AP Article: "Nearly 1 in 5 troops has mental problems after war service"

[vietnam_war_vet]

((All the while the VA remains woefully understaffed and under-resourced, even recently closing the VA Psychiatric Wing at the Dallas VAMC. SSDD. -- Michael))



Nearly 1 in 5 troops has mental problems after war service

By PAULINE JELINEK, Associated Press Writer 27 minutes ago

Roughly one in every five U.S. troops who have survived the bombs and other dangers of Iraq and Afghanistan now suffers from major depression or post-traumatic stress, an independent study said Thursday. It estimated the toll at 300,000 or more.

As many or more report possible brain injuries from explosions or other head wounds, said the study, the first major survey from outside the government.

Only about half of those with mental health problems have sought treatment. Even fewer of those with head injuries have seen doctors.

Army Surgeon General Eric Schoomaker said the report, from the Rand Corp., was welcome.

"They're helping us to raise the visibility and the attention that's needed by the American public at large," said Schoomaker, a lieutenant general. "They are making this a national debate."

The researchers said 18.5 percent of current and former service members contacted in a recent survey reported symptoms of depression or post-traumatic stress. Based on Pentagon data that more than 1.6 million have deployed to the two wars, the researchers calculated that about 300,000 are suffering mental health problems.

Nineteen percent — or an estimated 320,000 — may have suffered head injuries, the study calculated. Those range from mild concussions to severe, penetrating head wounds.

"There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, the project's co-leader and a researcher at Rand. "Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation."

The study, the first large-scale, private assessment of its kind, includes a survey of 1,965 service members across the country, from all branches of the armed forces and including those still in the military as well veterans who have completed their service. The Iraq war has been notable for the repeat tours required of many troops, sometimes for longer than a year at a time.

The results of the study appear consistent with mental health reports from within the government, though the Defense Department has not released the number of people it has diagnosed or who are being treated for mental problems.

The Department of Veterans Affairs said this month that its records show about 120,000 who served in the two wars and are no longer in the military have been diagnosed with mental health problems. Of those, about 60,000 are suffering from post-traumatic stress, and depression runs a close second.

Veterans Affairs is responsible for care of service members after they have leave the military. The Defense Department covers active duty and reservist needs.

The lack of numbers from the Pentagon was one motivation for the Rand study, Tanielian said in an interview.

The most prominent and detailed Pentagon study on the military's mental health that is released regularly to the public is the Army's survey of soldiers, taken annually at the battle zones since 2003.

The most recent one, last fall, found 18.2 percent of Army soldiers suffered mental health problems such as depression, anxiety or acute stress in 2007, compared with 20.5 percent the previous year.

Other studies have variously estimated that 10 percent to 20 percent of troops had symptoms of mental health problems.

Col. Loree Sutton, who heads a new Pentagon center on brain injury, said the Rand study will add to the work defense officials are doing. That includes researching best practices used inside the military and out, improving and expanding training and prevention programs, adding mental health staff and trying to change a military culture in which many troops are afraid or embarrassed to get mental health treatment.

"We've got to get the word out that seeking help is a sign of strength," Sutton said.

She said officials have been working to add thousands more mental health professionals to help the uniformed psychiatrists, psychologists and others struggling to meet the wartime demands of troops and their families. Across the services, officials are trying to hire over 1,000 additional staff. Also, companies providing health care by contract to the Pentagon have added over 3,000 in the past year, and the U.S. Public Health Service has provided some 200, she said. Veterans Affairs has added some 3,800 professionals in the past couple of years, officials there said.

In other survey results:

_About 7 percent of those polled reported both a probable brain injury and current post-traumatic stress or major depression.

_Rates of post-traumatic stress and major depression were highest among women and reservists.

_About 53 percent of service members with post-traumatic stress or depression sought help over the past year, and 43 percent reported being evaluated by a physician for their head injuries at some time.

_They gave various reasons for not getting help, including that they worried about the side effects of medication, they believed family and friends could help them with the problem, or they feared seeking care might damage their careers.

The Army's own warfront survey found the stigma associated with getting help has been decreasing slowly but steadily in recent years.

