I don't know if those suicide statistics are out of line for men of that age whether or not they served in Vietnam.

I also wonder if those suicide numbers are out of line for veterans from other wars. In other words, is it different for Vietnam vets?

Tough post there 173 airborne. Your progression of the return ceremonies was well put. I have read several times in various news papers oveer the last years that the 'rumors' of returning vets being spit on are untrue, no one has ever produced veriviable evidence that it really happened.

I wonder if you (not you, just geneerally)presented a stuffed and mounted hippie and said that you would never do such a thing unless you really had been spat upon if they would believe that. worth a try I'd guess.

PTSD - The concept assumes there's stress to be "post". A "boots-on-the-ground" combat GI/Marine in Iraq/Afghanistan has plenty of stress (I'm away from home, I could die any minute, I've seen buddies die, I've maybe killed people, maybe "innocent" civilians - yeah, that's stressful).

What's interesting is that Predator drivers are apparently suffering from PTSD, too. These guys work in Virginia or New Mexico or somewhere, and go home to the wife and kiddies after their shift.

I guess there's got to be some ameliorating effect knowing that what you're doing is viewed favorably by the public (e.g., WW-II and the "Greatest Generation"), as oppposed to the Viet Nam "baby killer" thing.

In any case, I think there's still an attitude within the services that GIs are supposed to "man up" and tough it out - and that reporting PTSD-type "issues" is considered by the service as a "black mark", so career-oriented folks (i.e., guys who want/plan to stay in) probably won't report any psychological problems. If I'm wrong about this, and the services are more open and sophisticated about the issue, I'm happy to be corrected.

Remember Rudyayd Kipling, writing about Afhanistan 125 years ago:
"When you're wounded and left on Afghanistan's plains,
And the women come out to cut up what remains,
Jest roll to your rifle and blow out your brains
An' go to your Gawd like a soldier."

quote:

Originally posted by KevinCW:

quote:

Originally posted by chongosuerte:

quote:

Originally posted by wishfull thinker:

quote:

There was nothing in that country that we needed worth that many American lives.

A lot of people thought that in the summer of love too.

I'm not a pot smoking hippie by any means, but as I get older I think I might one day agree with this. It's one thing for a volunteer army to go whoop some terrorist ass after we were attacked on our own soil, but quite another to draft thousands and send them to their deaths against their will in a shithole in a decades old situation that had already been lost by several other "colonizing" countries.

I agree with you. I don't think there was anything in Vietnam that warranted so many American lives.

I also think we screwed up in the way we fought that war by trying to use the minimal amount of resources possible. I see the current administration doing the same minimalist approach in A-stan right now.

I'm certainly not a "peace, love, and dope" hippie, but i question our involvement in that war.

Kevin

I will disagree with you on this Kevin. We threw everything we had at this including the Kitchen Sink. The force to space ratio was much more than enough. We tried to lure the guerilla's into a conventional war and they weren't biting. Especially after the TET. Read Giap's book. We kicked their ass there. We needed to take and hold. A guerilla war just peters out. There is no "Victory". We did a lot of things wrong. Most of them tactical. One of my best freinds committed Suicide 2 years ago. He had been a Ranger. He did security for me at my guitar shows in Nashville. I had taken him to the VA to try and get him some help. They gave him Morphine for his back and he took the whole bottle. He had a lot a demons and I know he felt guilty for killing innocent people while he was over there. We thought we could preval with all the power we had. We didn't even go by the book. It was a guerilla war. It's a battle of mindset. Whoever holds out the longest and gets the people on their side wins. You don't bomb them. You don't kill their women and kids. Even if your best friend is hanging upside down with his guts hanging out on the outskirts of their village when you klick in. The guerilla's did that to get you to over react. If you don't want to play this guerilla war game, Don't get invloved in it. We are in one now in Afganistan. It might not have started out this way but it is now.

Any suicide is tragic. I was one of the draftees and we did what we were asked to do. I have many friends who came back screwed up and more that didnt. Also a lot who did not come back at all.

The best book about the war is Nelson Demille,s Up Country. Its fiction and entertaining but truly captures the thoughts ( yes he was there).

I believe we have advanced enough to help our vets. But I also believe that there exists a futility in some measure.

I'm not so sure I would agree with those numbers. From what I have read the number is around 9,000 suicides.

