In September 2001, our concept of national security and our responsibility to our first responders was completely changed. We were soon presented with a new and bold concept for the protection and safety of our homeland and how to thwart terrorism. The threat of terrorism within the United States has been more than a topic of discussion. There are serious attempts being made to deal with such eventualities.

September 11, 2001 had a profound effect on this country. People directly affected by those events who live and work on the east coast underwent some severe trauma individually by direct contact or vicariously. People in the rural Rocky Mountain West were not as close to the events, yet did have vicarious exposure through TV, photos and radio. There were also some direct connections with relatives, colleagues, and friends (e.g. airline pilot from Colorado). Children of various ages watched and/or were aware of what happened on September 11.

The war in Iraq and subsequent insurrection events there have been a major focus of this country for over two years. The National Guard and Reserve Forces, as part of the Total Force, have been integrally involved in the wars in both Afghanistan and Iraq. Personnel from Wyoming, Colorado, Utah, Nevada and other western states have been serving in these areas. Recent events have resulted in military Reservists and Guard members serving in Iraq having their one year tours extended by at least 3-4 months. They and their families had been previously told these tours would be for one year. Most of these members have left jobs that provided for them and their families. They are civilian soldiers.

Rotation of assignments, completion of military obligations, etc. are also resulting in many Reservists and Guard members returning home from assignments in Iraq or Afghanistan. They will be returning from a war environment to civilian, peaceful situations.

Some questions of concern about the above situations were discussed at the recent CRISES IN RURAL AMERICA Conference held in Casper, WY April 21-24, 2004. These included:

• What effects, short and long-term, have there been on communities in the rural Rocky Mountain West as a result of September 11?

• What effects did exposure, vicarious or otherwise, to the events of September 11 have on children in rural communities?

• How was the situation explained?

• What lasting effects, if any, are there for children?

• How are they being prepared for possible future events?

• What effects does the war in Iraq and subsequent insurrection events have in the rural Rocky Mountain area?

• How does this affect children in our rural communities?

• What is the role of mental health responders in rural communities in the Rocky Mountain West?

• Are we at risk?

• How do we deal with the vicarious exposures that occur on an almost daily basis?

• Are rural communities in the west too isolated to be concerned about?

• Should we be concerned that we may have terrorists in our communities?

• Are people safer or do they perceive themselves as being safer and/or protected or distanced from terrorism or terrorist activities in rural western communities than in more urban and/or eastern communities?

• How does the deployment of National Guard and Reserve Forces affect the daily lives of families and children of both military and non-military families in our rural communities?

• What effects on morale, families, children, communities and military members will the extended tours of duty of Guard and Reserve members have in rural communities?

• What is the role of mental health providers, clergy, and other community helpers in helping families, communities, children and military members cope with this situation?

• What can Reservists and Guard members expect to encounter upon returning home as a result of rotation of assignments?

• What does the community and the families expect of them?

• Is PTSD a possibility for some of them?

• What can mental health professionals and other responders do to assist in a smooth transition back into civilian life?

• What should families do?

• How active should mental health professionals and other responders be?

• Are there any connections that can be made between professionals and military service groups such as military family services?

• How can we all work together?

• As the military returns home to rural communities, especially in the frontier states, what can we expect to see as far as transition? They are being dispersed rapidly. What problems could we expect to see and/or work with?

The following is a synopsis of the discussions that attempted to address at least some of the concerns outlined above during symposium panels at the conference.

Children And Vicarious Trauma

The effects of these situations on children was also discussed by panel mambers and delegates. There are news reports of these events every day. Children are absorbing at least some of these reports on TV and through other resources. One delegate recalled the focus on body counts on the News every night during the Viet Nam War. It was pointed out by others that these images and News reports can be re-traumatizing. However, they can not be avoided. Therefore, we do need to talk about them. It is a new world that we are living in. We cannot avoid this because children know what is real and what is fiction. Talking about it helps. Additionally, it was pointed out that just because someone sees these events on TV does not necessarily mean they will need help. If children cry, talk to them and go on. If behavior problems begin to occur, then help people to find ways to talk about it and work through it. The goal is to integrate these events and to move on. Discussing what is troubling is important. Let children and others know that what they are experiencing is normal and is a normal reaction to some very abnormal events. A few delegates recalled the funeral of President John F. Kennedy and the shooting from the University of Texas Tower in Austin, Texas in the 1960s. They recalled the images and the events, but are not traumatized by them. Images can be very troubling when encountered. However, most people integrate them, adjust to them and move on. It is important that we not assume that there will always be long-term trauma associated with such events with all who have been exposed.

