Tuesday, January 30, 2007

Military's New Mental Health Assessment Hotline Arrives February 12

From AP:

A new automated phone-in assessment program is the latest effort by the military to reach out to soldiers and family members who might not otherwise seek help for post-traumatic stress or other psychological issues. The program is similar to an anonymous mental health screening effort begun online last year. About 40,000 troops or their family members - roughly 7 percent of them in Iraq - have participated.

There's much concern among those in the military that seeking help will affect someone's career, so it's good to have more anonymous options, said Dr. Jay Weiss, a former Air Force psychiatrist in private practice in Louisiana who has treated Iraq veterans.

While seeking help via telephone and Internet is not ideal, it's "certainly better than nothing," he said. ... The phone-in program was introduced Monday at the Military Health System annual conference in Washington. It is expected to begin taking calls by Feb. 12. The calls will be conducted in English and Spanish and will operate 24 hours a day.

The toll-free number for the Telephone Self-Assessment will be (877) 877-3647. A companion anonymous online Mental Health Self-Assessment test is also available.

Friday, January 26, 2007

See 'The War Tapes' at IAVA's House Parties Tomorrow

If you haven't had a chance yet to see the award-winning documentary, The War Tapes, you might want to find the nearest house party and head on over tomorrow. Riveting. (Here's a little write-up from last summer and a few pics, too.)

And for those of you in New York City, check out a special IAVA benefit performance of Incumbo Theater Company's Pvt. Wars by James McLure on February 3, 2007. There will also be panel discussion with director, cast, playwright and IAVA members. General details, additional showtimes.

Thursday, January 25, 2007

War and the Soul Workshop - In Pictures

I attended the War and the Soul Workshop conducted by Dr. Edward Tick today, author of the highly recommended book War and the Soul: Healing Our Nation's Veterans from Post-traumatic Stress Disorder. If there is a direction we might move in to help our returning veterans spiritually find their way back home, I think this is it.

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On a beautifully crisp and clear winter day, Dr. Tick kicked off the first part of his four-day combat PTSD program at the University of Wisconsin-Parkside. David "Eight Eagles" Granados of the Earth Lodge Foundation joined Dr. Tick in the teaching of cleansing rituals used by a wide variety of cultures throughout the ages to help warriors successfully fold back into society after conflict.

Slides were used to bring the Greek period to life, a time ruled by the war gods Ares and Athena, and to take us back to Vietnam on a journey seeking closure and release.

One of the more moving moments of the day was Dr. Tick's request for veterans to stand for a moment to allow us to honor them and welcome them home. Two Marine, six Army, four Air Force and two Navy service members stood and introduced themselves. Collectively, they had served in Korea, Vietnam, the Cold War, Gulf War, and Iraq.

With Dr. Tick's help, and his Sanctuary/Soldier's Heart project, we can go far in making sure that veterans -- of all wars -- receive the welcome home and support that they truly deserve.

Please consider offering a small contribution to this foundation so that it may continue its important work. And take the time to view one of Dr. Tick's recent War and the Soul engagements...I guarantee you'll benefit greatly from his words and deeds.

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America's 'Ready' Brigade Not So Ready Due to Deployment Stress

From the Associated Press:

The four brigades in the Army‘s 82nd Airborne Division usually rotate the role of the nation‘s "ready" brigade, prepared to leave for anywhere in the world within 18 hours. But this summer, the 82nd may be forced to briefly give up its role as the home of the nation‘s quick-reaction force. It‘s the latest example of how the wars in Afghanistan and Iraq are pushing the Army to its limits. ...

The division‘s 3rd Brigade is now in Iraq. The 2nd Brigade was sent to Kuwait to move to Iraq, making it the only unit fulfilling President Bush‘s order to send an extra 21,500 troops to Iraq that had not been previously scheduled to serve there this year. But the 1st Brigade is scheduled to leave for Iraq this summer, around the time the 3rd Brigade returns.

"The reason we have a light, air-mobile force is to go anywhere fast, and you can‘t do that when you‘re committed to a theater of conflict," Thompson said.

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Moving a Nation to Care: Reviews

Book reviews list for Ilona Meagher's Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops.

