Danish Soldiers After a War-zone Deployment

The interview study presented in this report is a large 360 degree study of how deployment on international missions is experienced and the needs brought about by such deployments for soldiers deployed and their relatives. A 360-degree approach means that focus is on the people deployed, their relatives and the help offered to these people by the Danish Defence, the public system and support groups. The assessment of these offers (Challenges) which concludes the report is therefore elucidated from different angles through 44 interviews. Twenty of these 44 interviews were with people who had been on deployment. The others were relatives and some of the representatives with whom those on deployment come into contact.
This is a qualitative interview study. This means that when, during this part of the study, we identify the needs brought about by deployment, this does not imply that all the 25,000 people who have been deployed experience the same needs. Whether this is true, and to what extent this is true will be covered in a subsequent quantitative study.
This report identifies the positive and negative consequences of deployment experienced by those deployed and their relatives. This is done by a discussion of the following questions:
•How do those who have been deployed consider the deployment has affected their lives before, during and after deployment?
•How are these needs met by the Danish Defence and by the rest of the public sector.
The study starts with a review of relevant anthropological and sociological literature. The literature has provided input for the interview study with regard to the relevant themes, as well as with regard to the theoretical perspectives. The themes in this literature deal primarily with challenges related to deployment. People on deployment experience things which can lead to changes for both the soldiers on deployment themselves and their relatives. The theoretical perspective which has come from the literature is transition theory. Transition theory has helped sharpen the focus on the transition from deployment to everyday life and thus how the Danish Defence and the rest of the public system manages to deal with the consequences of deployment and set up relevant support programmes.
Five overall factors have proved to be significant for deployed soldiers’ ability to work and their mental condition during deployment.
1. The type of mission and what soldiers experience as a result of this can affect them in different ways. A mission with a limited mandate can cause stress if a person feels powerless in the face of abuse and injustice, while a ‘harder’ mission can affect a person through combat situations, for example from witnessing serious injuries or death.
2. Similarly, the managers and leaders of the mission are decisive for the wellbeing of soldiers during deployment. Leaders who can exhibit a good example through experience from other missions, focus on targeted and relevant training and awareness of different reaction patterns in those on deployment are crucial for how soldiers experience deployment.
3. Close comradeship and the ‘military family’ which soldiers experience during deployment has proved to be a sort of substitute for the civilian family and a close bond arises because of the mutual dependence for ‘life and death’.
4. Even though relatives (the civilian family) move a little into the background during deployment, they are still extremely important and communication between the two parts has a direct influence on the mental condition of the soldier on deployment.
5. Similarly, the soldier on deployment is affected by contact with Danish society. In general media coverage of the war is considered as negative and lacking subtlety, and the opinions reflected through the media negatively affect those on deployment.

Addressing the needs of soldiers on deployment so that they can come home with as little physical and psychological injury as possible requires focus on both the soldiers on deployment and their relatives. For people deployed, mission preparation and confidence in equipment and leaders give peace of mind, and material conditions do not give rise to complaints. However seeing fellow soldiers seriously injured or die is a great emotional burden, despite training and acute assistance on the mission in debriefings and from field clergy/military psychologists. After deployment, soldiers returning home say that, despite any psychological after-effects or physical injuries, deployment has had a positive effect on their personal development. Deployment is considered a maturing process and a foundation for strong friendships.
Both soldiers coming home and their relatives can see that the person returning has changed after deployment and this gives rise to a number of problems in rediscovering their normal place in the family. The transition from the ‘military family’ to the real, civilian family is difficult. In particular ‘being accountable’ to the family as well as the occasional lack of recognition from society and the media are two aspects highlighted as significantly affecting how soldiers returning home experience the post-deployment period. Reintegration into close relations and society in general seems to be a challenge for those returning home.
A large proportion return to Denmark after deployment with different kinds of injuries. Some experience psychological after-effects from deployment such as stress, restlessness, anxiety and aggressive behaviour. These reactions seem to apply in the period immediately after returning to Denmark, and symptoms usually diminish with time. The extent and seriousness of these psychological after-effects are a theme that will be covered by the follow-up quantitative study. An increasing number of Danish soldiers also return with permanent physical injuries. This group of soldiers have to adapt to daily life in Denmark and to life with a disability. Psychological after-effects of deployment, a life with physical injuries, and the difficult transition from the military to the civilian, all place great demands on the Danish Defence and the public system, if soldiers’ needs for support are to be met.