Thursday's report was titled "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery." It was sponsored by a grant from the California Community Foundation and done by researchers from Rand Health and the Rand National Security Research Division. The division also has done work under contracts with the Pentagon and other defense agencies as well as allied foreign governments and foundations.

http://news.yahoo.com/s/ap/20080418/ap_on_go_ca_st_pe/troops_mental_health

On the Net:

Rand Corporation: http://www.rand.org

Army studies: http://www.armymedicine.army.mil

Copyright © 2008 The Associated Press.

[forever_frost]

1. Not Suprising

This finding doesn't suprise me at all. Every single one of my friends who came back from Iraq as well as me, have severe PTSD. As in, barricade the house and watch shadows moving.

[stillcool]

2. I bet the VA is "shocked" at this!!

I've seen bodies ripped to pieces by bullets, blown into millions of scraps by bombs, and pierced by booby traps. I’ve smelled the stench of bodies burned. I’ve heard the air sound like it was boiling from rounds flying back and forth. I’ve lived an insanity others should never live..."
-- Dennis Tenety, Fire in the Hole

-Michael C.C. Adams, The Best War Ever: America and World War II About 25-30 percent of WWII casualties were psychological cases; under very severe conditions that number could reach as high as 70-80percent. In Italy, mental problems accounted for 56 percent of total casualties. On Okinawa, where fighting conditions were particularly horrific, 7,613 Americans died, 31,807 sustained physical wounds, and 26, 221 were mental casualties.-Adams, 95Trying to repress feelings, they drank, gambled suffered paralyzing depression, and becameinarticulately violent. A paratrooper’s wife would “sit for hours and just hold him when he shook. Afterward, he started beating her and the children: “He became a brute.” And they divorced —-Adams, 150

Reevaluating Society's Perception of Shell Shock:
A Comparative Study Between Great Britain and the United States
By Annessa Cathleen Stagner
West Texas State University
http://www.wfa-usa.org/new/shellshock.htm

Some returning soldiers suffered through nightmares, while others suffered physically, exhibiting nervous twitches, blindness, or limb dysfunction. <2> In 1915, physician C. S. Myers unknowingly acknowledged the result of soldier's mental conflict between idealistic courage and survival leading to a form of nervous disorder, which he termed shell shock. <3>

The large number of soldiers affected by shell shock continues to engage World War I historians even today. "The heightened code of masculinity that dominated in wartime was intolerable to surprisingly large numbers of men." <4> Nearly 80,000 men in Britain were diagnosed with shell shock during the War, and the number of cases continued to rise after the War ended. Some estimates, including undiagnosed soldiers, claim 800,000 British cases and 15,000 American cases. <5> Shell shock was not just a disease of the common soldier either. Myra Schock acknowledged "historians have generally taken it for granted that officers experienced shell shock in far greater numbers than soldiers of other ranks." <6> Inevitably numerous soldiers from all ranks were diagnosed with shell shock, thus having a tremendous impact on all of society.


During World War I, the British government's primary focus was to keep as many men available for service and in the field as possible. Shell-shocked soldiers directly hindered the army's ability to successfully wage war because their inability to fight decreased the army's number of active troops. Myra Schock pointed out the conflict doctors experienced when trying to balance their governmental obligations with their own sympathy for the mentally strained soldiers. The doctors knew firsthand what shell shock felt like and realized it as a genuine sickness among the troops. However, the British government viewed shell shock as a form of malingering, deserving court martial, and many soldiers "were shot for cowardice, even when doctors argued that the accused was suffering from a medical condition caused by trauma and/ or shell shock." <7> Schock stated British "doctors attempted to draw firm distinctions between their service as doctors and their role as members of the armed services at war." <8> The British government clearly put pressure on doctors and officials to treat shell shock harshly, not as a disease, but as a form of malingering.

Chapter Five
WORLD WAR I
In the 20th century, each war has produced its own categories of psychological and psychiatric casualty; however, World War I was the first clear exemplar of the complex interacting variables of combat stress and its dominant symptom sets.

