For the first time in history, the government, the military and private healthcare providers are working together to deliver the appropriate counseling resources to returning war veterans.
This year, the Haywood Regional Medical Center, working with a Department of Defense grant in conjunction with the Smoky Mountain Center and the Mountain Area Health Education Center, has launched a counseling clinic for returning veterans and their families. The pilot program is aimed at providing support to soldiers and their families in an environment that encourages confidentiality and an integrated approach to their behavioral and medical health needs.
At the same time, the North Carolina National Guard has spent the last year putting in place a new system for reintegrating its citizen soldiers back into their civilian lives. The Yellow Ribbon Program, also DOD-funded, is a four-phase curriculum designed to make National Guard service men and women aware of the resources available to them when they come home.
The long road back
Glenda Sawyer, a licensed clinical social worker with over 30 years of experience counseling military personnel, is in charge of the Service Members Counseling and Support Center at Haywood Regional Medical Center. Sawyer has spent the bulk of her career counseling Marines deployed from Camp LeJeune, but her new challenge is to reach out to soldiers without a base. Haywood County has more combat veterans than any other county in Western North Carolina, and many of them are members of the National Guard.
“The purpose of this is to take care of people not connected to a military installation,” Sawyer said. “As a percentage, guardsmen tend to have a higher incidence of mental health issues.”
The Veterans Counseling Program at HRMC also attempts to treat the military family as an entire unit. In Sawyer’s experience, separating post-combat symptoms from family issues is artificial, but the Veterans Administration does not have programs for family counseling.
“There’s really nothing for families at the VA and many times it’s the family, usually the spouse, that initiates the call for help,” Sawyer said. “They’re not coming because of PTSD, they’re coming because they need marriage counseling.”
Sawyer said the program integrates medical treatments like pharmaceuticals and physical screenings with counseling techniques to help soldiers regain a sense of normalcy.
“When they’re over in Iraq and Afghanistan, they’re constantly in hyper-arousal –– that’s the fight or flight instinct –– and they miss that because it’s like a natural high,” Sawyer said.
Veterans returning to their families often use coping mechanisms that push away the people they love.
“When they see something terrible, they numb out,” Sawyer said. “It’s not conscious. It’s a coping mechanism and that just doesn’t stop when they get home.”
Sawyer also said the economy has made a difficult situation nearly untenable. Military personnel are increasingly re-enlisting because of the combined effect of emotional and financial pressures.
“The economy is so bad. You’re talking about a lot of people who may only have a high school education, and they can’t find work,” said Sawyer. “For a lot of them, that’s why they joined up in the first place.”
Faced with a difficult re-integration to a civilian life that offers little potential for success, on the one hand, and high-risk pay on the other, many soldiers re-enlist. The impact, according to Sawyer, will be felt across society.
“We’re just now seeing how bad it is,” said Sawyer. “It’s right now that people are coming back form third and fourth deployments.”
Sawyer said the center is currently treating 18 veterans and family members and has added a full-time nurse practitioner to address medical issues. Sawyer said the combined medical and psychological approach is most appropriate for transitioning veterans because the overall aim is to get them feeling again.
“Everything is about re-conditioning themselves to be in a calm and relaxed state instead of an aroused one,” Sawyer said. “To feel again and get back in touch with their emotions.”
The center also has the advantage of being totally confidential. One of the largest barriers for soldiers who need counseling support is still the military culture, which stigmatizes any kind of perceived weakness.
“There is still stigma, even though the military is working hard on it. Particularly in low levels of command,” Sawyer said. “The biggest thing is confidentiality. Knowing that they can come in and no one in their command will ever know.”
While the Service Members Counseling Center at HRMC signals a new level of public-private cooperation around veterans services, the National Guard has also stepped up its own efforts to help its soldiers return to their civilian lives.
The Yellow Ribbon Program, funded in 2008 by the Department of Defense, is a mandatory curriculum for National Guard members that encourages the participation of family members.
John Gattis, formerly Command Staff Sgt. Major of the North Carolina National Guard, is the program’s administrator. Gattis said Yellow Ribbon is a proactive approach that maintains contact with service members throughout all the stages of their deployment. Because it’s mandatory, Gattis believes more soldiers will feel free to utilize its resources without worrying about what other people think.
The program deals with demobilization by maintaining contact with service members during each of their first three months back from their deployment in a series of all-day workshops.
The monthly checkups include surveys that can help soldiers inventory the effects of combat-related mental health issues. In the past, some soldiers have not used counseling supports for fear it could jeopardize their futures in the military.
“All we’re asking them to do is be honest with their assessment and identify potential problems,” Gattis said. “It’s not designed to identify problems in order to keep them out of the military as was once thought. It’s been developed for them.”
The program is in place just in time to deal with the return of the 30th Heavy Brigade Combat Team –– comprised of National Guard troops from North Carolina and West Virginia –– later this year.
Gattis believes it’s crucial to ensuring a successful transition back to civilian life.
“We are at war and as long as soldiers are returning from combat zones, we have to take care of them,” Gattis said.
For more information about Yellow Ribbon visit www.nc.ngb.army.mil/index.php/yellow-ribbon/.
For information about the Service Members Counseling and Support Center call 828.452.8354.