The Mounting Multiples of Mental Health War Casualties

The Mounting Multiples of Mental Health War Casualties | Risk & Insurance | The year 2005 was one of crisis for the mental health policies of the New Hampshire National Guard. That year, five National Guard soldiers returning from combat committed suicide.

By PETER ROUSMANIERE, the Risk & Insurance® workers' compensation columnist

All over the country, families, friends and public officials from small towns to large cities almost overnight found themselves going from preparing gala welcoming parties to organizing funerals and arranging access to support networks.

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In Vietnam, when the U.S. Army was still made up of conscripts, 10 percent of the troops were from the Army Reserve, and virtually none from the National Guard. In the Gulf War, when the Army was staffed by professionals and where combat operations lasted just a few weeks, 60,000 National Guard and 84,000 reservists were called up.

Among the 1.6 million troops deployed in Iraq and Afghanistan through 2007, about 250,000 have been from the National Guard and 200,000 have been with the Reserves.

In the past, troops were transported by ship back from the front. As they gradually distanced themselves from battle, they had plenty of time to decompress, work through psychological issues and reconnect with their buddies.

Now troops are flown in and out of battle quickly, and National Guard and Reserve soldiers are dispersed from their units shortly after their tour of duty. Compared with past wars, the routine normalcy of civilian life is thrust upon today's soldiers relatively rapidly.

TOO SUDDEN A SHIFT?

The sudden shift from peacetime to warrior status and back may be contributing to high rates of post-traumatic stress disorder (PTSD) among the troops, according to Dr. Matthew Friedman, executive director of the Veterans Administration's National Center for Post Traumatic Stress Disorder.

In assessing troops six months after returning from their respective theaters of operations, clinicians identified 20.3 percent of regular army and 42.4 percent of National Guard and Reserve soldiers as requiring mental health treatment, according to an article in the November 14, 2007, issue of the Journal of the American Medical Association.

The Army has also woken up to the extent of brain injuries caused by cheap but devastatingly effective improvised explosive devices (IEDs), detonated electronically by a signal sent from a cell phone or garage-door opener.

By 2004, the threat of IEDs became widely acknowledged, and National Guard troops doing convoy work, traditionally a relatively safe supply chain function within an Army unit, suddenly found themselves on the front lines of battle.

A Rand Corporation survey conducted in late 2007 estimated that about one-third of returning soldiers suffering from either PTSD, depression or traumatic brain injury also suffered from at least one other medical condition, also incurred during their service

As many as 19 percent of all soldiers returning from Iraq and Afghanistan had been affected by traumatic brain injury, 12 percent by PTSD and 10 percent by depression, the survey also found.

July 1, 2009

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