Community Case Study_ Part 2_Greer

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MILITARY MALE SEXUAL ASSAULT RESPONSE 1 Community Based Approach to Military Male Sexual Assault Prevention and Response Paul B. Greer School of Behavioral Science Liberty University Author Note Paul Brian Greer I have no known conflict of interest to disclose. Correspondence concerning this article should be addressed to Paul Brian Greer. Email: pbgreer@liberty.edu

MILITARY MALE SEXUAL ASSAULT RESPONSE 2 Abstract When it comes to prevention and support for this unique military population, religious and veterans’ organizations, social services and military supported services are often not aligned in planning or support efforts thereby leading to redundancy in services or creating gaps in service to the veteran and military population. Since the COVID pandemic, the mental health system has been overtaxed among the military and community health systems leading to greater outsourcing and increase of military chaplain care to fill the gap. One trend that has emerged is male sexual assault victim self-reporting to chaplains. Military chaplains are often ill equipped for this type of care, as are many community support resources such as churches and veterans’ organizations. As such, a sociological-ecological model that ties together military and community resources as a coalition to organize prevention and response, as well as education and advocacy are critical to assist with the unmet need of military male sexual assault victims. Keywords : military, veteran, male sexual assault, community-based approaches, veteran organization partnerships, community partnerships, community coalition, prevention, advocacy, religious support, moral injury.

MILITARY MALE SEXUAL ASSAULT RESPONSE 3 Community Based Approach to Military Male Sexual Assault Prevention and Response As a provider in the military-centric community of Hampton Roads, Virginia, which includes Langley Air Force Base, Army’s Fort Story and Fort Eustis, Naval Weapons Station Yorktown, Naval Air Station Oceana and Dam Neck Annex, Joint Expeditionary Based Little Creek, and Naval Station Norfolk which is the largest naval base in the world. According to the Hampton Roads Economic Development Alliance (2022), the military represents approximately 45% of the region's economy and supports over 315,000 jobs. In terms of military personnel, there are over 87,000 active-duty service members, over 25,000 civilian personnel, and over 80,000 military family members living in the Hampton Roads region yielding a military population of over 192,000. As a result, the community and military are inextricably linked and mutually interdependent, especially when caring for the large population of military members and their dependents. Lack of Coordination and Outsourcing However, when it comes to prevention and support for this unique military population, religious and veterans’ organizations, local government based social services and military social support and medical support services are often not aligned in planning or support efforts, thereby leading to redundancy in services or creating gaps in service to the veteran and military population. Additionally, since the COVID pandemic, the mental health system has been overtaxed the military and community health systems with wait times as high as six to eight weeks between appointments. This has led to military referrals and outsourcing of uniformed service member mental health care through the TRICARE network and Military One Source for self-referrals. As such, community partnerships are critical to assist with the unmet and under supported mental health needs for military members.

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MILITARY MALE SEXUAL ASSAULT RESPONSE 4 Chaplains Filling the Gap As the leader of a military chaplain community whereby chaplains are primarily trained in theology and a minimum of nine hours of pastoral counseling, the array of caregiving competencies varies from those with the minimum education standard, to those with clinical chaplain residency, board certification and others holding clinical counseling licensure and credentials that is likewise mimicked in the local community among clergy. This creates a unique challenge for chaplain and pastoral care competencies and consistency in standards of care delivered to male sexual assault victims. Military chaplains offer a unique resource to male sexual assault victims not found in the local community. Military chaplains have the unique benefit in the Department of Defense as not being required to abide by mandatory reporting requirements of any kind, including compliance with local and state law requirements while performing their duties as federal employees, and have unlimited confidentiality under the clergy penitent tradition and protections of military law. As such, victims of trauma and sexual assault primarily seek out chaplain support services first before other resources knowing their story is kept strictly confidential and can avoid revictimization often associated with reporting. This lends to a unique problem and need for specialized training for military chaplains to avoid doing harm for this unique and sensitive population in their most critical time of need. Emerging Problem Further, since the COVID pandemic, not only has there been an increase in mental health service utilization, but a trend is also emerging among chaplain reporting with increases in sexual assault disclosure by victims to military chaplains. Specifically, there has been a unique increase in male service members disclosing sexual assault prior to entry into military service when

