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Returning Servicemembers to Community: Here's How You Can Help

Capella University study explores post-combat re-entry needs of returning servicemembers & preparedness of mental health professionals, family, and community to help

MINNEAPOLIS, July 1, 2008 - Military troops are returning from combat zones with mental health issues, and counselors, psychologists, and other mental health professionals feel unprepared. Yet, there are things that every American can do to help. These are among the findings in Joining Forces America, a Capella University-sponsored study of returning servicemembers and mental health professionals.

Servicemembers & mental health professionals agree that troops are reluctant to seek help

Nearly half of servicemembers surveyed (44 percent) said they returned with a mental health condition. But most feel that recognition of a mental health issue isn't likely to be paired with getting treatment. Nearly two-thirds said their peers would be unlikely to ask for professional help to deal with such issues as depression, post-traumatic stress, or family adjustment.

Mental health professionals had similar concerns. Seventy-two percent of those surveyed indicated they were very concerned about the reluctance of some servicemembers to seek mental health treatment, which was the top-rated concern. Several recent studies support this finding, including the Rand Center's study, Invisible Wounds: Mental Health and Cognitive Care Needs of America's Returning Veterans, which indicated that only about half of servicemembers who need mental health treatment actually seek it.

“Soldiers are recognizing they are experiencing post-combat problems, and that's a good thing,” said Will Wilson, PhD, president-elect of the American Psychological Association's Society of Military Psychology and faculty chair for Industrial/Organizational Psychology at Capella University. “When I came back from Vietnam and my wife said I was a different person. I didn't see it. I would never have gone for help on my own,” added the former Green Beret and retired U.S. Army Colonel.

“People want to believe that time will solve the problem, but time solves nothing. We have to take action to help these servicemembers,” Wilson added. “It's a national responsibility that we all need to address.”

Mental health professionals feel under-prepared, but most are trying to gain knowledge

More than a third (37%) of mental health professionals indicated they felt “not very prepared” to help returning servicemembers with post-combat and re-entry issues. Only 18 percent of mental health professionals said they are “very prepared” to help returning servicemembers Those working at a military base feel much more prepared than their peers in other settings, but even there, less than half feel “very prepared”.

Most mental health professionals indicated that they are already taking some steps to increase their knowledge of post-combat mental health issues. Three-fourths of mental health professionals surveyed indicate they have taken further coursework, read scholarly materials, and/or consulted more experienced practitioners about this subject.

Servicemembers take a more positive view of the mental health community's preparedness. Fifty-seven percent said the mental health community was at least somewhat prepared to help with post-combat issues, compared to only a third of mental health professionals. Further, among those who sought mental health treatment, 77 percent said the assistance was helpful, with community mental health providers receiving higher rankings than military providers.

“A big part of the challenge in meeting servicemembers' mental health needs is making sure there are enough qualified professionals to address the need,” said Wilson. “We certainly see Capella as part of that solution. Our online counseling and psychology programs—including the only online CAPREP-accredited master's-level counseling specializations—make it more feasible to pursue advanced degrees in the mental health field. This is especially true for those who would find it difficult to attend a campus-based school, such as those in the military and people living in rural areas.

“Nonetheless, this study is a wake-up call for Capella and other universities who educate mental health professionals,” said Wilson. “We need to look closely at the special mental health issues of servicemembers and their families to make sure we are meeting the need.”

Replace one mission with another

Servicemembers and mental health professionals agreed on several coping strategies that can help servicemembers adjust to post-combat life. Setting a goal, such as earning a degree or focusing on a new career was the top-ranked strategy by servicemembers, with 87 percent finding this helpful. A similar percentage (88 percent) of mental health professionals said this strategy would be helpful, though their top answer was “keeping in touch with fellow servicemembers who shared similar combat experiences.”

“Our military students tell us that pursing a degree after returning from combat gives them a new mission and focus,” said Nicole Lovald, Capella University's armed forces & veterans support supervisor, who oversees the team that provides support to the more than 3,700 military-affiliated students enrolled at Capella. “To further support our troops, we are offering 20 new $5,000 scholarships available to veterans, servicemembers, and their immediate family members. This is in addition to five $10,000 Spirit of Capella Scholarships we have available to students who have been injured in Operation Enduring Freedom or Operation Iraqi Freedom.”

Servicemembers welcome help from family and friends but find them unprepared

Support and encouragement from family, friends, co-workers and the community is vital — especially if there is a reluctance to seek professional assistance. Servicemembers, as well as mental health professionals, reacted favorably to suggestions about what friends, neighbors, and others could do to support returning servicemembers.

