Reader Dan on PTSD and Medical Care, Part 5

This one is by Reader Dan.

What does supporting the troops mean to you? If you ignore looking at these things, can you claim you are in the support category?

“Lead researcher Mark Kaplan of Portland State University in Oregon” reports that

male U.S. veterans are twice as likely to die by suicide than people with no military service, and are more likely to kill themselves with a gun than others who commit suicide….

The study tracked 320,890 U.S. men, about a third of whom served in the U.S. military between 1917 and 1994. The rest had no military background.

Of the veterans, about 29 percent served in the Vietnam War, 28 percent in World War Two, 16 percent in the Korean War and the rest in other conflicts up through the 1991 Gulf War.

Those who committed suicide were more likely to have been white, better educated and older than the other men, the researchers found. The most acute risk was among veterans with some sort of a health problem that made them unable to participate fully in home, work or leisure activities.

The researchers said unlike some previous studies on suicides among U.S. military veterans, theirs did not focus on Vietnam War-era veterans or veterans who get health care through the Department of Veterans Affairs system. They said three-quarters of veterans do not receive health care through VA facilities.

Both the VA and the Pentagon in recent weeks have acknowledged a need to improve “mental health treatment”. Jan Kemp, a VA associate director for education who works on mental health, has estimated there are up to 1,000 suicides a year among veterans within the VA system, and as many as 5,000 a year among all living veterans.

A recent investigation by the Government Accountability Office found that just 22 percent of U.S. troops returning from Iraq and Afghanistan who showed signs of PTSD were being referred by Pentagon health care providers for mental health evaluation, citing inconsistent and subjective standards in determining when treatment was needed.

Penny Coleman is the widow of a Vietnam Veteran who took his own life after coming home. Her latest book, Flashback: Posttraumatic Stress Disorder, Suicide and the Lessons of War, was released on Memorial Day, 2006. In a moving and compassionate way she outlines how ignoring this cost as an externality reverberates for years. She includes in her book how new discussions of human costs of war re-trigger old wounds and, in my mind, might have something to do with the irritability that readers mention about people they know.

And off topic but another problem faces soldiers. Military and family law experts don’t know how big the problem is, but 5.4 percent of active duty members — more than 74,000 — are “single parents”, the Department of Defense reports. More than 68,000 Guard and reserve members are also single parents. Divorce among service personnel is rising.

Custody battles for male or female soldiers is a problem. Hence we have not looked at what conflicts might exist between reasonable laws of family, children, and supporting troops. Family court versus federal law. Why not? is a well known problem, and tangled.

To summarize posts to date:

The military admits to recognizing a real problem that warrants funding in addition to regular care.

To admit to symptoms means loss of career advancement for many. The actual hostility (soldier to soldier and superiors) to admitting symptoms is quite robust, but to date I have only anecdotal evidence.

To seek help is to run into major barriers in VA, Tricare, and private insurers, depending on how you access your insurance. This includes your family as well.

The costs in the short run, much less long run remains as an externality to the cost of war. On the other hand, as more is known, it is harder to ignore.

The system to date appears to prevent best practice and good research from taking the lead as the metric seems to be geared to demand reduction rather than treatment efficacy in this realm of the cognitive sciences. Both public and private funding sources appear to use this metric.

Research is headed in the direction that PTSD is brain based and body based, and has been around awhile, and could help most soldiers and ex-soldiers and families. It is clearly diagnosable and treatments are successful.