Mental Wounds Often Burned into Veterans' Psyches
Posted on: Sunday, 9 March 2008, 09:00 CDT
ARMY MAJ. RAYMOND A. KIMBALL came home from Iraq without any physical wounds, but he was injured just the same.
The Reading native suffered from post-traumatic stress disorder, or PTSD.
While driving down a highway shortly after his return he flashed back to his days in combat and briefly thought a police officer using radar to check
his speed was actually pointing a weapon at him.
Kimball started to swerve his car toward the officer before realizing what he was doing.
Kimball promptly received successful treatment and counseling for PTSD.
But he worries that other Iraq and Afghanistan combat veterans aren't receiving the care they need for their psychological wounds.
"There still isn't enough help available right now," said Kimball, a cofounder of the Iraq and Afghanistan Veterans of America.
That means that not only will those veterans suffer, but so will society, he said.
That is because untreated PTSD victims are more likely to abuse drugs and alcohol, abuse their spouses, lose their jobs, end up homeless or commit suicide, he said.
Others share his concerns.
Some 30,000 U.S. troops have sustained physical injuries from Iraq and Afghanistan, but far more have mental health wounds, according to Kimball's group, the IAVA.
The group estimates that a third of the almost 1.7 million troops deployed to war zones beginning in 2002 have suffered serious psychological wounds.
Last year the Army experienced the most suicides and suicide attempts since it began keeping records in 1980.
Unless the federal government improves mental health care for veterans, the country faces an epidemic of veterans with untreated psychological injuries, according to the IAVA and Veterans for America.
While federal agencies claim they are doing well identifying and treating such casualties, the veterans groups say the system is already overwhelmed and that problems will grow as more troops return from war.
Veterans for America believes too many active-duty troops with those problems are being discharged as having preexisting personality disorders rather than being treated for PTSD, though the military denies that charge.
The stigma associated with mental health problems also prevents many from seeking help, said Bobby Muller, Veterans for America president.
"We are facing a massive mental health problem as a result of our wars in Iraq and Afghanistan," he said. "As a country, we have not responded adequately to this problem."
Also concerned about the care of psychologically wounded troops is Dr. Steven M. Silver, who retired in January as director of the in-patient PTSD program at the VA center in Coatesville, Chester County, the largest regional VA facility for mental health care.
Silver says the program needs more money and more mental health professionals.
Shortages of staff and funding mean some patients don't get adequate care or are discharged too quickly. And as more troops are returning from war, patient lists get longer and treatment suffers, he said.
Dr. Ira Katz, national head of mental health services for the VA, said he didn't know of problems at the Coatesville center. Nationwide, though, most veterans with psychological wounds are receiving good treatment without delay, he said.
The government is focused on helping those casualties, he said, noting the VA's mental health care budget has risen from $2 billion in 2001 to a projected $3.9 billion for 2009. Since mid-2005, the VA has added 3,800 mental health employees, he said.
Also, better education of troops has led to greater identification of those with psychological problems, he said.
And combat veterans are now eligible for free health care for conditions related to combat for five years after separating from the service, up from the previous window of two years. Since the onset of PTSD symptoms is often delayed, that is a big improvement, Katz said.
Also, the military has taken steps to reduce suicides among troops, such as setting up a VA suicide hot line last year, he said.
The military now has the best mental health care program in the world, Katz said.
"We have enough resources to meet all the cases we have, and it looks like we'll have enough to meet all the anticipated cases," he said.
Mental health support is available in combat zones to all active troops who need it, said Defense Department spokeswoman Cynthia Smith.
Service members and their families are better trained than ever to recognize mental health problems related to deployment and to find help, she said.
Troops returning home from deployment must complete a health assessment survey that includes questions about their mental health. Those in need of further mental health assessment are referred to the appropriate evaluation and care.
Between three and six months after returning from deployment, active and former service members take another health survey. If they list any mental health concerns, they are referred for care.
Though the defense department cites the success of that screening system, recent studies by the Veterans for America and IAVA claim there are problems.
Because of the stigma in the military regarding mental health problems, many troops don't answer questions honestly, said Jason Knobloch, research coordinator for Veterans for America.
Those veterans are afraid revealing psychological wounds will make them seem weak to their comrades, will delay their return to their families or damage their careers, he said.
To reduce that stigma a top military official needs to admit that he or she has suffered PTSD and been helped by treatment, said Kimball, a history professor at the U.S. Military Academy at West Point, N.Y.
"Soldiers would see a leader willing to speak about an important health issue, unafraid of the consequences," said Kimball, a Reading High School graduate.
The screening process should also change so that troops must meet one-on-one with a health care professional who could better detect psychological difficulties requiring treatment, Knobloch said.
While Silver agreed that would be a better screening method, he said it isn't possible due to the influx of returning troops and the amount of time and resources such interviews would require.
IAVA claims there are other flaws with the mental health care system for veterans, citing a 2007 quote from a top VA official that long waiting lists at some clinics have made mental health and substance abuse care virtually inaccessible.
Also, more than 90 percent of military mental health professionals have no formal training or supervision in the recommended PTSD therapies, according to IAVA.
Making matters worse, the VA has consistently underestimated the number of newly released veterans who would need care, resulting in failure to spend millions earmarked by Congress for mental health treatment, the IAVA reports.
"Psychologically wounded troops are falling through the cracks," a recent IAVA report said. "Decisive action must be taken to fix the gaps in the mental health system if we are to reach this generation of combat veterans in time."
Experts agree serious cases of PTSD are curable, but only through medication or psychotherapy.
Otherwise those cases will only get worse, Knobloch said.
"More troops are being deployed, and if they aren't taken care of, America will feel the problems," he said.
Most at risk are the veterans themselves, he said.
"We sent them to war, and it is our responsibility to take care of them when they get home," he said.
Katz said the VA is committed to doing just that, and is constantly monitoring and improving its mental health care.
"It's very important that care is available to our troops, that they know it's available and that it works," he said. "If there are problems, we want to know about them so we can fix them."
Source: Reading Eagle
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