George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 1
COMBAT VETERANS: ARE THEY RECEIVING THE CARE THEY NEED TO PROPERLY REINTEGRATE INTO SOCIETY? Introduction Following the historic attacks on the United States in September of 2001, the United States Government began deploying forces to Afghanistan under Operation Enduring Freedom (OEF). The goal of this operation was to effectively remove the threat of the Taliban from the country of Afghanistan and to bring those responsible for the attacks to justice.
Four weeks following the attacks, Central Command
(CENTCOM) assumed operational control and began the mobilization of our forces to support this operation. By 2002, forces working in support of OEF had grown to include forces from 68 countries; 27 of which maintain representatives at the CENTCOM headquarters. On March 19, 2003, the United States in conjunction with the United Kingdom began military operations in Iraq with the goal to disarm any weapons of mass destruction this county may have had and
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 2
well as to remove the oppressive regime in power. Unlike Operation Enduring Freedom, Operation Iraqi Freedom (OIF) had a more complex set of objectives. GlobalSecurity.org outlines them as being 1) remove Saddam Hussein from power, 2) isolate and eliminate Iraq’s weapons of mass destruction, 3) seek out and remove terrorists from the country, 4) collect intelligence relevant to terrorist networks, 5) collect intelligence relevant to the illicit production of weapons of mass destruction globally, 6) end sanctions and provide humanitarian aid to the local population, 7) secure Iraq’s oil field resources and 8) to help the Iraqi people create conditions for a transition to a representative selfgovernment. With these two campaigns being conducted simultaneously, in addition to normal national support provided by our military forces, we have seen an unprecedented number of service members redeploying with conditions such as Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injuries (TBI). The US Department of Veterans Affairs National Center for PTSD describes the condition as follows;
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 3
“Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following the experience or witnessing of a traumatic event. A traumatic event is a life-threatening event such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.” Traumatic Brain Injury is defined by the Centers for Disease Control and Prevention as “…a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury”. Statistically, this condition is more deadly than PTSD due to the fact that 50,000 die as a result. As a soldier, having close friends and subordinates which I have trained and, who have served in the aforementioned campaigns, these topics are something that my generation of servicemen and women are not prepared to deal with. We entered the military during a time of “peace keeping” operations and working “standard” jobs; With the war on
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 4
terror being one that will likely not end any time soon, there is a good possibility that I will see family members deploy in support of OIF/OEF. But what should they expect when they return from proudly serving their country; who will return home? In this essay I will exam the question of whether our service men and women are receiving the care their need when returning home from combat environments. I will look at some of the available programs and treatment options available. I will also present information regarding the apparent lack of treatment options and programs.. The purpose of this essay is to provide you with the available fact on this topic to help you formulate an answer to the question; are combat veterans receiving the care they need to properly reintegrate into society?
Evidence in support of Veterans receiving adequate treatment Since the return our men and women from the Vietnam conflict, the American people along with health care organizations nationwide have become more aware of PTSD. With current operations going on its
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 5
9th year, what are the resources that are currently available to our veterans returning home after 1, if not more, tours of service in hostile environments? The US Department of Veterans Affairs, whose primary missions is serve the needs of the men, woman and family members of the US military, has dedicated resources in the form of the National Center for PTSD. The National Center for PTSD has been enacted to advance the clinical care and social welfare of America’s Veterans through research, education and training in the science, diagnosis and treatment of PTSD and stress-related disorders. As part of their services, the National Center has released an information sheet which has very helpful information on some frequently asked questions regarding PTSD, and a broad overview of what a person and/or family member can expect if they think them or their loved one is a victim of PTSD. As part of their treatment programs, the VA provides cognitive behavioral therapy, group therapy, prescription solutions, and family therapy. There may, however, be months or years between the time a service member returns from a combat situation until they are enrolled in
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 6
the VA service system. What programs or assessments are available for them during that period of time? Upon a service members return to their base of origin, they are required by Department of Defense policy to undergo a barrage of evaluations to assess their mental and physical wellbeing. As part of this, they must participate in a comprehensive psychiatric screening which has been designed to help determine if they are suffering from either PTSD or TBI. With TBI, many of these service members would have been assessed by the medical assets in their theaters of operation due to their receiving some sort of physical trauma during their deployment. Being part of their permanent medical record, these personnel may already be required to undergo rehabilitation as part of their redeployment and/or separation from military service, depending on the severity of their head injury. In addition to the US Department of Veterans Affairs, there are also civilian organizations such as the Disabled Veterans of America, American Legion, and the Veterans of Foreign Wars which provide an
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 7
