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The Impact of Deployment on

Service Members and Their Families

Focus on the Military and their Families

By: James J. Messina, Ph.D.

Background
Most current statistics on deployed military from the Defense Manpower Data Center indicate the following percentage make up of those deployed to our current war fronts in Iraq and Afghanistan:

Men = 90%   Women = 10%

Married = 53% where with children = 68% and without children = 32% Single = 47% where with children = 13% and without children = 87%.

Major stressors for Military families involved in deployments are:

  1. Frequent moves and separations
  2. Individual augmentees (individually assigned out of their own companies or branch of the military)
  3. Risk of injury and death
  4. Expectations
  5. Long and unpredictable Foreign residence.

 

Risk factors for Military families involved in deployments are that many are:

  • Composed of younger spouses
  • Composed with younger children
  • Socially isolated and dependent families
  • Families undergoing major transitions
  • Families with multiple needs and problems before deployment
  • Children with school history of special education
  • Have children who showed poor coping skills prior to deployment
  • Families with a history of mental health issues
  • Families of junior enlisted
  • Composed of single parents
  • Composed of foreign-born spouses
  • Composed of pregnant spouses
  • Veterans of prior deployments
  • Composed of dual military roles of both spouse
  • Newly married

Since the beginning of Operation Enduring Freedom (OEF-Afghanistan) and Operation Iraqi Freedom (OIF-Irag), over 1.5 million service members have been deployed, and over 33,000 have been severely wounded, suffering battlefield injuries that in previous wars and conflicts would most likely have been fatal (Murdough, 2008).  Because of improvements in battlefield medicine, body armor, and medical evacuation, these wounded warriors are surviving. But many will face lifetime challenges, including chronic pain due to the complexity and severity of their wounds. Injuries from improvised explosive devices (IEDs) cause traumatic brain injury (TBI), traumatic amputation (the loss of a body part that occurs as the result of an accident or trauma), multiple fractures, shrapnel wounds, and post-traumatic stress disorder (PTSD) (Murdough, 2007). 

Murdough (2007) points out that these injuries often leave the wounded with lifelong consequences, including chronic, disabling pain and the resulting impact on their ability to perform daily activities that were once taken for granted. These injuries can profoundly impact the overall quality of life for an individual and his or her family system. Murdough (2007) alos points out that many times, these individuals are young adults with young families, whose lives are now changed and challenged as they struggle to redefine roles, expectations, and financial responsibilities. The wounded, their families, and their caregivers will require information, resources, and the support of their communities to ensure that these individuals have the necessary means to improve self-care and function and to regain a maximum quality of life after surviving such complex and severe injuries.

Three Component of the Deployment Cycle

Pre-Deployment

With Stressors of:

  • Notification
  • Preparation
  • Training

Deployment

With Stressors of:

  • Departure
  • Sustainment
  • Combat and conflict

Post-Deployment

With Stressors of:

  • Return from deployment
  • Reunion
  • Reintegration

 

Pre-Deployment
Maguen, Turcotte, Peterson, Dremsa, Garb, McNally & Litz (2008) found that rates of pre-deployment PTSD symptoms were relatively low and positive emotional health was greater than negative emotional health among the military personnel they studied. However they concluded that military personnel who have other pre-deployment stressors might place them at risk for mental health complications. If military personnel are worried about a variety of stressors at home, then it becomes increasingly more complicated for them to remain focused on their military duties during their deployment. Pre-deployment stressors may create a high baseline of tension, resulting in a ripple effect of stress for military personnel serving in deployed locations.

 

Common Pre-Deployment Stressors are:

  • Preparedness – Practical preparation:
  • Power of attorney/Will/Financial plan
  • Location of important papers
  • Emergency contact procedures
  • Child care arrangements


Emotional preparation:

  • Prepared to cope with unexpected problems
  • Trust service member will be protected
  • Support mission


Other Stressors are:

  • Lack of Preparation Time
  • Unit Preparation vs. Family Preparation
  • Shifting expectations
  • Length of upcoming deployment
  • Open-ended deployments
  • Deployment date
  • Clarifying changes in family dynamics
  • Anticipation of threats to service member
  • Perception of mission purpose
  • Lack of information
  • Rumors                                          

 

Pre-Deployment stressors on spouses are:

  • Confusion
  • Denial
  • Resentment
  • Arguing
  • Worrying
  • Planning

 

