Despite years of efforts to improve health care and support networks for the National Guard and military reserves, these service members report higher rates of mental health problems and related ills than active-duty troops, according to current and former officials, troops, experts and government studies.
More than 665,000 National Guard and reserve troops — known collectively as the reserve component — have served in Afghanistan and Iraq during the past decade. Upon returning home, many have been hastily channeled through a post-deployment process that has been plagued with difficulties, including a reliance on self-reporting to identify health problems, the officials and experts say.
WARNING: CONTAINS GRAPHIC IMAGES. Traditionally, the United States has looked to active-duty military to defend the nation in times of conflict. The National Guard and Reserve always have played a role, but never more so than today. They comprise 28 percent of the 2.3 million service members who have deployed to the Afghanistan and Iraq wars in the last decade. Wisconsin National Guardsmen Jeffrey Vorpahl and Cory Loomis said they didn’t expect to go to war when they joined the guard. But two years after the U.S. invaded Iraq, they were deployed to fight there in 2005. (Feb. 9) (Video by Caitlin O’Neil/Medill National Security Journalism Initiative)
New research and interviews with those familiar with the military health-care system suggest that attempts by Congress, the military and private contractors to address the problems have been uncoordinated and often ineffective. From September 2010 to August 2011, post-deployment health-reassessment screenings found that nearly 17 in every 100 returning reservists had mental health problems that were serious enough to require a follow-up. That is 55 percent more likely than active-component service members, according to the Armed Forces Health Surveillance Center.
Active-duty troops come home to military bases with free, comprehensive medical care and support networks that help diagnose what military leaders call the signature wounds of the wars that began after the attacks of Sept. 11, 2001: post-traumatic stress disorder and traumatic brain injury.
Reservists do not have access to the same system or networks that experts say are needed to assess and treat their injuries. After brief demobilization assessments, reserve troops return home and must navigate disparate health-care and support providers, often without the psychological safety net that comes from living near members of their unit.
“The National Guard faces unique challenges compared to our active-duty counterparts,” Gen. Craig R. McKinley, chief of the National Guard Bureau — which is responsible for administering the guard’s 54 state and territorial units — said at a public forum in November. He said the Obama administration is increasing its efforts to address resulting problems, including substance abuse, depression, PTSD and suicide.
Gen. Peter W. Chiarelli, who retired on Feb. 1 as Army vice chief of staff, also said efforts are underway to provide better care for reservists, especially because they are an integral part of the nation’s operational fighting force.
“A National Guard soldier . . . has anywhere from 10 to 14 days of demobilization training and processing, and then we throw them back into their community to work with folks who are part of the 99 percent who never fought,” Chiarelli said. These communities often can’t relate to their military experiences, he said, leading to job and family friction.
Reserve members and their advocates have raised concerns about the system of care and support since shortly after they were mobilized to fight overseas after the Sept. 11 attacks. But they say the consequences of inadequate post-deployment efforts persist.