"Return to Honor" Reintegration Workshops

I received the following transition training workshop information from Martin Richardson of Freedoms Foundation of Valley Forge, PA. They will be conducting a series of free workshops, called Return to Honor, aimed at helping returning veterans and their families return to peaceful life following service.

Upcoming dates:


All Return to Honor programs were designed as portable containers and can be conducted where needed. The Freedoms Foundation Staff and Return to Honor program director, Martin Richardson (mrichardson@ffvf.org) will be happy to assist with planning a Return to Honor program in your local area.

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Additional details:

Upcoming Workshops

February 2-4, 2007
FREE 3-Day Reintegration Workshop for Veterans and Their Families

RETURN TO HONOR is a three-day intensive, cognitive and experiential reintegration training designed by “those who have been there”. It is particularly geared to those who are suffering from the mental and emotional trauma of war including combat stress and focused upon their reintegration as healthy, productive members of the service/society.
What I wanted and needed when I returned is the following; I just didn't know it then.
• Someone to listen to my truth
• A way to process what I was denying
• Direction, where to go, what to do and how to continue
• Someone to speak the truth; my life is not the same and never will be
• A place to acknowledge what I was feeling
• How to communicate what I was feeling to family and friends
• Integrating who I was before I left, who I was during these events and who I am now
Return to Honor is a process from which to move through the experience for both the veteran and their family with other veterans. Return to Honor offers understanding, coping skills, re-alignment, and a renewed sense of purpose and mission.

Location: Freedoms Foundation of Valley Forge, PA

For more details and/or to register for either of these programs, go to www.freedomandhonor.org; contact Martin Richardson at 610-717-9977 cell
Or at the Freedoms Foundation 610-933-8825 x241.

Further details:

Re: Reintegration Workshop; After-Theatre Decompression Training for Veterans and their Families

Objective of Return to Honor Programs: The Return to Honor programs are conducted by the Freedoms Foundation of Valley Forge, (501c3) to support military troops in making healthy transitions after combat duty to maintain service readiness for active duty and return reservists and veterans to productive civilian life. Return to Honor will also provide on-going support mechanisms while collaborating with existing services.

Issue Addressed: Combat duty places extreme demands on the mind, body, senses, and emotions of military personnel. Prepared with hundreds of hours of training, the intensity and realities of war present a multitude of challenges which only become “real” in-theatre. These realities can create readjustment issues upon return such as the constant state of heightened alert, coping with killing, the deaths of comrades and innocent civilians as well as changes in family structures and roles. These and many other issues often do not appear until 60-90+ after returning home.

Return to Honor is a three-day intensive, cognitive and experiential reintegration training designed by a military therapist and conducted by “those who have been there” which includes education and integration with the family. Return to Honor is to be conducted several months after return to avoid combat stress and readjustment issues from developing into PTSD. The intensity of the military persons experience equally needs to be addressed by an intensive period of readjustment/decompression. Specifically, Return to Honor provides such a forum. Return to Honor was designed with a deep knowledge and understanding of the subject area, real world experience and expertise in a variety of modalities. The training integrates information, models and exercises which reduce the impact -- “trauma” experienced. Strategic bio-energetics techniques and coping skills are presented in a hands-on manner in conjunction with the groups’ dynamics to address the physical and emotional needs of each participant. These needs can range from inappropriate reactions set off by “triggers”, rage, loss of mission and values to employment and family tensions. Each participant is supported by an almost one-to-one ratio of veterans with in-theatre experience.

This workshop should not be considered therapeutic in the traditional sense nor is it designed to replace such services. However, the nature, time commitments as well as the accessibility of such traditional services fail to address the initial extreme impact of combat duty as well as are often conducted by those who have not be in-theatre.

Implementation: Return to Honor can be implemented in a number of ways. Return to Honor programs are conducted on the Freedoms Foundation main campus in Valley Forge PA. Additionally, programs can be supported around the country at alternative locations and/or on a military base. Due the intimate nature of the subject matter private settings provide an extra measure of safety and confidentiality for the participants.

Costs: The cost of the workshop is free to veterans and their families. The costs to conduct the Return to Honor initial 3-day program will vary depending on location, meals & lodgings and number of participants. Costs for strictly bring trainers to a site can be provided. The Freedoms Foundation of Valley Forge is seeking funding through private corporate donations, state funding and from the VA/DOD as well as working with direct funding by the military base. Coordination of efforts with a specific military base/veterans organization brings critical value propositions to the funding raising efforts. Donations are welcome by all and are a charitable donation. Marketing and sponsorship opportunities are also available.

