As part of the 10 Ideas: A Defense Strategy for the Global Generation series, a recognition of the need to improve the care of our women who serve.
Upon his retirement in January, General Peter Chiarelli, the vice chief of the U.S. Army, told reporters that prohibiting women from serving in combat was anachronistic. Female soldiers, he claimed, were essentially already seeing combat. “I have felt for the longest period of time that on a nonlinear battlefield there are no safe jobs,” he said. “Everyone is in a situation where they are, in fact, in harm’s way. There is this mistaken belief that somehow that through prohibiting women in combat jobs we can protect them. I would rather have standards that we apply across the board.”
Chiarelli’s comments come at a time when the implications of the roles women play in the U.S. military affect more veterans and families than ever. Over the past decades, women have joined branches of the military at higher rates than ever before, comprising 14.6 percent of active duty forces. On top of this, women comprise 13 percent of the veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn.
While official policy mandates that women do not serve in combat roles in the U.S. military, women still suffer from physical and psychological injury. In 2009 and 2010, post-traumatic stress disorder (PTSD), hypertension, and depression were the three conditions diagnosed most frequently among female veterans. In addition, approximately one in five women seen by Veterans Administration (VA) hospitals respond “yes” when screened for military sexual trauma (assault or harassment experienced while in the military).
While significant cuts to the VA budget in 2009 slowed programming in 2010 and 2011, the prioritization of female veteran health care was increased in 2010 with the Caregivers and Veterans Omnibus Health Services Act. The Act created the first comprehensive study in recent years of barriers to health care for female veterans, designed pilot programming for group therapy for female veterans no longer on active duty, and created a two-year pilot program to assess the feasibility of offering childcare to veterans.
In addition, in early February the military began slightly easing restrictions on the roles female soldiers can play in combat zones. About 14,000 combat positions will now be open to women, although 283,000 positions, nearly all of them in the Army and Marine Corps, will remain closed.
These numbers, however, don’t reflect the reality of American military service, in which even those in “non-combat” roles may find themselves embroiled in violent confrontations. And while there have been recent improvements in services, not all of the needs of women who have served in the military are being met.
It is vital that the VA adapt to meet the needs of the increasing numbers of female veterans. While VA services in recent years have increased their emphasis on mental health, logistical aspects of many hospitals can make accessing care challenging for patients, particularly for women. An important example is that women may be barred from group therapy sessions dealing with issues of PTSD because spots are reserved for those who saw combat. Even female veterans decorated for their performance in combat may be prohibited from group therapy for this reason. While appeals processes exist, they are slow and unknown to many veterans. Making these groups available to all veterans diagnosed with PTSD will increase the speed with which veterans access group therapy services.
VA hospitals may also not be physically laid out to provide comfortable access to mental health services. Creating specific exam rooms and separate clinic entrances for women attempting to access female health services (i.e. gynecological services) or mental health services may prevent the harassment and discomfort they experience when they must walk through wards of physical care services full of older, largely male veterans. In addition to the provision of childcare, these minor policy changes will make health care more accessible to female veterans and will ease their search for treatment.
The simplest solution to gaining access to therapy for all those facing post-combat trauma would be for the military to acknowledge that women deployed in Iraq and Afghanistan have already experienced combat, regardless of official policy. The VA should amend therapy eligibility to include all patients diagnosed with “combat-related” PTSD, which would include female veterans whose combat experience is unofficial. Individual hospitals should create separate waiting rooms, entrances, and exam rooms for female veterans, particularly when their diagnosis may be more sensitive (i.e. mental health services or sexual trauma). No veteran should face harassment or roadblocks in his or her search for treatment.