Wednesday, July 25, 2007

Treating the war’s invisible wounds

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Two years ago, Dr. Barbara Romberg of Bethesda saw the crisis coming: Combat-wounded troops would return from repeated deployments to Iraq and Afghanistan, and the military’s mental health system would strain under a wave of haunted soldiers.

As Romberg recalled growing up — watching young men come home forever changed by Vietnam — she thought about her daughters, now 11 and 9 years old, who were troubled whenever they saw homeless Vietnam veterans.

‘‘I can’t have them grow up and think, ‘Why didn’t we do more for this generation?’” she thought.

Motivated by the tens of thousands of physically and psychologically damaged fighters returning from the Middle East, Romberg started a nonprofit organization and named it Give An Hour. The network links soldiers and their families with mental health providers who volunteer one hour of therapy per week.

Nearly 500 mental health providers across the country have signed up since the network opened in late June. A few more clinical psychologists are added each day, Romberg said.

While the network is still too young for an official count on its client load, Romberg said she has gotten calls from military personnel at local bases including Bethesda’s National Naval Medical Center and Walter Reed Army Medical Center.

Romberg has reached out to the National Guard, the Veterans Administration, mental health professionals at the Department of Defense, and veterans’ service organizations like Veterans of Foreign Wars to let them know there are hundreds of private therapists in the civilian sector hoping to help by giving free psychotherapy sessions.

Romberg said she launched Give An Hour to supplement similar local and regional networks. Another civilian organization, Military OneSource, arranges free short-term therapy off the military base, with licensed civilian counselors. The service is limited to six sessions and does not deal with long-term mental illness.

Recent research, including a Defense Department mental health task force report last month, says demand for war-related psychological treatment is growing faster than the military can handle. Redeployments, the ordered ‘‘surge” in troops to Iraq and Afghanistan, and a mental health system deemed ‘‘woefully inadequate” by the Pentagon report are straining the system.

Research suggests that if the need for counseling goes unmet, the effects on American soldiers will be dire.

Male veterans are twice as likely to die from suicide than are non-veterans, according to a study published last month in the Journal of Epidemiology and Community Health. The study compared a sample of 320,890 adult men and found a significantly higher risk of suicide among veterans, calling for ‘‘clinical and community interventions” in military and civilian health care facilities.

‘‘I absolutely experience this to be a high need for military service members and their families,” said Bethesda-based therapist Kathryn Rheem. Rheem is a member of the Give An Hour network and specializes in treating traumatized military service members and their spouses.

Therapists said Give An Hour may bypass a confluence of factors making mental health care an obstacle for some soldiers.

Soldiers may hold off on psychiatric and psychotherapeutic care because they fear being perceived as weak or mentally scarred. Those who do seek counseling on a military base face waiting lists, therapists said, and some bases offer strictly pastoral care.

‘‘People who don’t subscribe to one religion or another are often uncomfortable going,” Rheem said.

Give An Hour is not military-commissioned. Therapists are bound by their ethical guidelines and privacy laws.

Unlike military mental health care, Give An Hour’s nationwide network is also wide open to a soldier’s parents, siblings and other family members. That will ease the burden on an already taxed system because, Rheem said, it can bring family members into the process and prepare them for a loved one returning with post-traumatic stress, brain injury or depression.

TRICARE, the military’s health insurance, does not cover parents or unmarried domestic partners. Give An Hour does.

‘‘We can’t treat the individual soldier with [post-traumatic stress disorder] by themselves. We have to treat their spouses and family members as well,” Rheem said.

Give An Hour’s mission is to make family members partners in the recovery process, but also to treat those left behind after a Middle East deployment.

‘‘Whether it is a young military wife who is anxious because her 4-year-old has had nightmares since her husband’s deployment or a mother who is struggling to cope with the loss of her son’s leg as a result of an explosion in Iraq, each will receive the assistance they need to move through their experience,” the Web site reads.

As must be the case with federal nonprofits, Give An Hour’s mission is not politically motivated. Romberg said the mission is to treat the effects of — not to end — the war.

‘‘It doesn’t matter what side you’re on, because this is about helping people cope with the consequences of war,” Romberg said. ‘‘It feels better to do something [to help] than to do nothing and feel bad.”

Give An Hour

Web site, with searchable directory: http:⁄⁄www.giveanhour.org

E-mail: info@giveanhour.org

To volunteer, contact:

Barbara V. Romberg, Ph.D Founder and Executive Director c⁄o Give an Hour 6101 Durbin Road Bethesda, MD 20817