Teresa Ann Grenawalt & Emre Umucu (Section Editor)
TRANSITIONING FROM THE STRUCTURED MILITARY SERVICE to a less regimented civilian lifestyle may cause psychosocial readjustment issues for service members and veterans (Sayer et al., 2014). While survivorship rates have increased compared to earlier conflicts, this is not without physical and psychological consequences (Tanielian et al., 2016) that undoubtedly affect reintegration into their communities. The combination of improved body armor and advancements in medical care in combat, many surviving veterans seek disability benefits for physical injuries and the “invisible’ wounds of war” (Resnik et al., 2012, p. 2). For instance, traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are common military service-related health concerns (US Department of Veteran Affairs [VA], 2021). As wounded warriors separate from the military, they are faced with the challenges of processing their combat experiences, psychosocial adjustment to disability, and entering community life.
Community reintegration is defined as the adjustment process to life at home and in the community, and considers participation in life roles (e.g., family or social roles), employment or other meaningful activities, and the ability to live independently (Resnik et al., 2009). Challenges to community reintegration are common in recently separated veterans. More than 70% of veterans returning from combat in Iraq experienced at least one readjustment stressor (Interian et al., 2012). A variety of life domains are affected by adjustment issues, including employment challenges, unstable housing, legal problems, and strained interpersonal and family relationships (Sayer et al., 2014). A national survey of veterans receiving VA healthcare found that 25% to more than 50% experienced reintegration difficulties in several of domains such as participation in:
- community activities (49%),
- maintaining non-military friendships (45%),
- intimate partner relationships (42%),
- completing work or school activities (35%), or
- relationships with children (29%; Sayer et al., 2010).
Similarly, research suggests community reintegration is further complicated for veterans that acquire disability. Among inpatient veterans (N = 154) in the VA’s TBI Model Systems program, moderate to severe TBI was associated with lower levels of community participation, independent driving, and employability (McGarity et al., 2017). Among those with mild TBI, PTSD and depressive symptoms were associated with lower levels of community reintegration. In a qualitative study of community-dwelling injured veterans, a lack of social support, low self-efficacy, a lack of motivation to reintegrate, challenges in the work environment, and access to services and benefits were reported as barriers to community reintegration (Hawkins et al., 2015). Social support and personal factors (e.g., self-efficacy, personal motivation) were the primary means for high levels of community reintegration. Barriers and facilitators of community reintegration were also qualitatively investigated among injured female veterans (Hawkins & Crowe, 2018), which similarly found inadequate services, a lack of access to services, poor social support, difficulty trusting others, non-supportive personal beliefs, and injury factors as barriers. Facilitators of community reintegration included strong social support, impactful programs, and protective personal beliefs. [Continue…]