day to day," said Nina Sayer, a clinical psychologist working at the Minneapolis VA. "What we are interested in doing is looking at how people are doing in their home communities."
An estimated 40 percent of the Iraq/Afghanistan veterans who had used VA medical services within 30 days of answering the questionnaire expressed difficulty in readjustment. Their problems included an unwillingness to confide in others and frequent conflicts with family and friends. Thirty-one percent reported more drug and alcohol use and 57 percent more anger-control problems.
"The implications are that we should be asking people about what's important to them and how they are doing with what's important to them," Sayer said. "What we need to avoid is people coming back and feeling isolated from their civilian community."
An estimated 41 percent of those surveyed screened positive for post traumatic stress disorder or a drug or alcohol disorder. The participants had a median of 42 months between when they returned home and when they completed the survey. Roughly 22 percent reported more than one deployment to Iraq or Afghanistan.
Because the survey is the first of its kind, there is no way of knowing if returning veterans from other conflicts have the same readjustment issues at the same rate. The impact of multiple deployments on the combat veterans was not addressed in the survey, but researchers suspect extended deployments could affect readjustment problems and feelings of isolation upon return.
Those surveyed were Iraq and Afghanistan combat veterans who made at least one visit to a VA facility in the United States from October 2003 to July 2007. The findings were first reported in the June issue of the journal Psychiatric Services.
Mark Brunswick • 612-673-4434