For more information: please contact Nancy McGrory, Development Director, 610-933-8825 x241 or click on www.returntohonorworkshop.com

Thank you, Mr. Richardson, for this information -- and more importantly, this program.

Wednesday, January 24, 2007

PTSD a Priority to New Marine Sergeant Major

From the San Diego Union-Tribune:

Camp Pendleton's Carlton W. Kent is the service's new sergeant major. He will serve as the point man for the Corps' commandant, Gen. James T. Conway, on everything from wartime deployments to health concerns for the enlisted. “My main focus is on the Marines and sailors in combat,” Kent, 49, said yesterday. He was chosen Friday for his new job.

Kent wants to maintain strong leadership for the enlisted ranks as the Corps aims to grow by about 5,000 Marines per year. He also cited a need to fully diagnose and treat service members' mental health problems, including post-traumatic stress disorder. “Some of these young Marines are seeing things that some people don't see in their whole lifetimes,” he said. “I know that PTSD is a priority . . . This issue of PTSD is personal to me, very personal because I have friends who have it.”

Sergeant major is the highest rank achievable by an enlisted service member.

DoD Mental Health Task Force Update

Today's News-Tribune devotes 20 full column inches of real estate to the just-concluded two day DoD Mental Health Task Force meeting held in Tacoma, Wash. Columnist Mike Gilbert's blog offers a few details on one of the people to testify:

[In my report,] I went with retired Command Sgt. Maj. Thomas Adams' account because it was the first time he's told his story in public – a senior leader from one of the Fort Lewis Stryker brigades speaking bluntly about how emotionally tough it was for him and his troops. Adams said he is battling his own case of severe post-traumatic stress disorder and that it felt good to get what he had to say off his chest. He said he wants soldiers to know he's going to counseling.

"I'm not a walking time bomb," he said. "I just have some issues, because I didn't like all that stuff that was going on, and it's OK not to like that stuff. ... In our line of work, there's a lot of bravado. There's no bravado in killing people, nobody but a murderer truly likes to kill people."

UPDATE: Jan-24-07 11:22
The column is up; adding a few grafs below...

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From the News-Tribune:

A combat infantryman who led 4,000 Stryker soldiers through a bloody year in Iraq says the Army must do more to help its men and women cope with the harsh emotional realities of war.

For all their preparations for Iraq, Thomas Adams said the troops from his Fort Lewis Stryker brigade weren’t ready for the hurt of losing buddies, and of killing. And the retired command sergeant major said fear of being stigmatized as weak or unbalanced continues to keep many soldiers from seeking the help they need. “We had all the new equipment training, all the generals came down and told us how good we were, sprinkled holy water on us. We were the best,” Adams told the Department of Defense Mental Health Task Force, meeting Tuesday in Tacoma.

But we had not one class. … Not one professional came in and talked to us about what it was going to be like when we lose somebody for real.” Adams wasn’t pointing fingers. He said as the unit’s top noncommissioned officer, he should have thought of bringing in experts to prepare him and his fellow leaders in the 1st Brigade, 25th Infantry Division.

After 28 1/2 years of service, and his deployment to Iraq, Adams has retired. He also has PTSD. He came forward to speak of how the collateral damage, of unintentionally killing innocent women and children, affected him in ways he was not prepared to deal with.

“We killed 186 human beings needlessly,” Adams said. “I saw the looks on their faces every time they came back, and I was ill-prepared. What do you say to a guy who has killed a woman and a kid because the bad guy had hidden among them? “It’s crushing. … and I wasn’t prepared to do it.”

With his vast experience, Adams had concrete suggestions to offer the task force. Key among them is the need for training of line units and commanders in issues having to do with mental health.

Last month, the Mental Health Task Force met in Washington, D.C.

From the Army Times:

The Mental Health Task Force, established in June at the direction of Congress, is a 14-member panel made up of seven members from inside the Defense Department and seven non-defense health professionals. The task force will submit a final report in May 2007 with assessments and recommendations for improving the military’s mental health services.

