Mental health needs and the soldier-as-victim narrative
Neither military veterans nor current active duty members and their spouses consider Post-Traumatic Stress Disorder (PTSD), Combat Stress, and Traumatic Brain Injury (TBI) to be the most pressing issue facing military families. Rather, even while concerns about quality of life and wellness have been increasing relative to financial concerns over the past few years, in 2016 the military family community still places top priority on the financial security aspects of their life — questions about military pay and benefits, changes to retirement benefits, and military spouse employment.
Surprisingly — given the tenor of the most common national discussion about veterans — the latest research from Blue Star Families’ recently released annual Military Family Lifestyle Survey reveals that 14% of active duty members and 38% of veterans rank PTSD/Combat Stress/TBI as a top issue, well behind the 61% of active duty and 56% of veterans who rank monetary compensation (pay and benefits) as their top concern. This hardly means that members of the military community think that mental health is unimportant or that occupational challenges to their mental health are nonexistent. Nor does it mean that the military brass or VA leadership should not continue their efforts to recognize legitimate mental health concerns of the Armed Forces and to meet them forthrightly.
What these numbers do represent, however, is an invitation to engage in a more active thoughtfulness about the public narratives we are crafting around the mental health of those who engage in America’s military activities. Currently, there is a strong national impulse towards pathologizing combat experience, or even, in more extreme versions, all military service: viewing war as a disease which produces constellations of violent symptoms, rendering soldiers as victims, who must be treated only as patients.
Outgoing Secretary of the Army Eric Fanning seemed to nod in this direction recently, when at an event held at Brookings Institution to unveil the 2016 Lifestyle Survey he commented:
…[W]e need to completely change the paradigm of behavioral health — it’s not we’re going to make it easier to access it if you want it, it’s we’re asking you to do things over and over again that is against how your body is biologically wired from generations and generations and generations of evolution.
We should expect — you should expect — that you are going to need it, so you are going to have it, and you are going to go through it when you come back….
We are at the point where we pretty much accept that anybody who serves and goes into combat, everybody, 100 %, is going to come back with PTS. And some people find their way out of it on their own some people don’t and we shouldn’t wait until symptoms manifest themselves; we should be preemptive on it.
To be fair to Secretary Fanning, it’s impossible to know from his comments what exactly he means by PTS — whether he is using it as a generic term to cover sleeplessness, restlessness, and anxiety, or whether he is using it as the current PC term for what PTSD often stands for in the general consciousness. But the good intentions that are clearly in evidence in his comments can certainly also be seen as working at cross-purposes to the efforts of veterans themselves not to be painted as broken human beings or helpless victims, rendered so by their military service.
The narrative issue of veterans and mental health/PTSD is further deserving of thoughtfulness at this moment, as the 115th Congress gears up to contend with some potentially substantial VA reform legislation. Just as the narrative of the broken, traumatized veteran harkens back to Vietnam-era narratives, so can a substantial post-Vietnam era study from 1980 about Vietnam veterans highlight a danger that a legislation-driven narrative can pose to veterans.
In the Harris and Associates “Myths and Realities: A Study of Attitudes toward Vietnam Era Veterans” survey, researchers found that a compounded consequence of drumming up support for veterans’ legislation that emphasized the social struggles of veterans was a reinforcement of public misperceptions about veterans — the same misperceptions emphasized most heavily by the (Vietnam) anti-war protestors.
A recycled, inflated narrative about broken veterans will benefit neither veterans and the larger military community, nor the civilian population they must eventually reintegrate into.
Accordingly, the public was more worried about the perceived mental and emotional health problems of veterans, in addition to their perceived heightened drug and alcohol abuse. Meanwhile, the Vietnam era veterans themselves were most concerned about employment and employment-related problems.
The Harris study acknowledged the legislative success of emphasizing this narrative, but also acknowledged the long-term cost to veterans themselves. As we focus on legislative solutions for Veterans Affairs reform, we need to be clear-eyed about the reality of veterans’ needs as much as about the narratives we intentionally or unintentionally are crafting. A recycled, inflated narrative about broken veterans will benefit neither veterans and the larger military community, nor the civilian population they must eventually reintegrate into.
First published on AEIdeas.org on December 20, 2016.
