The Invisible Wounded Warriors in a Nation at Peace: An interview study on the lives of Swedish veterans of foreign conflicts and their experiences with PTSD, moral injuries, and military identities
Although there has not been war in Swedish territory for many years, this does not mean that the country has no veterans who have experienced the challenges of war zone deployments or suffer from combat trauma. The Invisible Wounded Warriors in a Nation at Peace gives a rare look at the international operations of the Swedish military, while offering the reader a unique and deeper understanding of life with PTSD. The book uses terms such as moral injury to further describe the complexity. Complex PTSD after deployment in a conflict zone is a uniquely complicated web of problems that can have medical, psychological, moral, existential and spiritual dimensions. The book discusses what this might mean from an identity and pastoral care perspective.
Abstract: The U.S. Army’s Ask, Care, Escort (ACE) suicide gatekeeper training has been the annual requirement for all personnel since 2009; however, this training has never been formally evaluated. The present study evaluated three updated versions of ACE: a training for Army leaders (ACE-Suicide Intervention), a training for basic combat trainees (ACE for Basic Combat Training and One Station Unit Training), and a standard training for all personnel (ACE for the Force). Self-report surveys measured pre- to posttraining changes in objective and subjective knowledge and stigma, as well as preparedness, self-efficacy, and likelihood to engage in gatekeeper behaviors. Implementation outcomes, such as training acceptability, suitability, and usability were also assessed. Across these evaluations, participants reported that knowledge and gatekeeper behaviors significantly improved from pre- to posttraining. Implementation metrics revealed a high degree of acceptability and relevance for all three ACE trainings. Overall, the findings of these evaluations suggest important changes in key suicide prevention outcomes following the ACE suite of trainings. Further longitudinal assessment is needed to establish the full effectiveness of gatekeeper interventions in the Army.