The Psychic Costs of War: Is the Military Ready to Help Iraq Vets Heal?

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The Psychic Costs of War

Is the military ready to help Iraq vets heal?

BY ROB WATERS

Guerrilla insurgents attack with impunity. Friends and foes are indistinguishable, creating the need for constant vigilance. Death is always lurking, and can come from hand grenades thrown by children, earth-rattling bombs in suicide trucks, or snipers hidden in bombed-out buildings. Troop morale has plummeted, with many feeling unsupported and unprotected by their political and military leaders.

There are many parallels between the wars in Iraq and Vietnam, and one of the most striking is the devastating toll each war has taken"or will take"on the psychological state of its combatants. Nearly two years after President Bush declared an end to active combat operations in Iraq, the insurgency rages on, creating relentless danger for U.S. soldiers and presenting the military's overtaxed mental health system with its most serious challenge since Vietnam.

There are many signs of a looming crisis:

- At least 24 American soldiers have committed suicide in Iraq, as have at least 7 recent returnees.

- More than 900 soldiers have been evacuated from Iraq for psychiatric reasons.

-Some 28 percent of soldiers surveyed in Iraq by military researchers experienced symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD)"more than 17 percent so strongly it impaired their ability to function"according to a study in the New England Journal of Medicine.

In the aftermath of Vietnam, hundreds of thousands of American veterans returned home emotionally and psychologically scarred. At first, the military and the Veterans Administration (VA) paid little attention to their problems, but the veterans refused to be ignored. They organized and fought for services, leading to the creation of counseling and treatment programs geared to their needs, and to the recognition of a new mental health diagnosis"PTSD.

Things were supposed to be different this time. Today's trauma professionals are much better at diagnosing and treating the effects of PTSD than those in the post-Vietnam era. But questions remain whether the Pentagon and the Department of Veterans Affairs will make trauma services widely enough available to Iraq War veterans, and whether the military's macho culture will keep large numbers of soldiers from seeking help.

Pentagon planners say they've learned from the past and have set up programs designed to psychologically support soldiers on the battlefield and help them adjust to civilian life afterward. In this war, they dispatched combat-stress teams to Iraq, made up of mental health professionals empowered to work with soldiers in battle zones and pull them out of combat for rest and counseling. Soldiers treated this way are able to return to their units 96 percent of the time, says Col. Tom Burke, a psychiatrist and chief of mental health policy for the defense department.

But Stephen Robinson, a former Army Ranger and executive director of the Gulf War Center, is among those who question whether the Pentagon and the VA are devoting adequate resources to mental health. A report issued last September by the Government Accountability Office found that the VA couldn't say how many veterans with PTSD it's currently serving or how many more it could handle. The report also noted that officials at six of seven VA medical facilities said they might be unable to keep up with the demand for PTSD services.

Those fortunate enough to get in can take advantage of programs like the VA's National Center for Post-Traumatic Stress Disorder. Its Menlo Park, California, site provides both residential and outpatient treatment for veterans with PTSD. They include people like Dean, a 37-year-old sergeant still in the Army Reserves, and Tom, a Vietnam veteran who's suffered from PTSD symptoms for more than 30 years. Both men asked that their last names not be used.

Dean served in the Army in the 1980s, then rejoined after 9-11. …