It was recently announced that according to Pentagon figures, more than 100,000 Middle East war veterans are likely to require mental health treatment in the years ahead. Typically, official bad news numbers are low, and the report explained that even if it’s accurate, the news is probably much worse than it sounds.
The New England Journal of Medicine studied members of four U.S. combat infantry units using an anonymous survey administered to thousands of subjects, either before their deployment or three to four months after their return from combat duty in Iraq or Afghanistan. In survey responses, major depression, generalized anxiety and post-traumatic stress disorder ranked 15.6 percent to 17.1 percent after duty in Iraq, 11.2 percent after duty in Afghanistan, and 9.3 percent before deployment to Iraq.
Evidence shows that when post-traumatic stress disorder is military in origin, it is usually resistant to treatment and is often considered permanent. The kicker is that only about a third of the portion of those who admit a problem will seek mental health care; many don’t even realize the existence of the problem until they get home and realize they can’t hold a job, maintain a relationship, control their drinking, and/or exhibit signs of a condition known as “hypervigilance.”
These points only begin to expose the invisible problem, the true number of severely traumatized adults among us desperate for help but unable to ask for it. True exposure is realized later as their untreated problems surface in the forms of suicide, abuse of many sorts, divorce, and of straining the limits of hospital capacity and law enforcement. The subjects reported that their perception of stigma would be the major barrier to applying for mental health care and services; the study is recent but this is old news to the mental health-care community.
The mental health stigma is an ancient many-headed hydra that must be systematically dismantled so that the solutions may become accessible to those who need them, to open the door for our veterans who responded to the call to duty and who now so desperately need help themselves.
This can be accomplished by facing, teaching, revealing and explaining the human being’s vulnerability not only to the unspeakable violence of war but also, more to the point, to that of trying to survive in a society that does not accept the fact that mental disabilities are no more dishonorable than physical ones.
If Congress is willing to allocate hundreds of billions to support an illegal war based upon misinformation, perhaps it would consider starting to remedy the situation by allocating just a few of those billions to the war against misinformation that seeks to destroy us from within. Coming to recognize an enemy more insidious and threatening than terrorism, as it does not discriminate among those it decimates, would be a good start down the road to a much healthier future for all of us, and specifically for those upon whom, because of congressional actions, an unaffordable toll is being exacted.
Gilles Malkine is director of services, Action Toward Independence Inc., in Monticello.