Consider model for treating mental wounds of war
As we brace for another troop escalation expected to last several years, we urge increased caution and awareness of the risk of nonmedical injuries to the men and women serving in our armed forces. Current Middle East deployments have resulted in an alarming rise in signs of mental distress and an increase in suicides among returning soldiers who otherwise seemed well.
The suicide rate among servicemembers has doubled since 2001. Today, a veteran is twice as likely to commit suicide as someone who has never served. The reasons are complex and only now are being investigated.
Military and veteran leaders must continue to explore comprehensive initiatives to minimize these silent but deadly wounds for returning soldiers. The University of Medicine and Dentistry of New Jersey (UMDNJ), the largest academic medical center of its kind in the nation, has been at the forefront of developing successful programs to aid the diagnosis and management of these silent killers of those returning from the battlefield, and we have a strategy that can be adapted nationwide.
Nearly five years ago, in partnership with the New Jersey Department of Military and Veterans Affairs (DMAVA), UMDNJ’s statewide mental health services network, University Behavioral HealthCare (UBHC), launched a 24/7, toll-free confidential helpline called Vet-2-Vet. Modeled after the state’s Cop-2-Cop helpline, this initiative is designed as an early intervention for veterans suffering from psychological or emotional distress and in need of help assimilating back into civilian life. The helpline employs combat veterans specially trained to function as peer counselors because they understand the rigors of combat and challenges of returning home.
Last year, Vet-2-Vet managed more than 3,200 calls. Most callers served in Iraq or Afghanistan and are troubled by anxiety, depression, aggression, post-traumatic stress disorder, suicidal thoughts, or simply the challenges of reintegrating into civilian life.
A growing body of evidence suggests that our approach makes a difference. A significant number of New Jerseyans deployed in Iraq or Afghanistan are members of the National Guard. Yet during the past five years, our state has had no suicides among this large group of veterans. The Guard in neighboring New York has suffered 16 suicides and Pennsylvania has suffered 13.
In a speech at this week’s Department of Defense/VA Suicide Prevention Conference in Washington, Secretary of Veterans Affairs Eric K. Shinseki, a retired Army general, said that suicide among soldiers was one of the toughest challenges he faced as Army chief of staff (from 1999 to 2003). The DoD/VA Task Force wants to learn more about our efforts.
Several key characteristics of our support line help to account for its success. Our combat-experienced counselors have a visceral understanding of many spoken and unspoken issues facing returning servicemembers. Multiple deployments of a loved one affect spouses, children and parents as well. Our helpline support services are also available to these family members, another distinctive feature.
The veterans staffing the helpline also provide predeployment assistance to our troops based on the “my brother’s keeper” model. Through this initiative, selected soldiers are trained to identify and report early signs of mental health difficulties among fellow combat troops. They are taught how to best get help — even when the servicemember in need may have concerns about seeking assistance.
Further, our veteran counselors meet with each servicemember returning from combat to conduct a brief screening, then follow up with each one after 30, 60 and 90 days. Should any concerns be identified, the returnees are immediately connected with services they need.
With suicides among soldiers occurring at an alarming rate, the array of services developed through the partnership of UMDNJ and the New Jersey DMAVA offers critical intervention. Just this past summer, UMDNJ counselors provided mental health screening to 2,700 newly returned National Guard members. And our efforts to keep New Jersey from adding to the sad suicide statistics are gaining national attention as leaders study our strategies and how they are implemented.
UMDNJ’s veterans’ helpline could quickly and economically be configured to serve the country. Further, we could train veterans in other states to provide the case management and peer support services essential to complete the continuum of care. We anticipate such a program would cost less than $6 million a year. This is a paltry amount compared to the estimated $1 million a year spent for each servicemember in Afghanistan, but priceless compared to the emotional cost of losing a servicemember after she or he returns home.
New Jersey’s selfless citizen-soldiers will be full participants in the surge in Afghanistan. And, we hope, all will return home well and fit. However, for those who return and find it difficult to re-enter civilian life, UMDNJ and the New Jersey DMAVA will be there to support and help heal them. For mentally wounded warriors of other states, we hope that leadership in Washington will recognize that New Jersey has developed and demonstrated a workable and successful model. We owe our fighting men and women no less.
Dr. William F. Owen Jr. is president of the University of Medicine and Dentistry of New Jersey. Christopher Kosseff is CEO of University Behavioral HealthCare, the university’s statewide mental health services network.
