Returning Service Members With Mental Health Violations

Introduction

Mental and emotional issues and challenges, associated with the staying on a frontline are generally regarded in the context of metal deceases and violations. The fact is that, all the possible aspects of emotional challenges on the frontline are aimed at damaging the mental health of the solders, independently on the aims and successes of the army, it is impossible to stay mentally healthy and stable after observing the scenes of violence and murders. Thus, the problem of mental health has become the problem of the national scale, and the US government is often criticized for leaving the servicemen and women without the proper emotional and mental adaptation. Originally, the necessity to analyze the situation, associated with the aspects of the increasingly serious violations of the mental health within the participants of Iraqi campaign, and the lack of proper attention towards this problem from the side of US government. (Adas, 2007)

Veterans of war generally deserve sufficient attention, related with the problems of social defense, medical care, and historical value of the military campaigns. Nevertheless, the medical assistance, associated with the mental health and emotional stability is the problem which requires closer attention not only from the side of government, but also from the side of medical experts and associates, engaged in the solving the problems with veterans. (Gabriel, 2002)

The aim of the paper is to provide the close analysis of the problem, associated with mental health within the participants of the US campaign in Iraq, and provide the solid grounding of the theoretical problems, associated with these disorders. The key part of the paper will be dedicated to these issues of internal design of the rehabilitation centers. Surely, these researches and theoretical points may be used for creating the design of personal apartments of the veterans, nevertheless, the research paper will be based on the experience of the VA centers, engaged in physical recreation of the veterans, and their mental health recovery. Moreover, the extensive literature review will be required for the proper justification and explanation of the topic from the theoretical practical and social viewpoints.

Research Question

The research question of the paper is closely associated with the issues of emotional health issues challenges, as the emotional health may be essentially affected by the design, the tips and considerations, associated with the design creation will be considered. Thus, the research question is focused on the matters of design of rehabilitation centers and accommodation places for Iraq veterans, in order to restore their mental health and emotional stability. The paper is aimed to review not only the decoration aspects, but also the location of the important objects and buildings for the increased comfort of achieving the necessary place.

Justification of the Topic

The necessity and the values of this topic are closely associated with the necessity to gain experience in overcoming these problems, as soldiers need not only the healing of physical wounds, but also mental and soul wounds, which often cause more serious pain, in comparison with injuries. (Finnegan, 2008) Considering the fact that young veterans and disabled people are the common thing for the nowadays society, the ways of solving the problems of veterans should be improved in accordance with the current requirements and necessities, originated by the problems, which society and veterans face. (Joint Commission on Mental Illness and Health, 1961) The necessity to study this topic is closely associated with the lack of attention from the side of official bodies, and it is often emphasized that servicemen and women are left without help, as government is often criticized for failing to help these people to overcome their mental problems. Additionally, the theoretical basis of the problem will be useful for the further studies of the possible mental deceases and adaptation of the servicemen after participation in military campaigns. The fact is that, the problem of mental deceases within soldiers became the burning issue after the campaigns in Vietnam and Korea, when soldiers had to face the inhuman violence and murders. (Mckelvey, 2008) In comparison with the other military actions, it should be emphasized that contracted soldiers are more vulnerable for the mental disorders, as their motivations are mainly material, and money is not worth the injured lives, deaths and violence. Thus, in comparison with the soldiers, who fought with Japanese or German troops during the Second World War, the amount of mental disorders within these soldiers is essentially lower. Originally, it is explained by the fact that soldiers of the World War II had the common idea and strong motivation to fight the global evil. (Bhagar and Schmetzer, 2007) As for the soldiers in Iraq, they have the only motivation – financial benefit and the possible social benefits for participation in this campaign. Originally, the material motivations are the weakest, and are not able to protect servicemen from possible mental injuries. Moreover, the situation is aggravated by the fact, that the soldiers are thousands miles away from their home, they are in hostile environment, and the behavior of the local population is unpredictable. The constant mental and emotional tension causes the nervous breakdown. Consequently, the soldier will not be able to perform the set of tasks calmly, which makes the entire situation dangerous and improperly controlled. (Goodman and West-Olatunji, 2008) For instance, a serviceman is working with explosives. Being subjected to nervous breakdown or emotional overload, the actions by this soldier will not be accurate, and may cause disaster. Consequently, the issues of emotional health should be studied not only within those who have already returned, but also within those who stay in the hostile environment.