The meeting [in Washington, D.C. was] the group’s fourth [last] year. The others have been field hearings in Texas, San Diego and the San Francisco area. The task force’s first planned meeting of 2007 has already been scheduled for Jan. 22 and 23 in Tacoma, Wash.

While the Washington state visit included a public hearing and comment period (online comments may still be submitted), the task force turns its focus this week to Fort Carson, Colo., conducting private interviews with some of the soldiers on base. (You may remember last month's explosive NPR report charging commanding officers at Fort Carson with intimidating troops attempting to seek mental health care.)

From the Rocky Mountain News:

Four members of the Department of Defense Task Force on Mental Health are visiting the Army post outside Colorado Springs to talk with active-duty soldiers, their families and key leaders about mental-health issues, including post-traumatic stress disorder, that have arisen since duty in Iraq, according to Army spokeswoman Cynthia Vaughan. ...

Lt. Gen. Kevin C, Kiley, Army surgeon general, has scheduled a Thursday press conference about behavioral-health issues, said 1st Lt. Gregory Dorman, a Fort Carson spokesman. However, Kiley will not discuss information or issues specific to the task force during the roundtable with members of the news media because the information is being gathered for the May report.

But, Steve Robinson, director of veterans affairs for Veterans for America, contended the Fort Carson interviews should be open because of the highly publicized allegations of inadequate mental health treatment, or denied treatment, for soldiers returning from Iraq. "What we are saying is that there are soldiers who should have mental-health services and drug-and-alcohol services who didn't receive them and were kicked out of the military for disciplinary issues," he said. Closing the interviews "has the appearance of the Army's trying to control the story," Robinson said.

Members of the task force have visited some 30 stateside and foreign military bases conducting interviews and hearings. Their next international visit will be later this month:

From Stars & Stripes:

Mental health experts from a Department of Defense task force will be in Kaiserslautern later this month to hear from troops and their families. The meeting is scheduled for 9:30 to 11 a.m. on Jan. 31 at Kaiserslautern’s Vogelweh Community Center.

“Members want to hear from beneficiaries about all aspects of mental health care, including access, quality — even the stigma associated with seeking this care,” according to a news release. “They are also interested in understanding how deployments impact children and spouses, and about care received from civilian practitioners.”

The meeting is designed to foster frank discussions between servicemembers, their family members and the task force, the release stated. The forum is not open to the public or media.

Following the task force's final report to be delivered in May, Secretary of Defense Robert Gates will have six months to formulate a plan based on the group's "assessment and recommendations for improving the effectiveness of mental health services provided to servicemembers," delivering it to Congress for approval and funding.

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Tuesday, January 23, 2007

The Search is On for Objective, Biological Test for PTSD

From Marine Times:

Rather than argue over whether a 15-minute survey can determine if service members suffer from post-traumatic stress disorder, researchers are trying to find biological ways to make the diagnosis. “We’re looking for an objective, independent, biological marker,” said Dr. Charles Marmar, who directs the PTSD facility for the San Francisco Office of Veterans Affairs, told the House defense appropriations subcommittee Friday.

The best bet so far is using brain imaging to look for areas of the brain with unusual activity, he said. ... A physical test could change the stigma of mental health issues. If a brain image could show PTSD, the illness is no longer invisible: The test could make the diagnosis objective because it would not depend on a service member explaining why he’s sick.

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Reporting on Today's Changing Journalism

Some quick links to share my coverage of the Journalism That Matters and National Conference for Media Reform gatherings in Memphis earlier this month. Most recent report at the top, filed just a few hours ago with ePluribus Media:

Will have more on the latest in PTSD news through the night...

Wednesday, January 17, 2007

Special Report from N. Ireland on U.S. Combat PTSD Suicides

A special report from Channel 4 News broadcast out of Belfast, Northern Ireland. View the full report online (mature audiences only, please):

Navy Psychologist Warns of Mental Health Provider, PTSD Training Shortfalls

From USA Today:

From his distant vantage point treating Marines at a base in Iwakuni, Japan, [Navy Cmdr. Mark] Russell, 46, has been speaking out for three years that the U.S. military faces a mental health crisis in the treatment of its combat veterans.