Pre-Deployment stressors for Children are:

  • Confusion
  • Regression
  • Anger Outbursts
  • Sadness
  • Surprise
  • Guilt
  • Behavioral problems

 

Pre-Deployment stressors on Adolescents are:

  • “I don’t care”
  • Fear of rejection
  • Denial of feelings
  • Anger
  • Higher value on friends

During Deployment

Figley & Nash (2007) pointed out that stressors for military service members during deployment include: Operational-heat, dehydration, lack of comforts, desert, noises, fumes, Cognitive-boredom, monotony, unclear role or mission, experiences that defy beliefs, info overload

Emotional-fear of failure, guilt, horror, fear, anxiety, feeling devalued

Social-separation from loved ones, lack of privacy, public opinion and media, Spiritual-change in faith, inability to forgive, and loss of trust.

 

Felker, Hawkins, Dobie, Gutierrez & McFall (2008) found that soldiers with preexisting and/or serious mental health problems were more likely to present early in a deployment for mental health services, whereas a larger number of new-onset cases might present later.

 

Some trauma descriptions offered by soldiers and marines included:

  • Friends burned to death, one killed in blast
  • A friend was liquefied in the driver’s position on a tank
  • A huge bomb blew my friends’ head off like 50 meters from me
  • Marines being buried alive
  • Seeing, smelling, touching, dead, blown-up people

 

Tough realities about combat identified by WRAIR Land Combat Study Team included:

  • Fear in combat is ubiquitous
  • Unit members will be injured and killed
  • There will be communication breakdowns
  • Leadership failures will be perceived
  • Combat impacts every soldier mentally and emotionally
  • Combat has lasting mental health effects
  • Soldiers are afraid to admit that they have a mental health problem
  • Deployments place a tremendous strain upon families
  • Combat environment is harsh and demanding
  • Combat poses moral/ethical challenges

 

There were and are unique challenges of Operation Iraqi Freedom (OIF) & Operation Enduring Freedom (OEF)

  • No “front line”
  • Highly ambiguous environment - Complex and changing missions – combat, peacekeeping, humanitarian
  • Long deployments
  • Repeated deployments
  • Environment is very harsh – extreme heat; 24 hour operations; constant movement by ground or air; limited down time; crowded uncomfortable living conditions & difficult communications

 

Hoge et al (2004) report the following statistics about Boots on Ground Troops in Irag:

Percent of On Ground Troops’ Combat Exposure in Iraq

  • 95% Seeing Dead Bodies/Remains
  • 93% Shot at /Receiving Small Arms Fire
  • 89% Being Attacked /Ambushed
  • 86% Receiving Artillery, Rocket, Mortar Fire
  • 86% Knowing Someone Killed/Seriously Injured
  • 80% Clearing/Searching Homes
  • 77% Shooting/Directing Fire at Enemy
  • 69% Could not help Ill or Injured Women or Children
  • 65% Seeing Dead/Seriously Injured Americans
  • 50% Handling/Uncovering Human Remains
  • 48% Responsible for Death of Enemy Combatant
  • 38% Participating in Demining Operations
  • 22% Buddy Shot/Hit Near You
  • 22% Engaged in Hand-to-Hand Combat
  • 21% Saved Soldier/Civilian Life
  • 14% Being Wounded or Injured
  • 14% Responsible for Noncombatant Death
  • 8% Close Call/Hit but Saved by Gear

 

Common reactions to trauma include:

  • Fear and anxiety
  • Intrusive thoughts about the trauma
  • Nightmares of the trauma
  • Sleep disturbance
  • Feeling jumpy and on guard
  • Concentration difficulties
  • Avoiding trauma reminders
  • Feeling numb or detached
  • Feeling angry, guilty, or ashamed
  • Grief and depression
  • Negative image of self and world
  • The world is dangerous
  • I am incompetent
  • People can not be trusted

 

Hoge, Castro, Messer, McGurk, Cotting & Koffman (2004) found that there was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants, and the prevalence of PTSD. They also reported that the majority of persons in whom PTSD develops meet the criteria for the diagnosis of this disorder within the first three months after the traumatic event. They finally reported that in the military, there are unique factors that contribute to resistance to seeking mental health services because of the concern about how a soldier will be perceived by peers and by the leadership. Concern about stigma was disproportionately greatest among those most in need of help from mental health services. Soldiers and Marines whose responses were scored as positive for a mental disorder were twice as likely as those whose responses were scored as negative to show concern about being stigmatized and about other barriers to mental health care.