Another aspect of mental disorders is the staying of soldiers in captivity. Most are subjected to physical and mental violence, their dignity is injured, and, as a result, most of them will never be able to become the full-fledged members of the society. Thus, it means that all the tools and means of overcoming the possible problems will be oriented at providing the proper adaptation design, for the servicemen and women could return to their normal lives as soon as possible.

Methodology

The methodology of the research will be mainly based on literature review, dedicated to the aspects of design, VA rehabilitation and the construction of the health rehabilitation centers for veterans. Originally, there is not much difference between Vietnam and Iraq veterans from the perspectives of their mental health, consequently, the experience of Vietnam veterans will be also taken into consideration. Additionally, this paper may be regarded as the summary of the previous researches associated with mental health disorders and the internal design creation for the veterans of the Iraqi campaign. Considering the fact that Middle East campaigners experience similar problems, the experience of the Afghanistan veterans will be taken into consideration.

Literature Review

The review of the problem of mental health and emotional challenges, which soldiers generally face staying in Iraq, is closely associated with the aspects of helping them to overcome the difficulties and problems, caused by nervous breakdowns and emotional overloads. The problem of mental health may be regarded from several perspectives. These are the maintenance of the emotional stability staying on the frontline, overcoming of the emotional and mental injuries after returning home, and staying mentally stable and healthy in captivity. (Jamil, Nassar-Mcmillan and Lambert, 2004) Considering the fact that the main aspect of this problem is the solution of the problem from the interior design perspective, it should be emphasized that in order to define the design tips, the psychological aspects, and backgrounds of these mental disorders should be defined. Basing on the origins of the problems, the key requirements towards the design will be outlines. Thus, previously to outlining the required aspects of interior design, there is strong necessity to regard the problem of mental health within soldiers in general, and define the key aspects of the adaptation process, in order to define the required aspects of the interior design. (Martin, Sparacino and Belenky, 1996) Moreover, there is strong necessity to provide the interior tips for several categories of servicemen, depending on the root of the problem. The problems may be of various natures:

  • Injury, and violation of the work of internals
  • Injury, which caused loss of an extremity
  • Loss of a friend (death on one’s hands)
  • Staying in a captivity (with related emotional overload and nervous breakdown)
  • Witnessing of violent murders
  • Loss of family as a result of injury
  • Feeling of loneliness and helplessness (Shalev, 1998)

Depending on the original necessity of the adaptation, and the root of the problem, the strategy of overcoming the problem will be created. The key values of the adaptation and studying of the mental health problems are covered in the fact, emphasizing that most of the veterans feel themselves broken, thus, their environment should make them feel useful for the society and for the people, who surround them. (Wilson, 1990)

The key problem of the mental health disorders is called Post Traumatic Stress Disorder (PTSD). (Vasterling and Brewin, 2005) Originally, this concept was first outlined during the First World War, and was also described as a “Shell Shock”. Nowadays, this is the problem of psychological condition that may potentially affect anyone, who had previously experienced or witnessed a traumatic event. (Salvatore, 2009) Originally, this shock is expressed in sleeping disorders, nightmares, and flashbacks, problems with concentration. This often caused the previously described problems with the feeling of isolation and detachment. Therefore, the design should not create the feeling of loneliness. (Iraq Veterans Show Memory Lapses, 2006) The entire environment should remind veterans that they are not alone, and they are not useless for the society. If a veteran has a family, design of the apartment should include tiny things, which will remind of his or her children, parents, or spouse. Veterans should be granted the possibility of immediate link with the people, they need beside. (Shea-Porter, 2009)

Originally, the study describes the problems associated with the first Iraqi campaign, while the PTSD within the soldiers of the second campaign is essentially higher. Surely, some of them do not experience serious problems, or consider they do not need the qualified assistance, nevertheless, the impact of their staying in a hostile environment, witnessing of cruelties and inhumane treatment left a deep scar in their souls and minds. Thus, as it is emphasized by Camp (1994, p. 451):

The impact of combat experience can also manifest a long time after the event, with the mental health charity citing studies whereby troops deployed to the first Gulf War in 1991 showed higher than normal levels of psychological distress and fatigue many years after the conflict. Similarly, psychological difficulties within British troops increased by 50 per cent after return from duty in Northern Ireland during the conflict there.

