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NEWS | Sept. 28, 2009

DoD, VA panel discuss barriers to care

By Military Health System

LAS VEGAS - They deploy alongside their active duty counterparts. They shed blood and lose lives. Much like active duty service members, their spouses remain at home alone while they serve their country. They serve as medics, infantrymen, military police and intelligence personnel.

The difference? They are stationed not in communities with a large military presence, but in places where people do not always remember that service members are their neighbors.

"Sometimes that is a blessing. But in times of war, it's a definite curse," said Rosemary Miguel, wife of an Air Force reservist. "We don't have the support the active duty and their spouses have. We usually don't have other military families around to ask for help. Heck, most times, we don't know where to go if we have issues or if our spouses start to experience some deployment-related medical issue."

The Department of Defense (DoD) and the Department of Veterans Affairs (VA) both recognize these issues. "Reaching Out to Reserve and Guard Forces: Outreach, Reintegration and Psychological Support" was the topic of a session at the VA-DoD Operation Enduring Freedom/Operation Iraqi Freedom Evolving Paradigms II Conference held in Las Vegas Sept. 23.

The session, led by Cmdr. Anthony Arita, director of outreach and advocacy for the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), focused on how the DoD and VA leadership can come together to meet the needs of and provide support to the military's Reserve and Guard forces.

The panel discussed the issue of stigma as a barrier to accessing care. They emphasized that both DoD and VA leadership are in support of addressing the issue of stigma and overcoming the barriers it poses. Arita discussed the many efforts and programs currently underway to help service members, veterans and their families reach out and get help.

Among these is the DCoE-led Real Warriors campaign, directed toward service members, families, leaders, caregivers and others who provide support to the military. In order to reach U.S. forces and their families across the globe, the program collaborates with a variety of organizations and associations that share the military's mission and can help reach out to soldiers, members of their families and health care providers.

"By collaborating with these advocacy organizations that already have the eyes and ears of our military and their families worldwide, we can better reach out and provide the most relevant and up-to-date information and resources to them" said Arita.

The Real Warriors program promotes the processes of building resilience, facilitating recovery and supporting reintegration of returning service members, veterans and their families.

The Real Warriors Web site has a 24/7 help line and live chat option that provides service members and their families the opportunity to speak to a trained health resource consultant who can answer their questions and provide guidance and resources that are needed. is an online service that provides wellness resources to members of the military and their families and helps them manage the challenges that are often faced following a deployment. In an effort to continue to overcome the barriers posed by stigma, the online resource is designed for those who may still be reluctant to step out and seek help.

"Web tools provide 24/7 access anywhere an Internet connection is available. Users can anonymously log on in the privacy of their homes if they are uncomfortable going in to see a counselor," said Dr. Robert Ciulla, program manager for

Capt. Virginia Torsch, a special projects coordinator for the Office of the Chief of the Navy Reserve, and one of the panel members at the conference session, discussed another initiative aimed specifically at Reservists and their families. "The Returning Warrior Workshop is a retreat format geared specifically toward spouse and caregivers for our Reservists," said Torsch. "The workshops are designed to help reduce feelings of stress, isolation and other psychological and physical disorders and injuries that family, friends and caregivers often cannot fully understand, especially when their service members are dealing with post traumatic stress disorder and traumatic brain injury."

So far the workshop has attracted 1,421 service members and 1,069 family members.

"One of the positive outcomes we've seen is that the workshop has encouraged our attendees to seek counseling afterwards and many have received a referral for psychological health follow-up," said Torsch.

Col. Dean Stinson of the Office of the Assistant Secretary of Defense for Reserve Affairs and a panel member at the conference session discussed the DoD Yellow Ribbon Reintegration Program (YRRP), signed into law by Congress in January 2008. The program provides Reserve and Guard forces with information, services and support needed during their entire deployment cycle.

"We've seen that there is a gap between support services provided to active components versus the National Guard and Reserve components," said Stinson. "The intent of the YRRP is to bridge that gap by providing members and their families with a wide range of programs as close as possible to their places of residence" he said.

Stinson encouraged attendees at the conference and military leaders to join in spreading the word about this unique program.

Other panel members discussed a variety of behavioral and psychological health efforts and programs geared toward the Reserve and National Guard members. "The issue of stigma does not only apply to the active duty component," said Miguel. "Our spouses face the same issues on a day-to-day basis. They come back home with brain injuries and post-traumatic stress disorder. We need just as much help and support as the active duty spouses do."