It is difficult today to comprehend the enthusiasm with which the belligerent populations of both sides greeted the outset of World War I. The notion of war was both glamorous and desirable; it was to be the test of both national and individual toughness, character, and worth.
----------------------------------------------------------
As a cultural phenomenon during World War I, the legitimacy of the symptoms that called for withdrawal of the soldier from the trenches or the combat zone would then, for most, be questionable if physical symptoms were not a part of the expression of the disorder. The punishment for the exhibition of essentially psychological symptoms was often in the earlier years of World War I, summary and massive. Men whom we would today classify as combat-stress casualties were shot for "cowardice." Ferguson (1999) indicates that a significant proportion of the 346 British soldiers executed were shot for cowardice, many of whom were suffering from shell shock. Babington (1997) illustrates this cogently with four cases of soldiers previously seen as suffering from shell shock who were subsequently executed for cowardice. In Britain, "cowardice" was punishable by death until 1930.

The values of Western culture changed between World War I and World War II. For instance, before World War I, dulce et decorum est pro patria mori (it is a sweet and decorous thing to die for one’s country) was engraved at the top of memorial boards at schools and colleges. Throughout the war, many people really believed this sentiment, as did such prowar poets as Rudyard Kipling, Ruppert Brooke, and Alan Seegar. It was not until the 1920s that the concepts of war as a waste, loss, and/or sacrifice in vain were widely explored in relation to World War I.<10> Along with such percepts came a corresponding legitimization of both behavior breakdown for some and a view that the "normal" person was capable of negotiating a symptom-free life course in war and after it.

http://www.gulflink.osd.mil/library/randrep/marlowe_paper/mr1018_11_ch5.html

All Soldiers Fade Away
Justin HudallPosted November 11, 2007 | 06:39 PM (EST)
http://www.huffingtonpost.com/justin-hudnall/all-soldie...

"Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home, while 12% per year were diagnosed with a mental health problem. Against this grim backdrop is an issue that has ignited debate among veterans, government officials and civilians in the healthcare industry: how the Veterans Affairs Department could improve access to healthcare services for rural veterans, who account for about 40% of the VA's patient population." There are 21 states with higher than the national average of veterans within their populations. Eighteen of these are rural states.Because of advances in body armor and medical technology, this war will produce a higher proportion of seriously wounded, traumatized, and brain-damaged veterans than any other.Compounding this is an expected baby boom among military personnel, meaning that the next generation, growing up in the shadow of the Iraq war, will be significantly affected as well.

PTSD and Murder Among Newest Veterans
Jon Soltz | Posted January 14, 2008 | Politics
This weekend, while the 24-hour primary coverage raged on, the New York Times published a very well researched and stunning report on the number of Iraq and Afghanistan Veterans involved in killings, here in America. They found at least 121 cases, now, where a veteran was charged with involvement in a homicide.The trend of our newest veterans being involved in killings on the homefront can be largely attributed to four letters -- PTSD. Our failure to properly screen for and treat this mental injury is the source of so many problems our newest veterans face -- from drug and alcohol abuse, to homelessness, to joblessness, to spousal abuse, to suicide, and now, to murders.
http://www.huffingtonpost.com/jon-soltz/ptsd-and-murder...

Battle Continues Over Vietnam PTSD Numbers
08.23.07, 12:00 AM ET
http://www.medicinenet.com/script/main/art.asp?articlek...
THURSDAY, Aug. 23 (HealthDay News) --
-In the years following the end of U.S. involvement in Vietnam, the actual number of veteran psychologically scarred by what they had encountered in the war became the subject of heated controversy.
A 1988 study, conducted by the U.S. Centers for Disease Control and Prevention, estimated a relatively low lifetime rate of PTSD among veterans of 14.7 percent.
-------------------------------------------------------
"The most important results have been underemphasized, and that is the dose/response relationship, and that's about as close as you can come to a causal relationship," he said. "The other thing is the rate of 1-in-5 war-related onset of PTSD and 1-in-10 still current after the war of impairing PTSD. That
is far from trivial. This is a heavy cost by any count.

