2 January 2020
2 January 2020
Healing from the Outside In: Veterans Helping Veterans in Nature
Since the attacks on the twin towers, the issue of veteran's mental health has been increasingly evident in the news cycle. It is not that this is a new problem. Veterans coming home from World War I and World War II dealt with the same traumas and reintegration. The same goes for the warriors of the Korean and Vietnam era. The difference is that as we have become more aware and how post-traumatic stress affects an individual and how being institutionalized in a combat environment can change a person. It is now seen as something to be treated and actively addressed for better interpersonal relationships and overall quality of life.
In the realm of treatment for PTSD and programs for reintroduction into civilian life there are many programs that are available and in the case of PTSD there are even medicinal interventions to help with the process. There are not any one size fits all answers when it comes to these types of programs. This paper seeks to look into one possible treatment and its validity in the veteran world. In this paper we will show that peer integrated activities in nature such as wilderness backpack hunting trips are beneficial for the mental well-being of veterans and can aid in reintegration.
I.Throughout history veterans have experienced difficulties with reintegration upon leaving the military. This manifests itself in many ways. The more obvious indicators are the PTSD epidemic and the depression and suicide that is so prevalent in returning veterans. The more subtle side of this of this struggle may actually come with a reintegration into society. The attitudes and emotional responses that work as survival strategies in war are not useful in civilian life (Dietrich et. al. para 1). Some Veterans struggle with getting a job, or dealing with daily relationships with family members, friends or colleagues. Coping methods often include substance abuse and homelessness is disproportionately high for veterans (Berman et. al. para.5).
A.Probably the most obvious hurdle that some veterans can face is PTSD. PTSD affects at least two million veterans (para 3). The VA estimates that somewhere between eleven and twenty percent of active duty personnel from both Iraq and Afghanistan will be diagnosed with PTSD. While PTSD is more prevalent in combat veterans it is interesting to note that even among those with no combat experience, the rates were still at three to ten percent among those with no combat deployment history (para 3).
B.Another glaring issue is depression and the suicide rate among returning veterans. Compared to the rest of the population, veterans take their own lives at an alarming rate. In 2013 the VA releases a report stating that approximately twenty-two veterans took their own lives every day (Dietrich et al. para 2).
C.Although more subtle, the aspect of reintegrating into ordinary life can be the biggest hurdle for veterans. Whether it is adjusting to a normal job, reconnecting with family members, or even maintaining simple relationships it seems that returning veterans have difficulty readjusting. Polling of caregivers found that in pre-9/11 veterans fort-six percent needed help in coping with stressful situations and thirty-six had a mental health condition, as apposed to seventy-five percent of post-9/11 veterans requiring assistance in coping and sixty-four percent having a mental health condition(para 3).
II.There are many programs already in place to help veterans but as we will see there is not a one size fits all answer to this problem. VA researchers found that ninety-six percent of veterans polled were interested in service to help in transition from military to civilian life (para 6). However, only 9.5 percent of veterans diagnosed with PTSD complete and evidence-based VA treatment and less than fifty percent will receive any mental healthcare at all (Kumar para 1). Next, we will discuss what are some of the issues with these programs.
A.First, many programs already in place are expensive. A 2012 report stated that the VA had spent more than three billion on treating PTSD alone (Berman et.al. para 4) and the pentagon had spent another 294 million in 2014.
B.Secondly access to treatment is often an issue. It was found that while service were expanded to more than seven million veteran visits per year, the waiting list also increased by fifty percent (para 5). But access to treatment isn't the only barrier facing some veterans. There may be a stigma associated with receiving treatment as well. Research suggests that some veterans may not seek out help due to stigma (Gorman et.al. para 3). In fact, another 2014 study states that combat veterans tend to underutilize health services, particularly those involving mental health (Rogers et.al. para 2).
C.Thirdly, many treatments are specifically for those diagnosed with PTSD. This does not help the returning veteran who may just need a support system to help him reintegrate into civilian life. It has been noted that post deployment many veterans express feeling alienated from family and had difficulty fitting into civilian society (Gorman et. al. para 1).
III.So how can we support these veterans who are in need of some assistance in an inexpensive, accessible and non-threatening environment? First, veterans may benefit from peer supported programs. These are programs that are sponsored or staffed by fellow veterans. These are individuals who have the same background and may have some of the same experiences or struggles. This is beneficial for recovery and reintegration in a number of ways.
A.First peer support uses the "warrior" bond. One of the things that many veterans state is they feel a loss of their "military family" and share that non-veterans do not understand the military experience (Gorman et.al. para 6). In years past many veterans from earlier wars could go to the American Legion or the VFW (Veterans of Foreign Wars) clubs to get this comradery. However, these organizations are shrinking in size and do not draw younger veterans.