 

Battlemind skills helped military personnel survive in combat, but may cause them problems if not adapted when they get home

  • Buddies (cohesion) vs Withdrawal
  • Accountability vs Controlling
  • Targeted Aggression vs Inappropriate Aggression
  • Tactical Awareness  vs Hypervigilance
  • Lethally Armed vs “Locked and Loaded” at Home 
  • Emotional Control vs Anger/Detachment
  • Mission OPSEC vs Secretiveness
  • Individual Responsibility vs Guilt
  • Non-Defensive Driving vs Aggressive Driving
  • Discipline and Ordering vs Conflict

 

Financial Stressors of Deployment
A harsh reality facing deployed service personnel are the financial stressors such as:

  • Although most do not experience serious financial difficulties – Potential loss of income offset by supplement which have been challenged in the economic downturn which began in September 2008
  • Substantial minority does face financial hardships (1) 18% of spouses report serious financial difficulties (2) 29% of spouses report trouble paying bills and (3)1/2 reporting difficulties are from junior enlisted grades
  • Increased expenses– Supplies for deployed service member such as: Shipping costs; maintaining communication and additional childcare costs

Post Deployment

Rand Corporation’s 2008 Findings

What follows are some key finding of the Rand Corporation (2008) in Invisible Wounds of War in their study of deployed troops from Iraq and Afghanistan once they have returned home to the United States.

 

Since October 2001, approximately 1.64 million U.S. troops were deployed to Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF; Iraq).  The pace of deployments was unprecedented in the history of the all-volunteer force (Belasco, 2007; Bruner, 2006). A higher proportion of armed forces are being deployed and deployments have been longer, redeployment to combat has been common, and breaks between deployments have been infrequent (Hosek, Kavanagh, and Miller, 2006).


OEF and OIF have employed smaller forces and produced lower casualty rates of killed or wounded than Vietnam and Korea. More service members are surviving due to advances in medical technology and body armor (Regan, 2004; Warden, 2006). However, casualties of a different kind have emerged—invisible wounds, such as mental health conditions and cognitive impairments. These deployment experiences may include multiple deployments per individual service member and exposure to difficult threats, such as improvised explosive devices (IEDs).


The following is data from a phone survey of approximately 2000 OEF and OIF veterans who reported experiencing the following:

  • 14% PTSD
  • 14% depression
  • 19% TBI
  • 33% PTSD, depression or TBI
  • 5% symptoms of all 3


Rand found that the top three barriers of returning service personnel from getting mental health services were:

  1. Treatment not confidential; could constrain future job assignments and military career advancement
  2. Medications may have unpleasant side effects
  3. Even good mental health care is not effective.


Rand also found that the costs of PTSD, depression, TBI and other psychiatric diagnoses is that returning service personnel:

  1. Risk of attempting suicide
  2. Higher rates of unhealthy behaviors (smoking, overeating, unprotected sex)
  3. Higher rates of physical health problems and mortality
  4. Missed more days of work or less productivity
  5. A relationship to being homeless


Categories of returning service personnel whom Rand found to be most vulnerable to PTSD, depression and other psychiatric diagnoses were:

Service members with identified or unidentified Traumatic Brain Injury(TBI)

  • Service members not on active duty (Reserve Corps, discharged, retired)
  • Enlisted personnel
  • Females
  • Hispanics
  • More lengthy deployments
  • More extensive exposure to combat trauma

 

In summary, the Rand study found that:

  • About 10-15% of Soldiers develop PTSD after deployment
  • An additional 10-15% have significant symptoms of depression, anxiety, or PTSD
  • Alcohol misuse also increases post-deployment
  • Prevalence varies as a function of deployment experiences
  • Mental Health problems were often associated with functional impairment, attrition, and physical health problems
  • One-third of Soldiers use Mental Health services after deployment (includes screening and prevention services)
  • Perceptions of stigma may be improving. However, many Soldiers don’t seek help, due to stigma and other barrier

Update on TBI

Post Deployment Issues:
Typical reintegration of Service Personnel returning home to the United States finds that family resilience is the rule and not the exception. Usually, families return to the normal routine. It is common in such families to incorporate changes without major disruption in family functioning.

