Data on Veterans
Traumatic brain injury (TBI) is the signature injury among United States military personnel involved in combat in Iraq and Afghanistan. Due in part to advances in protective armor and medical triage that have saved the lives of many who would likely have died otherwise, the rate of brain injuries in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) is thought to be significantly higher than all other previous wars. Additionally, the frequency of explosive or blast attacks in Iraq and Afghanistan has been significantly higher than in past military conflicts. Data from the Defense and Veterans Brain Injury Center at Walter Reed Army Medical Center indicate that 30% of all OIF/OEF veterans have experienced traumatic brain injuries (a very conservative estimate).
Combat-related brain injuries can include symptoms such as fatigue, memory issues, confusion, disorientation, inability to focus, cognitive deficits, headaches, balance problems, and anger. Symptoms such as these often overlap with others like extreme irritability, inability to sleep, high anxiety and depression - the classic symptoms of post-traumatic stress.
Post-Traumatic Stress (PTS) and other psychological disorders following Iraq deployment are significantly higher than in other theaters as revealed in recent studies. According to a recent survey conducted by the RAND Corporation, more than 300,000 veterans of Iraq and Afghanistan suffer from PTS. PTS symptoms often surface in combat veterans who have experienced blast injuries. This suggests that PTS symptoms may result, in part, from traumatic brain injuries, explaining why PTS is so often diagnosed in tandem with TBI.
While PTS continues to be the prevailing acronym, there is growing sentiment among service members to not identify PTS as a "disorder" because it is actually an injury due to trauma, not an organic disorder. Often, soldiers returning with TBI and PTS cannot go back to their former jobs or social lives. Bills start to pile up while they are receiving therapy. Depression, family problems, substance abuse, suicide risk, homelessness, and other complications often follow. These wounds plague hundreds of thousands of soldiers and veterans, exacting an emotional cost on individuals and families, and a growing financial burden on our society. Military and veterans agencies struggle to cope with a condition that can often leave soldiers a shadow of their former selves, unable to keep a job or perform accustomed tasks.
Strong Interest in Continued Service, Lack of Understanding How to Engage by Bridgeland and Yonkman
Data from a 2009 survey of 779 OIF and OEF veterans entitled "All Volunteer Force: From Military to Civilian Service" found a strong interest in community service opportunities among veterans and a corresponding lack of awareness of how to uncover those opportunities. According to survey respondents:
- 92% of veterans strongly agreed or agreed that serving their community is important to them
- 90% strongly agreed or agreed that service was a basic responsibility of every American
- 69% said they had not been contacted by a community institution, local nonprofit or place of worship
- 69% had not yet volunteered because they had not been asked to serve or did not have enough information on meaningful service opportunities
There is growing evidence that engagement in community is good for mind, body, and spirit. Recent scientific studies have uncovered the phenomenon known as neuroplasticity - the brain's ability to revitalize itself by forming new neural connections throughout life to compensate for injury and disease based on the finding that the brain is 'plastic' and malleable. Neuroplasticity can lead to improved recovery of neurological and other functions, and this may be possible even years after an initial injury. Research is now focusing on how to leverage neuroplasticity to optimize recovery. Current therapy within clinical settings focuses on stimulating relearning via the brain's capacity for neuroplasticity.
A program that engages veterans with TBI and PTS in community service with appropriate supports can help veterans practice and translate the skills learned in therapy into their daily lives in a community service setting. Service has long been acknowledged to be a proven therapeutic modality that holds great potential for enhancing the recovery of veterans suffering from a wide array of physical and emotional ailments. Lessons learned from organizations that work closely with individuals recovering from TBI and PTS (such as the New York State Apprentice Program and HeadStrong for Life), offer a guide toward future development of an initiative focused on veterans.