A psychologist from the police department expressed concern about hiring or rehiring returning reservists who may suffer from undiagnosed illnesses, such as mild traumatic brain injury (TBI) or PTSD, which could affect their judgment if they were civilian law-enforcement officers. She was concerned about providing certification for weapons possession for many of those who applied to become police officers. Several other issues were raised by community representatives, such as the large number of returning OEF and OIF veterans who had TBI or had screened positive for PTSD returning to the community and the costs associated with those illnesses (both social and economic).

Numerous attendees described the many programs that had been developed at the state and local level to address the needs of the retuning OEF and OIF veterans and their family members. They noted that there are many resources and services but that better coordination is needed to maintain effectiveness and cost effectiveness. Others noted that service members and family members are not aware of all the programs available, that family and peer support is weak, and that the issue of stigma prevents many from seeking mental health counseling and treatment. Finally, the results of a statewide survey regarding unmet needs of OEF and OIF veterans and family members were reported. Several themes emerged: military families need stronger support (such as financial assistance, housing, food, clothing, and child care), health services are insufficient and should be expanded (both mental and general medical), returning veterans need more employment training and education than are available, and many people do not know how to connect with the resources available to them, both government and nongovernment organizations, both local and national.

Toledo, Ohio: Michigan, Indiana, and Ohio National Guard

To gain a better understanding of the unique challenges faced by those serving in the National Guard, a subgroup of the committee met with members of the Michigan, Indiana, and Ohio National Guard and health-care providers for these populations. The meeting was held at the Hampton Inn in Toledo, Ohio, on May 11, 2009. The reserve and National Guard have many of the same readjustment needs as active-duty service members and veterans, but their support systems might be less effective. In Michigan, for example, the National Guard and reserve members are activated from communities across the state rather than from a local unit, so Guard members and reservists are not deploying or returning home with their peers; this results in isolation and limited or remote services. The committee was told that many of the programs and services that are available are poorly advertised and that many people who have readjustment needs may not be aware of the services. In addition, especially in rural areas, the geographic distance between patients and providers creates an additional barrier to access.

Fayetteville, North Carolina (Fort Bragg): Army

With almost 50,000 service members stationed at the base, Fort Bragg, near Fayetteville, North Carolina, is one of the largest Army installations and has the largest airborne facility (see http://www.time.com/time/magazine/article/0,9171,1860898,00.html, accessed on November 18, 2009). Fort Bragg deploys more troops to OEF and OIF than any other post (see http://www.mybaseguide.com/army/fort-bragg/units.aspx, accessed on November 19, 2009).

The meeting was held on June 2, 2009, at American Legion Post 202. The active-duty service members and veterans discussed primarily mental health issues and noted that stigma is

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