B.Secondly, peer supported programs cultivate a safe and comfortable environment. The Veterans Health Administration (VHA) has already begun integration of peer support programs and have found that the emphasis on unit cohesion, and teamwork within the military culture give increased credibility to the peer support specialists involved (Shepardson et. al. para 2).
C.Thirdly peer supported programs do not need highly trained staff to operate. In reality, a peer support program could be just a veteran facilitating a meetup group for other veterans. There are differing levels of training historically in peer supported programs, but all carry much less training then other modalities with full psychiatric staff.
IV.Another modality that can be used with good effect is outdoor and wilderness programs. These are programs that utilize outdoor experiences such as hiking, kayaking, rock climbing and other often difficult tasks in in wilderness and other austere environments as a catalyst for recovery.
A.A few examples that were used with success in the past began with the warrior hike, which was through hiking of the Appalachian trail devised after World War II. Other programs include Outward bound, a course that includes rock climbing, hiking and white-water rafting (Duvall & Kaplan para 6), Sierra club's Military Families and Veterans Initiative, and a couple different programs put on by the Wounded Warrior Project. The Wounded Warrior Project programs implemented elements of adventure, and perceived risk into their program (Berman et. al. para 16,22-24).
B. Not only have these programs been used with success but they also use a free and abundant resource owned by all U.S. Citizens. Public lands are accessible and free to all Americans. From rivers, to mountains to beaches, in total 650 million acres of the United States is federally managed public land. That is nearly one third of the entire country (Randall pp 1).
V.Given the success and promise of both peer supported therapies and the successes of wilderness and outdoor programs, A peer led wilderness backpack hunting program could combine multiple aspects to create a healing environment. It could be facilitated by veterans who have knowledge of certain regions and game and could be utilized by any veteran who wishes to reach out or contact one of the facilitators.
A.Wilderness backpack hunting meets the criteria for both peer support and the wilderness/outdoor environment. This combined with that element of adventure and perceived risk noted in the Wounded Warrior programs make for excellent therapy.
1.A wilderness backpack hunting program should emphasize shared hardship. This will help shift the focus onto a mission or goal like those experienced in the military. This takes the focus off of daily problems which can help them be viewed in a different light and open up communication.
2.Secondly the shared hardship can simulate the bonds experienced in the military as previously noted many returning veterans cite the loss of military family and comradery as one of the issues they face during reintegration. Bonding during a hunt can give that back in a civilian setting.
3.Thirdly, conquering a difficult experience provides a sense of accomplishment. Sometimes in the process of coming home a veteran may just be looking for a win, something positive to have accomplished. Wilderness backpack hunting is an excellent way to get that sense of accomplishment.
B.Another benefit to this type of programs could be very flexible in operation. There are several different ways it could be organized and still be effective. Two such ways that it could work are as follows;
1.First it can be set up to be operated by a peer support specialist. This would be a Veteran volunteer who is trained in the operation of the program. He would lead small groups on hunting expeditions possibly with other volunteers and would follow a loosely structured discussion or campfire talks throughout the outing. Benefits of this style of program would be the ability to set and track goals for recovery criteria.
2.The second way this could be set up is to be a meet up community for veterans. This would function more as an online meeting place for like minded veterans to find each other and go hunting together. In polling conducted by the VA, fifty-three percent of respondents reported that they would prefer information by electronic means (Dietrich et.al. para 2). By establishing a social media presence, veterans would be able to connect and establish relationships and set up their own outings. It would simply be a source to find other veterans in order to bond and work through veteran issues in a positive environment.
C.This type of program would be inexpensive. The cost to operate a meet up community is very low and could be augmented easily using the nonprofit format. Several hunting organizations already do similar work although the peer support component is missing in most of their charities.
D.This type of program can build a support system that can last long after the activity. The beauty of this type of program is that will provide relationships that can last long after the hunt is finished. Making these bonds afield is only part of the process. The goal is that these hunts will provide a social community for the veteran to fall back on in times of struggle.
In the ongoing struggle for mental health and integration into normal life for veterans there is no one size fits all answer. Any tools that we can provide to veterans to further personal growth and the quest for integration into civilian life is a step in the right direction. A wilderness backpack hunting program would provide both peer support and the outdoor environment which have both shown to be beneficial for recovering veterans. Combined with the cost effectiveness and continued support gained by relationships established during the hunt, these programs can help bridge the gap for affordable and accessible therapy.
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