I have of late made a bit of a study of PTSD brought about by the fact that I finally admitted that I have at least a mild case. I think going to work for the VA after my last trip to Iraq and finding out that there was actually an effective medicine for the nightmares available tipped the scales. While I was still on active duty and in the reserves it was just not something you talked about.

What I have tried to figure out is not why folks have PTSD but why it is totally debilitating for some while a greater number of folks go on to live relatively normal lives. For those who have not, watch Band Of Brothers. Pay very special attention to the parts where the vets, not the actors, the vets. Watch their eye. The majority of these guys jumped on D-Day, fought at Bastogne, saw more and did more.....

Anyway, for me, I suspect that PTSD has had a major influence on why spent 30 years of my life off and on in active and reserve service, did a "short tour" in Baghdad as a contractor and finally ended up working at the VA. It's just nice to be around folks who know where you have come from.

Last but not least. If not the greatest thing since sliced bread the Blue Pill is a close second. In the year and a half since I started taking it I have only had one fighting dream where I punched my wife and that is a real plus, also I have not had any of the "something dark, black, and evil stalking me" dreams--the one where you try to scream and no sound comes out!!! Sooooo, if you have "dreams" ask your doctor if Prazosin is right for you. Saddly, the Blue Pill does not work for everyone.

Shit, I am beginning to ramble so I will just shut up now. BtP

Interesting article. By the time this war has ended, the fallout with respect to PTSD is going to be huge, and very expensive. I just hope they quit blowing these people off and make effort in helping them deal with this problem so they can get on with some means of a normal life. After all, it is them putting their life on the line for us.


News Release
OFFICE OF MEDIA RELATIONS
703-413-1100 x5117
and 310-451-6913
media@rand.org

FOR RELEASE
Thursday
April 17, 2008

One In Five Iraq and Afghanistan Veterans Suffer from PTSD or Major Depression

Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — report symptoms of post traumatic stress disorder or major depression, yet only slightly more than half have sought treatment, according to a new RAND Corporation study.

In addition, researchers found about 19 percent of returning service members report that they experienced a possible traumatic brain injury while deployed, with 7 percent reporting both a probable brain injury and current PTSD or major depression.

Many service members said they do not seek treatment for psychological illnesses because they fear it will harm their careers. But even among those who do seek help for PTSD or major depression, only about half receive treatment that researchers consider "minimally adequate" for their illnesses.

In the first analysis of its kind, researchers estimate that PTSD and depression among returning service members will cost the nation as much as $6.2 billion in the two years following deployment — an amount that includes both direct medical care and costs for lost productivity and suicide. Investing in more high-quality treatment could save close to $2 billion within two years by substantially reducing those indirect costs, the 500-page study concludes.

"There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, the project's co-leader and a researcher at RAND, a nonprofit research organization. "Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need."

The findings are from the first large-scale, nongovernmental assessment of the psychological and cognitive needs of military service members who have served in Iraq and Afghanistan over the past six years. The RAND study is the first to comprehensively assess the current needs of returned service members from all branches of the military.

Researchers concluded that a major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans. The effort must include the military, veteran and civilian health care systems, and should focus on training more providers to use high-quality, evidence-based treatment methods and encouraging service members and veterans to seek needed care.

Since October 2001, about 1.6 million U.S. troops have deployed to the wars in Iraq and Afghanistan, with many exposed to prolonged periods of combat-related stress or traumatic events. Early evidence suggests that the psychological toll of the deployments may be disproportionately high compared with physical injuries.

Tanielian and project co-leader Lisa Jaycox headed a group of 25 RAND researchers who conducted a three-pronged assessment of the needs of returning service members: a national survey of those who had served in Iraq and Afghanistan to assess their psychological and cognitive injuries; economic modeling to estimate the cost not only of providing needed treatment, as well as the costs associated with lost productivity and suicide; and an assessment of treatment services that are available to service members, as well as barriers to treatment.

Researchers surveyed 1,965 service members from 24 communities across the country to assess their exposure to traumatic events and possible brain injury while deployed, evaluate current symptoms of psychological illness, and gauge whether they have received care for combat-related problems.

Service members reported exposure to a wide range of traumatic events while deployed, with half saying they had a friend who was seriously wounded or killed, 45 percent reporting they saw dead or seriously injured non-combatants, and over 10 percent saying they were injured themselves and required hospitalization.

