Washington, DC (September 7, 2004) — The alarming number of suicides earlier this year among U.S. troops serving in Iraq has raised a red flag about the mental strain on our service men and women as they face grueling battles and a conflict with no clear end in sight. These suicides are only the most visible manifestation of the rising mental health toll from the Iraq war and other U.S. combat operations abroad. Studies indicate that troops who served in Iraq are suffering from post traumatic stress disorder and other problems brought on by their experiences on a scale not seen since Vietnam.
“It is time for the military to more effectively monitor and treat mental health needs before, during and after a combat deployment,” said Lawrence Korb, senior fellow at the Center for American Progress. “The country owes every military member sent to fight and potentially die in combat access to proper mental health care while deployed, upon their return to the United States and after leaving active military service.”
These figures have mental health professionals and veterans groups worried, and with good reason. At a time when our troops are working hard to answer the nation’s call, their own needs remain unmet. Barriers to mental health care persist both in the field and at home, leaving mental health problems to fester or worsen.
The personal burden on troops affected by mental trauma and their families is enormous, and these mental health problems have consequences for communities and the nation as well. The full extent of this hidden cost of war will not be apparent for some years to come, but experts believe it may involve tens of thousands of service members. Preparing for the challenge at hand and extending the appropriate care and respect to our troops must be a top priority.
The following are a number of concrete steps that the Department of Defense, the Administration and Congress can take to address current shortfalls and meet coming challenges in mental health care for our soldiers and veterans.
- The Department of Defense should work to improve mental health care in the field of combat. Combat, particularly ground combat, produces a high-stress environment that can be corrosive to troops’ mental health. DOD should take steps to implement fully the recommendations made by the Army Mental Health Advisory Team for improving mental health care in the field. In addition, similar follow-on studies in current and future military operations should become standard, so that troops’ needs can be addressed and methods of care assessed and improved regularly.
- The Department of Defense must ensure that all troops are given pre- and post deployment medical examinations. Medical examinations – including mental health assessments – to identify troops who should not be deployed or who need help after returning home are critical. They should be completed on all active duty and guard and reserve troops. Pre-deployment examinations should take place at an individual’s home station before departure to the mobilization site. Troops with pre-existing conditions that prevent deployment should be rehabilitated, reclassified or seen before a medical evaluation board. Post deployment examinations should be required within a specified period after the units return to the United States. Questionnaires are not sufficient to establish physical and mental fitness.
- The Department of Defense and the Department of Veterans Affairs should provide aggressive mental health counseling and outreach programs for returning troops and their families. Studies have shown that troops who need mental health services do not always seek or receive them because of stigma and other barriers to care. In order to address this challenge and prevent mental health problems from developing into severely debilitating conditions, the DOD and the VA should work with local civilian agencies, chaplains and family centers to reach out to active duty and guard and reserve troops and veterans and their families proactively and systematically.
- The Department of Defense should launch a service-wide anti-stigma campaign. The stigma associated with seeking help for mental health problems will not decrease without a service-wide campaign to change perceptions and attitudes among troops and leadership. Training and education programs for military members and their families should be initiated. In addition, commercial ads similar to those currently targeting depression among civilians could be run in military newspapers and magazines as well as on Armed Forces Radio. The ads should give symptoms and descriptions of common combat-related and other mental health problems, publicize resources, encourage troops to come forward, and guarantee that seeking treatment will not be held against an individual’s career.
- The Department of Defense and the Department of Veterans Affairs must work as a team to provide proper and seamless care for our soldiers and veterans. No combat veteran leaving military service should fall through the bureaucratic cracks. The DOD and the VA should improve the system for handing over responsibility from the DOD to the VA for on-going medical care of those leaving the service. The hand-off should include a detailed history of care provided, including mental health, and an assessment of what each patient may require in the future.