[From PTSD: A Soldier’s Perspective, originally posted JAN 2009. Click through the above link for Scott Lee’s full post.]
For our WWI and WWII vets it was to suffer in silence, for our Korean and Vietnam vets the denial of such suffering, and for my generation of Desert Storm vets the myth of the “Jarhead” movie as a common experience and of the denial of the Gulf War Syndrome (which was recently acknowledged by the US government) and now with our modern veterans, the effects and realities of multiple deployments.
Preliminary self-reported rates of PTSD from OIF and OEF have reached 15% already according to Hoge et al. (with a 15-40% lifetime rate after combat; Hoge and Castro, 2005 para. 2) and we continue to have naysayers saying the problem could not be as bad as we say it is. How many times have our veterans been on the receiving end of this same kind of generational denial and recrimination?
Rand (2008b) reports,[O]f the 1.64 million service members who had been deployed for OEF/OIF as of October 2007, we estimate that approximately 300,000 individuals currently suffer from PTSD or major depression and that 320,000 individuals experienced a probable TBI during deployment (p. xxi).
These figures taken with the above place estimate levels of PTSD today in soldiers and veterans of our nations modern wars at 23%.
The data on multiple tours was quite disturbing, due the fact that soldiers and veterans who have more than one deployment have significantly higher rates of mental health problems. Quoted directly from the horses mouth, the Mental Health Advisory Team (MHAT) V, the military’s own research arm reports,Soldiers on multiple deployments report low morale, more mental health problems, and more stress-related work problems. Soldiers on their third/fourth deployment are at particular risk of reporting mental health problems (MHAT V, 2008, Sec. 2.2.2, No. 8).
VFA reported on October 8, 2008 that 1,321,019 soldiers had been deployed to wars abroad, 796,483 (60%) had been deployed once, and that 469,095 soldiers had been deployed 2 to 3 times (36%), and 55,441 (4%) had been deployed 4 to 6 times. With multiple tours our modern veterans will become exponentially more vulnerable to join the ranks of the walking wounded.
In the monograph, a truncated report, titled “Invisible Wounds of War,” recently published by Rand (2008a),Early evidence suggests that the psychological toll of these deployments—many involving prolonged exposure to combat-related stress over multiple rotations—may be disproportionately high compared with the physical injuries of combat. Concerns have been most recently centered on two combat related injuries in particular: posttraumatic stress disorder and traumatic brain injury. Many recent reports have referred to these as the signature wounds of the Afghanistan and Iraq conflicts. With the increasing concern about the incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise (p. iii).
The report adds,The pace of the deployments in these current conflicts is unprecedented in the history of the all-volunteer force (Belasco, 2007; Bruner, 2006). Not only is a higher proportion of the armed forces being deployed, but deployments have been longer, redeployment to combat has been common, and breaks between deployments have been infrequent (Hosek, Kavanagh, and Miller, 2006). At the same time, episodes of intense combat notwithstanding, these conflicts have produced casualty rates of killed or wounded that are historically lower than in earlier prolonged conflicts, such as Vietnam and Korea. Advances in both medical technology and body armor mean that more servicemembers are surviving experiences that would have led to death in prior wars (Regan, 2004; Warden, 2006). However, casualties of a different kind—invisible wounds, such as mental health conditions and cognitive impairments resulting from deployment experiences—are just beginning to emerge (p. 2).
The Psychiatric Times reports a “gathering storm” due to the estimate that 70% of soldiers and veterans will not seek help from federal agencies (DoD or the VA), placing an undue strain on private facilities and practitioners. With this in mind the public sector of mental health has little to no preparation for the oncoming onslaught of help seeking veterans and soldiers.
[These statistics are two years old. Time to do some digging, I want to see if I can find current ones, or related reports on DOD efforts to reverse trends in treatment (or lack thereof), etc. -R]