May 23, USA Today Editorial: Our View on Mental Health and the Military – Wars Take a Deadly Toll, Even After Vets Return Home

USA Today

VA, ill-equipped to handle suicide problem, plays it down instead. 

May 23, 2008 – When a top doctor at the Department of Veterans Affairs learned in February that about 1,000 veterans under VA care attempt suicide each month, he knew just what was needed: A smart public relations strategy.

Ira Katz, the agency’s deputy chief for mental health care, sought advice from an agency public affairs officer. “Shh!” he wrote in an e-mail. “Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

This approach toward a tragic statistic is just one indication that the agency in charge of caring for veterans is more interested in minimizing the extent of mental health problems that today’s veterans face than it is in tackling them.

On Memorial Day, the nation will honor those who have given their lives in service to their country, including the more than 4,500 men and women killed in Iraq and Afghanistan since 2001. But the nearly 37,000 who have been wounded in those wars often remain in the shadows. Even less attention goes to those suffering from invisible wounds.

Nearly 20% of servicemembers who have returned from Iraq and Afghanistan report symptoms of post-traumatic stress disorder (PTSD) and major depression; only half have sought treatment, according to a survey released last month by the RAND Corp., a non-profit think tank.

RAND found that the majority of the returning veterans have experienced the kind of traumatic events — seeing friends and non-combatants seriously injured or killed, smelling decomposing bodies, being knocked over by an explosion — that can trigger PTSD and depression.

A VA study in February found more than 8,200 suicides among VA patients from 2001 through 2005 — a rate more than three times the general population. And just as surely as there is a suicide problem, the VA is ill-equipped to handle it, according to several independent reports.

RAND found that while the VA’s 153 medical centers offer quality treatment, a confusing system makes it hard to access. Many of today’s vets seek treatment at local VA centers, where specialized service is harder to find.

A 2007 report by the VA’s inspector general found that much of the agency’s 2004 plan to upgrade suicide prevention services was unfinished, with several initiatives still in the pilot stage.

And Ronald Maris, a University of South Carolina suicide expert, told Congress this month that the VA’s routine questioning to determine whether a patient is a suicide risk is “woefully inadequate.”

RAND and others agree that the VA’s mental-health system needs to be less confusing and more accessible. The military also needs to remove cultural barriers that discourage soldiers and veterans, who fear stigma, from seeking treatment. Simple tools exist to assess risk, and at-risk veterans need their cases followed. RAND says better treatment would ultimately pay for itself or save the nation money, given the costs of problems associated with mental illness — such as homelessness, domestic violence and substance abuse.

A powerful case for change was made last year by Mike and Kim Bowman, whose son Timothy survived service in Baghdad as a gunner, only to return home and kill himself in 2005. Many soldiers are turned away or misdiagnosed at VA facilities, the Bowmans told Congress in December. Then, like their son, they lose “their battle with their demons.”

It’s the VA’s duty to ensure that fewer of these demons win.

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