Thursday, September 11, 2008

Casualties of War

One of the ramifications of the Bush Administration’s rush to war in Iraq was that it offered returning service-members a Veterans Administration that was unready and incapable of handling both the influx of returning troops in need of care and the complexities of their injuries. Troops were engaged in a war with no front lines and, because of improved armor (when it was available) and combat medical technology, they were surviving blasts and injuries that would have killed many of their predecessors from generations past. While grateful for their lives, they were left to confront mental health issues such as Traumatic Brain Injury and Post-Traumatic Stress Disorder in unprecedented numbers. Along with increased and extended deployments, this trend has led to symptoms such as depression and bouts of rage which cost many of them their civilian jobs, their families, and, in increasing numbers, their lives. CNN reports:

The rate of suicides among-active duty soldiers is on pace to surpass both last year's numbers and the rate of suicide in the general U.S. population for the first time since the Vietnam war, according to U.S. Army officials. As of August, 62 Army soldiers have committed suicide, and 31 cases of possible suicide remain under investigation, according to Army statistics. Last year, the Army recorded 115 suicides among its ranks, which was also higher than the previous year.

Army officials said that if the trend continues this year, it will pass the nation's suicide rate of 19.5 people per 100,000, a 2005 figure considered the most recent by the government. The rise can be attributed to the increased pace of combat operations, the number of deployments and financial and family troubles connected with deployments, Army officials said.

"Army leaders are fully aware that repeated deployments have led to increased distress and anxiety for both soldiers and their families," Secretary of the Army Pete Geren said. "This stress on the force is validated by recent studies of Iraq and Afghanistan veterans reporting symptoms of post-traumatic stress disorder or major depression."

To combat this disturbing trend, representatives from the DoD, the CDC and the NIH made the following recommendations:

• Design a study that will identify suicide risk among veterans of different conflicts, ages, genders, military branches and other factors.

• Improve the VA's screening for suicide among veterans with depression or post-traumatic stress disorder.

• Foster a better understanding of suitable medications for depression, PTSD and suicidal behavior.
Senator Daniel Akaka, Chairman of the Senate Veterans Affairs Committee, made the following statement on the floor of the U.S. Senate:

For all that is being done to support our troops in battle, we must remember this truth: for many veterans, their battles do not end when they return from war. Instead, war returns home with them, and within them. They face an enemy that is hard to understand, and harder to defeat. Their wounds, and their enemy, are unseen. But the reality and the sometimes deadly consequences of these invisible wounds cannot be ignored.

I am deeply troubled by the latest information we have received from VA. The number of veterans lost to the enemy of suicide is rising. Suicide among Iraq and Afghanistan-era veterans is at an all time high. The most recently recorded year, 2006, saw 113 Iraq and Afghanistan-era veterans lost to suicide, almost as many as were lost in the years 2002 to 2005 combined. This is disturbing.

Iraq and Afghanistan veterans are not the only ones suffering from service-related mental health injuries. Indeed, the number of veterans found to have service-connected PTSD is not just rising – it is rising several times faster than service-connected disabilities overall. Nor are suicide and mental health only a matter of concern among discharged veterans. Recent news reports show that suicides among active-duty soldiers are positioned to reach an all-time high, exceeding last year’s record number.

Much is being done to protect and heal veterans with mental health issues. VA has expanded mental health outreach. The Vet Centers, run largely for vets and by vets, offer a safe haven and readjustment counseling. And for those in desperate need, VA now operates a 24-hour suicide hotline. In the one year it has been operating, they have received tens of thousands of calls, and performed over a thousand rescues of veterans about to take their own lives.

Unfortunately, these efforts are not enough. Veterans are committing suicide at a higher rate than their civilian counterparts. A recent RAND study found that nearly three out of four veterans in need of mental health care receive inadequate care or no care at all. This cannot be acceptable to a nation intent on protecting those who wear its uniform...

PTSD and other service-related invisible wounds are real injuries. They are also an enemy to veterans, to the families that support them, and to all Americans. It is not enough to bring our troops home – we must support them when the battle follows them home. It is unacceptable that veterans who come home safely later lose their lives to the enemy of suicide. We must do more to support those who have served us.

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