He has fired off memos to higher command and has gone public with his views, an unusual step for many in the military. Russell discussed his concerns in phone and Internet interviews. "We cannot provide the standard of care to treat PTSD via psychotherapy when we can barely keep up with new referrals and have to manage crises while filling in for the staffing gaps and vacancies due to deployment, attrition or no billeting," Russell says. "This is why I have been so outspoken."

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Russell testified at the Pentagon's Task Force on Mental Health hearings in San Diego recently, pointing to the following problems:

Mental health trauma is on the rise. Army studies show that more than a third of combat-deployed troops seek mental health care when they return home.

Training for mental health professionals is inadequate. A survey by Russell of 133 military mental health providers done from 2003-05 shows that 90% of the psychiatrists, psychologists and social workers reported no formal training or supervision in four PTSD therapies recommended by the Pentagon and Department of Veterans Affairs.

Staffing is down. Russell says vacancies remain for mental health providers in the Navy. In addition, psychiatrists and psychologists deployed overseas deplete resources at home, and burnout makes it hard to keep skilled therapists on staff, he says. His concerns were supported by a 2005 Army study showing one of three mental health providers deployed in the war zone report high burnout or low motivation or morale.

Klam says the Army and Navy have emphasized providing mental health counseling in war zones at an unprecedented level. As a result, he says, the military has a record of returning more than 98% of troops with emotional issues back to their units.

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Tuesday, January 16, 2007

WGTD Morning Show: A Discussion with Dr. Edward Tick on Combat PTSD

Thanks to new media, you don't have to be in Kenosha, WI Wednesday morning to catch an informative program on combat PTSD. Just tune into WGTD's online stream at 8:10 am CST/9:10 am EST (or check show archives following its airing).

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KENOSHA - WGTD (91.1 FM) is owned and operated as a public service of Gateway Technical College and is an affiliate of Wisconsin Public Radio. "The Morning Show" airs every weekday morning between 8:10 and 9 a.m. Wednesday['s] guest will be Dr. Edward Tick, author of "War and the Soul: Healing our Nation's Veterans from Post-Traumatic Stress Disorder." Tick is a psychologist who treats PTSD in soldiers. He will be in southeastern Wisconsin at the end of January for several public presentations.

More information on the programs offered during Dr. Tick's visit available via Lake House Center, or download a handy PDF flyer.

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DoD's 2005 Survey of Health Related Behaviors

Released on Friday, the DoD's 2005 Survey of Health Related Behaviors among Active Duty Military Personnel is now available.

From the DoD:

This is the ninth survey in the series of anonymous surveys asking active duty service members about various lifestyle and health-related behaviors. In addition to substance use, the survey also assesses national health status goals from the Department of Health and Human Services’ Healthy People 2010 objectives, nutrition and weight management measures, mental well-being of the force, and deployment issues. More than 16,000 service members, randomly selected to represent men and women in all pay grades of the active force throughout the world, completed the survey.

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First, some of the good news:

The findings show notable decreases in the use of cigarettes and illegal drugs since initiation of the surveys in 1980 and progress towards meeting selected Healthy People 2010 objectives. The 2005 survey, however, revealed rates of heavy drinking remain elevated especially among our young people, use of smokeless tobacco has increased, and even though most military personnel engage in moderate or vigorous exercise, more service members meet criteria for being overweight.

The 2005 survey indicates the majority of our U.S. Armed Forces, although under heavy work stress during the current wartime environment, use positive coping mechanisms to deal with stress.

According to Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, “These survey findings provide very useful information for the department to target programs that continue to enhance the physical and mental well being of our troops. I am pleased, and even a little surprised, that despite the stresses of war and ongoing deployments, nearly all indicators of service members’ health and well-being continue to be quite good compared with civilian populations.”

Regarding PTSD and the relationship between self-medication and mental health:

Rates of current (one month) Post Traumatic Stress Disorder (PTSD) symptoms in the DoD population as measured by a self-report screener were 6.7 percent for total DoD and ranged from 3.7 percent to 9.3 percent for each service. An estimated 8.1 percent met screening criteria for further evaluation for serious psychological distress.

“It is important to remember the results come from self reported data and may differ from information in official records or other data sources,”Winkenwerder noted. “These screening questions do not represent a formal clinical diagnostic evaluation, but suggest some of our personnel should be encouraged to obtain more evaluation.”

