Soldiers With PTSD Are Not Getting Treatment

US Soldiers from Iraq with PTSD are not Getting Treatment

[Original article published in the New England Journal of Medicine]

The basic conclusion of this article, which is a review of a study of soldiers returning from Iraq and Afghanistan, is that: "... among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care."

This has appeared many times in the literature. It is "not acceptable" for soldiers to experience trauma, much less to seek help for it. Soldiers are expected to be hard as nails and innately able to tolerate the stresses of war. Superhuman, in fact.

The study also found that "the prevalence of PTSD (according to the strict definition) increased in a linear manner with the number of firefights during deployment: 4.5 percent for no firefights, 9.3 percent for one to two firefights, 12.7 percent for three to five firefights, and 19.3 percent for more than five firefights." Because of this, soldiers serving in Iraq are more likely to experience PTSD than those serving in Afghanistan.

Not surprisingly, there was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants, and the prevalence of PTSD. And having been injured or wounded also increased the rates of PTSD.

The military recognizes the reality of PTSD, however it is systemically unable to address it properly.

Echoes of Vietnam

This is interesting. Within this article is an observation about differences in Vietnam veterans' experiences compared with World War II veterans upon their return home.

"The coming home process of the Vietnam soldier failed to account for the mind's need to assimilate this experience in a slow-paced manner. After twelve to thirteen months of combat duty, the military flew soldiers back to the States in a matter of hours and, again, as isolated individuals rather than as teams. This is in stark contrast to the weeks or sometimes months that World War II veterans spent on ships returning to the U.S., while sharing time with other soldiers close to them.

"In forty-eight hours the Vietnam combat soldier could go from a unit assault in which he killed four North Vietnamese soldiers with an M-16 to sitting on the front steps of his parents' house in the U.S. While in Southeast Asia, soldiers would dream of that day. But when it arrived they weren't prepared...."

[The article goes on to discuss that the American public turned against the Vietnam war, and rather than receiving ticker-tape parades, the soldiers were spat upon. In addition to the traumatic return to civilian life unprepared, Vietnam Vets became the villains. This may yet happen in the Middle East, but that's not the real point of this observation.]

It appears that through an unintended side effect of technology, World War II (and earlier) veterans had some of the exact same transitional support our returning soldiers now need. Weeks and months of transition time within the supportive context of other soldiers ... established teams with shared experiences and shared needs.

Yet now, as the article suggests, transportational technology and "efficiency" has completely erased this meager support system. Little wonder that we are seeing increasing numbers of reported cases (6400 according to the VA, but that number is disputed), and the expectation that the cases will skyrocket as troops are rotated out of the theater.

From: Post Traumatic Stress Disorder: Summary - The Anxieties Site