LANDSTUHL, Germany — A reintegration team that treats POWs during their first moments of freedom took care of 18 people this past year — a spike from previous years indicative of how the team’s role has evolved with the changing nature of warfare.

Besides POWs, the Landstuhl Regional Medical Center team is increasingly treating servicemembers whose helicopters crashed or whose convoys took a wrong turn, said Rachele Smith, the team’s chief at Landstuhl.

“The definition of what it means to be isolated is changing,” Smith said.

Though American POWs — such as reporter Jill Carroll, contractor Thomas Hamill and seven members of the 507th Maintenance Company — earned ample attention when they went through the reintegration program at Landstuhl, the team has treated 38 people since 2003, most whom were quietly sent home or back to their units. Nearly one-half were from this year alone.

“Commanders are becoming more aware of what reintegration can do,” Smith said. “The benefit it has in helping them heal and get back into the fight.”

Recent counterinsurgency operations have required American troops to spend more time away from giant forward operating bases, patrolling the dangerous villages and cities in Iraq and Afghanistan. One consequence is that it’s much easier for servicemembers to become separated from their unit, said Air Force Tech Sgt. Joseph Thomas, the team’s Survival, Evasion, Resistance and Escape, or SERE, expert.

“Several years ago, a convoy getting lost might not be reported,” Thomas said. “We now know that even though they may never have been shot at or captured, there is a psychological aspect to being out there alone.”

Thomas debriefs patients, gleaning information from them on the enemy’s tactics that might help troops on the battlefield. Besides him, the team is made up of psychologists and physicians, who assess a patient’s medical and mental conditions, as well as chaplains, intelligence debriefers and military lawyers.

If the patient has no pressing medical needs, then much of what the team does is help him or her “decompress.”

The team starts by making patients comfortable, meeting any of their requests, besides seeing family members. One patient wanted a watch, another asked for a haircut, Thomas said. Over the next four days, the patients will be asked to recount their stories to Thomas and Air Force Maj. Jeremy Haskell, a psychologist with SERE training.

With POWs, Thomas focuses on how they were captured, how they were treated, and what led to their release. Thomas isn’t looking to lay blame or point out mistakes; rather he is searching for strategies that may help the next person held hostage.

These debriefings, which last up to four hours, can also be therapeutic, Haskell said, because the SERE expert reinforces what servicemembers or civilians did correctly in extremely difficult and horrific circumstances.

“I’ve seen a light come on in folks when they get that feedback,” he said.

While team members declined to talk about specific cases, they said many patients exhibit the same characteristics.

Whether servicemembers have been held hostage or separated from their units, there is always the possibility of psychological trauma — especially when comrades have been killed or injured, Haskell said.

“That is real challenge, particularly working with teams that are very close, that have trained together,” he said. “We’ve had several instances where the mission didn’t go as planned … and people beat themselves up.”

Silence exacerbates this problem, Thomas said, reinforcing impressions that they did something wrong—even shameful.

“A person who was not reintegrated,” Thomas said, “may feel they messed up so bad that no one wants to talk to me about it.”

Guiding patients through these emotional quandaries is difficult, Haskell said.

“Our natural tendency after a traumatic or difficult event is not to want to talk about it or keep thinking about it,” he said. “What we have learned is the best time to deal with it is as quickly as possible after the event. ‘Out of sight out of mind’ doesn’t work.”

Sign Up for Daily Headlines

Sign up to receive a daily email of today's top military news stories from Stars and Stripes and top news outlets from around the world.

Sign Up Now