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Friday, October 30, 2009

Combat Clips: A Selection of OEF/OIF Veteran Statistics, October 2009

Let's jump right into the data.

First up, VA Secretary Eric K. Shinseki's comments from this week's first-ever joint DoD/VA National Mental Health Summit in Washington, D.C., are noteworthy:

Post-traumatic stress and traumatic brain injury have outcomes as devastating as those from physical injuries, and everyone is vulnerable, Shinseki said, noting that both departments are eager to learn how to better address those injuries through various programs and methods.

The debilitating effects of psychological trauma can lead troops and veterans into a downward spiral of drug and alcohol abuse, homelessness, anger issues, failed marriages and eventually suicide, he explained, noting that more veterans have committed suicide since 2001 than the number of servicemembers killed in Iraq and Afghanistan over that period.

“There is urgency in addressing the mental baggage of war,” he said. “Our newest generation of veterans, returning from the ongoing conflicts, is experiencing increased rates of alcohol and drug abuse and domestic violence as they undergo reintegration at home. While [Iraq and Afghanistan] veterans comprise no more than 10 percent of all veterans being seen for mental health care, they could be in treatment for a very long time if early intervention, diagnosis and treatment are not priorities.”

Although I could have missed it, this is the first time I've seen the volume of OEF/OIF veteran suicides so clearly presented to the American people by a top official.

In educational interest, article(s) quoted from extensively.

Jeremy Schwartz, American-Statesman, on the costs of PTSD:

A 2008 Rand Corp. study estimated that in the two years after deployment, the cost of treating PTSD or major depression in service members, coupled with the value of their lost productivity, was more than $6 billion.

Increasingly concerned with the costs of PTSD and other mental disorders related to combat, the Army recently announced that its 1.1 million soldiers will undergo training in emotional resiliency, according to The New York Times. The $117 million program is expected to begin this month and gradually be phased in throughout the Army.

Melissa Healy, Los Angeles Times (an important piece on TBI):

Through January 2009, nearly 9,000 U.S. troops in Iraq or Afghanistan had been evaluated or treated for traumatic brain injury, or TBI — the catch-all medical term for concussions and more severe injuries caused by a forceful blow to the head. But the scope of the problem is almost certainly much larger. A recent assessment by the Rand Corp. estimates that at least 180,000 — and as many as 360,000 — U.S. troops serving in those wars may have sustained head trauma capable of causing brain injury.

That has put the Pentagon and Veterans Affairs, which provides care to those returning from combat, on high alert for such injuries. Their substantial budgets have funded a host of projects that promise to improve the prevention, diagnosis and treatment of traumatic brain injury well beyond the battlefield, brain-injury experts say.

For the first time, medical professionals serving on the sidelines of sports and front lines of war are huddling with gadget geeks, neuroscientists and rehabilitation experts at confabs regularly called by the Pentagon.

The results are promising new approaches to curbing the silent epidemic of traumatic brain injury.

Healy's piece is must-read, especially if TBI is important to you personally or professionally. On to IAVA's released report, "Women Warriors: Supporting She 'Who Has Borne the Battle" [pdf]:

"Women make up 11% of the force in Iraq and Afghanistan. Yet, their challenges have largely been overlooked and underreported. IAVA's new report pulls together the most up to date information on a broad range of issues confronting female servicemembers and veterans," said IAVA Executive Director Paul Rieckhoff. "Countless women have served bravely and honorably for their country. It's time for the Department of Defense, the VA, lawmakers and the public to take bold action on behalf of these women warriors and give them the support they have earned."

IAVA's newly released report explores a wide range of issues, including:

Sexual Assault, Harassment and Military Sexual Trauma (MST): Women in the military have been coping with significant and underreported sexual assault and harassment for decades. The report examines the statistics behind this prevalent issue, the measures that are currently in place and steps that must be taken to aggressively address this systematic problem.

Higher Divorce Rates for Female Servicemembers: Marriages of female troops are failing at almost three times the rate of male servicemembers. The report examines the data behind this troubling trend.

Barriers to VA Health Care: In recent years the VA has been challenged to care for female veterans, who now make up 12% of all Iraq and Afghanistan veterans seeking VA health care. The report examines the fragmentation of women's VA services, privacy and safety concerns and problems communicating eligibility and benefits to female veterans.

Homelessness among Female Veterans: Of homeless Iraq and Afghanistan veterans, almost 10% are women, and many of them have families. The report examines this growing trend and the urgent economic challenges facing female veterans.

Kristin Jensen, Bloomberg, on the stateside topic du jour:

As Congress considers changing Americans’ access to health care, the veterans agency, whose projected budget this year is $45 billion, is evidence that the government can provide care favored by patients that may offer savings when compared with private insurers.

