March/April 2011 Issue

Military Sexual Trauma
By Jennifer Van Pelt, MA
Social Work Today
Vol. 11 No. 2 P. 8

Sexual assault, no matter when or where it occurs, is a horrible crime, causing lifelong mental and physical health problems. But for victims of military sexual trauma (MST), the consequences may be even more severe.

A victim of sexual harassment or assault by a colleague or a superior in a civilian workplace can be certain that human resources staff will terminate the perpetrator’s employment or risk facing a lawsuit. Due to conditions of combat, enlistment, or deployment, active duty MST victims are often forced to remain in contact with the perpetrator, who is most likely to be a member or a superior in their unit.

Just a few years ago, it was commonplace to hear of MST victims being assigned longer duty time and other punishment, while perpetrators received minor administrative consequences such as a location transfer. While the government has implemented programs for MST prevention education and universal screening for veterans, MST continues to increase. In fact, the rates of sexual assault in the military population are significantly higher than in the general civilian population.

MST is defined as psychological trauma resulting from physical sexual assault or sexual harassment occurring during active duty. Examples include threats of negative consequences for refusing sex, assault, unwelcome sexual advances, and offensive remarks about a person’s body or sexual activities. Universal MST screening conducted at all VA facilities asks victims whether they experienced any unwanted sexual attention, uninvited sexual advances, or forced sex while in the military and whether the experience continues to affect their life today.

Incidents of MST continue despite program development and outreach by the VA initiated in 1992. Recent media coverage reported lewd videos with offensive sexual content shown to crew members by a high-ranking naval officer, an increasing prevalence of sexual assaults in military training academies, and sexual harassment and assault by military recruiters, including military chaplains.

While it is possible that the increasing prevalence is related to a higher level of reporting as a result of government efforts, it is also possible that educational efforts have been slow to penetrate the pervasive mentality among military culture that sexual harassment and assault are just rites of passage and that reporting an assault on oneself or others is whistleblowing that will draw retaliation. A few years ago, at an MST conference, a high-ranking male officer participating in a panel stated, “Sometimes I wonder what women expect when they decide to go into the military. After all, boys will be boys.”

“Hopefully, that kind of mentality rarely exists anymore,” says Claudia J. Dewane, DEd, LCSW, BCD. Currently an associate professor at the College of Health Professions and Social Work at Temple University in Harrisburg, Dewane worked for the VA for 32 years, with the last 12 spent as national deputy field director for the Women Veterans Health Program. She has also authored a manuscript for training films on MST.

In previous years, many reports of MST were ignored or whitewashed, with perpetrators simply transferred to another location with no punitive consequences. “This situation does not happen as much anymore. The military now [allegedly] has a zero tolerance for MST. There are required trainings and new rules for reporting that protect victims,” Dewane explains.

Yearly classes focusing on MST awareness and the availability of resources for MST victims are held by the military, according to Michael Volz, outreach specialist, and Marian Bova, PsyD, team leader and MST therapist at the Harrisburg Vet Center, a specialty program for readjustment counseling for veterans returning from combat. The center is also a designated counseling center for any veteran, regardless of combat service, who was sexually traumatized while on active duty.

The Harrisburg Vet Center staff includes a psychologist and a licensed clinical social worker, and a licensed social worker according to Volz. Specially trained counselors and specialized outpatient mental health services focusing on MST are provided by many VA facilities, and residential and inpatient facilities with specialized MST treatment programs are available for veterans who need more intense treatment and support, he says.

MST Statistics
MST statistics vary. Studies conducted by the Government Accountability Office in 2007 indicated that 25% to 50% of all military women experienced some type of sexual harassment, and 20% experienced overt sexual assault during military service. According to VA MST brochures, one in five women and one in 100 men respond “yes” to universal screening questions. However, these numbers are derived only from veterans seeking healthcare at VA facilities and may underestimate the actual rate of MST.

