For soldiers who have recently returned from Iraq, creeping along Interstate 35 at 15 miles per hour is enough to send some into a panic.
It’s in these types of high-traffic situations, says Greg Zarbo, program director at Mental Health America in Dallas, that suicide bombers would often strike in Iraq.
Although the men know they’re not in combat, if they’re one of the more than 30 percent of soldiers who are affected by mental disorders after serving in Iraq or Afghanistan, it can be hard to separate their past trauma from their present situation, said Lt. Cmdr. Shannon Johnson, who works as a Navy psychologist.
At home, after the light-hearted clamor of sitcoms is replaced by the silence of a sleeping family, Johnson said many previously deployed soldiers must fight off their tendency to replay the horrors of battle, which can include anything from reliving a friend’s death to regretting their own acts of violence.
For those who can fall asleep, even the slightest noise can elicit extreme fear, Zarbo said.
For soldiers suffering through daily activities such as these or even for those having simpler readjustment issues, Zarbo said, finding sufficient help can be one of the biggest challenges to beginning the recovery process, especially since the Army and Navy are experiencing about a 40 percent shortage of psychologists.
“The military is catching up with the idea that they do need help,” Zarbo said, but “The care is simply not adequate.”
In an effort to meet the shortfalls of an overwhelmed military system, Zarbo said Mental Health America of Dallas is launching a support program for previously deployed soldiers this month.
With a more than $550,000 grant from the Dallas Foundation of Texas Resources for Iraq-Afghanistan Deployment, MHA and the American Red Cross aim to provide free mental health services for about 700 soldiers and family members, according to TRIAD, which is a foundation that provides grants for philanthropic endeavors related to Iraq-Afghanistan veterans.
“The VA here in Dallas is doing a terrific job,” Zarbo said, saying that through MHA’s program, others in the community may be able to “help augment what services the military offers.”
The Red Cross will screen soldiers to determine if they have been deployed to Iraq or Afghanistan and those who are eligible will go through a psycho-social screening at MHA to determine what types of services they need, Zarbo said. From there, the soldiers and or their family member will be referred to community resources that will provide free counseling and other services.
Susan Poff, public affairs officer for the Department of Veterans Affairs in North Texas, said the VA would not be involved in MHA’s new program, but that they are taking care of their own situation to ensure veterans receive mental health care.
“There was a gap there,” Poff said. “I think we are addressing that gap.”
Poff said the VA has recently hired additional staff in the mental health care services area and has also extended its hours - including on Saturday - to provide additional counseling slots and other services to veterans.
Johnson said the military has been making similar efforts throughout the country, but that waiting lists are often still long, especially because many are being redeployed or deployed for extended periods of time, which increases their risk of developing a mental disorder.
“It’s hard enough for these soldiers to seek help, so they’ll usually go right when they’re in crisis,” Johnson said. “If they get there and they’re told they have to wait eight weeks, they’re going to say, ‘Forget it,’ the immediate crisis will resolve.”
And Poff said, because of the overwhelming number of veterans, health care services offered to active duty soldiers and their families is limited — a service Zarbo said MHA will work to provide.
Johnson said soldiers could seek help outside of the military, but that it is often expensive or difficult to find. Plus, she said, they often have a hard time relating to professionals who don’t have military experience or training — a concept Johnson said she fully understands having just returned from being embedded in Iraq for seven months.
“It’s easier for me now to have trust. Service members feel more comfortable talking to people who have been there,” Johnson said, noting soldiers have said that mental health providers who haven’t been over can’t understand.
Zarbo said to try and meet the need for trained mental health care providers, MHA will host a two-day conference in February to help train the professionals they refer soldiers to about how to deal with military culture.
David Riggs, a psychologist and executive director of the Center for Deployment Psychology, will be one of primary educators at the training session.
“We try and look at the whole picture when we set up our education programs,” Riggs said, “so in addition to the kinds of problems that service members might have, we’ll talk a lot about the stress that’s placed on families by having somebody gone.”
Riggs said reintegrating someone into a family after they’ve been gone is always difficult, but that when PTSD or depression is added to the situation, matters are complicated even further, which is something professionals need to understand.
He said parents who have been taking care of the children often feel they’re the ones that need a break when the soldier comes back into the home and that when the soldier is not in the mental condition to provide this relief, stress is increased for both parties.
Riggs said the workshop will also cover issues related to deployments for soldiers who are about to go to Iraq or Afghanistan and will focus on ways for professionals to reach out to people who might not come in for care without encouragement.
“A lot of it is getting information out to people and recognizing that it (a mental disorder) doesn’t necessarily prevent you from going on and doing anything you want in life,” Riggs said.
Outreach like this is important, Johnson said, because, according to a February 2007 American Psychological Association report she contributed to, while more than 30 percent of all soldiers meet the criteria for a mental disorder, only 23 percent to 40 percent actually seek help.
Plus, Riggs said, these figures don’t account for the military personnel that develop disorders later. He said the military screens all soldiers for PTSD when they return from deployment, but that often symptoms for this don’t show up until much later.
“The military is very aware of that and they do their best to look out for that,” Riggs said, but that, “People are usually excited to be home and don’t always acknowledge problems or think they’re going to have any.”
Johnson said the military is trying to address the stigma that often accompanies seeking mental health treatment and that part of making mental health care acceptable among military personnel is continuing to have embedded psychologists like herself.
Zarbo said MHA will be sending out flyers with information about different mental disorders and hopefully, with the combination of this and support from family to seek help, the demographic of soldiers in the Dallas-area who need treatment and have not asked for it will start to decrease.
“A person that has a mental illness is probably the last person who wants to admit that,” Zarbo said. “You can tell somebody that their leg got broken, but it’s a whole different ballpark when you try and tell a person, ‘You’ve got a mental illness, you need some help.’ ”
Symptoms of combat related mental health issues:
Some symptoms that indicate you or your family member should seek mental health care include:
Long-term depression and grief Incessant traumatic nightmares or severe/consistent trouble sleeping A lack of social trust that often results from having seen people treated poorly Startled responses to normal situations such as traffic, loud noises, etc Heightened anxiety Trouble interacting with and relating to a spouse and/or children Problems concentrating, especially at work or during daily tasks
Tips for readjusting to life after deployment:
Get into a daily routine Practice self-care, including basic hygiene and exercise Build up a social support system of friends, family or other soldiers Think about family or marriage counseling to readjust to family relationships
*Tips from Ltn. Cmdr. Shannon Johnson, Navy psychologist