By Bob Denney
According to an independent study conducted in 2008 by the Rand Corporation, one in five service members, or at least 300,000, suffer from post-traumatic stress disorder (PTSD) or major depression.
Such imposing numbers reflect a generational issue facing both professionals and dependents of the men and women who have served this country.
The ongoing mission of the treatment of our nation's veterans, a daunting task, includes the work of such professionals as Dr. Michael Hall of the Iowa VA Medical Center in Iowa City; and Penny Miller, CTRS, of Walter Reed Medical Center in Washington, D.C., a Recreation Therapist in the WRMC Department of Psychiatry – Psychiatry Continuity Services.
"I am an optimistic person, who focuses on strengths of each patient," says Miller, a native of Warsaw, N.C., who has worked with more than 100 patients within the past two years. "We have a lot of organizations working with our veterans, and our staff does not advocate for any particular one program. Since implementing the game of golf into our programs, I've observed that some of the participants still desire to continue playing the game and developing their skill. Golf is used as a therapeutic treatment modality, to help patients restore, remediate and rehabilitate to improve functioning and independence in life activities, as well as to help the patients integrate back into society.
"We see patients presenting symptoms of their medical conditions to include: insomnia, lack of concentration, anxiety and inability to form social relationships. The golf clinics that have been implemented over the past two years have involved about 30 patients. Golf is used as a vehicle to support patients psychosocially."
Dr. Hall, a neuropsychologist at the Iowa VA Medical Center, has specialized in the treatment of PTSD and TBI (traumatic brain injury), a signature of the conflicts in Iraq and Afghanistan.
"One of my concerns is that people say that this is just golf," says Hall. "It is not just golf, it is more than golf. Golf is a venue again to create a positive environment, positive experiences. Sometimes that is the only time I see that emotion. Granted I am focused on problem areas, but it's a big deal. It's not something that shouldn't be dismissed, because it's golf.
"Those activities of daily living that we all take for granted. The veterans don't have that luxury anymore, particularly those that are injured. With The PGA's involvement there's a connection. There's a working relationship that is incredibly helpful."
Miller, who has worked with various organizations that include PGA Professional instruction [including the Salute Military Golf Association of Olney, Md.], said that as a part of clinical activity, participant self-surveys were administered during golf clinics as part of outcomes treatment metrics, which are part of the standard operating procedure for the service.
"The skill development time varies among those who can pick up the game of golf quickly, to the patient who is an absolute natural in holding the golf club," she says.
WRMC, composed of a 4,766-person staff, admits an average of 30 patients daily, performs an average of 40 surgeries a day and since March 2010, has treated 696 of the total 967 service members from Operation Enduring Freedom and Operation Iraqi Freedom. By the end of September 2011, Walter Reed will merge into a joint facility with Army, Navy and Air Force staff in Bethesda, Md., and will become the Walter Reed National Military Medical Center.
Since 1952, the Iowa City VA Medical Center has served men and women veterans, with care now available to more than 184,000 veterans living in 56 counties in Eastern Iowa and Western Illinois.
Hall has witnessed how individual treatment of a veteran extends to that individual's partner, spouse or dependents.
"Issues related to post-combat do not just affect the veteran – it affects the whole family structure," says Hall. "How I see golf in general, it essentially is with the degree of physical injuries that we are seeing, the cognitive problems and the emotional problems, that golf really serves the specific role of being accessible to a large population. It's also something that is something that people generally gravitate towards.
"So, I see the direct result of being increased self-esteem, increased self confidence - something that has been eroded essentially by having such a change from maybe how they were before deployment or maybe how they were during deployment.
"Anything that we can do to build self-confidence, self-efficacy, and to bring the families in as a unit, because again, it's not that one person, it's the family structure, it's the community. All of these things together with what we can do at the VA, together with what we can do in other arenas, it really does takes the community coming together."
"People come back from deployment with many issues, and this is not just about the current veterans. It goes back to Vietnam, Korea, some World War II veterans who are getting beyond the age when they can really play golf.
"These are experiences that we can not erase from people's pasts, but certainly anything we can do for these veterans, to enhance their quality of life is critical."
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