Thus, the mental health of the servicemen, who participated in the latest military campaigns causes serious concerns for the mental health specialists. Nevertheless, the main problem of the PTSD is not the physical and mental condition of the soldiers, but the mental barriers, which their minds impose for treatment. (Potter, Baker et.al. 2009) In accordance with the specialists of the Combat Stress association, the key problem is to select the suitable treatment, for the serviceperson and his or her mind accepted it. The key reason why veterans avoid addressing rehabilitation centers is that they consider that professionals can not understand them fully. The others feel themselves guilty, and consider they are not worthy of accepting the assistance. (Williams and Sommer, 1994) In the light of this fact, it should be emphasized that the rehabilitation environment should entail all the necessary means for spiritual practices. Veterans should have an opportunity to confess. Consequently, the design of the rehabilitation centers is impossible without a chapel. (Vogt, 1951)

Mental health, as it is stated by Derville and Spurling (1994) is the second largest problem, which veterans of Iraq and Afghanistan face. Originally, they are searching for help at the Department of Veterans Affairs facilities, which provide the necessary assistance, by creating the special environment for the adaptation of veterans, and providing the clam surrounding, which will not remind them of the past affairs. Thus, they are isolate from their memories, and aim to adapt by overcoming the mental barriers and feelings of guilt and loneliness. (Umbrasas, 2009) Additionally, this environment (internal design as well), is aimed to prevent veterans from alcohol and drugs addiction, depression and the generalized anxiety disorder. The fact is that, these problems originate deeper troubles, such as job loss, family loss, incarceration, or mental health disorders like schizophrenia. Considering the fact that only half of servicemen who have such problems address for help. Thus, the entire system should be improved. (Popham and Graham, 2008)

As it was stated by Akbayrak (2005) the traditional approach towards overcoming the possible PTSD problems, the internal design, for the former servicemen and women, should be without bright and aggressive colors. Depending on the original problems, and the nature of the problems, the design should be suited to avoid possible reminding of violence, murders, victims, and possible losses of a soldier. If a soldier was injured, and lost one of the extremities, the entire environment and the internal design should be friendly, for the person could cope with the everyday assignments without feeling discomforts, caused by amputation. If a serviceperson lost a friend, or became a witness of a violence, it would be useful to remove TV from the apartment, and, possibly, photos with the lost friend or family. Originally, the environment should be not just friendly, but also easily adaptable for possible changes, and presuppose active actions from the side of the soldier-patient. Thus, people who need help should be able to create their own environment, and find an occupation, that will help them to overcome their problems.

As it was stated by Burke Degeneffe and Olney (2009, p.5):

Unusual circumstances of the wars in Iraq and Afghanistan add to the normal stresses of war, increasing the potential for traumatic stress–related disorders. For example, absence of a clear distinction between frontline and rear echelon reduces the ability to escape high-stress situations. Other unique issues presented by these “modern wars” include extended and multiple tours of duty and intense involvement of National Guard members and reservists, many of whom are drawn away from established careers and young families.

Thus, their problems originate by feeling of loneliness, while staying on the frontline. In the light of this statement, it should be emphasized that the internal design, and the environment in general, should remind him or her that there are people who are waiting at home, and it is forbidden to give up. This should entail photos, possibility to connect with these people, and the necessity to participate in a calming activity. Independently on the origins of the problem, people should have an opportunity to be engaged in any physical activity, or any activity, which is socially useful. (Friedman, 1998)

In accordance with the statistical data, up to 19% of returners report essential post traumatic brain injuries, and nearly 7% report the post traumatic stress disorder and depression caused by the brain injury. (Jobes, Moore and O’Connor, 2007) The main problem, which are reported by Department of Veterans Affairs, most of the injured servicepersons do not search for help because of the fear of losing a job. Thus, they suffer quietly, and often aggravate their problems. Originally, as it is stated by Sterling (2004), this problem can not be solved by the means of internal design, as considering the possible problems, soldiers require emotional assistance and psychological help, and internal design is the secondary tool for providing the treatment. Independently on the origins of the problem, the rates of suicides means that the assistance system is ineffective. As for the reasons and origins of suicide, Brenner, Gutierrez et. al. (2008, p. 211) emphasizes the following statement:

A suicide prevention hotline started by the VA and the Substance Abuse and Mental Health Services Administration in July 2007 has served 22,000 veterans and prevented 1,221 veterans from taking their lives in the first year of operation. In 2006, the Army reported the highest suicide rate ‑ 17.3 per 100,000 soldiers ‑ since it began recording such deaths in 1980.

