title: "I'm Coming Home, Tell the World I'm Coming Home". The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans.
abstract: This study explored the journey of American armed forces personnel from their decision to join the service, through their service in an active military conflict and how these factors may be associated with potential resistance for mental healthcare. The data came from qualitative interviews with 46 OIF/OEF/OND active-duty military, reservists, and discharged veterans of the average age of 25 years, who presented for a new episode of mental health treatment to a large Veterans Affairs Hospital (VAH) in Northeastern United States in 2011-2012. Qualitative analysis of veterans' perceptions revealed several major themes describing how a mental health diagnosis would negatively impact both their sense of identity and pragmatic career-building goals: enlisting as a career-building avenue, 'noble superhero' identity, escaping from hardship, and mental illness as a career-killer. Findings suggest that factors making young veterans resist mental healthcare may be reduced by partnering VAH psychiatrists with career counselors, and by enhancing military leadership's awareness and understanding about how to support soldiers with emotional and mental health needs, with a goal to eliminating stigma.
authors.affiliation: Department of Internal Medicine, Yale School of Medicine, 135 College Street Suite 351, New Haven, CT, 06510, USA. julia.rozanova@yale.edu.
authors.forename: Julia
authors.identifier: 0000-0002-9971-6767
authors.initials: J
authors.lastname: Rozanova
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Noulas
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Smart
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.|United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, 950 Campbell Avenue, West Haven, CT, 06516, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Roy
authors.affiliation: United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, 950 Campbell Avenue, West Haven, CT, 06516, USA.|Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
authors.affiliation: United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, 950 Campbell Avenue, West Haven, CT, 06516, USA.|Yale Program for Recovery and Community Health, 319 Peck Street, Building 1, New Haven, CT, 06513, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Davidson
authors.affiliation: United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, 950 Campbell Avenue, West Haven, CT, 06516, USA.|Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT, 06511, USA.
authors.forename: Ilan
authors.initials: I
authors.lastname: Harpaz-Rotem
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D002321:Career Choice; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008605:Mental Health Services; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D012933:Social Identification; D057545:Social Stigma; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D014830:Vocational Guidance; D055815:Young Adult
keywords: Mental healthcare resistance; Pragmatic career-building goals; Qualitative interviews; Sense of identity; Young US veterans