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Mental Health Treatment for Families of Servicemembers Subject of Subcommittee Hearing

On February 28, the House Veterans Affairs Subcommittee on Health held a hearing, “Mental Health Treatment for Families: Supporting Those Who Support Our Veterans.” The hearing examined the unmet mental health needs of the families of returning active duty servicemembers.

In his opening statement, Chair Michael Michaud (D-ME) said, “Mental health issues are at the forefront of our agenda, and for good reason. Of the approximately 300,000 veterans from Operations Enduring and Iraqi Freedom who have accessed VA [Veterans Affairs] health care, over 40 percent have presented with mental health concerns, including PTSD [post traumatic stress disorder], substance abuse, and mood disorders. Veterans’ mental health conditions not only affect the returning veterans, but also have a significant impact on their families. Living with, and caring for, veterans with mental health concerns is stressful and can change the way that families relate to one another. While the VA is working hard to care for veterans with mental health needs, too often families of these veterans are neglected. Spouses, children, and parents of veterans have been affected by this conflict, yet oftentimes they do not have access to treatment which may help them…As we will hear, the VA is currently limited in the authority Congress has given them to provide treatment to families. I know that the VA does everything they can to care for the whole veteran, including the family unit, when possible. But the question is, how can we do more?”

Ranking Member Jeff Miller (R-FL) said, “A report released in November 2007 by the Institute of Medicine found that there is a correlation between deployment to a war zone and several mental health conditions, including PTSD, depression, and marriage and family conflict. Unfortunately, this is not news to those of us familiar with the myriad of issues facing veterans. Although valuable mental health services are provided by VA and DOD [Department of Defense], family members still are the first and most important network of support for veterans and their role in the mental health care process should not be underestimated…Families of soldiers make tremendous sacrifices so that the men and women they love can defend the country we all love and I want to take this moment to thank them for their role in supporting America…I look forward to hearing from our witnesses and their views on what else could be done to support the mental health needs of family members. Meeting the health care needs of veterans in the best way possible will always be our first and greatest priority.”

Linda Spoonster Schwartz, Connecticut commissioner of Veterans’ Affairs, said, “In addressing the issue of mental health treatment for families, I would be remiss if I did not reference the increasing body of evidence which links combat veterans, PTSD, and violent and abusive traumatic events in the home. Domestic violence has always been a factor in military life. It is not new. What is new is the fact that victims are no longer silent and someone is listening…While the Pentagon has made efforts to address the issue and offer support and education to families in the military community, this war’s heavy reliance on citizen soldiers of the Reserve and National Guard components bring this volatile scenario into every town, every city, and every neighborhood of America…The long separations, multiple deployments, and sense of isolation from the very supportive military community creates confusion, anxiety, and anger, which increases the stress and difficulties experienced by families. The New York Times recently reported ‘more than 150 cases of fatal domestic violence or child abuse in the United States involving servicemembers and new veterans during the war time period that began in October 2001 with the invasion of Afghanistan’…Admittedly, these cases are the extreme. However, headlines do not always capture the slow, insidious erosions of trust, disruptions of anger, violence, and abuse that deeply wounds and destroys families. The reality of PTSD in men and women who serve in the Armed Forces also engenders a link between the symptoms of this condition, family estrangements, and dissolution of family units.”

Dr. Spoonster Schwartz discussed Connecticut’s Military Support Program (MSP) and urged the Veterans Administration to adopt a similar model nationwide. The MSP, in operation since 2004, offers mental health services to the families of active duty or transitioning servicemembers who are unable to obtain care through the Department of Defense’s health care coverage. The MSP has a staffed, 24-hour hotline that refers veterans and their family members to three mental health providers in their immediate geographical area who have been trained to provide veteran-specific support. The MSP encourages family therapy, as a 2005 study of Iraq war veterans found that participation rates increased, and perceived stigma lessened, when the therapy included other veterans or was couples/marital-based.

Suzanne B. Phillips, testifying on behalf of the American Group Psychotherapy Association, echoed Dr. Spoonster Schwartz’s comments: “One of the most compelling rationales for using group modalities in meeting the mental health needs of military is that group experience by normalization and communization of traumatic symptoms reduces the barriers to care.” Ms. Phillips stressed the difficulty in transitioning from military deployment to civilian life, saying, “Veterans serve bravely and then bring the war home in the physical wounds and posttraumatic symptoms they bear. Over 29,000 of our veterans have been wounded and 25 percent of those seen at the DVA [Department of Veterans Affairs] have mental health diagnoses. Their marriages and families are both at great risk and are the greatest resources they have research tells us that the lack of social support and subsequent life events are variables that put veterans at great risk for PTSD. Conversely, the strength of close social ties like marriages and families are the most potent antidotes to the despair and isolation of combat stress.” Ms. Phillips advocated a wide array of mental health services for the family of veterans, including school-based groups for affected children, training and support for teachers in areas with high percentages of military families, faith-based service groups, on-site support services at service headquarters, and telephone- and Internet-based counseling services for homebound or rural veterans.

Also testifying were Stacy Bannerman, author and wife of a servicemember; Peter Leousis, deputy director of the H.W. Odum Institute for Research in Social Science at the University of North Carolina; Dr. Charles Figley, on behalf of the American Association for Marriage and Family Therapy; Ralph Ibson, vice president for government affairs at Mental Health America; Scott N. Sundsvold, assistant director of Veterans Affairs and Rehabilitation at the American Legion; Joy J. Ilem, assistant national legislative director at Disabled American Veterans; Fred Cowell, senior health analyst at Paralyzed Veterans of America; Dr. Thomas Berger, chair of the National PTSD and Substance Abuse Committee at Vietnam Veterans of America; Todd Bowers, director of government affairs at Iraq and Afghanistan Veterans of America; Kristin Day, chief consultant at the Office of Patient Care Services at the Veterans Health Administration; and Barbara Cohoon, deputy director of government relations for the National Military Family Association.

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