The high rates of suicide are caused not only by the staying on the frontline, within the hostile environment, but some of the suicides were registered because of the bureaucratic difficulties, which soldiers had to challenge after returning home. Originally, the confusion in documents caused the confusion in realities, and some soldiers either had to prolong their contract, or stayed without some social benefits, or felt unable to sort out the entire set of papers and records, which are required for registering the servicemen as a participants of the military campaigns. (Grob and Goldman, 2006) Thus, considering the aspect of the research paper, it should be stated that the internal design, intended for the adaptation of the soldiers should not emphasize the complexity of the forms. Surely, everyone has his or her own representations on the matters of complexity, nevertheless, simple forms, straight lines and absence of complex patterns should feature the design. (Hudson and Devito, 1994)

As it is generally stated, that main problem, which returned servicemen and women face is the reluctance of official government to help. Thus, the special mental health communities are created for the US servicemen, which are aimed at arranging the proper returning of veterans and their families. (Ford, Chandler et.al., 1998) Moreover, they are creating the necessary friendly environment for those who need psychological assistance, and provide the necessary tips for the families in order to create the suitable internal design. Considering the experience of the organization in the sphere of internal design, it should be stated that most preferably that the person, who needs help, should first complete the psychological course of adaptation, and then create the necessary design by him- or herself. (Muehlenkamp, 2006) It will be the simplest and the most effective decision for creating the internal design, as the person will create it in accordance with the feelings and emotions, he or she experiences, or needs to experience. If someone else will be engaged in design creation, there will be strong necessity to find answers for such questions as:

  • What are the concerns of the soldiers, who returned from Iraq?
  • What is the cultural background of a person, and how did the cultural representations changed after returning from the frontline?
  • How does conflict in Iraq differ from other conflicts? (from the perspective of mental health)
  • What are the behavioral patterns of the veterans? (Pyles, 2008)

And lots of others. Nevertheless, the approach towards solving the problem, aimed at involving the veterans into the process of design creation is an effective tool, which will not require searching for the deep roots of the problem, as the main part of the problems will be solved by veteran, by his or her participation in creating the necessary design. (Marquis and Holden, 2008)

As for the matters of design in general, the adaptation process requires individual approach towards every veteran, and the rehabilitation centers, created with the only aim – to assist veterans in overcoming their psychological problems. The fact is that, the key requirements towards the internal design are stated by Brende and Parson (1985). Thus, it is emphasized that the healing and rehabilitation environment should be mainly focused on:

  • Positive Self Awareness
  • Link to Nature
  • Culture
  • People
  • Sense of Privacy
  • Harmless to the Environments
  • Meaningful/Diverse Stimuli
  • Place for Relaxation
  • Interaction with Outside World
  • Balance between New and Familiar
  • Beauty (Brende and Parson, 1985, p. 134)

These are the key tips, which define the internal design of the recreational environment. The concept of the physical environment required for the proper adaptation period is described by Benda (2001).Originally, the requirements for the physical environment, which defines the features of the internal design, presuppose that the positive environment should influence the mood and the mental condition of the veterans. The hierarchy of the building zones is often defined in accordance with the specification of the rehabilitation center. Thus, the universal set of requirements generally presupposes the understanding of the physical end emotional needs of the veterans, and the existence of several key zones: public, patient, staff and service.

