Mental war wounds need extended care

As the U.S. military draws down troops in Afghanistan on this Veterans Day, more attention has rightly begun to focus on the mental health conditions of our men and women in uniform. By some estimates, one in five of those veterans returning home experience post-traumatic stress disorder or major depression. Counseling and mental health care systems now under way in the military are helping, but the community at large also must respond when needed as soldiers return to civilian life.

In realization of the growing stresses of battle fatigue, the Army assigned "stand down" or pause in activities at bases in Hawaii and worldwide one day in September for training to cope with the reality of soldiers susceptible to suicide. The suicide prevention effort was "to focus on promoting good health, teammate involvement, risk reduction and resilience training."

In an essay published Sunday in the Star-Advertiser’s Insight section, Dr. Kenneth A. Hirsch, manager of the Traumatic Stress Disorders Program in the Veterans Administration Pacific Islands Health Care System, told of efforts by the VA and the Defense Department to provide needed treatment to soldiers and veterans throughout the Pacific Basin.

The Army has initiated a counseling system to assure that every soldier has a leader directly responsible for him or her.

However, that system has been somewhat criticized by Veterans for Common Sense as being regulated by senior leaders under the constraints of "task, condition, standards" from the commander’s physical training manual. Leaders should assume the role of family members with a gentler tone than that of the common approach of a commander, as difficult as that might be in a military context. Made effective, a sensitive policy is vital and should be made permanent.

"Even though large-scale military operations in Afghanistan and Iraq are ending, the effects on the mental health of active-duty service members, reservists and veterans are just beginning to be felt," says Dr. Timothy Lineberry, a Mayo Clinic psychiatrist, Air Force veteran and suicide prevention expert for the Army. "Moreover, the potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses."

That’s a crucial lesson for veterans and civilians alike to absorb: leaving the battlefield behind does not mean automatic release of battlefield mentality and readiness. Lineberry says the warning signs for families and friends of veterans consist of sleep disturbances, disturbing thoughts and feelings for more than a month, "self-medication" in the form of alcohol or drugs and "flashbacks" of a traumatic event for minutes or days at a time.

Psychiatric admission has become the most common reason in the Army for hospitalization, and suicide rates in the Army exceed the rate in the U.S. general population. That trend, now a priority issue for military leaders, has logical pass-on ramifications for returning veterans.

American men and women who have been heroic in facing the dangers of war should be provided the best physical and mental health care, as members of the military and as veterans in civilian society. The Pentagon and the Veterans Administration are adapting to meet those obligations. Their efforts should be supported and reinforced by the rest of us.