PTSD/TBI | March 14, 2012
War is definitely hell- A U.S. veteran commits suicide every 80 minutes
While the public focus in Afghanistan is the killing of civilians by an American soldier, little is reported on the toll this war is taking on veterans and their families.
The never-ending war in the Middle East has consequences, serious consequences. According to an October 2011 policy brief the U.S. Armed Services is losing the suicide battle on the home front.
The report concludes that a U.S. veteran kills himself every 80 minutes while Operation Iraqi Freedom/Operation Enduring Freedom service members is committing suicide every 36 hours. These statistics are staggering in light of the fact that only one-percent of the American population serves in the military, yet the military accounts for roughly 20 percent of the national suicide rate.
Veterans and service members report substantial paperwork and even longer wait times as one reason they don’t get the proper treatment for Post Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI).
Another challenge military personnel face is the stigma attached to the term PTSD. Many service members can be ridiculed by fellow soldiers, told to toughen up by superiors or don’t fill out the required paperwork to seek counsel.
The military disconnect regarding the pervasiveness of PTSD within the military is a contributing factor to suicide. If the military leadership wants to turn the suicide numbers around, mental health care providers must work in concert with commanders to enforce guidelines for PTSD/TBI diagnosis and treatment.
“The responsibility inherent in military service, the importance of tasks assigned to relatively junior personnel and the high level of interaction among unit members establish the importance and usefulness of each unit member, particularly in an operational environment. In contrast, the experience of living in a garrison environment (for active component personnel) or returning to a civilian job (for Guardsmen, Reservists and veterans) or, worse, unemployment, can introduce feelings of uselessness. Individual accounts of military suicide both in the media and in interviews with us echo this sentiment. Over and over, these accounts show that individuals withdrew, felt disconnected from their units and their families, and perceived themselves as a burden,” Dr. Margaret Harrell and Nancy Berglass cited in their study.
While senior military leaders at the Department of Defense say they are exerting more energy than ever before to prevent the skyrocketing suicides, the dysfunctional relationship between DOD and the Veteran Affairs does little to provide adequate treatment options for veterans suffering from PTSD/TBI.
The DOD touts its “Never Let Your Buddy Fight Alone” program as a successful deterrent to suicide. And the VA’s Veterans Crisis hotline said their efforts to recognize the seriousness of suicide prompted nearly 150,000 hotline calls. The VA claims they saved 7,000 “actively suicidal veterans.” Yet, suicides remain alarmingly high.
The military must protect and care for those who voluntarily serve the country and return home with PTSD/TBI injuries. Suggestions made by this report includes; unit cohesiveness (returning soldiers should remain together as a group for at least 90 days after deployment), ensuring the military either has access or hires enough mental health providers to meet the needs of returning soldiers, and Congress needs to establish a federal pre-emption of state licensing, so providers can be treated across state lines.
Another area the military hierarchy must improve is dramatically changing the questions contained in the “Post Deployment” questionnaire.
“As service members return home from deployment, they complete a post-deployment health assessment (PDHA). As part of this assessment, they are asked questions about their physical and mental health, such as, “Did you encounter dead bodies or see people killed or wounded during this deployment?” and “During this deployment, did you ever feel that you were in great danger of being killed?” There are also self-evaluative questions, such as, “Are you currently interested in receiving information or assistance for a stress, emotional or alcohol concern?” While we do not question the contents of the assessment, its administration has been problematic,” the report explained.
According to a 2008 study (Christopher H. Warner et al., Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment), when Army soldiers completed an anonymous survey, the reported rates of depression, PTSD, suicidal attempts and an interest in receiving care were two to four times higher than the current PDHA test used by military personnel.
“Likewise, our interviews with veterans uncovered numerous accounts of returning service members whose unit leaders advised them to fabricate answers. Individuals across all services have been told, ‘If you answer yes to any of those questions, you are not going home to your family tomorrow.’” This may be factually correct, but it neglects to inform service members of the implications of answering untruthfully – namely, that they will have difficulty receiving treatment or compensation for mental health problems that appear after their service. As an improvement, the 2010 National Defense Authorization Act requires trained medical or behavioral health professionals to conduct the PDHA evaluations individually and face-to-face, in the hope that service members will respond honestly to a trained health professional. PDHA evaluations individually and face-to-face, in the hope that service members will respond honestly to a trained health professional.”
In conclusion, the study outlined the military’s vulnerabilities concerning the treatment of PTSD/TBI. “Although a goal of no suicides may be unachievable, the increasing number of suicides is unacceptable. Additionally, although benefits and services available from the Veterans Health Administration will likely remain the best system of care for veterans, the DOD has a moral responsibility to acknowledge and understand former service members,” researchers said.
“America is losing its battle against suicide by veterans and service members. And, as more troops return from deployment, the risk will only grow. To honor those who have served and to protect the future health of the all-volunteer force, America must renew its commitment to its service members and veterans. The time has come to fight this threat more effectively and with greater urgency.”
The real question Americans need to ask, “is the 10-year Middle East War worth the cost in blood and treasure? And if so, how do military personnel intend to care for those who suffer the invisible PTSD/TBI wounds?
The clash in Afghanistan is between cultures, religions, and political institutions. Returning warriors continue to complain that Afghanistan will never be molded into a “state” with the ability to be a productive member of the world community. Its tribal tendencies will always shift with opportunities from religious zealots. Bush was wrong to "nation-build" in Afghanistan, and Obama is wrong to continue to feed the corruption and profiteering of Afghan President Karzai’s sect at the expense of American warriors. How do the military/civilian leaders intend to care for soldiers with visible or invisible wounds?
Yes, war is hell, but unless U.S. soldiers are authorized to “win” all Americans should stand together and demand an end to a seemingly endless war.