[Denizen Commentary - Kat]
Tuesday, CBS ran a program regarding the "epidemic" of veteran suicides. I thought the report was strong with numbers, but did little to discuss the problems within the VA mental health system, point to possible solutions or even provide linkage to outside organizations that might be able to help. That last, I thought, would have been extremely helpful and the most important since it is likely that family and friends of soldiers needing help or soldiers themselves were watching the program.
From time to time, the issue has come up on military blogs. From time to time, the response ranges from defensiveness over interpreted political maneuvering (some blogs have attempted to discredit the numbers), disputing the numbers, to general discussions about the military or VA health system.
The numbers though, whatever part of the population they represent, are simply too high to ignore. According to their numbers, in 2005, over 6,000 veterans committed suicide. Of those, over 2,000 were veterans between the ages of 20-25. In other words, GWOT vets.
What we don't often get is a satisfactory solution. Budgets, politics, the sheer numbers and the multitude of variations on the psychiatric problems of vets and their own responses seem to make the discussions circle and circle. Some legislation gets passed. Earlier this year, the IAVA put out a call for support for congress to pass a bill to fund and establish a suicide prevention hotline. The hotline is already in place and working, though some reports have indicated that close to half of the calls received are not about depression or suicide. The hotline attempts to handle these calls or direct them to the right assistance. Lists of numbers and contacts for non-mental health issues adorn the walls.
But this hotline is only the first step and may be able to prevent more suicides if the number is more widely published and if veterans themselves or their families and friends will take advantage of it. That last is the one variable that we can't control in the depression/suicide vector. For that, we can only be more pro-active, make it as easy as possible, as accessible as possible, as acceptable as possible and proliferate it as often as possible.
Word to our veterans: You Are Not Alone. Decorated and iconic veterans, like the Marlboro Marine, suffer the same conditions, have sought treatment, have rejected treatment, have considered suicide. This is not the condition of the weak.
Often, it is the condition of the very strong who are unsure how to deal with the idea that they were not strong enough to prevent the things they saw or did. They are unsure of how to deal with no longer being in control of their lives. They question their right to live when others have died. They question how anything can be "normal" again after long days of abnormal sleep, abnormal eating habits, abnormal emergencies, abnormal death and destruction. They question everything. The more "normal" they or anyone tries to make it, the more they reject it and subconsciously do things to destroy that "normal".
The rest of the post is below the fold in the Flash Traffic/Extended Entry!
According to the IAVA, over 50,000 veterans of the GWOT have been diagnosed with PTSD. Tens of thousands are waiting for appointments, sometimes for weeks, to be diagnosed or start treatment. There are over 1 million veterans of every war who are receiving psychiatric treatment from the VA. Not all of them are for PTSD. This number is still under-representative because there is little or no way to track those who do not seek help. That is a major issue in detection, treatment and prevention. We still see a culture of "shame" among our veterans. They believe that its a weakness or, because of their training and experience to be strong individuals, that they can take care of it themselves.
According to VA stats, 9,000 mental health care givers treat these over 1 million patients across the country. At the Kansas City VA Medical Center, a designated regional psychiatric hospital, they served over 56k veterans in 2006. While many received basic medical treatment, over 10,000 were receiving mental health treatment. By June of 2007, the KCVA had over 4,000 veterans of Iraq and Afghanistan signed up for treatment and follow up at the facility. Over half are being seen for PTSD and various psychiatric problems. Many utilizing the special PTSD programs that the facility has had in place since the 80's and that are already overwhelmed by Vietnam Veterans and veterans of other wars.
According to the VA Mental Health Program, over 100,000 veterans of Iraq and Afghanistan have sought treatment through the VA between 2001-2005 for PTSD and other mental health disorders. That number has probably risen by half again, if not more, as we reach the end of 2007.
Young soldiers were three times as likely as those over 40 to be diagnosed with PTSD and/or another mental health disorder. Most mental health problems were first identified during visits with primary care doctors, not with mental health professionals.
According to this fact sheet from the VA:
One early scientific study indicated the estimated risk for PTSD from service in the Iraq war was 18 percent, while the estimated risk for PTSD from the Afghanistan mission was 11 percent. Data from multiple sources now indicate that approximately 10 to 15 percent of soldiers develop PTSD after deployment to Iraq and another 10 percent have significant symptoms of PTSD, depression or anxiety and may benefit from care.