The public zone includes lobbies, retail zone, a place for spiritual practices (yoga center, church, mosque, etc.), a conference hall, and the registration department. These are required for the full-fledged life of the veterans, especially for those, who are restricted in their movements, and will not be able to visit outdoor public places within the nearest time. These places should remind the normal life of people who are not disabled. The perfect variant, if these places remind some well known places for the veterans from their previous life. (Tehrani, 2004)

Patient zone is the department for recreation, medical procedures, and receiving care. These are the medical departments, consultation areas, as well as exam and treatment rooms. The key requirements for these departments is the friendly design, without bright colors. Moreover, the design itself should provide the simplified access for the medical equipment, gadgets for quick call of a physician. (Wilson and Drozdek, 2004)

The staff zone entails offices, work places, nurse stations and other rooms for the technical and medical personnel. Originally, veterans should not have access for these spaces; consequently, the design of this part is of lower importance for the rehabilitation and mental health of the veterans. Additionally, this area entails the service zone for the quick service of the technical appliances and support spaces. (Podus, Barron, et.al., 2003)

A special attention should be paid to the issues of staff participation in creating the necessary design. In accordance with the research by Dorfman, Holmes et.al (1996), this issue of the particular importance, as personnel is creating the working place for themselves, and for the people, they will be working with. Originally, psychological moments of the veterans health should be considered, as well as the proper materials for design creation should be selected. Thus, as Carless and Douglas (2008, p. 137) claimed:

Existing environments that are effected by sick building syndrome also require careful material selections. VA staff have a responsibility to understand the impact of their specifications on the immediate health of all building occupants, including patients, staff, and visitors. The emissions of building and furniture materials, cleaning products and ventilation of mechanical systems will profoundly affect the quality of the indoor air.

From the perspective of this statement, the internal design should focus not only on the decoration of the rooms and apartments. Clear realization of the purposes of the buildings is required for the creation of the proper healing environment, consequently, such aspects of the design should be considered: art, accessories, ceilings, color, floors, furniture, lighting, linens, music, plants, textures, upholstery, walls and wall coverings, window coverings and wood work. (Franklin, 2009)

More detailed review of these components should be provided from the perspective of the rules of design. Thus, art is required to provide the stress reduction, and tranquil behavior. Surely, considering this aspect, there should be no scenes of violence, and bright (aggressive) colors. Ceiling is required for creating the feeling of staying at home. It should be of mild colors, and provide the positive light distraction, when the patients are recovering. The feeling of comfort is the key requirement for this. The color gamma in general may essentially impact the patients healing and recovery process. Consequently, the colors should be warm, with mild and smooth tones. Moreover, there is strong necessity to mention that color perception changes dependently on the age of the patients. The requirements towards lighting are simple. These should not change the colors, and in no way affect the color perception. He only exception is the warm lighting, which is required to emphasize the warm colors of a room. (Gutierrez and Brenner, 2009)

Finally, the aspects of organizational planning should be discussed. On the one hand, it does not play significant role for the rehabilitation and mental health in general. On the other hand, it defines the comfort level of the personnel and patients, on the other hand, simplifies, or makes more complex the access to the required spaces and appliances. The fact is that, there are no strict rules towards this planning, as the entire organization is defined by the aims and requirements of the rehabilitation center. It should be stated, that the panning process is mainly based on researching the aims of the veterans and the medical personnel. (Kemp, 1993)

Wayfinding, which is the essential part of the organizational planning entail two main aspects: orientation (where) and navigation (how to find). Thus, special orientation signs and objects should be implemented. These are signs, plans of the buildings, arrows and pointers etc. On the one hand these are the tiny details, which do not deserve attention, on the other hand, these details increase the comfort essentially.

Conclusion

The aspects of the mental health and emotional stability within the veterans of Iraqi campaign are often solved by the psychological assistance and spiritual practices. Originally, these often entail the creation of the necessary internal design, the elements of which are aimed at solving the psychological problems of the veterans. Independently on the roots of the problem, the key solution of the problem is the feeling of usefulness for the society, and the opportunity to keep in touch with beloved people. Consequently, the organization of the internal design for veterans should include such elements as high comfort level, an opportunity to transform it in accordance with the needs and preferences of any particular patient (in rehabilitation centers), and the absence of aggressive and bright colors, which may remind of violence and hostile environment. The organizational planning of the building should entail all the necessary commodities, and the location of the interior objects should not make the access to these commodities complex, especially it is essential for veterans with disabilities.

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