Rates of PTSD and major depression were highest among Army soldiers and Marines, and among service members who were no longer on active duty (people in the reserves and those who had been discharged or retired from the military). Women, Hispanics and enlisted personnel all were more likely to report symptoms of PTSD and major depressions, but the single best predictor of PTSD and depression was exposure to combat trauma while deployed.

Researchers found many treatment gaps exist for those with PTSD and depression. Just 53 percent of service members with PTSD or depression sought help from a provider over the past year, and of those who sought care, roughly half got minimally adequate treatment.

"If PTSD and depression go untreated or are under treated, there is a cascading set of consequences," Jaycox said. "Drug use, suicide, marital problems and unemployment are some of the consequences. There will be a bigger societal impact if these service members go untreated. The consequences are not good for the individuals or society in general."

Service members report many reasons for not seeking treatment. Many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional. Even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities.

The RAND report recommends the military create a system that would allow service members to receive mental health services confidentially in order to ease concerns about negative career repercussions.

"We need to remove the institutional cultural barriers that discourage soldiers from seeking care," Tanielian said. "Just because someone is getting mental health care does not mean that they are not able to do their job. Seeking mental health treatment should be seen as a sign of strength and interest in getting better, not a weakness. People need to get help as early as possible, not only once their symptoms become severe and disabling."

Researchers also found an urgent need to train more mental health providers throughout the U.S. health care system on delivering evidence-based treatments to service members and veterans. While many opportunities for treatment exist for active-duty personnel, there is no system in place to monitor the quality of those services to ensure they are getting the latest science-based forms of treatment.

The Department of Defense's newly created Defense Center for Excellence for Psychological Health and Traumatic Brain Injury may provide a historic opportunity to change the culture of psychological health within the military and to promote and monitor the use of high-quality care to service members. The RAND report provides information that the center could use to pursue these objectives through the use of innovative care models and performance measurement techniques.

Researchers suggest special training programs are needed to instruct mental health providers in the military, veterans and civilian health systems about the type of evidence-based treatments needed by service members. Only providers with such training should be eligible to treat service members and payment programs should be retooled to reward providers who use science-based treatments.

"It's going to take system-level changes — not a series of small band-aids — to improve treatments for these illnesses," Tanielian said.

The RAND study estimates the societal costs of PTSD and major depression for two years after deployment range from about $6,000 to more than $25,000 per case. Depending whether the economic cost of suicide is included, the RAND study estimates the total society costs of the conditions for two years range from $4 billion to $6.2 billion.

The RAND study also estimates that about 320,000 service members may have experienced a traumatic brain injury during deployment — the term used to describe a range of injuries from mild concussions to severe penetrating head wounds. Just 43 percent reported ever being evaluated by a physician for that injury.

While most civilian traumatic brain injuries are mild and do not lead to long-term impairments, the extent of impairments that service members experience and whether they require treatment is largely unknown, researchers said. In the absence of a medical examination and prognosis, however, service members may believe that their post-deployment difficulties are due to head injuries even when they are not.

One-year estimates of the societal cost associated with treated cases of mild traumatic brain injury range up to $32,000 per case, while estimates for treated moderate to severe cases range from $268,000 to more than $408,000. Estimates of the total one-year societal cost of the roughly 2,700 cases of traumatic brain injury identified to date range from $591 million to $910 million.

The report is titled "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery." The full report and several summaries are available at http://veterans.rand.org/.

The project, jointly conducted by RAND Health and the RAND National Security Research Division, was sponsored by a grant from the California Community Foundation.

RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics.

The RAND National Security Research Division conducts research and analysis for the Office of the Secretary of Defense, the Joint Staff, the Unified Commands, the defense agencies, the Department of the Navy, the U.S. intelligence community, allied foreign governments and foundations.

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Could you imagine the uproar today if their were these kinds of casualty numbers coming in from the current conflicts? It wouldn't matter who the president was, he'd be impeached and strung up by his nuts. maybe it is because it is an information age.

It's a similar case with career EMS, firefighters, and law enforcement officers. They're expected to Cowboy Up, even after grim details such as accident scenes, structure fires involving trapped occupants, homocides, suicides and come back for more without skipping a beat. One does not have to travel 10,000 miles from home to fight a war.

Our guest speaker for our Veterans Day ceremony said those figures are BS. The suicide rate among Vietnam veterans is no more than any other group.