This facility, like many others around the country, are overwhelmed by these numbers even as the VA has sought to expand it's programs and time of availability. Still, as the above stories have indicated, getting in to see someone at the VA can some times take two to three weeks, maybe more. Sometimes, they must seek treatment at facilities that are far away from home. Veterans suffering from PTSD and other diagnosed conditions or waiting for diagnosis, cannot wait three or more weeks to begin treatment.
Time is important. People suffering from depression can experience serious changes in their mental status within hours or days and definitely within weeks.
Those stories are not simply stand alone anecdotes. In May of 2007, one of the American Legion Riders that we worked with and who was a Veteran of OIF II was finally convinced by his girlfriend and fellow riders to seek treatment. When he went to sign up at the KCVA he was told that there was a six week waiting list to begin therapy in the PTSD program. He was given the choice to wait or to go to Topeka where he could sign himself in as an "inpatient".
He was there for over three months. A two and a half hour drive for friends and family who wanted to support him. As many here know through Soldiers' Angels VALOUR IT project, that support and connectivity is very important in the healing process of the wounded. Whether that is a physical or mental wound, it doesn't matter. Connectivity keeps that soldier grounded.
One of the causes of PTSD is that, after a traumatic event, the soldier is often immediately separated from their previous life, from their friends, from the people they have seen as "family" during their deployment or long association within a unit and from their family at home. Sometimes that is because of a severe injury that has them hospitalized for long periods of times. Others, it is the trauma of losing friends suddenly or leaving what had become "normal"; living in danger and hyper-vigilance for fifteen months. There are many causes.
But, separation from that support base is a crucial factor in many veterans PTSD. Situations where they must again be uprooted in order to seek treatment are equally damaging.
There are private organizations that seek to help veterans with PTSD either for free or paid for by the VA. However, the availability of these programs, their locations and their exposure to the general population are also issues. Veterans, their families and their friends need to know.
We need to know.
What can we do? It's not all about money, but money for programs could help.
There are three sets of issues that effect the care of our service members with these conditions. First, we have to recognize that we play a part in the acceptance of these conditions and reducing the stigma that many service members feel about having these conditions and seeking treatment. Milbloggers have the ability to reach out within our community, to reach greater numbers with information about PTSD, symptoms, treatment and programs. Those among our population who have experience with their own adjustment or have sought treatment might share their own experiences and let others know that they are not alone. As long as we stay silent, the stigma remains.
Second, with over 175k troops in Iraq and another 20,000 in Afghanistan, many of whom will be returning in the next eight months, we should be aware that the numbers who will be diagnosed with PTSD and other depression will increase exponentially with their return and will seek treatment at facilities and treatment centers that are already operating above capacity. Even with the increase in available programs inside and outside of the VA, more supplemental programs and outside assistance will be needed in the short run. As the program information indicates, many will see a recession of their symptoms within 3-6 months, while others may go for a year or more and still others, particularly combat veterans, may need treatment for years.
Still others may not experience symptoms or seek treatment until six months or more after return or discharge from service.
We need to spread the information regarding programs among our community and out into the general public through contacts in the media and general contacts.
Third, we need more information about the status of programs and budgets within the traditional VA system. We need to make our representatives to congress aware of what additional support and funds these programs will need. For instance, the current program indicates:
VA has launched new programs, including dozens of new mental health teams based in VA medical centers focused on early identification and management of stress-related disorders, as well as the recruitment of about 100 combat veterans in its Readjustment Counseling Service to provide briefings to transitioning servicemen and women regarding military-related readjustment needs.
It's well known that combat veterans are more likely to be comfortable sharing their situation with others who have had the same experiences. One hundred additional combat veterans in these programs may not be enough. These programs may need additional "recruits" or volunteers, as well as need supplemented by the development of other programs that are outside of the VA. Ad hoc programs may act as stop gaps. We need congress to be aware and make an effort to pressure the VA to adjust their programs as necessary. We will need congress to evaluate the funds being provided. At the beginning of next year, as troops return, these programs may need immediate and emergency funding in order to handle the increase.
Access to outside services and psychiatric assistance may need to be expanded. The more available the services, the earlier the diagnosis and treatment, the more likely it is that these conditions will not have a long term effect on our veterans and they can return fully to their lives, their families and friends.
Finally, veterans who are interested should look into volunteering with existing outside programs or at the VA. Both the VFW and the American Legion both have programs to assist veterans through VA paperwork and processes.
It's time to recognize that we play a part in bringing our troops "all the way home".
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