GENERAL ISSUES IN HOW THE SYSTEM COPES
The study has identified the following requirements for the system:
•That a thorough screening be carried out, in addition to the more informal existing screening during training, to identify personnel who are unsuitable for deployment. The study shows that the Danish Defence does not have a special psychological screening procedure prior to deployment of Hazardous Response Unit (HRU) personnel (first-time deployment).
•That personnel on deployment can have confidence in the Danish Defence emergency response. That there is acute assistance in connection with violent and intense incidents in which soldiers witness death and serious injury. There must be good, experienced and ‘accommodating’ leaders in addition to good training for the specific mission and including exercises as close to reality as possible. That soldiers are prepared for the type of mission they are to take part in.
•That soldiers are prepared for the fact that the close companionship and loyalties arising from deployment can overshadow other family and emotional ties, but that these ties must be maintained and nurtured.
•That personnel returning to Denmark receive help to adjust to civilian life. This adjustment, however is very difficult for many returning home. High adrenaline levels and isolation from everyday life in Denmark during deployment mean that afterwards the transition to a normal life is a problem for many. The Danish Defence is unable to prepare soldiers optimally for this transition before they return to Denmark and this is why there is an apparent lack of focus before returning home on the importance of soldiers re-entering social relationships and on the psychological reactions. The Danish Defence is dealing with part of this issue by offering a reintegration programme in which soldiers are offered support for a period to adjust to civilian life. The programme has been received positively by soldiers and representatives from the Danish Defence and support functions.
•That post-deployment programmes and offers address real needs for support. There are several different offers and programmes available during the post-deployment period, including sessions with a psychologist after certain missions and a compulsory questionnaire. These initiatives have been introduced to identify and follow-up on soldiers returning with possible psychological after-effects.
•That the Danish Defence endeavour to support soldiers returning to Denmark with potential psychological injuries. Identification of these personnel (in Denmark or while on deployment) is still incomplete in some areas in that emphasis is primarily on soldiers’ own initiatives and to a lesser degree on outreaching work from the Danish Defence. In this context, soldiers with severe psychological injuries and social isolation can risk ‘falling through’ the system.
•That physically injured soldiers receive treatment, including those with long-term injuries. The increase in the number of physical injuries has increased the focus on offers from the Danish Defence for the physically injured and their relatives. A new rehabilitation unit is taking special care of those with physical injuries and this is deemed a relevant offer. However, personnel with physical injuries are still experiencing barriers in, amongst other things, their contact with the public system, for example waiting lists for disabled housing.
•That there is more knowledge and possibly more resources for the areas in which soldiers in Denmark after deployment meet the public system. The increasing number of deployments on international missions means that the public system has a new group of citizens and patients with a new type of need and there is general criticism of the support received by soldiers returning to Denmark.
•That personnel deployed and their relatives are prepared for what ‘society’ and the media think of the deployment.
•That relatives are prepared to receive personnel returning to Denmark who often come home with high adrenaline and stress levels. Contact with the outside world is important for the wellbeing of soldiers on deployment, and relatives are an important factor for soldiers’ mental condition during and after deployment.
•That relatives are taken care of, so that they can support and help each other and find the reserves of energy necessary to support those on deployment. Some relatives support the deployment despite disagreeing with the decision, meaning that the person on deployment has more peace of mind in the mission area. Other relatives are against the deployment and this often means that their concerns and anxiety become a mental burden for the soldier on deployment. The many existing programmes in this area are being received positively by relatives, although there is some confusion regarding what programmes are on offer, by whom, and how to find the right programme.
The new Danish veterans policy is expected to contain solutions to the various issues highlighted in this report.