The Tribune Democrat, Johnstown, PA

Editorials

June 15, 2009

At war with PTSD | Mental affliction in soldiers tied to area homicide, robbery

The Department of Defense has taken major steps to help military personnel returning from deployment.

The Veterans Administration offers counseling and treatment for soldiers suffering from the effects of combat, including post-traumatic stress disorder.

So why are we publishing stories about military veterans who say they have PTSD and who are being charged with violent crimes?

The condition has recently been linked to a double homicide in the Altoona area and an armed robbery in Cambria County. In both cases, the alleged assailants said they were suffering from PTSD.

PTSD is a complicated problem that is growing in scope and intensity nationally and here in our region, where a disproportionately high number of residents has served in Iraq and Afghanistan due to our region’s strong commitment to military service.

“People come in when they have a crisis,” said John Grove, chief of social work with the James E. Van Zandt VA Medical Center in Altoona. “Of course, we’re seeing more (PTSD) related to Iraq and Afghanistan because they’re coming back.”

Some level of PTSD is an inevitable reality during times of war. And the incidence is elevated now because of the high rate of re-deployment – multiple tours of duty.

Identifying military personnel who are in need of help, and getting them that help, is a two-sided coin:

The Department of Defense must continue to do more for these veterans, moving toward a system where soldiers are not penalized for undergoing psychological evaluations. In the past, officials could lose their rank and soldiers could lose their careers if questions existed about possible psychological concerns.

On the other side, military personnel and their families must be willing to seek evaluation and treatment – before a “crisis” has occurred. There are many places for veterans to get help, even anonymously. Soldiers must recognize in themselves the signs of PTSD and then act.

“The treatment process is very involved, very state-of-the-art,” Grove said. “But we need the patients to come forward and seek treatment.”

Signs of PTSD can include:

* Combat flashbacks or bad dreams.

* Avoiding talking with friends and family, especially about battlefield experiences.

* Difficulty in relationships.

* Alcohol or drug abuse.

* Elevated anger or irritability.

* Difficulty sleeping.

Not everyone who has one or more of these symptoms is suffering from PTSD. But you can’t know without seeking help.

“We’re ready to help them as soon as they’re ready to make the self-referral,” Grove said.

And self-referral appears to be the only option at this time. He said it is against the law for a military organization, including the VA, to force an individual to be evaluated or get treatment. And a full psychological test is not part of standard post-deployment activities.

But there is much the DOD and other agencies can do – and have done, in some cases.

In an address to the House Appropriations Committee’s Subcommittee on Defense in March, Brig. Gen. Loree K. Sutton detailed steps the DOD has taken recently to help offset the impact of PTSD.

Sutton listed more than $700 million in programs to help service men and women who have suffered physical and psychological trauma in combat. Among the many projects is a new brain-treatment center in Johnstown.

Steps taken since 2007 have included:

* Establishment of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

* Introduction of a new evaluation process, the Military Acute Concussion Evaluation tool, to assess the likelihood of mild traumatic brain injuries.

* Standardization of training for medical providers.

* A conference – “Building Community Connections: Suicide Prevention for the 21st Century” – to enhance cooperation among suicide prevention experts in government, medicine and communities.

* Improved mental-health care and expanded access to care.

* Better pre-deployment testing.

* Production of educational tools – including a DVD – for military personnel and their families.

One step being taken by the DOD is a concept that we wholeheartedly support.

Sutton said the department has instituted a “pro-resilience and anti-stigma campaign ... and eliminated the requirement to divulge combat-related mental health history on security clearance forms.”

This step should encourage soldiers to seek help without fear of losing their standing with the military just for being tested.

“Despite the progress, much work remains to be done,” Sutton said. “We will continue to work to meet the needs of our reserve forces, especially those in rural or underserved areas.”

That’s good news.

We need the DOD to have a greater involvement in the impact of combat on soldiers as they return to civilian life. These men and women pay a huge price to serve their country, and they deserve full support in their training, their deployment and after they return home.

Likewise, soldiers and those close to them must have the courage to seek out help when problems begin to surface – and not after a personal or community tragedy has occurred.

PTSD is a problem society cannot ignore.

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