Courage After Fire

Tuesday, September 26, 2006 - by Sen. Bob Dole

Recently I was asked to write the forward to the book, Courage After Fire. Reading this book—a self-help guide for veterans returning from Iraq and Afghanistan and their families—prompted me to write this editorial encouraging our brave service men and women who are having readjustment problems to get help now.

My own experience as a WWII veteran and involvement with other veterans over the years have made it crystal clear that returning stateside is not the end of the mission. A sizable percentage of the 1.2 million men and women who have rotated through Iraq and Afghanistan will experience significant readjustment challenges as they integrate back into their hometowns. A recent study published in the Journal of the American Medical Association (Hoge, Auchterlonie & Milliken, 2006) found that 20 percent of Iraq veterans will suffer some sort of mental health problem upon return. These problems can include relationship and work difficulties, posttraumatic stress disorder, anxiety, substance abuse, or depression. Many will appear fine, showing no visible scars of war. And many who do need help will not seek it primarily because of their military training and mindset. The authors of this study also found that approximately 50 percent of Iraq veterans given a mental health referral based on a questionnaire completed upon return did not seek help during the year that followed.

This pattern is not new. For generations, service men and women have come home to face depression, awkward relationships, and a disconnection with day-to-day life, and have suffered alone and in silence. The prospect of appearing weak by seeking professional help for these kinds of concerns was both embarrassing and dispiriting.

Those of us who have served know the military mindset can get in the way of asking for help. It’s all about serving the group first, and serving yourself later (if ever). During wartime, toughing it out through injuries, loneliness, grief, fear, and stress becomes second nature, and much depends on the ability to put personal issues aside for the benefit of the greater good—the success of a mission and well-being of fellow soldiers. This mindset of self-sacrifice, a key part of being a good team player and surviving war, is hard to abandon when you get home. Our military service men and women also don’t want to burden their loved ones with their problems; however, not talking about their experiences can actually make problems worse.

Fortunately, today there is increased understanding of these issues and assistance to ease the transition home. We also know the sooner veterans address their readjustment problems, the better the prognosis. When I came home, there were no websites, no medical articles, few educational materials, and no books that I can recall for veterans who suffered from war-related problems, including what was then called “battle fatigue” and is now precisely defined as posttraumatic stress disorder (PTSD). But our current generation of veterans can take advantage of the hard-fought progress made by Vietnam veterans and members of the medical community that eventually led to the designation of PTSD as a recognized mental disorder in 1980.

Nowadays, high-quality resources and services exist. The Department of Defense is making more assistance available to service men and women during deployment. The Department of Veterans Affairs is doing more to help our newest veterans and their families after deployment. Research and resources abound, and books like the recent Courage After Fire can help our troops and their families see that readjustment problems are common and can improve through family and professional support.

For returning veterans, focusing on your readjustment now that you are home is a worthy, yet difficult mission because it often goes against your ideas of strength and courage. Actually, it takes guts to face problems and get help. I encourage you to make use of the many valuable services and resources available today. Both you and your loved ones deserve it. God Bless America.

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