A brief history of the Bush administration's refusal to apply sound science and humane policy to the question of combat-related PTSD and PTSD-related suicide among soldiers and veterans.



In August 2003, a string of soldier suicides and daunting psychiatric casualties provoked the army to send a team of mental health experts to Iraq. Their report confirmed a suicide rate three times greater than what is statistically normal for the armed forces. It further acknowledged that fully one-third of the evacuated psychiatric casualties "departed theater with suicide-related behaviors as part of their clinical presentation." Yet in spite of the daunting numbers and ominous implications for the future, the report concludes that "suicide among OIF [Operation Iraqi Freedom] deployed Soldiers is occurring for the same reasons typically found among Soldier-suicides": namely insufficient or underdeveloped life coping skills; marital, legal, or financial problems; chronic substance abuse; and mood disorders.

In April 2006, the Army released statistics showing that in spite of much-touted new prevention initiatives, the suicide rate had continued to climb. Col. Joseph Curtin, a senior Army spokesman, is quoted saying, "We're not alarmed." Curtin went on to say that the Army was not aware of any single reason for the rise, but he discounted the notion that the increase was caused by exposure to combat. Instead, he blamed factors such as financial difficulties, failed relationships, drugs and alcohol. Once again, the Army would have us believe that individual soldiers with personal problems are to blame.

It is baffling, if not astonishing, that these military psychiatrists, supposed experts in combat-related stress, have so normalized war that it is overlooked as the source of the disease they have been sent to diagnose, that its horror can be thus discounted and its psychic effects rendered invisible. A separate section of the report, intended to assess the general health and well-being of soldiers in Iraq, lists as the most often reported combat stressors "seeing dead bodies or human remains, being attacked or ambushed, and knowing someone who was seriously injured or killed." But the report considers none of these factors in its analysis of the etiology of soldier suicides.

Furthermore, active duty soldiers are only part of the story. One of the well-known characteristics of posttraumatic injuries is that the onset of symptoms is often delayed. Some soldiers manage to bring their memories home before they are overwhelmed. The military doesn’t track or count veteran suicides at all. They get written up in hometown newspapers; they are locally mourned, but they are officially ignored.

In October 2004, the army released a new study, published in the New England Journal of Medicine, reporting that one in six of all Iraq veterans suffers from PTSD or depression. Given that well over one million U.S. troops have fought in the wars since September 11, 2001 (as of January 1, the exact figure, according to the Pentagon, was 1,048,884, or approximately one-third the number of troops ever stationed in or around Vietnam during the fifteen years of that conflict), that would mean that at least 166,000 men and women already are living with serious mental illness as a result of their war experiences. But the Journal article went on to say that of those soldiers included in the army estimates, fewer than 40 percent have sought professional help, and that those who have not sought help are generally the most vulnerable, the most fragile, the most likely to develop serious and lasting symptoms.

In March of 2006, however, the Journal of the American Medical Association published a new study claiming that the number of soldiers who will experience "clinically serious stress reaction symptoms" was actually more like one in three. That would make more than 333,000 veterans who already need help. And consider that the data thus far available concern only the acute cases. The delayed and the chronic cases have yet to manifest themselves.

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