by Daniel D Lion

Over the course of the last 14 years the United States has fought two major wars that mentally and physically disabled our fighting force for decades. The Veterans Administration health system has become ineffective, while troops mental health has become more critical and destabilized. There are not enough doctors, administrators and technicians to handle the war torn generation. Service members continue to have substance abuse problems, homelessness, Post Traumatic Stress rates have skyrocketed and the suicide rates have been at its highest in our young nation’s history.

If the proper support isn’t given so these young veterans can succeed, rehabilitate and also develop effective medical treatments to their lifestyle needs, it will be a failure by our nation’s leadership. There isn’t a clear cut cure way to deter suicide but it’s just a possibility to find an effective way of treating this epidemic because it will take an effort from the individuals and the government to come together and find the a better avenues of treatment.

One of the first things I think they need to do is a study of a group of veterans coming in with no issues at all and follow them over the course of their career. They need service members that have never shot weapons or ever been subjected to concussions or any type of brain injury. First military medicine needs to establish baseline brain scans to see how their brains are operating before being sent into combat. This must be followed with extensive baseline testing of all their bodily functions and chemical testing. The government needs to follow these soldiers every move and study them before, during and after deployment. The doctors must be the same providers so they can observe the continuity of medical treatment throughout the study.

Purpose

My purpose is to give a first person view on something that hasn’t been done to my knowledge and I have not found studies that have been this in depth. I’m not a doctor but they can detect to see if there are in changes in the brain and within the body. It might be possible to detect and see why they are having substance abuse problems and committing suicide at an alarming rate. Once they follow them for a certain amount of time they might see minute or major changes to their body while conducting combat operations.

I would like to raise awareness to the civilian and military populace on different avenues to go about treatment. Everything tends to be a knee jerk reaction in the government because they just respond to what’s happening at the time. This could possibly lead to different avenues of treatment and new scientific ways to treat these service members. They must listen to the troops that are having issues instead of thinking of new studies themselves.

The problem is that in one year, for example in 2012, there were more active duty service members committing suicide than all fatalities in combat operations that particular year. This doesn’t even account for the average of 22 veterans that kill themselves each day after leaving the service. They have substance abuse problems, relationship failures, high unemployment which leads to suicide or homelessness. The short and long term consequences are an overloaded health care system and poor medical treatments. This wrecks families and destroys their lives at such a young age. They fail to adapt back to society and could lead future generations of veterans down the wrong path because proper treatment has not yet been discovered.

In the article “Suicide Rate among Vets and Active Duty Military.” Forbes. Forbes Magazine, 05 Feb. 2013. Web. 03 June 2013 by Haiken, Melanie she discusses the suicide rate among active duty and veteran service members. The author talks about how every 65 minutes a veteran commits suicide. This is an alarming rate that needs immediate attention because the nation owes it to service members. She mentioned that that there were 349 active duty suicides in 2012 which were more than combat deaths in Afghanistan. In the study 69 percent of the suicides were 50 and older and 31 percent were 49 or less. This is staggering numbers at any rate. There is epidemic that is occurring and is going to effect the nation for decades. In the article it mentioned that President Obama signed an executive order to bring on more mental providers within the VA Health System to help with the overload of patients. This is something that should’ve been thought of well before him but is this just a knee jerk reaction to put a Band-Aid on it. There needs to be additional policies and procedures in place to screen veterans on health issues before becoming suicidal.

In his article, “Suicide in the Military” Augusto Ruiz at the Center for Deployment Psychology noted that suicides were lower than the civilian population prior to wars in Iraq and Afghanistan but has continued to surpass these numbers. He states that the Army has the highest rate of suicide among all the services, but it still continues to rise in other branches. The article states that suicide is the leading cause of death among female veterans and second to males. Most of the males are white and educated over the 12th grade of high school. Other contributing factors were relationship failures, financial and legal troubles. All of these combined lead to stress levels where veterans feel that the only option is suicide. They are now being proactive at the beginning of boot camp and teaching suicide awareness classes to educate them on this serious issue. The units are offering mandatory classes upon returning from combat and teaching them coping mechanisms on how to deal with stress. They talk about how they create hope and give future oriented thinking about their bright futures. The article continues on how they want to offer a clear path to help and not wait for an appointments to open up because it can be too late for the service member. It offers safety plans so friends and family can call hotlines to seek advice for service members that are potentially suicidal. These are some of the initiatives and steps they are taking to curb this epidemic.

An article titled, “Concussion Epidemic Linked to under Reported US Military Suicide.” reported on concussions or which the military call Traumatic Brain Injury (TBI) and how they are linked to suicide rates of service members. With TBI’s comes depression and combined with Post Traumatic Stress Syndrome (PTSD) is a deadly combination that can lead to suicide. They suggest these are becoming the deadliest causes of death to active duty service members and veterans. This goes on to suggest that service members with more than one concussion are more likely to develop suicidal thoughts than their counterparts that don’t encounter any. With multiple deployments completed and another one lined up it just increases the chances of suicidal thoughts. Service members leave their families behind which leads to failed marriages and substance abuse problems that lead to the path of destruction.

