Progress in caring for survivors of military sexual assault

Military sexual trauma is too often exacerbated by poor care in the aftermath. While the Defense Department struggles to improve prevention and prosecution, the VA is has made strides to ensure veterans receive respect and treatment. But more work needs to be done.

Opinion

This week, an unusual thing happened on Capitol Hill. Two tea party favorites in the Senate – Rand Paul (R) of Kentucky and Ted Cruz (R) of Texas – threw their support behind Democratic Senator Kirsten Gillibrand’s bill to reform how the military handles sexual assault cases. We’ve heard a lot in recent months about sexual harassment and assault in the United States military. But it begs the question: What about the aftermath?

The data shows that military sexual trauma is more strongly correlated with symptoms of post-traumatic stress than either combat trauma or civilian sexual assault. Homeless veterans are disproportionately likely to have experienced military sexual trauma, or MST.

The Department of Veterans Affairs provides mental and physical health care to veterans, as well as compensation for those with service-connected disabilities, which many of us associate only with war wounds. With all the controversy, many are wondering: How is VA doing in providing care and compensation to survivors of military sexual assault? After a less-than-stellar history, the VA has re-tooled and is now doing better job at identifying, compensating, and tailoring care for these veterans.

Historically, the VA did a poor job evaluating the applications of survivors who sought disability compensation for conditions related to military sexual trauma. Sexual assaults are notoriously under-reported, making it difficult for those who experienced sexual trauma in the military and later develop problems to prove they are service-connected.

Thankfully, the VA significantly changed its regulations in 2002 to expand the list of markers that could be used to document exposure to military sexual trauma. That list now includes statements from family members, requests for transfer to another military duty assignment, and deterioration in work performance. Despite those changes, analysis by SWAN (the Service Women’s Action Network) showed that between 2008-2010 only 32 percent of applicants for benefits for conditions related to military sexual trauma were granted compensation, compared to 53 percent of all other post-traumatic stress disorder (PTSD) claims.

In 2011, the VA developed additional training to rectify that problem and also created “segmented lanes” that route certain claims, including those related to military sexual trauma, to processors who specialize in those areas. As a result, the VA says the rate of compensation for military sexual trauma-related PTSD is now similar to that for all other PTSD claims. In addition, the VA sent letters to all those whose military sexual trauma claims were denied in recent years inviting them to resubmit so their claims can be reexamined under the new system (a move that some lawmakers criticized as “insensitive and unhelpful”).

Mental and physical health care for conditions caused by military sexual trauma is available for nearly all survivors for free at VA facilities. The status of a veteran’s disability benefit claim status does not matter when seeking care for conditions related to military sexual trauma. In fact, even those whose discharge status may preclude them from getting some other VA benefits can qualify for physical and mental health care related to military sexual trauma. This can be particularly important for those who were inappropriately discharged with personality disorder or who may have gotten a bad-conduct discharge due to disciplinary problems that were caused by symptoms of their PTSD.

All veterans who seek care at the VA are screened for military sexual trauma (not everyone recognizes or admits their experiences right away); men and women who screen positive are offered treatment. PTSD inpatient treatment programs specific to military sexual trauma are available at several VA medical centers around the country; others offer outpatient group therapy sessions. Each VA facility has an MST (Military Sexual Trauma) Coordinator, and patients can request health-care providers of a specific gender to increase their comfort level. For those uncomfortable with the “big VA,” Vet Centers provide another venue for seeking behavioral health care.

The VA is certainly not perfect. Not all facilities are fully compliant with security and safety standards to explicitly address the needs of women veterans (changes that would also improve conditions for male veterans who prefer higher levels of privacy, among other things). Some of those who experienced military sexual trauma may find it “triggering” to seek care in a setting full of people who share characteristics with their attackers and be deterred from seeking care.

Military sexual trauma is a terrible betrayal of those who have served our nation, one that has sadly often been exacerbated by poor treatment once reported and inadequate care in the aftermath. Today, while the Defense Department is struggling to improve prevention and prosecution, the VA is working to ensure that once veterans who have survived military sexual trauma seek care and/or benefits, they are treated with dignity and respect. Though more work remains to be done, some of which is addressed in pending legislation, tremendous strides have been made in the past few years.

With continued advocacy and oversight, the US can drive down the rate of military sexual trauma and also ensure that survivors who seek care and benefits from the VA are treated compassionately and fairly. 

Kayla Williams is a fellow at the Truman National Security Project. She is the author of “Love My Rifle More Than You: Young and Female in the US Army” and “Plenty of Time When We Get Home: Love and Recovery in the Aftermath of War” (forthcoming).