6-24-06, 9:54 am
According to reports produced by the Department of Veterans Affairs, more than 56,000 veterans of the Iraq and Afghanistan wars have been diagnosed with mental illnesses ranging from post-traumatic stress disorder (PTSD) to depression and bipolar disorder. Robinson believes these mental illnesses should also be considered combat injuries.
On a Washington-area radio show this past week, Robinson said that military culture refuses to acknowledge mental illnesses arising from combat as 'real injuries.' Ignoring these injuries as such has had dire consequences for the service members inflicted. A long tradition of stigma placed on service members who seek mental health care has had unique and even deadly effects on people serving in the current conflicts and on returning veterans.
For the first time in US military history, according to a series of articles published recently in the Hartford Courant, there is hard evidence that the military is 'recycling' troops who have sought mental health care, who have been diagnosed with mental diseases, or who have indicated symptoms of mental duress and illness to their peers and chain of command. Without adequate treatment, they are being returned to their duty stations in Iraq and Afghanistan.
Matthew Kaufman, a co-author of the Courant series, told a radio station that as part of the investigation he helped conduct, he talked with families and friends of veterans and found troubling results. A number of cases of service members committing suicide while in theater, i.e. areas occupied by US forces preparing for or engaged in war or occupation activities, showed symptoms prior to their deaths, but didn't get medical help.
Some personnel who reported mental distress to military medical services often received inadequate care and were returned to duty quickly. Kaufman described the plight of some personnel who, after reporting mental distress, were pulled from duty, given 72 hours of rest and recreation, supplied with anti-depressant medications (such as Zoloft or Prozac), and were returned to their original duty stations.
This procedure goes against standard medical opinion regarding the use of anti-depressants. When anti-depressants are prescribed, doctors usually recommend extended observation of a patient for signs of increased depression that can occur when starting on anti-depressant medication. Kaufman’s articles cited cases where service members returned to duty under these conditions committed suicide.
Kaufman argued that normal military policy is to disqualify service members prescribed anti-depressants for extended deployment. Kaufman cited military commanders who said the actual practice in Iraq and Afghanistan, however, is that if troops seem physically able to accomplish their duties, they are returned to their duty stations despite risks associated with mental illness.
Kaufman’s investigations found that since the war in Iraq began, the military has reduced the number of mental health screenings and may even have weakened their effectiveness. Concerns about mental illness did not stop the deployment to war zones of soldiers who may have symptoms. Service members, who in non-theater bases and posts were disqualified from normal duty because of mental health prior to deployment to Iraq or Afghanistan, found these restrictions lifted once they arrived in theater.
One military study estimated that 9% of pre-deployed personnel displayed signs of mental health illness. But after deployment orders are cut, the military screens only about 1 in 300, according to Kaufman. This screening process is composed of a single question on a form asking soldiers if they have sought medical treatment for mental health related symptoms. In other words, thousands of soldiers whom the military has estimated show symptoms of mental illness outside of theater, once they are ordered to be deployed to Iraq or Afghanistan, fall through the huge holes in the screening process.
The policy of both allowing mentally ill troops to fall through holes in the screening process and of returning mentally injured troops to their duty stations without adequate treatment is further exacerbated by over-stretching personnel resources with multiple deployments, or serving more than one 'tour' in a war zone. In the current wars in Iraq and Afghanistan multiple deployments are almost the norm. About 378,000 out of 1.3 million people who have served in Iraq or Afghanistan have been there more than once. Because of this, Kaufman suggested, the risks for mental illnesses have been intensified.
Kaufman also said that there was an effort in 2003 to de-stigmatize mental health in the military in order to encourage personnel to seek care. Nevertheless, indicators such as suicide, violence (aimed at themselves and others), and claims by returning veterans for mental health care spiked in 2005.
Some causes of the lack of adequate care include:
1. continuing stigmatization of mental health 2. failure of leadership up and down the chain of command to make adequate care available and to relieve soldiers who need extended care 3. failure to regard mental illness as a combat injury 4. multiply deployments to war zones due to troop shortages
Even the Department of Veterans Affairs has had a hard time believing the extent to which combat-related mental illnesses have affected US service members. Under pressure from the White House to cut veterans' benefits, the VA investigated about 2,100 cases (of tens of thousands) of Iraq and Afghanistan war veterans claiming benefits for PTSD injuries. They dropped the study after finding zero cases of fraud, according to the Washington Post. Still, according to the GAO, 4 out of 5 returning veterans who by the military's own standards are at risk for mental illnesses receive no treatment.
While some pundits may try to blame individual soldiers for not seeking health care or individual commanders for not providing care and ordering wounded soldiers back into duty, the principle of command responsibility makes both military and civilian commanders responsible for this systemically dire situation.
Not only have thousands of families been ruined by this bad policy, but the casualties of war continue long after vets return. Continuing illness, crime and violence, addictions to drugs and alcohol, inability to re-socialize and re-adjust to civilian life, difficulties finding work, economic instability and homelessness are serious consequences of war that veterans face, Robinson said.
Men and women asked to sacrifice their lives and health for a clouded cause that turned out to be little more than a struggle over shrinking oil resources and geo-political maneuvering are then tossed aside where the Republican ideology of individualism and hatred of social programs demands they fend for themselves.
As serious as these consequences are, the ability of the country to defend itself against real threats has also been dangerously jeopardized. We cannot afford to entrust the Bush administration or the Republican-controlled Congress with leadership of these matters any longer.
When we say 'support our troops,' what do we mean? Some of us mean that we should not ask them to make such sacrifices unless we can give hard evidence that they are truly defending our country. In addition, we mean providing them with the means to be healed when they do make that sacrifice.
Others mean that we should blindly follow the Bush administration and that soldiers should buck up and be 'real men.' This attitude demands blind obedience for a war based on lies that has cost the lives of over 2,500 US troops and over 75,000 wounded – whose scars are both physical and mental.
We need our sons and daughters, our spouses, partners, and friends, our mothers and fathers to come home safe. They need to heal. We need to be whole again. The price for this war based on lies has already been too high.
--Contact Joel Wendland at