This article originally appeared in the July 2007 volume of the Zero To Three
Journal on Coping With Separation and Loss.
The Young Military Child
Our Modern Telemachus
Stephen J. Cozza
Uniformed Services University of the Health Sciences
Alicia F. Lieberman
University of California, San Francisco
-A combat mindset or what has been referred to as Battlemind can lead to misdirected irritability or aggression that can impact on small children. Irritability, emotional rage, jumpiness, hypervigilance, or overreactivity can all lead to family conflict and misunderstanding on the part of the young child. Social withdrawal or reduced communication because of anxiety about sharing upsetting war-related experiences may cause further withdrawal from family members and lead to a child’s confusion about the meaning of such parental nonavailability.
—Postdeployment emotional and behavioral responses can range from more typical short-term distress responses, such as change in sleep, decreased sense of safety, or social isolation, to the development of more serious psychiatric conditions, such as post traumatic stress disorder (PTSD) or depression.
Studies conducted by Hoge and colleagues (Hoge et al., 2004; Hoge, Auchterlonie, & Milliken, (2005) at the Walter Reed Army Institute of Research have demonstrated significant postdeployment distress in populations of combat exposed soldiers and marines returning from Iraq. When screened 12 months after return from combat deployment, nearly 20% of service members endorsed symptoms consistent with a mental
disorder, most often PTSD or depression.
—Studies have demonstrated that the children of parents with depression (Beardslee, Versage, & Gladstone, 1998) evidence significant problems in a wide range of functional areas. Children of Vietnam veterans with PTSD are more likely to evidence symptoms similar to those of their combat-exposed fathers (Rosenheck & Nathan, 1985; Rosenheck & Thompson, 1986).
http://www.zerotothree.org/site/PageServer

FIELD MANUAL NO. 22-51
HEADQUARTERS DEPARTMENT OF THE ARMY
Washington, DC, 29 September 1994
CHAPTER 5
BATTLE FATIGUE FM 22-51
5-1. Introduction
Battle fatigue is the approved US Army term (AR 40-216) for combat stress symptoms and reactions which

* Feel unpleasant.
* Interfere with mission performance.
* Are best treated with reassurance, rest, replenishment of physical needs, and activities which restore confidence.
a. Battle fatigue can also be present in soldiers who have been physically wounded or who have nonbattle injuries or diseases caused by stressors in the combat area. It may be necessary to treat both the battle fatigue and the other problems.
b. Battle fatigue may coexist with misconduct stress behaviors. However, battle fatigue itself, by definition, does not warrant legal or disciplinary action.
---------------
b.Leader and medical personnel in forward areas should expect as many or more soldiers to present with duty or rest battle fatigue as there will be hold and refer cases. It is essential that the former not
become casualties by unnecessarily evacuating or holding them for treatment.
c. In general, the more intense the combat, especially with indirect fire and mass destruction, more cases become heavy and need holding or referral, and the harder it is for them to recover quickly and return to duty.
d. Fifty to eighty-five percent of battle fatigue casualties (hold and refer) returned to duty following 1 to 3 days of restoration treatment, provided they are kept in the vicinity of their units (for example, within the division).
NOTE
Premature evacuation of battle fatigue soldiers out of the combat zone must be prevented as it often results in permanent psychiatric disability. If the tactical situation permits, the vacuation policy in the corps should be extended from 7 to 14 days for the reconditioning program, as this will substantially
improve the returned to duty rate and decrease subsequent chronic disability.

HEALTH-US: Iraq Vets Left in Physical and Mental Agony
By Aaron Glantz
The group Veterans for America, formerly the Vietnam Veterans of America Foundation, estimates that 10,000 veterans of Iraq and Afghanistan are now living on the street.

"What's unique about the men and women coming back from Iraq and Afghanistan is that they're not able to integrate with their family," Feldstein said. "They've seen horrible things. They've been in horrible places and their family can't relate. And so you become homeless in the last place you lived."

A recent study by Harvard's Kennedy School of Government found that by the time the Iraq and Afghanistan wars end, there will be at least two and a half million vets.
------------------------------------
Pentagon studies show that 12 percent of soldiers who have served in Iraq suffer from post-traumatic stress disorder. The group Veterans for America, formerly the Vietnam Veterans of America Foundation, estimates 70,000 Iraq war veterans have gone to the VA for mental health care.
http://www.ipsnews.net/news.asp?idnews=36056

[w8liftinglady]

3. that is an excellent post...thanks..