Other Than Honorable: Treating Veterans Without Benefits

According to reports, disciplinary and other conduct related discharges have been on the rise since around 2007-2008. Many of those being discharged have been diagnosed with Post Traumatic Stress Disorder (PTSD) and/or Traumatic Brain Injury (TBI). I would bet that even more should have been diagnosed but because of pride and/or fear of being labeled as broken, never sought treatment for those problems.

Many of those being discharged have had problems with impulse control, aggressive behavior, sleep disorders, or substance related problems; all symptoms of PTSD and/or TBI. Once discharged, they find themselves in a bleak situation with little in the way of benefits or treatment options and often separated from the people they’ve considered family for the months or years prior.

When Tulsa started its Veterans Treatment Court they had to operationally define the term Veteran. As a result, the program uses a very liberal definition of the term, allowing many into the program with other than honorable discharges. For some people, anything less than an honorable discharge status disqualifies a person from veteran status. That’s too bad because many of these men and women have served faithfully, often in combat zones, before the problems started.

Many of those not eligible for VA treatment still need help. They need professionals who will understand and treat their unique needs. For those with other than honorable discharges, the private sector will be providing that treatment. I urge anyone who may be working with this population to seek out and receive special training in the following  areas:

• Military Culture: The military has a set of shared values and beliefs. Each branch of the military has its own set of core beliefs and values. Military language is foreign to many of us but is vital if we’re going to connect and help this population. We have to know the difference between a FOB and an IED.
• Post Traumatic Stress Disorder (PTSD): It’s critical to understand the criteria for diagnosis but equally important is learning to recognize the many ancillary symptoms that may indicate a problem. Counselors should receive specialized training in evidence based practices such as Cognitive Processing Therapy, Prolonged Exposure or EMDR.
• Traumatic Brain Injury (TBI): We must understand the signs and symptoms of TBI and work to differentiate between TBI and PTSD. Not all TBI’s have been diagnosed and the person  may not even realize they’ve had one. It’s critical to be able to recognize and prepare for the implications of a TBI in treatment.
• Substance Use Disorder (SUD): For those not already trained in treating SUD,  be ready to recognize and possibly refer to someone who does. We should also understand the implications of treating co-occurring SUD and PTSD.
• Military Sexual Trauma (MST): This topic has been in the news recently and we’re only starting to understand the scope of the problem of sexual assault in the military.

We should also consistently ask clients about military service and explore how closely they identify with that service.  Many may be disillusioned with the military and don’t readily report their service. Others may be embarrassed about the events leading up to their discharge and would rather not revisit that period of their lives. However, that information may be critical in helping those left behind get the treatment they deserve.