A study of 125,729 Afghanistan and Iraq veterans found that 15.1% of women and 0.7% of men reported MST when screened at a VA facility (Kimerling, Street, Pavao, et al., 2010). In a larger study of 33,259 women and 540,381 men, 19.5% and 1.2%, respectively, reported MST (Kimerling, Street, Gima, & Smith, 2008).

The most commonly reported MST is male against female, with officers assaulting enlisted personnel. However, male-against-male MST also occurs frequently but is less likely to be reported. The least reported is female against female, although there are reports of sexual harassment in this population, says Dewane.

While VA statistics and various studies suggest it occurs less often in men, the numbers of men victimized by MST are almost equal to the number of women simply because there are so many more men in the military.

“Interestingly, our focus on women veterans revealed that men also frequently experienced MST. The number of men is comparable proportionately to the number of women,” Dewane notes. The VA reported in 2004 that 54% of all VA users who screen positive for MST are men.

MST and Mental Health
Detecting MST via universal screening increases the likelihood of mental health treatment (Kimerling et al., 2008). Identifying MST victims through universal screening is important because serious mental health issues can be attributable to MST. Therefore, it is essential that MST victims receive appropriate care. A social worker’s most important role is in initial MST screening. “Most victims will not admit to MST initially, so the social worker’s skill is important in identifying signs of trauma,” says Dewane.

MST is associated with an increased rate of mental health issues (Suris & Lind, 2008; Kimerling et al., 2008; Kimerling et al., 2010); men and women reporting MST are three times more likely to be diagnosed with a mental disorder, most commonly depression, posttraumatic stress disorder (PTSD), substance abuse disorders, and anxiety disorders. Female MST victims are also more likely to report eating disorders. Female veterans with MST are nine times more likely to develop PTSD compared with female veterans with no history of MST. Physical health issues such as headaches, pelvic pain, and gastrointestinal problems have also been linked to MST (Suris & Lind, 2008).

Because MST may manifest as physical health issues, it is important to consider that the presenting physical problem may be linked to MST, Dewane says. In cases of patients with a variety of physical medical problems, MST may be an underlying factor. Physicians may not ask about MST, but a social worker can identify symptoms of MST during a client interview, making sure that the veteran receives much-needed care.

Social workers are also involved in counseling MST victims; those in vet centers undergo special training. According to Dewane, MST treatment methods are similar to those used to treat any military-incurred PTSD and include cognitive behavioral therapy and group therapy. One of the most powerful forms of treatment for female victims of MST is group therapy, which Dewane believes can encourage victims to share MST experiences in a supportive setting.

Most research on MST treatment has focused on women. “A difference in treatment of MST in women veterans [vs. civilians] may lie in feminist and existential approaches to counseling emphasizing the violation of power and helping women find an appropriate voice about it. The rape is viewed in the broader context of the patriarchal military system. It is still a man’s world, even more so in the military,” Dewane explains.

More research into the experience of male MST victims is necessary since statistics indicate a substantial number of male MST victims. The recent repeal of the “don’t ask, don’t tell” military policy could bring to light more information regarding male-male and female-female MST incidents. As more is learned about the types of MST that are less likely to be reported, treatment programs and resources may need to be revised or expanded.

— Jennifer Van Pelt, MA, is a Reading, PA-based freelance writer with 15 years of experience as a writer and research analyst in the healthcare field. She has written on depression, attention-deficit/hyperactivity disorder, schizophrenia, mental wellness, and aging.

References
Kimerling, R., Street, A. E., Gima, K., & Smith, M. W. (2008). Evaluation of universal screening for military-related sexual trauma. Psychiatric Services, 59(6), 635-640.

Kimerling, R., Street, A. E., Pavao, J., et al. (2010). Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. American Journal of Public Health, 100(8), 1409-1412.

Suris, A., & Lind, L. (2008). Military sexual trauma: A review of prevalence and associated health consequences in veterans. Trauma. Violence & Abuse, 9(4), 250-269.