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Addressing the Mental Health Needs of Returning Combat Veterans in the Community

NAMHC Concept Clearance


Robert K. Heinssen, Ph.D., ABPP
Adult Treatment and Preventive Intervention Research Branch
Division of Services and Intervention Research


This initiative will systematically evaluate the impact of community-based “reintegration” programs on the mental health and behavioral adjustment of National Guard, Reserve Component, and newly separated combat veterans from Operation Iraqi Freedom and Operation Enduring Freedom.


Recent reports document substantial mental health distress and adjustment difficulties among military personnel returning from combat operations in Iraq and Afghanistan. Problems with depression, Post-Traumatic Stress Disorder, and alcohol misuse are common, particularly among National Guard and Army Reserve soldiers. Screening efforts to identify mental health concerns in the months following return from combat suggest that up to 42% of National Guard and Army Reserve troops require mental health treatment, but that relatively few actually get care (<10%). Many redeployed soldiers express concerns about interpersonal conflict (14-21%) , highlighting the potential impact of war on the well-being of family members, as well as friends and employers.

The Departments of Defense (DoD) and Veterans Affairs (VA) are investing heavily in clinical services and treatment research to help address the unmet mental health needs of returning combat veterans. However, the mental health requirements of returning National Guard and Reserve soldiers, as well as active duty veterans who have separated from the armed forces, extend beyond the DoD and VA and include community-based initiatives that emphasize successful reintegration into civilian status. Numerous state and non-profit initiatives are designed to address the mental health and behavioral adjustment concerns of returning veterans. To our knowledge, however, none of these programs incorporate systematic evaluations to gauge the impact of outreach efforts and clinical services on mental and behavioral health outcomes. Evidence regarding the effectiveness of particular programs could inform existing and future efforts, with benefits to soldiers, family members, employers, and relevant federal, state, and local agencies.

This initiative aims to support research on existing national, state, and community programs addressing returning National Guard, Reserve Component, and newly separated combat veterans’ needs. Partnerships between mental health services researchers and program providers will be encouraged. This initiative responds to the National Advisory Mental Health Council report, The Road Ahead (PDF File, 50 pages), which recommended that “NIMH should seek out opportunities to add research components to ongoing efforts and demonstration projects funded by others…”


Miliken, CS; Auchterlonie, JL; Hoge, CW. (2007). Longitudinal Assessment of mental health problems among active and reserve component soldiers returning from the Iraq War, JAMA, 298(18):2141-2148.

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