Psychiatric Quarterly

, Volume 87, Issue 3, pp 427–443 | Cite as

“I’m Coming Home, Tell the World I’m Coming Home”. The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans

  • Julia Rozanova
  • Paraskevi Noulas
  • Kathleen Smart
  • Alicia Roy
  • Steven M. Southwick
  • Larry Davidson
  • Ilan Harpaz-Rotem
Original Paper


This study explored the journey of American armed forces personnel from their decision to join the service, through their service in an active military conflict and how these factors may be associated with potential resistance for mental healthcare. The data came from qualitative interviews with 46 OIF/OEF/OND active-duty military, reservists, and discharged veterans of the average age of 25 years, who presented for a new episode of mental health treatment to a large Veterans Affairs Hospital (VAH) in Northeastern United States in 2011–2012. Qualitative analysis of veterans’ perceptions revealed several major themes describing how a mental health diagnosis would negatively impact both their sense of identity and pragmatic career-building goals: enlisting as a career-building avenue, ‘noble superhero’ identity, escaping from hardship, and mental illness as a career-killer. Findings suggest that factors making young veterans resist mental healthcare may be reduced by partnering VAH psychiatrists with career counselors, and by enhancing military leadership’s awareness and understanding about how to support soldiers with emotional and mental health needs, with a goal to eliminating stigma.


Young US veterans Mental healthcare resistance Qualitative interviews Sense of identity Pragmatic career-building goals 



This study was funded by the Department of Veterans Affairs HSR&D MERIT award PPO-09-265-1 to Dr. Ilan Harpaz-Rotem.


Funding for this research was available through a Department of Veterans Affairs (VA) Health Services Research & Development (HSR&D) Merit Review award PPO-09-265-1 awarded to the senior author. The views presented here are those of the authors and do not represent the position of any federal agency or of the United States Government.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and Animal Rights and Informed Consent

The study was approved by the human subjects committees of the VA Connecticut Healthcare System and Yale University, New Haven, CT. Informed consent was obtained from all individual participants included in the study. The manuscript has been de-identified.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Internal MedicineYale School of MedicineNew HavenUSA
  2. 2.VA Connecticut Healthcare SystemWest HavenUSA
  3. 3.United States Department of Veterans Affairs National Center for Posttraumatic Stress DisorderWest HavenUSA
  4. 4.Department of PsychiatryYale School of MedicineNew HavenUSA
  5. 5.Yale Program for Recovery and Community HealthNew HavenUSA

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