In “Brain Line Military” by David Cifu and Cory Blake the authors write about effects of combat on the brain, service members, and their health once returning from combat. They want to show signs and symptoms of what the body will go through once returning from the combat theater of operations. Post-Traumatic Stress Syndrome, Traumatic Brain Injuries and substance abuse effects more than just the service member. It takes a toll on the units, family and friends that have to deal with the aftermath of the war. The United States has been engaged in its longest wars since becoming a country and service members are doing multiple tours of combat duty overseas at a high rate of operational tempo. The service members come home with physical injuries and invisible ones that are even harder to treat. These doctors give veterans medications and form support groups to help ease the stress of reality. They come home irrational, emotional distressed and, most people aren’t comfortable to be around them because anything seems to set them off in rages of anger. The authors talk about how health care workers are worn out because of the amount of cases that are coming back and piling up. The treatments are delayed because of the number of cases. This leads to worsening symptoms that could have been treated earlier. They go on to explore on the links of a strong foundation before entering a combat zone. They think people with strong family foundations before entering the military will have a better success rate than one who comes from a broken family. This brings them into people with a higher degree of formal education with succeed better because they can adapt to their environments and understand aspects of war and what they do to the body.

Littlepage, Marry S. “Multiple Deployments Lead to Major Increase in PTSD Cases, New Study Says.” Truthout. TruthOut, 5 Jan. 2010. Web. 04 June 2013. Mary Littlepage is the reporter that has reported on findings from Amy Fairweather that troops with multiple deployments lead to a increased chance of PTSD. Amy Fairweather is Director of the Coalition for Iraq and Afghanistan Veterans which helps oversees treatment for members associated with wars. She helps educate combat veterans to return them to the civilian workforce because they tend to become homeless and live in low income areas. There was a study with the Surgeon General’s Office that stated troops with three or more combat deployments have the rate of 27% of developing some type of mental health issue while deployed. They say this because it’s different from the prior wars like Vietnam which had a distinctive front lines of battle. These wars in Iraq and Afghanistan have no real front and they are constantly engaged with the enemy. She did a study of New Jersey National Guard Troops that completed multiple tours of duty and found that they have a significant increase in health issues. They compared these health issues to troops who have only done one have seen quite lesser health problems. Since there is no clear medical dis-qualifier for mental health assessments because the questionnaire is just based from the soldier’s point of view. Most troops don’t want to seek treatment because of the backlash they might have from their chain of command and it’s putting food on their family’s plate. Troops tend to get frowned upon once they seek help for mental health issues from their deployments. They feel obligated and sense of guilt by not being back over in the fight. The report wants to help identify factors in pre and post deployments health assessment that can raise red flags on their mental health status. They go on to report on how they are training officers and noncommissioned officers on implementing a plan when they spot mental health symptoms associated with combat tours.

“Topics in Brief: Substance Abuse among the Military, Veterans, and Their Families.” Substance Abuse among the Military, Veterans, and Their Families. National Institute on Drug Use, Apr. 2011. Web. 04 June 2013. This article focuses on statistics based on substance abuse of service members. They are usually associated with PTSD, Traumatic Brain Injuries and Depression. The article states that the most abused drug is alcohol in which 27% met the criteria. Most of these are not referred to alcohol treatment centers unless involved with some kind criminal charge when the problem is brought to light. The study states that 30% of suicides have substance abuse related issues. Researchers are developing ways of treating drug abuse by monitoring veterans with electronic devices and watching their responses to stresses of everyday life. Special court systems are being set up for veterans with nonviolent crimes to put them in treatment programs rather than prison terms to treat their issues. This has spread rapidly to more than 60 courts in 20 states. The National Institute of Drug Abuse was awarded $6 million in funding to educate, train and assist veterans to seek healthy lifestyles. This research technique could be used in the future to help protect service members returning from combat zones to keep healthy lifestyles and steer them away from substance abuse.

“American Soldier Pleads Guilty in Afghan Massacre.” Fox News. FOX News Network, 05 June 2013. Web. 05 June 2013. This article from about a soldier from the Army that plead guilty to 16 counts of pre-meditated murder while on deployment to Afghanistan. This is article is importance because this wasn’t his first deployment to a combat zone while a service member of the United States Army. SSGT. Bales was an Ohio native that grew up about 4 miles from where I lived in within the city of Cincinnati. He had prior deployments to Iraq in which he suffered a TBI and PTSD. On the night of the massacre he was drinking alcohol and snorting Valium that he received from other soldiers. During the night he walked off his base on two occasions and committed these horrific acts of murder. In a plea bargain so he could be spared the death penalty he is giving a detailed description of the night he committed these acts. This raises questions about the screening process for troops who are injured and sent back overseas for another tour of duty. This is not totally placed on the shoulders of the Army because there is personal accountability in these actions but a more thorough screening process must be found to assess their suitability of deploying for another tour of duty. This goes to show that the military is straining their forces to push their agenda and protect America’s freedoms at all cost.

