Of the more than two million service members who have deployed as part of operations in Iraq and Afghanistan, approximately 665,000 were reserve component members. As a result, a large number of these troops have experienced the individual or combined stressors of long and/or multiple deployments with short breaks between their services. 

In the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) May webinar, “Psychological Health Issues in the National Guard and Reserves: Prevalence, Barriers and Treatment,” Dr. M. Tracie Shea, a psychologist and director of posttraumatic stress disorder research at Providence Veterans Affairs Medical Center, R.I., discussed psychological health concerns experienced by reserve component members post deployment, challenges they face accessing care, and treatment recommendations for providers who work with them. 

Active-duty and reserve component members face different reintegration challenges. Shea explained that the different stressors that National Guard and reserve members face may contribute to psychological health concerns after deployment (posttraumatic stress disorder, depression, substance abuse, anger and aggression). These stressors include:

• Less preparation for active service commitment
• Not being embedded with military units after deployment, leading to lower levels of post-deployment support
• Financial struggles and strains on relationships since civilian careers and families may be disrupted when called up for active duty 

Two studies comparing reserve and active components cited by Shea suggest that there are more mental health care referrals for National Guard and reserve members. Rates of posttraumatic stress disorder and other psychological issues tend to be higher in this population. And, coping mechanisms, such as alcohol misuse, are also reported at higher rates for reserve components (13-14 percent) than active components (10-12 percent). These details may be a result of obstacles that reserve component members experience when they decide to reach out for health care, according to Shea.

Although similar challenges to accessing health care are shared in both the reserve and active components, such as difficulty scheduling appointments or getting time off from work to get to appointments, Shea highlighted the following barriers as being more prevalent among reserve component members: 

• Individuals don’t know where to go for psychological health care support
• Transportation issues (unable to reach psychological health care support)
• Cost

Shea’s recommendations to health care providers helping reserve component members include: flexibility in scheduling appointments, being alert to negative perceptions about mental health treatment, and showing familiarity with military culture and common experiences of deployed veterans. Providers should also monitor isolation tendencies and encourage contact with other veterans for peer-to-peer support.

With appropriate health care and additional encouragement from family and friends, these service members are better able to cope with the unique forms of stress experienced during deployment and reintegration.

Please check out these resources for the active and reserve components following their deployments: inTransition, afterdeployment.org, Military OneSource, DCoE Outreach Center, Real Warriors Campaign and National Guard Psychological Health Program. Be sure to also review these resources for warriors and families of the National Guard and Reserve.

For more on this subject, check out the presentation, audio and resources from this webinar on the DCoE website.

Be sure to join us for a discussion on assessing the risk of violence in the next DCoE webinar, from 1 to 2:30 p.m. (EDT) June 27.