outlet for our servicemen, servicewomen and their families, along with treatment options and resources. Evidence that Veterans are not receiving adequate treatment A large number of government officials, public health organizations and citizens believe that although the men and women of the US military have risked everything in support of their countries objectives, their country has failed to provide the treatment they desperately require for their PTSD. “Between 2002 and 2008, nearly 50,000 veterans from the Iraq and Afghanistan wars received diagnoses of post-traumatic stress disorder. But fewer than 10 percent of those completed the recommended treatment of 10 to 12 weekly sessions within four months; the number only grew to fewer than 30 percent over a year�. For some, this treatment plan is unreal; having to spend 10 – 12 sessions per week, for some, limit their ability to hold down employment and provide for themselves and their families. In addition to this apparent inconvenience, there are several
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 8
categories of veterans who are less likely to receive the care they need. Those include males below the age of 25, those living in rural areas and those who received their diagnoses from primary-care facilities and would need to have their treatment transferred to a mental health facility. According to a Business Week article titled “PTSD Treatment Still Lacking for Veterans: Young, male and rural most likely to face obstacles, research shows”, most veterans who participated in a mental health study with the San Francisco Veterans Medical Center did attending at least one mental health appointments. However, problems which included systemic problems and personal issues caused many of them not to return for follow up appointments. In a transcript from a Congressional meeting on the mental health needs of our veterans, which was a discussion on funding, the VA’s mental health strategic plan and the Uniform Mental Health Services Handbook, there are alarming statements that show our governments
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 9
apparent lack of recourses and programming for our mentally ill veterans. At this point in April of 2009, almost 10 years after current operations began, Dr. Michael Shepherd of the US Department of Veterans Affairs testified that not until 2004 did the Veterans Health Administration develop its 5 year mental health strategic plan. Dr. Shepherd made the following statement regarding the VA’s PTSD programs as of his testimony before the subcommittee; “Additionally, we are concerned that while a section of the Handbook addresses access to specific evidence-based psychotherapies for PTSD, it appears that VA does not have in place a national system to reliably track provision and utilization of these therapies. A national system would allow for a population-based assessment of treatment outcomes with implications for treatment of other veterans presenting for PTSD-related care. While VA has relevant process measures in place to monitor program implementation, we believe that VA should develop more outcome measures where feasible to allow for dynamic refinement of program requirements in order to meet changes in mental health needs and to
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 10
optimize treatment efficacy.� Given the information that is provided above, it is clear that while there are programs in place to help our servicemen and women battle their post combat mental issues, the systems and procedures are not in place to ensure that we are effectively treating and maintaining a uniform level of care across the board. Coupled with the fact the PTSD has been a publicized issue since the return of our Vietnam veterans, it would only seem logical that our government, specifically the agency charged with the care and well being of our veterans, would have put these systems and program in place decades ago. Conclusion In order to present an essay that I felt fairly represented both sides of this debate; I chose to begin my research by looking at the definitions of both PTSD and TBI. From those helpful resources, I was able to find information on the existing programs available to our veterans and even some programs to their families. After gathering all of this information, there was one question that kept surfacing for me; why are we fighting
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 11
this war? As you can see from the information provided in this essay, there are arguments for both sides of the question. Some would argue that the programs are in place to help our service members battle their mental issues; from the US Department of Veterans Affairs to the private organizations. While others would argue that the programs that are in place are ineffective and “too little-too late�. Regardless of which side you stand on with this question, the big picture remains clear; mental health care for our veterans must be an ever evolving and progressive entity. As the way in which wars are fought and won changes, so do the challenges and repercussions for our veterans.
Harris 12
WORKS CITED 1. National Centers for Post Traumatic Stress Disorder. (Unknonwn). WHAT IS PTSD? - A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD. Published by the US Department of Veterans Affairs; Washington, DC. 2. "What is Traumatic Brian Injury?" Http://www.cdc.gov/ncipc/tbi/TBI.htm. National Center for Disease Control and Prevention, n.p. Web. 18 Mar. 2009 3.
“Operation Enduring Freedom – Operations” http://www.globalsecurity.org/military/ops/enduring-freedomops.htm, GlobalSecurity.org, n.p., 2 Sep. 2008.
4.
“Operation Iraqi Freedom” http://www.globalsecurity.org/military/ops/iraqi_freedom.htm, GlobalSeucrity.org, n.p., 27 Apr. 2005
5.
“Coping with a Traumatic Event” http://www.cdc.gov/masstrauma/factsheets/public/coping.pdf, National Center for Disease Control and Prevention, n.p., n.d.
6. Business Week Article : Author, Dotinga, Randy,( Feb. 10, 2010). PTSD Treatment Still Lacking for Veterans: Young, male and rural most likely to face obstacles, research shows, Business Week, http://www.businessweek.com/lifestyle/content/healthday/635984. html 7. Subcommittee on Health of the Committee on Veterans Affairs. (2009). Charting the U.S. Department of Veterans Affairs' progress on meeting the mental health needs of our veterans [electronic
George Harris (830353266) ENGL 2030OL3 INST: Nicole Piasecki 17 FEB 2010
Harris 13
resource] : discussion of funding, mental health strategic plan, and the uniform mental health services handbook. Washington, DC: U.S. Government Printing Office.