MILITARY MALE SEXUAL ASSAULT RESPONSE 5 seeking primary services for depression, anxiety, and skill-building in response to maladaptive coping and increases in legal issues from destructive behaviors such as alcohol and substance abuse, DUIs and self-mutilation. This trend is overtaxing chaplain competencies and the need to increase education and skill-building. Further, chaplains are struggling to find unique collaborative support services for client referral and have identified gaps in military and community-based partnerships for victim support. As such, there is a need to develop a coalition of support for male sexual assault victims from the sociological-ecological model with direct and indirect approaches to cooperative community-based outreach, advocacy, prevention and care. Description of the Population It is important to note that sexual assault can happen to anyone, regardless of their gender or age. However, men are often less likely to report sexual assault than women due to a variety of factors including stigma, shame, and fear of not being believed (Davies, 2002). In general, men may be less likely to report sexual assault compared to women and may take longer to come forward due to attitudes about masculinity and the societal stigma and shame associated with male sexual assault (Davies, 2002). According to a study by Dr. John Briere and colleagues (2004), the average age of men reporting sexual trauma is around 52 years old, thus lending to the hypothesis that male sexual assaults are significantly underreported and there is a significant male population suffering in silence and not receiving the care needed leading to maladaptive coping impacting society at large. According to the Department of Defense's "Population Representation in the Military Services" report as of September 30, 2020, the United States Military is 85.6% male. This uniquely patriarchal organization with its cultural norms of toughness and compartmentalization of stressors for mission prioritization does not lend itself to encourage self-reporting or help-

MILITARY MALE SEXUAL ASSAULT RESPONSE 6 seeking among victims dealing with the effects of sexual trauma. Identification of Need According to a study by the Department of Defense, out of the estimated 20,500 incidents of sexual assault in the military in 2018, approximately 38% involved male victims (Department of Defense, 2019). Another study by the Rand Corporation found that among military personnel who experienced unwanted sexual contact, approximately 23% were male (Lefebvre et al., 2014). In a study of male veterans seeking treatment for PTSD at a VA hospital, 15.1% reported experiencing sexual trauma during their military service (Kimerling et al., 2007) illustrating the disparity in reporting. The United States military as a male dominated organization poses unique challenges for chaplains and mental health providers in caring for male sexual assault victims. Recruits come from a large swath of American society, especially from socio-economically challenged subset of culture often associated with neglect and abuse which often leads to revictimization in the military (Loughran & Humphreys, 2018). "Research indicates that higher levels of childhood abuse and trauma are associated with an increased likelihood of military enlistment, as individuals seek out the structure and discipline of military life." (Ruscio, et al., 2001, p. 199). A review of the literature on trauma and military service found that up to 30% of military personnel may have a history of childhood trauma, and that this is associated with an increased risk of PTSD, depression, and substance abuse (Griffin et al., 2018). A study of Army recruits found that 12.5% reported a history of physical abuse, 14.5% reported a history of sexual abuse, and 25.9% reported a history of family violence (Brenner et al., 2011). In the United States, a study published in the Journal of Interpersonal Violence found that 1 in 6 males had experienced sexual violence at some point in their lives, predominantly before the age of 18 (Swartout, et al., 2014).

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MILITARY MALE SEXUAL ASSAULT RESPONSE 7 It can be assumed from the data that the military reflects this societal statistic but poses unique challenges for male victims of sexual trauma due to military recruitment pools compared to other civilian hiring agencies. Military cultural values including those of masculinity, stoicism, toughness and resiliency, further negatively impacting self-reporting and help seeking among make victims, as well as contributing to increased maladaptive coping and destructive behaviors. Intervention Strategies Education Utilize 1in6.org “Truth Telling” seminar for clergy, veterans organization caregivers and advocates, sexual assault victim advocates, sexual assault response coordinators, mental health providers and military social workers. This program focuses on male-centered approach to psychotherapy, male psychology and how this “coding” intersects with the lives of men facing trauma and post-traumatic responses. An overview of current research on both male sexual abuse and assault, and an analysis of how trauma commences, and a conceptual lens to the recovery process. With proper awareness, education and skills-based learning, veterans organization could fill a critical void in the community in meeting the needs of male survivors of sexual assault with support and resources. Resiliency Factors Coalition Local, state and federal governments, military leadership, religious organizations, clergy, veterans organizations, social services, mental health practitioners, professional counseling organizations and their lobbyists, non-government organization and not for profits such as 1in6.org have a unique opportunity to develop a community-based ecological approach in

MILITARY MALE SEXUAL ASSAULT RESPONSE 8 support of male sexual assault victims reducing redundancies, filling in gaps in services, maximizing community-based efforts to share the case management, prevention, and collaborate in planning to increase effectiveness. By aligning as a community-based collation, their efforts provide a stronger voice in advocacy, reduce redundancies and fill gaps in services and strengthen efforts in outreach reducing stigmatization. and professional advocacy resulting in policy changes, greater accountability for offenders, increased resource funding and support services for victims. Advocacy Program Veteran’s organization for decades have been the voice of advocacy and support for policy and legislative changes. Jasinski & Kaufman (2017) suggest that veterans’ organizations could play a critical role in the community due to their nationwide community presence and unique understanding of the military culture. Veterans’ organizations play a crucial role in advocating for legislative and policy changes that benefit veterans and their families. They use various methods to influence policy and decision-making, including lobbying, grassroots organizing, media campaigns, and public education. One example of a veterans organization that engages in advocacy and lobbying is the Veterans of Foreign Wars (VFW). The VFW has a long history of advocating for policies and legislation that support veterans, such as access to healthcare, education, and employment. They use their strong network of members and volunteers to push for changes at the local, state, and federal levels. According to a report by the Congressional Research Service, veterans organizations like the VFW "provide a valuable perspective on veterans' issues, as well as a well- organized lobbying presence in Congress." (Schwartz, 2019).

