Founder of the Coming Home Project
We all know the story of the Three Little Pigs: The house made of bricks proved to be the strongest. The flagship DoD facilities built by the Intrepid Fallen Heroes Fund, the Center for the Intrepid in San Antonio, Tex., and the National Intrepid Center of Excellence or NICoE, in Bethesda, Md., are state-of-the-art facilities. I have visited them, met their leaders, and seen the service members receiving excellent care. Having also contributed the invaluable Fisher Houses for service members' families, the Fund is now planning to build a total of nine treatment centers for brain injuries and psychological disorders at the largest military bases, at a cost of over $100 million, which they will raise as they did the previous $150 million.
By catalyzing public attention, the Fund is not averse to using public embarrassment as a motivator. Martin Edelman, an original Fund Board member, said that building things for the military could "force it's balky bureaucracy to act." Given the urgency of the issue, the thousands needing care and the tens of thousands soon to be needing care, I have no argument with the Fund's tactics.
But stop and think a minute. How long has it taken governmental health entities, Congress, the military, private and public funders and the general public to even begin to recognize and address the dangerous tendency to see only the visible injuries of war and to ignore the unseen wounds? We humans privilege what we can see. It is far more difficult to grasp the powerful impacts that escape the eye such as the PTS continuum and mild-moderate TBI. Might this factor now be at play in what kinds of resources are funded? I think the answer is yes.
In five years of caring for thousands of post 9/11 vets and families, our data has convinced me that most potent force in combating PTS and related unseen impacts of war trauma is hidden in plain sight: the experience of community and a trustworthy network of peer support. Why? Because this is what bonds service members to one another in the war zone and family members and caregivers on the homefront. We can and must leverage it to facilitate the most healing and empowering transition to civilian life.
The DoD medical command is strapped for staff and funds and this situation will become worse not better over the next few years. According to the recent Institute of Medicine report, the Department of Defense has "a woeful lack of information on the effectiveness and related costs of its post-traumatic stress disorder treatment programs, despite having spent millions of dollars on various initiatives to address psychological health and traumatic brain injury." Programs must address the whole person, including the family and wider support systems such as the community.
Although forcing the Pentagon's hand is not in itself objectionable, the question I raise is a pragmatic one: Is the 100 million dollars for the nine centers on military bases, and the hundreds of additional millions of dollars needed to properly staff, fund and maintain excellence at these centers for decades to come, the best use of these massive financial investments? I maintain that the answer is no.
The New York Times article refers to these nine centers as a "network." We need networks alright: real, empowering and durable support networks of veterans, spouses, parents, teens and other family members. Networks of professional care providers and family caregivers. Isolation kills and community heals. Troops come home to a community, not a series of isolated services. A safe place of welcome, belonging, and understanding, without judgment -- a true home -- is a palpable but ignored and therefore invisible factor. Brick and mortar structures in no way guarantees a real home.
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