Vann, Bill. “The Fort Bragg Murders: A Grim Warning on the Use of the Military.” Federal Observer Articles. The Federal Observer, N.D. Web. 05 June 2013. This article was during written by Bill Vann during the Bush administration and at the beginning of the Iraq and Afghanistan war. The article shows there were going to be potential issues with the war on terrorism. It doesn’t mention anything about mental health issues but we can read its context. In a six week span there were four Fort Bragg wives murdered by their husbands and which all but one of the men just returned from combat tours in Afghanistan. The writing is on the walls of this story but it was way too early to predict the magnitude of what was going to be witnessed. All of one of these men were part of the Army’s Special Forces the Green Berets and Delta Force. They are sent into combat zones to conduct assassinations and covert operations in the harshest conditions. These men returned with anger problems that spilled in domestic disputes with their wives. A deployed soldier just doesn’t suffer because their family is home to continue on daily life while they are deployed. They have to play the part of mom and dad while the father is deployed. It just goes to show that there will be problems to come for decades to come. Once returning from combat they have to turn off the kill switch which was so easily for them to carry out because of their training.

Zak, Katie. “Advocacy Group for Homeless Veterans Asking Government for More Help.” Public Source. Public Source, 25 June 2012. Web. 05 June 2013. Another problem facing veterans aren’t just the mental health problems or the substance abuse but homelessness. Katie Zak reports there are an average of 150,000 veterans a night on the streets. This number may not seem high but it’s alarming comparing the small numbers of veterans that are getting out of the service. Service members have issues keeping jobs because of their mental health issues, financial debt or substance abuse so they turn to the streets to escape the daily grind of life. This is not for all troops but most of them have high school educations upon leaving and it’s hard to find jobs without civilian certifications or degrees. It’s hard to give a person a job that has been involved in combat the whole time of their career. Their job skills aren’t marketable and with the economy in its current state the market is competitive. Advocacy groups are being set up to assist these veterans in their transitions back into services.

“The Ground Truth on Veterans’ Unemployment.” US The Ground Truth on Veterans Unemployment Comments. Time Magazine, N.D. Web. 05 June 2013. The veteran’s unemployment for service members 18-24 years old are at 20.4%. It is not a surprise that most veterans face unemployment for a period of time when leaving the service but they can’t sustain the current pace by the lack of jobs they are qualified for. Most veterans seek employment within the realms of their military job but find red tape that stops the hiring process. They have all the leadership skills and technical expertise but lack the formal education required by state and local officials. Advocacy groups are conducting discussions in Washington to help fight through the barriers. Businesses are starting to attend their Transition Assistance Program that helps ease the burden of the transition of military life. The class is only a week long but the employers are usually only there for the final hours of the last day to chat with the service members. Most of the time fliers and pamphlets are put out so they can reach out to the employer. There is a massive backlog within the VA system because of the amount of members getting out. They usually have to wait an average of a year to get any benefits they qualify for because of the backlog.

Solutions

I have chronicled many issues that trouble our service members. I haven’t even begun to list how many family members are affected by the ravages of war. Much sacrifice is done on the parts of families and service members but little seems to be done, as a whole, for them. There isn’t a simple solution but clearly the system is broken. The new director of the VA doesn’t appear as if he’s cleaned house at all.

We need to track a limited amount of service members and follow them throughout their military career and to detect changes within their body physically, mentally or physiologically over that time. The government needs to run brain scans, blood test and in depth full medical physicals to detect any changes at all within their body. It could be a small discovery that leads into something significant in military medicine. The resources will have to be a hand selected doctors to do this study to keep the continuity of care with their studies and patients. This is going to take an extensive amount of time and money to study these individuals because of the time and commitment it will need. The government and military will have work hand and hand to initiate this study and see it out. They need to limit the amount of times these service members can go into combat during their career.

Outcomes/Goals

There are really no short term benefits but the long term could be an extensive breakthrough in military medicine and the factors that surround these psychological disorders that lead to substance abuse that can untimely lead to suicide. If this is not accepted they will continue to find ways to better treat their soldiers. Most of it is time, which most with PTSD or TBI issues do not have, but it is time. There is no golden ticket to this problem which has been an epidemic over the last decade. The service members will be affected by this because they will either get quality medical care or just be another statistic. The government will feel the financial burden and the strain it has on our Veterans Administration system. Our combat effectiveness in all environments could be altered because of breakthrough treatments. We owe it to our Veterans to proper healthcare, education and long term solutions to their problems. I am just a Corpsman with an opinion. I know answers are out there.