Personnel deployed in the past three years (i.e., from 2002 to 2005), compared to those who did not deploy, had higher rates of work and family stress; higher rates of heavy alcohol use, cigarette use, and illicit drug use; and a greater number meeting criteria for depression, anxiety and PTSD symptoms on the screening questions. In contrast, there were no significant differences in self-reported mental health measures among those deployed to OIF/OEF compared to those who did not serve in an operational theater.

Statistically significant relations were observed among heavy alcohol use, stress, and mental health issues. Compared with abstainers, heavy users of alcohol reported more problems with stress at work (41.1 percent vs. 28.4 percent) or in their family (24.7 percent vs. 15.3 percent); were more likely to meet screening criteria for anxiety (17.5 percent vs. 10.1 percent) and depression (31.2 percent vs. 19.1 percent); and reported more limitations in activities as a result of poor mental health (4.8 percent vs. 2.0 percent).

Heavy drinkers were also more likely than those who drank less to meet the criteria for further evaluation for serious mental disorders and reported to have a history of suicidal ideation or physical or sexual abuse.

However, because the survey is cross-sectional data, we are unable to ascertain which behavior (the heavy alcohol use or the mental health problems) came first, but this association points to potential intervention strategies in which reducing one would help reduce the other .(e.g., encouraging more positive coping strategies could both lessen use of alcohol and improve mental health).

Military Resources Strain a Disservice to Current and Former Vets?

Donna Teresa in today's Monterey Herald:

Joshua Amaya, son of Raul Thomas Amaya, a Navy Vietnam veteran, who served in the reserves in 1967-1968 and active duty in 1969-1970, who recently died, experienced some of the consequences of this war. Josh and his family were having trouble getting confirmation that a color guard and American flag would be available to honor his father at this funeral. He was told that during wartime, this service cannot be promised due to unavailability of personnel due to deployment in war and extremely full schedules covering other military funerals.

Amaya said the reasons were not acceptable. "(A)t first I understood, and then I thought about it," he said. "Why was my dad's service or anyone else's service less deserving of a military memorial service and a flag? This president asks for billions of dollars to continue this war, but... I couldn't get my dad an American flag for his funeral. He enlisted to defend our country just as those serving now are doing.

"My dad was there for his country, was it too much to ask that they be there for him? Will the support of our uniformed men and women stop when the war ends? These are the last acts of thanks to our veterans of all wars. Our country claims to care, but actions sometimes speaks louder than words." The local American Legion came to Josh's rescue and his dad received the military funeral he deserved.

Heartbreaking and maddening.

Personality Disorder -- Or Combat PTSD?

A recent post on the fact that 22,000 OEF/OIF troops have been discharged with personality disorder -- the same diagnosis given to Steven Green, the soldier charged with raping an Iraqi girl and then killing her and her family in Al Mahmudiyah -- stimulated quite a bit of interest. One of the questions raised: Are troops being given personality discharges in place of a diagnosis of combat-related PTSD?

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First a bit more on the Green case via Newsweek:

Green's case has helped to spur a closer look at the Army's standards for recruitment and training. Green enlisted and passed basic training at a time when the Army was under terrific pressure to bring in new soldiers and had relaxed its entry requirements. In 2005, about the time Green was accepted, the Army raised the limit on the so-called Category 4 recruits it would allow, the designation for soldiers with the lowest scores on its aptitude test. (Green's score is not known.) The Army has also been handing out more waivers—including case-by-case exceptions for criminal offenses—which increased by 3 percent last year. Basic training has slipped as well. In years past, basic was geared to "wash out" those unfit for the stresses of military life. Now it has been reformulated to keep as many recruits as possible. "What you're seeing is the reverse of what made the Army so effective," says Sen. Jack Reed of the Armed Services Committee. ...

The most recent washout numbers show a dramatic decline in standards: currently only 7.6 percent of new recruits fail to get through their first six months of service, down from 18.1 percent in May 2005, according to the latest Army figures. "That's a heck of a drop," says Leo Daugherty, the Army's command historian at Fort Knox. "The young man who got in [Green] should never have gotten in the Army. He slipped through the system." The Army says it has adapted basic training to lessons learned in Iraq and Afghanistan, and helps soldiers to improve their weaknesses. "We will get rid of those individuals who have no business being a soldier," says Col. Kevin Shwedo, director of operations, plans and training for Army Accessions Command. "We're not going to quit on a soldier when they're trainable. That's a big difference."