 

However, reunions can be stressful because of:

  1. Changed roles/responsibilities
  2. New independence of spouse
  3. Lack of time
  4. Tug on loyalties
  5. Extended family
  6. Health/Mental health problems
  7. Unresolved marital issues haven’t vanished.


The most common stressors facing military personnel on return home are:

  • Readjustment to marital and family relationships
  • Lack of time for family reintegration
  • Couple jealousy and suspicions
  • Ongoing military stressors
  • Uncertainty about future retention according to Teitelbaum (WRAIR,1992) who conducted a study with the Army after Operation Desert Storm (ODS).

 

Charles Figley and  William Nash (2007) identified the following stressors which military personnel faced post deployment:

  1. Physical: traffic, crowds, unarmed, access to alcohol
  2. Cognitive: loyalty issues to family vs unit, secrecy vs disclosure, boredom, regrets, thoughts of losses;
  3. Emotional: grief, anger, feeling unsafe, guilt, withdrawal from war “rush,” numbness
  4. Social: separated from buddies, overwhelmed or misunderstood by family, feelings of alienation 
  5. Spiritual: asking why buddies died, lack of purpose, changed faith, conflicting values.


In a May 2008 briefing by Colonel Kevin Gerdes stated that the mindset of military personnel during deployment which comes with them home lies at the root of much of the readjustment problems in their reintegration such as:

  • Stay focused on mission /nothing else matters
  • Truly life or death / always on the edge
  • Constant adrenaline “rush”
  • Black or white / all or nothing
  • Sense of purpose, invincibility
  • Only trust battle buddies /others are threat
  • Need to control environment
  • Real problems and needs exist in Iraq
  • Life is now unfocused and complex
  • No longer on the verge of life or death
  • What can replace the “high” of war?
  • Things aren’t clear cut
  • No sense of purpose, nothing matters
  • Can’t trust anybody
  • Can’t be in control of surroundings
  • Problems at home pale in comparison to those in Iraq & Afghanistan

 

Military service personnel according to Gerdes (2008) face changes in their families on their return home. These changes include: new routines in the family; new responsibilities given to the family members; more independence and confidence of the family members; many family members made many sacrifices during the time of deployment; many family members felt worried or lonely and many family members had gone through milestones which the service members missed.


Gerdes (2008) points out that service members when they return home unintentionally could impact their families by: interrupting their routines; disrupting their space; throw off the family’s decision making; cause the family to walk on tip toes; not make everything perfect immediately after their return and not replace the sacrifices and missed milestones of family members.


Tbere are special stressors personnel in National Guard and Reserve Units such as:

  1. Return to civilian life
  2. Job may no longer be available
  3. May experience a reduction in income
  4. Transition of health care or loss of health coverage
  5. Loss of unit/military support system for the family 
  6. Lack of follow up/observation by unit commanders to assess needs.

 

Post Deployment Impact on the Children in Military Families
Doug Lehman in a May 2008 briefing identified the following stressors experienced by children when their parents return from deployment. They could be any or all of the following: afraid or avoiding of returning parent; want attention; clingy; angry; need reassurance; attempt to split parents; desire recognition; are filled with joy and/or excitement.


Lehman (2008) identified the following stressors of adolescents when their parents return from deployment. Adolescents could have any or all of the following: spend more time with friends; have school problems; exhibit behavioral problems; have a sense of relief; show defiance; exhibit resentment; are avoidant or withdrawn.

 

Impact on Spouses Post Deployment
The Center for Deployment Psychology (2007) suggest that spouses on their reintegration post deployment:

  1. Recognize that readjustment stress is commo
  2. Listen to each other’s stories and be curious
  3. Recognize that experiences have changed both partners
  4. Discover new family strengths
  5. Negotiate a new balance, roles, and routine
  6. Make sure each spouse has space
  7. Don’t play “one-up” games about deployment
  8. Build common interests again
  9. Go slow
  10. Don’t drill the other if there are concerns regarding an affair
  11. Don’t plan sudden romantic getaways
  12. Both spouses may feel unneeded, unwanted - discuss changes and gradually develop solutions
  13. Expect children to test limits
  14. Be flexible and patient
  15. Communicate respect
  16. Plan for the future together
  17. Complement each other more
  18. Be willing to apologize
  19. Take time outs when things feel out of control.


