As soldiers leave war behind and return to Fort Hood, what comes next?
November 6, 2011, Fort Hood, Texas (Austin American-Statesman) — By next summer, this sprawling Army post will be more crowded than it has been since U.S. soldiers began pouring into twin war zones a decade ago. With combat operations ending in Iraq and slowing in Afghanistan, times are changing at what has been the Army’s busiest deployment hub since 2001.
But while Fort Hood braces for the return of nearly 20,000 American soldiers, many of whom have served three, four or five tours overseas, Army leaders are struggling with the unprecedented task of reintegrating soldiers who have known nothing but war for the past decade.
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That same challenge is faced by the entire nation as it seeks to celebrate its service members this week by marking Veterans Day. Experts warn that America is stumbling into uncharted waters as it deals with the return of hundreds of thousands of troops — the 1 percent of the nation that shouldered the load of America’s two longest wars.
There is no historical precedent for the cycle of deployments that marked the Iraq and Afghanistan wars. In Vietnam, the vast majority of service members served a single, 12-month tour; in World Wars I and II, most troops were also deployed just once, remaining on active duty until the end of the conflict.
But over the past decade of war in the Middle East, soldiers deployed, returned home, then deployed again, a cycle of churn that Army psychiatrists knew was wreaking havoc on the psyche and families of many service members.
The toll however, has far outpaced initial estimates: More than 700,000 Iraq and Afghanistan veterans have already shown up at Department of Veterans Affairs clinics and hospitals — and more than half of them have mental health conditions, according to the Austin-based group Veterans for Common Sense.
Perhaps the biggest lesson of the wars — the need for longer time at home between deployments — still remains a goal, although longer “dwell times” are probably on the horizon.
At Fort Hood, the questions are how to make post-war Army training engaging enough for soldiers used to the real thing and how to motivate those war veterans to stay in the Army. “They have so much experience; we will need them down the road,” Fort Hood commander Lt. Gen. Donald Campbell Jr. said.
Fort Hood is also hoping to prevent the mental health problems that occurred in 2010, when the post’s population was similarly swelled by returning soldiers. That year, Fort Hood set a record with 22 suicides.
The challenges facing soldiers transitioning to the civilian world are well documented: Unemployment rates for young veterans continue to outpace those for their civilian counterparts, and veterans younger than 30 now make up nearly 9 percent of all homeless veterans.
But at the other end of the spectrum, a growing number of service members are returning from Iraq and Afghanistan infused with a desire to operate at the height of their abilities and be part of something bigger than themselves. According to one recent survey, 61 percent of veterans volunteer with local organizations within two years of returning home. Veterans are opening and operating a wave of enterprises aimed at helping fellow veterans and civilians, such as Team Rubicon, a nationwide nonprofit that has sent hundreds of veterans to help disaster victims in the aftermath of tornadoes, hurricanes and earthquakes since 2009.
Experts say reintegration means different things for different service members and that their future often depends on their experience in the war zone. But all come back changed in some way.
“We are at the beginning of a wave,” said Maxine Trent, a counselor and program manager at Scott & White’s Military Homefront Services in Temple, a grant-funded counseling program that has seen nearly 15,000 Fort Hood soldiers and their family members since 2008. “The work is just getting started. We need all hands on deck.”
‘Don’t throw in the towel’
The parking lot outside the Fort Hood auditorium is crowded with the cars and trucks of freshly returned soldiers, one with “I love you daddy” scrawled in white letters on a back window. Inside, a couple hundred soldiers with the 3rd Armored Cavalry Regiment settle into another day of reintegration training. They will hear presentations about travel vouchers, hostile fire pay and taxes, as well as domestic violence, post-traumatic stress disorder and suicide. It’s Friday, and they are antsy to go on their 3-day leave, their first since they returned from Iraq.
“Are y’all sleeping on me?” asks Mary Prater, with Fort Hood’s Family Advocacy Program. “You’re probably going through the honeymoon phase. I am here to tell you that after 90 days, stuff happens. But don’t throw in the towel.”
In coming months, thousands of soldiers will pass through Fort Hood’s reintegration training as they transition to American life.
Campbell, who took over at Fort Hood in the spring, is spearheading an effort to revamp the program. “We want to make sure that when they all come back, it’s not a check in a box, but a true reintegration process,” he said. “We want to make sure it’s designed for the future.”
Reintegration training has traditionally consisted of about two weeks of classroom instruction, as well as sessions for spouses and family members. In the months after homecoming, the Army also offers voluntary trainings, such as the Strong Bonds program for soldiers and their families, aimed at helping them readjust to home life after a deployment.