Ways for friends, neighbors, and community members to support returning servicemembers

Percentage who rated each idea as “very” or “somewhat” helpful	Servicemembers' responses	Mental health professionals' responses
Respect their personal privacy and the amount of information they do or do not want to share about their combat zone experience	86%	94%
Be available to listen or talk when the servicemember or family is ready	82%	98%
Offer household assistance so servicemembers can focus on themselves	79%	84%
Express appreciation for the service he/she provided to their country	77%	93%
Extend invitations to help the servicemember and family reconnect with each other, extended family, neighbors, friends, etc.	76%	93%

While they appreciate the support, most servicemembers say that neither military families nor the community are well prepared to help them with the transition from combat duty. Only 3% of servicemembers believe that the typical military family is “very prepared” to help servicemembers transition from combat duty, and more than half believe military families are “not at all prepared” to help servicemembers adjust to post-combat life.

Mental health professionals agreed. More than 70 percent of those who have worked with post-combat servicemembers report that military families are typically not prepared to help their servicemember transition back from combat duty.

None of the servicemembers surveyed felt that friends, neighbors, co-workers, etc. were “very prepared” and only 11% felt they were “somewhat prepared” to help servicemembers adjust to post-combat life. More than 80% believe that the broader community support network is typically “not at all prepared” to help servicemembers re-integrate into society after combat.

Capella sponsors online conversation about this issue

To invite further conversation and better understanding of the mental health and re-entry issues of returning troops, Capella University has created an online public forum, joiningforcesamerica.org, where anyone can contribute ideas and suggestions. A summary report of the Joining Forces America study is also available on the site.

About the Joining Forces America study

The study was sponsored by Capella University to explore post-combat mental health and re-entry issues from the perspective of returning servicemembers and the mental health community, and to solicit ideas for what we as a society can do to make post-combat transitions smoother for returning servicemembers. Two separate but similar survey instruments were used, one for servicemembers and one for mental health professionals.

The confidential servicemember survey was conducted online between May 27 and June 4, 2008. The survey group consisted of Capella University adult students who were affiliated with the military, including active servicemembers, veterans, and their immediate family members. Combat zone experience by the individual or an immediate family member was required to participate in the survey. In total, 238 participated as servicemembers/veterans and 11 participated as family members. The sample size of the family members was too small to be statistically reliable and their results are not included in this report. For the purposes of this report, the term “servicemember” is used to report the combined responses of servicemembers and veterans.

The confidential mental health professional survey was conducted online between May 27 and June 8, 2008, among four groups: an online panel of 201 mental health professionals; 29 members of a military psychology online discussion group; 1,064 Capella University adult students and alumni who were enrolled in or graduated from an advanced degree program with a mental health, counseling, or psychology focus; and 37 Capella University psychology and counseling faculty members. The reported results include the responses of the 999 survey participants in these four groups who identified themselves as working mental health professionals.

About Capella University
Founded in 1993, Capella University is an accredited*, fully online university that offers graduate degree programs in business, information technology, education, human services, psychology, public health, and public safety, and bachelor's degree programs in business, information technology, and public safety. Within those areas, Capella currently offers 104 graduate and undergraduate specializations and 15 certificate programs. The online university currently serves more than 23,400 students from all 50 states and 45 countries. It is committed to providing high-caliber academic excellence and pursuing balanced business growth. Capella University is a wholly-owned subsidiary of Capella Education Company headquartered in Minneapolis. For more information, please visit www.capella.edu or call 1.888.CAPELLA (227-3552).

Learn more about Capella's services and scholarship for military-affiliated students: http://www.capella.edu/armedforces or call 1.888.315.8001.
Learn more about Capella's graduate programs in the fields of counseling and psychology: http://www.capella.edu/mentalhealth.

*Capella University is accredited by The Higher Learning Commission and is a member of the North Central Association of Colleges and Schools (NCA), www.ncahlc.org.
Capella University, 225 South Sixth Street, Ninth Floor, Minneapolis, MN 55402, 1-888-CAPELLA (227-3552), www.capella.edu.

Additional Findings from Capella University's Joining Forces America study

Top 5 pieces of advice for returning servicemembers — from their fellow servicemembers

Be patient - with yourself, your family and others. Adjustment will take time, for all of you.
Stay connected/keep busy - spend time with family, friends and other servicemembers
Take care of yourself - seek professional help if needed, or at least indulge yourself in your favorite activities or some much needed time off
Give yourself credit - remind yourself of the good that has come from your service
Look to the future - use your experiences to create a good future; set new goals such as a degree or new career.

Selected quotes from survey respondents
“Life appears to have changed and you no longer think that you are the same person that you were before you left. Give yourself time and you will learn to re-appreciate those things that you appreciated before you left home.” Servicemember

“Do not set your expectations too high. You have changed and so has your family. Let them in and just relax.” Servicemember

“Connect to family, friends, and professionals as soon as possible. Have the strength to ask for help—it is not a weakness.” Servicemember

“Be patient with family, friends, and others. Many civilians do not understand the experiences or emotions involved in combat and they can overwhelm an individual just returning from combat.” Servicemember

“Breathe, you're home now. Now make everyday count and don't take anything for granted.” Servicemember

Top 5 ways for neighbors to help a returning servicemember — according to servicemembers

Offer support & encouragement (sometimes it helps to just listen)
Respect my privacy (don't push me to share my time or information if I'm not ready)
Just say thanks
Help me reconnect with my family and community (offer invitations, help with chores so I can spend more time with family)
Act normally (don't treat me too differently)

