A recurring scene plays out in airports around the country: American troops returning home from Afghanistan step off a plane and anxiously look into a crowd. A soldier spots her family, and her husband, son, and daughter rush to give her a hug. Passersby thank the soldier for her service as she and her family leave the airport for a well-deserved welcome-home party.
What we often don’t see, however, are the private struggles many veterans face as they transition to life back home. Off the battlefield and away from the cameras and crowds, many are suffering from post-traumatic stress disorder (PTSD), traumatic brain injuries (TBI), and thoughts of suicide, which often are interrelated. In fact, a 2008 Rand Corporation study found that one in five Iraq and Afghanistan veterans suffer from PTSD or major depressive symptoms.
Suicide among military personnel has become a major problem for the U.S. military in recent years. In 2012, more American service members lost their lives to suicide than enemy fire. Many questions remain as experts attempt to better understand the causes of suicide among this group.
The U.S. Army is responding with full force and has recently launched the “Ready and Resilient” campaign, an initiative that combines several programs in an effort to build physical, emotional, and psychological resiliency at the unit and individual levels. Other campaigns also seek to raise awareness of suicide prevention; in fact, every unit in the Army—active, Reserve, and National Guard—conducts yearly TBI and suicide prevention training.
But the military cannot fight this battle alone.
In 2011, led by First Lady Michelle Obama and Dr. Jill Biden, the White House launched Joining Forces, a national initiative to support service members, veterans, and their families by providing employment, wellness, and education resources. As part of the Joining Forces campaign, more than 100 AAMC-member medical schools have pledged to train the nation’s physicians to address the health care needs of the military and their families.
With their focus on education, clinical care, and research, medical schools and teaching hospitals are uniquely positioned to be part of this initiative. The relationship between Veterans Administration medical centers and academic medicine dates back to the end of World War II and serves as a model for successful partnerships between public and private institutions.
Medical schools and teaching hospitals have responded to the Joining Forces effort in remarkable ways. Schools are updating curricula to better treat service members and their families. Many schools have agreements with local VA hospitals for students and residents to conduct rotations, and several are going a step further by encouraging military cultural competency training as part of their coursework.
Several institutions are researching causes and treatments for PTSD, TBI, and suicidal behavior. Researchers from Emory, University of Miami, and Scripps Research Institute have identified a compound that may prove to prevent PTSD symptoms if prescribed to patients shortly after being exposed to a traumatic event. A recent study on veterans from the University of South Carolina shows that PTSD can lead to compromised immune systems. The National Institute of Mental Health, Uniformed Services University of the Health Sciences, Harvard Medical School, the University of Michigan, and the University of California, San Diego, currently are conducting a major study with the U.S. Army to determine patterns associated with suicidal behavior. Most notably, the researchers have found that while there is an elevated suicide risk for a soldier’s initial deployment, there is not a significant relationship between multiple deployments and suicide risk.
I know from my role as a junior officer in the Army Reserve that the work being done at medical schools and teaching hospitals is invaluable. Army leaders use this information to help soldiers build psychological resiliency within units prior to deployment. In combat zones, improved treatments for soldiers suffering from traumatic events will allow them to get back into the fight and enable them to better process trauma post-deployment. Identifying soldiers who are more susceptible to PTSD and suicide will allow leaders to direct resources and attention to those who need it.
The critical work being done at medical schools and teaching hospitals will continue to help experts better understand the causes and treatments for PTSD, TBI, and suicidal behavior in some of our returning soldiers.
Learn more about efforts to improve military health and wellness at the nation’s medical schools and teaching hospitals during Joining Forces Wellness Week—and throughout the year—at www.aamc.org/joiningforces.