Tuesday, May 06, 2008

PTSD v. Combat

Which will kill more U.S. military?

It might well be PTSD, or post-traumatic stress disorder, a mental condition ("failure to cope") which can follow difficult experiences such as childhood abuse, rape, car accidents or being a participant in a war:

The number of suicides among veterans of wars in Iraq and Afghanistan may exceed the combat death toll because of inadequate mental health care, the U.S. government's top psychiatric researcher said.

Community mental health centers, hobbled by financial limits, haven't provided enough scientifically sound care, especially in rural areas, said Thomas Insel, director of the National Institute of Mental Health in Bethesda, Maryland. He briefed reporters today at the American Psychiatric Association's annual meeting in Washington.

Insel echoed a Rand Corporation study published last month that found about 20 percent of returning U.S. soldiers have post- traumatic stress disorder or depression, and only half of them receive treatment. About 1.6 million U.S. troops have fought in the two wars since October 2001, the report said. About 4,560 soldiers had died in the conflicts as of today, the Defense Department reported on its Web site.

Based on those figures and established suicide rates for similar patients who commonly develop substance abuse and other complications of post-traumatic stress disorder, ``it's quite possible that the suicides and psychiatric mortality of this war could trump the combat deaths,'' Insel said.

There are reasons which make the second Iraq war especially likely to create PTSD. There are no safe places in that war, no time to relax. The military must always be super-vigilant, always alert, always scanning for bombs or possible enemies hiding in the crowds, tour after tour after tour. All that puts enormous pressure on the nervous systems of the soldiers.

Had I been one of the people in charge of this war I would have budgeted for lots of mental health care for the coming wave of PTSD sufferers. But then nothing about this war/occupation appears to have involved much planning, except for the victory celebrations.