Researchers publishing in the New England Journal of Medicine, the British Medical Journal and the Annals of Internal Medicine in recent years have endorsed the system. A Canadian policy journal, Healthcare Papers, devoted an entire issue to it in 2005.

“The VHA’s experiences have become a model around the world,” the editor-in-chief of Healthcare Papers, Peggy Leatt, wrote at the time. The government is both payer and provider of care to the veterans, employing 19,000 salaried doctors in 153 medical centers and more than 900 outpatient clinics. Last year, 5.1 million veterans were treated, and millions more are enrolled.

Martin Fletcher, London Times, penned a difficult story on how U.S. troops are faring in Afghanistan, according to a number of in-country chaplains interviewed for the piece:

Sergeant Christopher Hughes, 37, from Detroit, has lost six colleagues and survived two roadside bombs. Asked if the mission was worthwhile, he replied: “If I knew exactly what the mission was, probably so, but I don’t.”

The only soldiers who thought it was going well “work in an office, not on the ground”. In his opinion “the whole country is going to s***”.

The battalion’s 1,500 soldiers are nine months in to a year-long deployment that has proved extraordinarily tough. Their goal was to secure the mountainous Wardak province and then to win the people’s allegiance through development and good governance. They have, instead, found themselves locked in an increasingly vicious battle with the Taleban.

They have been targeted by at least 300 roadside bombs, about 180 of which have exploded. Nineteen men have been killed in action, with another committing suicide. About a hundred have been flown home with amputations, severe burns and other injuries likely to cause permanent disability, and many of those have not been replaced. More than two dozen mine-resistant, ambush-protected vehicles (MRAPs) have been knocked out of action.

Living conditions are good — abundant food, air-conditioned tents, hot water, free internet — but most of the men are on their second, third or fourth tours of Afghanistan and Iraq, with barely a year between each. Staff Sergeant Erika Cheney, Airborne’s mental health specialist, expressed concern about their mental state — especially those in scattered outposts — and believes that many have mild post traumatic stress disorder (PTSD). “They’re tired, frustrated, scared. A lot of them are afraid to go out but will still go,” she said.

Lieutenant Peter Hjelmstad, 2-87’s Medical Platoon Leader, said sleeplessness and anger attacks were common. A dozen men have been confined to desk jobs because they can no longer handle missions outside the base. One long-serving officer who has lost three friends this tour said he sometimes returned to his room at night and cried, or played war games on his laptop. “It’s a release. It’s a method of coping.” He has nightmares and sleeps little, and it does not help that the base is frequently shaken by outgoing artillery fire. He was briefly overcome as he recalled how, when a lorry backfired during his most recent home leave, he grabbed his young son and dived between two parked cars.

The chaplains said soldiers were seeking their help in unprecedented numbers. “Everyone you meet is just down, and you meet them everywhere — in the weight room, dining facility, getting mail,” said Captain Rico. Even “hard men” were coming to their tent chapel and breaking down.

Kate Kelland, Reuters, offers stats on British troops and PTSD:

A study by British psychiatrists found that more than 27 percent of troops suffer post deployment mental health problems, but only around 5 percent have post traumatic stress disorder (PTSD) -- a debilitating illness that can be caused by wartime trauma.

There were was little difference in levels of PTSD symptoms between British and U.S. troops deployed to Iraq. ... Senior British military figures have accused the government of failing to provide enough care for soldiers suffering mental trauma after fighting in Iraq and Afghanistan, where around 170,000 British troops have been deployed since 2001. ...

Among British troops, the most common problems were alcohol abuse (18 percent) and depression or anxiety (13.5 percent). The researchers also said they found that reservists deployed to Iraq were at greater psychiatric risk than regular personnel.

A study published in March showed that young British men who have left the military are up to three times more likely to kill themselves than people in the general population. A large U.S. study in 2007 found that U.S. male military veterans were twice as likely to commit suicide than people who had never been in the military.

Meanwhile, CBC News files a report on Canadian troops:

More Canadian soldiers killed themselves in 2008 than the year before, but the overall suicide rate has remained steady throughout the war in Afghanistan, says a military study.

Newly released Defence Department documents show 15 active-duty members of the military took their own lives last year, a rate of 23 per 100,000. In 2007 there were 11 confirmed suicides.

The average rate of suicide over the three years Canadian troops have been involved in the heaviest combat in Afghanistan — from 2005 to 2008 — was 17.9 per 100,000, the study found. The average suicide rate for all of Canada was 11.6 per 100,000 in 2005, the most recent year for which data from Statistics Canada is available.

The figures come as public awareness increases about the mental health of soldiers in both Canada and the United States.

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