MILITARY MALE SEXUAL ASSAULT RESPONSE 9 Another example is the Disabled American Veterans (DAV), which also engages in advocacy and lobbying on behalf of disabled veterans. The DAV has been successful in influencing policy and legislative changes that improve the lives of disabled veterans, such as expanding healthcare benefits and increasing disability compensation. In a study published in the Journal of Military and Veterans' Health, the authors note that "veterans organizations have been successful in leveraging their political power to shape public policy and legislation that affect the well-being of veterans and their families." (Meadows et al., 2017). Overall, veterans organizations play a crucial role in advocating for the needs and concerns of veterans and their families. Their efforts have led to important legislative and policy changes that have improved the lives of countless veterans. Challenges and Barriers to Services A cursory review of available service in the greater Hampton Roads area demonstrates that Virginia Sexual and Domestic Violence Coalition, as well as local crisis services focus primarily on women, children, and the LQBTQ community, but rarely mention or provide services specific to males or military males. Conclusion

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MILITARY MALE SEXUAL ASSAULT RESPONSE 10 References Brenner, L. A., Ivins, B. J., Schwab, K. A., Warden, D., Nelson, L. A., Jaffee, M. S., & Terrio, H. (2011). Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq. Journal of Head Trauma Rehabilitation, 26 (4), 312-318. Briere, J., Kaltman, S., & Green, B. L. (2004). Accumulated childhood trauma and symptom complexity. Journal of Traumatic Stress, 17 (1), 67-75. https://doi: 10.1023/B:JOTS.0000014671.90356.7a Davies, M. (2002). Male victims of sexual assault and rape: Challenges and barriers to accessing services and support. Journal of Aggression, Maltreatment & Trauma, 6 (1), 131-148. Department of Defense. (2019). Sexual Assault Prevention and Response Office Annual Report on Sexual Assault in the Military. Retrieved from https://www.sapr.mil/public/docs/reports/FY18_Annual/FY18_Annual_Report_on_Sexua l_Assault_in_the_Military.pdf Griffin, M. G., McDevitt-Murphy, M. E., & Wangelin, B. C. (2018). Trauma and military service: A review of the literature. Trauma, Violence, & Abuse, 19 (4), 399-410. Hampton Roads Economic Development Alliance. (2022). Annual Report 2022. Retrieved from https://www.hreda.com/wp-content/uploads/2022/01/HREDA-Annual-Report-2022.pdf Jasinski, J. L., & Kaufman, M. (2017). Meeting the needs of male survivors of sexual assault: Recommendations for best practice. Journal of Interpersonal Violence, 32 (1), 3-24. https://doi.org/10.1177/0886260515587237

MILITARY MALE SEXUAL ASSAULT RESPONSE 11 Kimerling, R., Gima, K., Smith, M. W., Street, A., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97 (12), 2160-2166. https://doi:10.2105/AJPH.2006.093490 Lefebvre, R., Srinivasan, S., & DeVoe, E. (2014). Sexual assault and sexual harassment in the U.S. military: Volume 2. Estimates for Department of Defense Service Members from the 2014 RAND Military Workplace Study. Retrieved from https://www.rand.org/pubs/research_reports/RR870z2.html Loughran, D. S., & Humphreys, M. (2018). The US military and the socioeconomic divide. Annual Review of Sociology, 44 (1), 599-620. Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs. (2020). Population Representation in the Military Services: Fiscal Year 2020 Summary Report. Retrieved from https://www.cna.org/CNA_files/PDF/DOP-2021-U-029989-Final.pdf Ruscio, A. M., Borkovec, T. D., & Ruscio, J. (2001). A taxometric investigation of the latent structure of worry. Journal of Abnormal Psychology, 110 (2), 193–200. https://doi.org/10.1037/0021-843X.110.2.193 Swartout, K. M., Koss, M. P., White, J. W., & Thompson, M. P. (2014). Trajectories of the likelihood of experiencing forced sex: Effects of victimization and characteristics of sexual assaults. Journal of Interpersonal Violence, 29 (13), 2333-2357. https://doi: 10.1177/0886260514534524

Community Case Study_ Part 2_Greer

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