Some soldiers have long complained that the Army’s classroom reintegration training is too bureaucratic and uses a one-size-fits-all approach that simply repackages messages they’ve heard before. One soldier, writing last year in her popular blog Army Girl, Army Wife, blasted class sizes as too large and anonymous.
“A 35-year-old infantry major who has been deployed 4 times sees the world differently than an 18-year-old female finance clerk who just finished her 1st deployment,” the anonymous blogger wrote. “But the content does not vary because the training is designed for everyone regardless of rank and combat experience.”
Barbara Van Dahlen, founder of Give an Hour, which links civilian mental health providers with service members and their families for free counseling, agreed that more individualized training would be more effective, though more expensive. “It’s hard to engage people from all different places in their lives,” she said. “It makes it harder to share.”
Some presenters at Fort Hood make an effort to draw soldiers into discussions. Master Sgt. Stanley Dyches, giving a class titled “Battlemind,” took the stage, microphone in hand, and slowly stalked the rows of soldiers. “Anyone here angry?” he asked, as a few dozen hands shot into the air. “Anyone waking up at 2 a.m.? Anyone sleeping with their weapons?”
Some soldiers snickered, but a few hands rose. “I have to have it next to me,” a soldier told Dyches. “Protection.”
Staff Sgt. David Thomas, 28, a nine-year Army veteran, said the reintegration training didn’t offer much that was new. “I think it will be helpful for the junior soldiers, but a lot is redundant for those who’ve been in for a few years.”
Experts also question the timing of reintegration training so soon after soldiers return.
“It’s a critical period of time, but are they receptive to it then?” Van Dahlen said. “They suck it up and want to get back into life, but when things fall apart a year down the road, would it be better to reach them then?”
But many soldiers have left the Army by that time, and too few of them seek help from the VA or continue with counseling if they do, experts say.
Retired Army Col. Charles Hoge, who directed the military’s research program on the mental health effects of the wars between 2002 and 2009, said understanding what combat veterans experience when they come home requires a deeper understanding of PTSD symptoms and how they relate to war. Nearly every PTSD symptom — hypervigilance, the shutting down of emotions and an exaggerated startle response — are essential survival skills in the combat zone, he said. But studies have shown that combat can cause physical, neurological changes in the brain.
“It’s about helping warriors understand how their bodies have physiologically changed because of combat and finding ways to dial down that reactivity,” said Hoge, author of the 2010 book “Once a Warrior Always a Warrior: Navigating the Transition from Combat to Home.” “It’s not a light switch, but they can learn how to dial those reactions down.”
And though most veterans don’t develop PTSD (studies estimate anywhere from 20 to 30 percent do), the 2.3 million service members who went to Iraq and Afghanistan are nonetheless transformed by their experiences, Hoge said. Unlike previous wars, the current wars lack a defined frontline, and even noncombat troops face roadside bombs and mortar attacks on their bases.
“They react differently after deployment,” he wrote. “There is a strength of character that is sharp and direct, but one that may at times make others feel uncomfortable. Warriors are more independent, but this may make it difficult to tolerate authority at work.”
For any kind of large-scale integration of combat veterans to be successful, experts agree, civilian society must at least be aware of these changes.
‘Too few guys’
Staff Sgt. Marc Basuel, a 30-year-old father of two who has deployed to Iraq four times since 2003, learned the hard way that he and his family needed strategies to survive all his comings and goings. The Fort Hood soldier said his marriage almost didn’t survive his third homecoming, after the bloody 2007 surge.
“One day it triggered, and I exploded,” he said. “My wife said, ‘If you don’t seek help, we’ll be leaving you.’u2009″
So Basuel — and his family — developed some techniques to make the transition easier, most based on improving communication. Before he returned home this summer, he and his wife exchanged cards.
“I wrote what I was expecting from her: to give me some time, to communicate with me,” Basuel said. “If I have a nightmare, come and hug me. And I let her know what she can expect from me: nightmares and distance. u2026 It’s a feedback between me and my wife.”
And his wife sent him a list of things she and their children wanted to do with him when he returned, including a trip with family and friends to a cabin in San Antonio. Basuel went to the gathering at the cabin but ultimately had to cut it short and send everyone home.
“I apologized, but I wasn’t ready for that,” he said.
Basuel said the deployments that defined his 20s — they began in 2003, and he spent four of the next eight years at war — took a toll.