Returning Military And Families

During the Viet Nam War, military personnel did not go to war as a unit. We have learned some things from that experience. Reservists and Guard members are being activated as units and are returning home as units. The larger military installations to which they return have built-in support and provide many amenities. However, those who have gone from rural states such as Wyoming will not have access readily available upon return to their homes. The only contacts that they will have will be on their weekly, monthly or other Guard or Reserve schedule. They will not be on a base or even near one to gain follow-on support if needed. About 50% will probably never re-up. The lack of contact could be problematic for some. VFWs, Legion Halls, and other Veteran groups will help. The debriefings that the returning Reservists and Guard members receive will be important. The Reserve and Guard centers will probably have support for them. However, there is a different mentality among them then among the career military. The mental attitude is different. They are not coming home to go to work in the military tomorrow. They are coming home to go back to work in their business, for their employer, on the farm or ranch, or to complete school, etc. They may not have the support of a job. This will be a hard situation for the Reservist or Guard member. Their salaries, in many cases, were cut by the deployment. High paid individuals went in and had their take-home pay cut in half or more. Then, how does the family survive? The Reservist or Guard member will have worries about the family.

Prior to deployment, it is as though most people are moving at a nominal speed of perhaps 25 miles per hour cognitively. Then things speed up to maybe 125 miles per hour. Upon return home things again slow down to around 25 miles per hour. This can result in a cognitive whiplash. Some friends and family members will want to hear a small amount about their experience. However, the family members want to catch them up on all of the past year's experiences at home. Some may take advantage of support groups and some may not. An estimated 3% may need intervention of some type. We need to not only address the returning soldier, sailor or airman, but also the family. Expressing what they need to others may be a difficult thing to do. They may have a need to express what they want their families to understand.

An example of a scenario that could play out often in small communities is the following. Two men return together and are greeted at the local airport by a large group of family, friends, and well-wishers. There are children with flags and baloons and there is even the local high school band which plays a number of patriotic marches and songs. There are hugs and sincere expressions of thankfulness and welcoming home. They are greeted by the mayor and other dignitaries from the community. Perhaps a small parade and/or party is held in their honor.

This scenario is a deserved homecoming. However, what will happen when all the hoopla is over? What resources will the returning Reservist or Guard member have to turn to? After all dies down in a few months, who can they turn to with any questions, problems or concerns? How can community members observe and note red flags such as possible increases in alcohol use/abuse?

Another example might be when a family member is deployed and misses his/her children's graduation. The family is hurting. Are there local support teams available to provide family support? Information on these problems and available resources needs to get to the communities. Family support units at military bases and Guard and Reserve units were mentioned as a resource.

Another area involves changes in the family that may have occurred during a member's deployment. Household rules may have changed while the Service member was deployed. Parenting problems may occur when a father returns and the rules are changed and expectations are different. Mother has run the home while he was away. Now, where does Dad fit in? How does Mother give up some of the controls? Discussants pointed out that this was one of the problems that many Viet Nam Veterans faced. Families had become so used to no Dad. Then, all of a sudden, this "stranger" came in and took over. Contacts and support and information about what to be expecting needs to be provided to families. Many of those returning will be young people in their 20's who have limited knowledge of such possible problems and solutions.

Another area involves families of Guard and Reservists who re-up and/or seek additional deployments. Panel members pointed out that there has been a great effort to train managers of Guard centers. A lot of effort has been expended to sensitize managers to potential problems.

A number of conference delegates discussed incidences where families had come to them in past similar types of situations saying that they did not want to go to work. Others have had families with children who, following a trauma, cry about Mom or Dad going back to work. Most delegates felt that there will likely be a lot of issues surrounding returning Service members and the readjustments they will be facing. Re-entry or coming home may be a more difficult adjustment than was the adjustment to the war environment itself. Some immediate questions might revolve around such things as: where did the new TV, car, appliance, etc. come from? Younger members coming home to more secluded smaller or isolated communities are not going to get the support and contact as regularly as those in larger communities or cities. We need to provide services to the families of returning members, surviving families of those killed in action, and the Service members themselves. Help will be needed for re-entering the family. Re-entry can be likened to a cold shower. Members have received training to go to war. However, they do not receive training about coming home and re-integrating back into the community. The VA and others in the communities need to assist with this transition.