Selected quotes from survey respondents
“[Family and friends] allowed me to ease into non-combatant life by patiently waiting for me to open up. They were not judgmental, they did not blame me for the actions and failures of war. We did not get into political discussions… They welcomed me with open arms and ears.” Servicemember “Families and friends [need to be educated]on how to be supportive… Too often, while meaning well, family and friends say and do things that exacerbate or alienate the service member further.” Mental health professional

“Sometimes just taking the family's children for a few hours so the servicemember and spouse can spend time alone is valuable. It's the little things that speak volumes of genuine care and concern during periods of distress.” Mental health professional

“Try not to constantly ask questions about the experiences. It is a touchy subject. It took me two years to be able to openly speak about the things I saw in combat … However, it always feels good to hear that someone appreciates our service.” Servicemember

“Follow the veteran's lead—if they want to talk, be there. If they want privacy, allow it and be on the fringes so they know they can approach you if they need or want to.” Servicemember

Top 5 reasons servicemembers didn't seek assistance for mental health issues
Among servicemembers who said they returned from combat duty with some or serious mental health issues, the top reason for not seeking assistance was their fear that it would have a negative impact on their career.

I was concerned that seeking mental health treatment would have a negative effect on my career	53%
No help was offered to me	35%
There was no one available with combat experience who could understand what I gone through	29%
I was concerned that friends, family and/or co-workers would lose respect for me	4%
I could not get in to see someone when I needed help/too few mental health providers in my community	18%
*Note: Small sample size; based on subgroup that had mental health issues but did not seek help.

Selected quotes from survey respondents
“I sought psychiatric help, at the beginning of which I asked the doctor whether physician-patient confidentiality protected me if I found it necessary to divulge classified information during a therapy session. The doctor advised me that I was not protected and if I divulged any classified information, he would report me immediately. Suffice it to say that I left the therapy session and never returned, even to this day.” Servicemember

“There aren't enough mental health professionals around any military base to serve the tens of thousands of combat vets returning.”– Mental health professional

“In my opinion the therapeutic model fails precisely because servicemembers resist therapy due to stigma … I met with members in their homes or recreation areas and not an office, where even the area brings with it stigma and fear of observation.”Mental health professional

Top 3 recommendations from mental health professionals on ways to improve mental health services for servicemembers

Make it easier for servicemembers to seek treatment.

Reduce wait times and paperwork.
Provide services at convenient places and times to allow servicemembers to seek care off the military base if they fear the stigma of seeking care through military providers.
Offer services and support to families of servicemembers.
Use outreach programs, marketing, and public service announcements to encourage servicemembers to seek mental health treatment or assessment.

Offer education and training to improve care and reduce the stigma of treatment

Increase the number of mental health providers with knowledge of servicemember needs.
Educate servicemembers and their families on symptoms, coping strategies, and the value of mental health treatment.
Increase awareness among the general public about military mental health needs.

Advocate for better mental health care and access for servicemembers

Encourage policymakers to increase funding.
Advocate or support military efforts to reduce the stigma of seeking mental health treatment.

Selected quotes from survey respondents
“Mental health workers have seen the writing on the wall ever since September 11th that the trauma of such an event and the war declared will have devastating consequences for servicemen, women and families for years to come.” Mental health professional

“[Mental health professionals need] specific training regarding the military and post-combat issues. Also, normalize the need for mental health treatment - to the military member, their family and friends. In other words, make it clear that counseling is a normal part of the post-combat reintegration process.” Mental health professional

“Everyday” Challenges for Returning Servicemembers

Percentage of servicemembers who found this issue “somewhat” or “very” difficult after returning from combat duty	Total	Those who returned with physical health problems	Those who returned with mental health conditions
Family issues	40%	59%	61%
Marital issues	39%	54%	69%
Outlook on job/career	35%	54%	67%
Clarity on future life choices	32%	48%	65%
Personal health/injury	28%	67%	65%
Personal mental health	27%	46%	84%
Finances	25%	30%	39%
Outlook on life	23%	35%	59%

Selected quotes from survey respondents
“I think it is difficult when a servicemember comes home to fit back in or to find his or her place in family life. People continue to change and life can never go back to the same as when the servicemember left.” - Mental health professional)

“[Returning servicemembers]are emotionally numb and traumatized, and it is extremely difficult for them to come into the ho-hum of everyday life and not go: ‘Wake up people, don't you know I have lost my buddies, and more are dying every day??? And all you can talk about is what type of outfit you want to wear, or what we are going to have for dinner tonight?” – Mental health professional

“Family counseling is most important to help family understand and adjust to problems and concerns of the service member.” Servicemember

“When the soldier comes home, it is normal for him or her to feel like they are not part of their real family; it is also normal for them to grieve the loss of the combat family - or feel that they want to go back to combat because that is where they were comfortable.”Mental health professional

“The best medicine is listening. And when that doesn't work, listen again.” Mental health professional