Yesterday, we paid tribute to those Service men and women who have given their lives defending their country and also to the families, especially those with young children, to whom these Service members were husbands and wives, fathers and mothers, sons and daughters. Today, we want to focus on those who have served their country and have come home, or will be coming home, to rejoin their families and communities. The withdrawal of troops from Iraq and the promise of the withdrawal of troops from Afghanistan will create a surge in men and women retiring from active duty and returning to civilian life as veterans. Infants and toddlers will certainly be part of this “coming home” picture.
One thing we know for sure about these returning veterans: overall, they are young, with many returning home to young families and others likely to start families. The active duty force is largely composed of young men and women: in 2009, 45 percent were age 25 or younger; 67 percent were age 30 or younger. Almost three-quarters of enlisted men and women were age 30 or younger. Many of our troops are already young parents. In 2009, 42 percent of the 1,224,556 children of active duty service members were under the age of 6. And, of those children, more than half were under the age of 3.
The lessons of the last decade tell us that we need to prepare for the stresses of reintegration on families and be especially attuned to the effects of these stresses on young children. Those lessons are twofold:
First, when warriors come home, often recovering from physical and psychological injuries, the challenge of reintegrating into family life, connecting with family supports, finding civilian employment, and redefining their roles in their families and in their communities can be overwhelming. Combat related injuries such as Traumatic Brain Injury (TBI) and Post Traumatic Stress Syndrome (PTSD) increase the likelihood of other emotional problems. The percentage of women veterans is expected to rise significantly over the next two decades, creating unique health care needs and raising other issues, including sexual trauma, that need to be addressed.
Second, just as we know more about the impacts of prolonged deployments on the mental health of Service members themselves, the science of early brain development tells us that the impacts of deployment and reintegration extend beyond the veteran to young children. While short-term stress is part of everyday life for young children as they encounter new situations, long-lasting or chronic stress can be damaging to developing brains, particularly to the child’s developing executive function. Not just the stress of the veteran, but also the stress experienced by caregivers of injured veterans who must cope with multiple responsibilities, can adversely affect veterans’ young children.
The Veterans Administration (VA) has long provided for many of the needs of its members, but today’s veterans may require a different type of response. Issues of unemployment, homelessness, and access to healthcare are among the many concerns that we share as a nation on behalf of those veterans and their families who have served and sacrificed. Timing is of the essence if we wish to reach these families early in their re-integration process to achieve the best outcomes. The goal should be to enhance the resilience of veteran families with young children, and support them where they live.
The VA recognizes this need and is open to providing more support for families, yet VA health and mental health services traditionally have been designed for the veterans themselves. Only recently have mental health services begun to include veterans’ spouses, and current VA services do not have sufficient resources or the capacity to address the needs of all family members. As veterans begin reintegrating into family and community life, civilian services have not been prepared to work with military and veterans’ families. Civilian community organizations need additional knowledge and programmatic capacity to effectively serve these families. They need education on military culture and military family life, fiscal agencies and referrals, and training on the proven, evidenced-based strategies that can best support young children in military and Veterans’ families. (The National Center on Homelessness, 2011)
The VA is beginning to take on this task. The VA recently created a regional family and caregiver system with regional case manager coordinators as a resource for veterans’ families. These regional case managers make referrals to regional and local community organizations for caregivers and families from Vietnam era, Gulf, and Afghanistan and Iraq conflicts. This is a promising new and developing program for the VA. Clearly the agency does not have the capacity to reach local communities alone, but needs strategic national and local partnerships to accomplish its goal. One way to give these efforts a leg up is to build on the strong partnerships fostered by the Department of Defense and the White House to better support children—especially the youngest—in active duty Service members’ families.
What are some of the necessary steps to meet the increased needs of young children in veteran families? There is a need for greater resources and concerted efforts to build community connections to create supports, including:
1. Increased capacity for VA family support programs built around the needs of young children—especially the youngest children—and developed with evidence-based approaches for practice.
2. Building local capacity by strengthening knowledge, skills, and resources on the unique needs of young children in military and veterans’ families, including the impact of trauma, grief, and loss on brain development, and by strengthening community collaborations among service providers.
3. Support for caregivers of injured veterans in supporting their young children.
4. Increased capacity to support the unique needs of women veterans, including ensuring that appropriate family, maternal, and infant healthcare facilities are available to meet the medical needs of Services members, their families, and their children.