November 9, 2008

20 Percent of U.S. Soldiers Return with PTSD

Army Maj. Gen. David Blackledge's bravery extends far beyond the battlefields of Iraq.  

The 54-year-old two-star Army Reserve general commanded a civil affairs unit during two tours in Iraq, and now works in the Pentagon as Army assistant deputy chief of staff for mobilization and reserve issues.

In February 2004 during his first deployment, Blackledge's convoy was ambushed. In the tragedy he has since relived in flashbacks and recurring nightmares, his interpreter was shot through the head, his vehicle rolled over many times before Blackledge was able to crawl out of it with a crushed vertebrae and broken ribs --only to find himself in the middle of a firefight.  He and other survivors took cover in a ditch.

Upon returning home to the U.S., Blackledge sought counseling to help him with the psychological trauma, and is now helping others by speaking out on the issue of mental health problems and treatment. 

"It's part of our profession ... nobody wants to admit that they've got a weakness in this area," Blackledge told the Associated Press, referring to mental health problems among troops returning from Iraq and Afghanistan.

"I have dealt with it. I'm dealing with it now," said Blackledge, who suffers with post-traumatic stress.

"We need to be able to talk about it."

Thousands of troops are returning from the wars with depression, anxiety and other emotional problems. Estimates show that up to one in five of the 1.7 million who have served in Iraq and Afghanistan have symptoms.  However, only half of those who need help actually seek it, according to studies.

Despite efforts to promote mental health treatment among returning military members, some officials fear generals and other senior leaders are unwilling seek such help, or even discuss it, out of fear it will hurt their chances for promotion.

That reluctance is also worrisome because it sends the wrong signal to younger officers and perpetuates the problem leaders are working to reverse.

"Stigma is a challenge," said Army Secretary Pete Geren during a Pentagon news conference on Friday.

"It's a challenge in society in general. It's certainly a challenge in the culture of the Army, where we have a premium on strength, physically, mentally, emotionally."

Chairman of the Joint Chiefs of Staff Adm. Mike Mullen called on military leaders to set an example for all soldiers, sailors, airmen and Marines.

"You can't expect a private or a specialist to be willing to seek counseling when his or her captain or colonel or general won't do it," he said.

Brig. Gen. Loree Sutton, an Army psychiatrist who leads the defense center for psychological health and traumatic brain injury, is working to create a forum for people to tell their personal stories.   The initiative would allow troops, their families and others to express and share concerns and ideas via Web links and other programs.

Blackledge volunteered to help.  He and his wife, Iwona, herself an Air Force nurse, will address a medical conference next week on the subject.

Following his February 2004 ambush, Blackledge was visited by a psychiatrist within days of arriving at Walter Reed Army Medical Center in Washington.  He had several subsequent sessions with the doctor during his 11-month recovery from his physical injuries.
"He really helped me," Blackledge said of his psychiatrist.

And that's precisely his message to troops.

"I tell them that I've learned to deal with it," he said.

"It's become part of who I am."

Although he still suffers from bad dreams about once a week, he no longer wakes from them in a sweat, and they are no longer as upsetting.

During his second tour to Iraq, Blackledge traveled to nearby Jordan to work with local officials on Iraq border issues.  He was staying at a hotel in Amman in November 2005 when suicide bombers attacked, killing more than 60 people and wounding hundreds more.

The bombing left Blackledge with a whiplash injury that took months to heal.  The experience, including a harrowing escape from the chaotic scene, regenerated his post-traumatic stress symptoms, though they were not as severe as those he'd suffered in the aftermath of the 2004 ambush.

As the nation marks Veterans Day on November 11, officials across all military service branches are working to improve access and discretion of mental health services for returning troops. Some have even embedded mental health teams directly into units. 

While they acknowledge it may take a while, they see signs that the stigma of post-traumatic stress is slowly fading away.