Healing Families Post Deployment

Armstrong, Best & Domenici (2006) suggest that parents on their reintegration post deployment:

  1. Spend one-on-one time with each child
  2. Be giving of time and energy
  3. Allow child to also have space
  4. Listen and accept child’s feelings
  5. Be realistic and flexible
  6. Avoid excess gift giving
  7. Don’t get upset if child has reactions to you
  8. Don’t give into demands of guilt
  9. Express specific concerns and offer to help but don’t push
  10. Become an expert in available resources
  11. Have honest discussion about financial situation
  12. Use connections made during deployment to develop strategies to help transition
  13. Give your child a chance to talk about war experiences
  14. Have a battle buddy talk to your child.

 

Follow up on Mental Health of Service Members Post Deployment

PTSD:

In a study of service personnel who had spent a year in OIF and given a mental health screening three to four months post deployment, (57.5%) exceeded criteria on the screening survey as experiencing PTSD and other mental illness related issues (Wright, Adler, Bliese & Eckford, 2008).

Gahm & Lucenko (2008) pointed out that a recent analysis of VA patient records indicated that possible mental disorders were reported for 26% of veterans who experienced combat in Iraq and Afghanistan. They also report that active duty soldiers, particularly those who experienced combat, are at increased risk of mental health difficulties, particularly posttraumatic stress disorder (PTSD), depression, and anxiety. Mental disorders have been shown to be a primary source of disability and separation from the military, with a reported 6-month attrition rate of 45% for those hospitalized for mental health diagnoses.

 

Hoge, Terhakopian, Castro, Messer, & Engel (2007) found that PTSD among veterans of the OEF and OIF was significantly associated with lower ratings of general health, more sick call visits, more missed workdays, more physical symptoms, and high somatic symptom severity. Resnick & Rosenheck (2008) reported that individuals with substance use diagnoses or who were homeless at program entry for treatment with PTSD were more likely to be employed at discharge, while receipt of public support income and severe mental illness decreased the likelihood of being competitively employed. Their research suggested that PTSD is a significant obstacle to employment. Friedman (2006) strongly encouraged that treatment for PTSD should be initiated as soon as possible, not only to ameliorate PTSD symptoms but also to forestall the later development of additional psychiatric and/or medical disorders and to prevent interpersonal or vocational functional impairment.

 

Veterans who come home from OEF and OIF with injuries are more prone to delayed PTSD according to Grieger, Cozza, Ursano, Hoge, Martinez, Engel (2006).  The course of illness in battle-injured soldiers is complex, and the initial assessments in their study were not predictive of the health or the life impact of such injuries 6 months later. The findings of their study suggest that severity of physical problems shortly after the injury may be of value in predicting persistence or later onset of PTSD and depression in severely injured patients. This is important information for families with returning family members who have been injured in combat.

 

Vasterling, Schumm, Proctor, Gentry, King & King, (2008) found that PTSD symptoms exerted some impact on health related functioning in a population not otherwise at heightened risk for diminished health status who were young veterans from OIF. Their study also identified the benefits of early mental and physical health screening in both primary care and mental health settings, even among seemingly healthy, newly returning veterans. Their findings also indicated the need for early mental health interventions to consider health symptoms and functional impact. Such outcomes as quality of life, psychosocial relationships, and occupational functioning they believe are equally important as intervention targets to more traditional symptom relief.

 

Santos, Russo,  Aisenberg, Uehara, Ghesquiere & Zatzick (2008) have recommended that treatment for people of diverse race and cultures with PTSD and related other mental health issues need clinical services integrating bilingual, bicultural care managers and addressing the spectrum of post-injury linguistic, medical, and mental health needs. 

 

Traumatic Bain Injury (TBI)
Hoge, McGurk, Thomas,  Cox,  Engel & Castro (2008) identified that concern has emerged about the possible long-term effect of mild traumatic brain injury, or concussion, characterized by brief loss of consciousness or altered mental status, as a result of deployment-related head injuries, particularly those resulting from proximity to blast explosions. Traumatic brain injury has been labeled a signature injury of the wars in Iraq and Afghanistan. Soldiers who reported mild traumatic brain injuries were significantly more likely to report high combat intensity, a blast mechanism of injury, more than one exposure to an explosion, and hospitalization during deployment. PTSD was strongly associated with mild traumatic brain injury. More than 40% of soldiers with injuries associated with loss of consciousness met the criteria for PTSD.  Soldiers with mild traumatic brain injury reported significantly higher rates of physical and mental health problems than did soldiers with other injuries. Injuries associated with loss of consciousness carried a much greater risk of health problems than did injuries associated with altered mental status.

