Exploritory Essay on Combat Veterans

George Harris (830353266) Harris 1ENGL 2030OL3INST: Nicole Piasecki17 FEB 2010

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

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 self-

government.

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;

“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

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

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

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

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

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

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

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

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 13

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-freedom-ops.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 resource] : discussion of funding, mental health strategic plan, and the uniform mental health services handbook. Washington, DC: U.S. Government Printing Office.

http://www.cdc.gov/masstrauma/factsheets/public/coping.pdf

http://www.globalsecurity.org/military/ops/iraqi_freedom.htm

http://www.globalsecurity.org/military/ops/enduring-freedom-ops.htm

http://www.globalsecurity.org/military/ops/enduring-freedom-ops.htm

Exploritory Essay on Combat Veterans

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