“The main issue for soldiers is they only have a couple of months to reconnect, and then they have to gear up for the next deployment,” Hoge said. “The expectation that the physiological conditions of deployment will reset is sometimes a little unrealistic.”
The Army’s own studies have shown that even more important to service members’ mental health than how much time they spend at war is how long they have between deployments. According to the Army Mental Health Advisory team, which has signaled the need for longer dwell times since 2007, troops need at least two years and optimally three years of rest for behavioral problems to return to pre-deployment levels.
But the vast majority of soldiers got just one year between deployments, a mental whiplash that is unprecedented in modern warfare and has contributed to the psychological fallout that has so defined the conflicts.
Trent of Scott & White has treated soldiers who have done as many as nine deployments. She said that when pre-deployment training is included, many Fort Hood soldiers have only had about six months of down time — not nearly enough to undo the rewiring of a soldier’s neurobiology that occurs during a year at war.
“We’ve never asked the human body and human brain to go to a constant state of war for 10 years,” Trent said. “It’s inhumane and unbelievable.”
Longer dwell times among British troops have been credited with their lower rates of PTSD. British troops stay at home for at least twice the time that they are deployed, and they generally serve shorter deployments, something political decisions made impossible for American troops.
“It’s a function of too much war and too few guys,” said Adrian Lewis, a military historian at the University of Kansas.
American troops have paid a heavy price: Multiple deployments are associated with higher rates of PTSD and failed marriages, according to military studies. More than 600,000 recent veterans have filed disability claims with the VA, which sees nearly 10,000 veterans file new claims every month, according to Veterans for Common Sense, citing information it obtained through the Freedom of Information Act.
Only now are manpower needs easing. Service members will leave Iraq by the end of this year, and troop reductions in Afghanistan are scheduled to accelerate through 2013. The Army has declared that beginning next year, most deployments will be reduced from one year to nine months. While that would imply longer periods between deployments, no fixed dwell times have been ordered. Army leaders are hopeful that dwell times will soon be stretched to two years.
‘What do we do for them?’
Soldiers who have deployed often describe the experience as moments of extreme intensity punctuated by passages of deep boredom — a pattern difficult to emulate not only in civilian life, but on a military installation.
“Some people come back and step into jobs that are not nearly as demanding or intense, with no adrenaline rush,” Van Dahlen said. “What do we do for them?”
A growing number of Iraq and Afghanistan veterans are beginning to harness that energy in positive ways. In many cases, that has meant founding or joining organizations to help fellow veterans. Groups such as Vets4Vets have become important counseling resources, and the Iraq and Afghanistan Veterans of America organization has become an effective lobbying and advocacy group for young veterans.
Others are channeling that energy to disaster relief. After the 2009 earthquake in Haiti, a group of veterans formed Team Rubicon, which has sent veterans to tornado-ravaged areas of the Midwest, to Turkey after last month’s earthquake and to Burma to train health care workers. The idea behind the nonprofit is that the skills that veterans learned at war — emergency medicine, teamwork and leadership — could be used in the aftermath of natural disasters.
Matt Pelak, 33, said Team Rubicon has provided him an outlet for the skills and drive he developed while at war. Pelak was a paramedic in New York before he deployed to Iraq in 2004 with the New York National Guard. For a year, Pelak served with a light infantry unit, going on raids, patrols and ambushes throughout the Sunni Triangle northwest of Baghdad. When he returned, he found his old paramedic job left him flat.
“I wasn’t the same person,” he said. “Being deployed, it gives you confidence. Certain situations, once you get through them, you realize, I am capable of doing a lot more than I expected. I see it with a lot of guys.”
So Pelak jumped at a chance to return to Iraq, this time as a well-paid contractor with the State Department’s Diplomatic Security Service. “I kept wanting something else, so I went back again,” he said recently in Austin, where he spoke as part of a panel at the LBJ Library related to a Time magazine article highlighting the growing number of recent veterans doing public service. “You think the more you deploy, it will be enough, you will get it out of your system. But the more you go, the more you get it in your system.”
When he returned home in 2009, he got a job as a firefighter, and though he thought that job might fulfill him, he found himself still searching for something more. “I still had an itch to travel, all this energy in my head,” he said.
So Pelak joined Team Rubicon. “I hear from a lot of guys who say this is something they’ve been looking for since they got back,” he said. “A little bit of excitement and helping someone at the same time. They get to use the skills they’ve developed while deployed, dust off the cobwebs and feel like they are part of the team again.”