Kennedy, Jaffee, Leskin, Stokes, Leal & Fitzpatrick (2007) pointed out that the biological and psychological risk factors for PTSD theoretically occur during traumatic events in which TBI is experienced. These factors can be exacerbated by TBI, leading to the documented increase in PTSD rates following TBI. A relevant finding of Kennedy et al was that there is a challenge in treating TBI and/or PTSD to achieve and modulate a changing balance between supportive care (including financial assistance) and the positive expectation of, and pressure toward, maximum recovery of function and independence. This becomes a real issue for families of service personnel with these conditions to motivate their family members to get the most they can get out of their rehabilitation services so that they can regain their prior war time functioning.  

Overcoming the Stigma of Gaining Mental Health Services
A major issue confronting families of returning military personnel who are experiencing severe mental health issues including PTSD is the over coming of their family member’s fear of stigma for seeking out help. Greene-Shortridge Britt & Castro (2007) report that within a military context, service members experiencing symptoms of PTSD and considering admitting they have a problem to someone else will likely be aware of public beliefs about psychological problems, perhaps anticipating negative consequences from different individuals (e.g., fellow service members, commanders). If soldiers fear social exclusion because they have symptoms of PTSD, they may forgo seeking help due to apprehension about societal stigma. Furthermore, soldiers' perceptions of society holding them accountable for their psychological problems may further inhibit treatment seeking. If the soldier comes to personally endorse the negative beliefs and attributions held by the public, he or she will experience a stronger sense of self-stigma and not be willing to seek out help.

Friedman (2005) reported that a possible explanation is that returning troops now perceive a great difference between disclosing PTSD symptoms to VA clinicians and disclosing them to military mental health professionals. Whereas there is still little stigma associated with such a disclosure within VA settings, there are perceived risks within the military setting - and a resultant reluctance to seek treatment. Yet times have changed dramatically since the post-Vietnam era, and military clinicians are eager to assist uniformed personnel whose functional capacity is affected by PTSD. All troops currently receive health assessments before and after deployment to facilitate the early identification and treatment of PTSD. In January 2005 military mental health policy was modified with the addition of a third health assessment three to six months after troops return from Iraq. Although the battle against this stigma is far from over, it is encouraging that the Pentagon recognizes its importance.

Suicide Rates in Army Update
On July 28, 2010, the US Army release a major report called: Army: Health Promotion, Risk Reduction and Suicide Prevention Report 2010.

The report can be read at: Press Release Site


The intent of the report was to inform and educate Army leaders on the importance of recognizing and reducing high risk behavior related to suicide and accidental death, and reducing the stigma associated with behavioral health and treatment.

The major findings of the report related to the impact of Deployment on the Military and their Families are:

  • an increase in indicators of high risk behavior including illicit drug use, other crimes and suicide attempts
  • lapses in surveillance and detection of high risk behavior
    an increased use of prescription antidepressants, amphetamines and narcotics
  • degraded accountability of disciplinary, administrative and reporting processes
  • the continued high rate of suicides, high risk related deaths and other adverse outcomes.

 

In his introduction to the Report, General Peter W. Chiarelli stated: "In Fiscal Year (FY) 2009 we had 160 active duty suicide deaths, with 239 across the total Army (including Reserve Component). Additionally, there were 146 active duty deaths related to high risk behavior including 74 drug overdoses. This is tragic! Perhaps even more worrying is the fact we had 1,713 known attempted suicides in the same period. The difference between these suicide attempts and another Soldier death often was measured only by the timeliness of life-saving leader/buddy and medical interventions. Some form of high risk behavior (self-harm, illicit drug use, binge drinking, criminal activity, etc.) was a factor in most of these deaths. When we examined the circumstances behind these deaths, we discovered a direct link to increased life stressors and increased risk behavior. For some, the rigors of service, repeated deployments, injuries and separations from Family resulted in a sense of isolation, hopelessness and life fatigue."

This report is an important reminder that it is important for all of us to be supportive to any member of the military and their families to provide the emotional and social supports systems to help them handle the stressors of today's deployment enviroment in a healthy way.

For more backgroup please read the report!

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