How about quitting on soldiers who do not appear to have had serious behavioral problems prior to enlistment but are now suffering from combat PTSD following their deployment to a war zone? Does the military stick with them?

From the Austin American-Statesman:

Soldiers suffering from the stress of combat in Iraq are being misdiagnosed by military doctors as having a personality disorder, lawyers and psychologists say, which allows them to be quickly and honorably discharged but stigmatizes them with a label that is hard to dislodge and can hurt them financially.

Though accurate for some, experts say, the personality disorder label has been used as a catch-all diagnosis to discharge personnel who may no longer meet military standards, are engaging in problematic behavior or suffer from more serious mental disorders. For returning veterans, the diagnosis can make it harder to obtain adequate mental health treatment if they must first show they have another problem, such as post-traumatic stress disorder. "It's an absolute disgrace to military medicine," said Bridgette Wilson, a former Army medic who is now an attorney in San Diego serving mainly military clients. "I see it over and over again, the dramatic misuse of personality disorder diagnosis. It's a fairly slick and efficient way to move some bodies through."

And stories coming out of Fort Carson, Colo., are far from comforting:

A government worker at Fort Carson in Colorado who has access to personnel records and who spoke on condition on anonymity for fear of losing his job said Army psychologists there have diagnosed some soldiers with a personality disorder after a single evaluation lasting 10 minutes to 20 minutes. Several soldiers at Fort Carson interviewed by Cox Newspapers said they have been given or offered the diagnosis in a handful of meetings lasting less than an hour.

The personality disorder diagnosis can result in a soldier getting an honorable discharge within days, which can be appealing for many returning from Iraq. The timing of many of the discharges, in some cases within months after soldiers have returned, appears to violate the military's rules, which say a personality disorder diagnosis should not be made if a soldier is experiencing "combat exhaustion or other acute situational maladjustments."

Personality Disorder is defined as "a deeply ingrained, abnormal behavior pattern that appears during childhood or adolescence." While a combat-related diagnosis for PTSD requires the military to invest in the continuing care of the veteran, a diagnosis of Personality Disorder does not.

A review of four soldiers' medical records at Fort Carson and records from a soldier at another post show that they were diagnosed with post-traumatic stress disorder before or after their discharge.Recommending a discharge on the basis of a personality disorder is a faster process than discharging someone for mental health problems of another nature. It requires only one military psychologist's finding, and the paperwork usually takes only a couple of days.

A diagnosis of post-traumatic stress disorder, on the other hand, must be handled by a medical review board, which must confirm that the condition stems from combat, a process that usually takes several months.

Dr. Joseph Bobrow, a former chief psychologist at Kaiser Hospital in San Francisco, said a personality disorder is one of the most difficult diagnoses to confirm, particularly when there is cumulative trauma. "I think it's ludicrous to make a diagnosis of personality disorder in a 20- to 40-minute interview," he said. "Even if you do a complete battery of psychological testing and intensive and informed clinical interviews over a week, some of those results can be and are contested in a court of law."

Some of the soldiers at Fort Carson say they had been told by Army psychologists that the Department of Veterans Affairs would take care of them if their troubles persisted. A personality disorder, however, is considered a pre-existing condition, not one related to a soldier's service, and Veterans Affairs can treat but not give disability benefits in these cases.

Many soldiers who sought mental health counseling after returning from Iraq, like former Spc. Donald Schmidt of Chillicothe, Ill., say they learned only after their discharge that they must repay part of their re-enlistment bonus based on the portion of time they did not serve — more than $10,000 in Schmidt's case.

Getting a Personality Disorder discharge also may make finding employment more difficult as employers examine the veteran's records and learn of behavioral problems noted on discharge papers.
In her 13 years in practice, San Diego attorney Wilson said she has seen dozens of Marines from nearby Camp Pendleton and soldiers from other posts separated for a personality disorder when the real reason, in her view, has been to punish a soldier, avoid paying disability benefits for a more serious condition or get rid of someone deemed undesirable.

Though some of her clients have personality disorders, she said, most who received the diagnosis and discharge had minor behavioral problems or were diagnosed with bipolar disorder or severe depression by either military or civilian psychologists. About three-quarters of her clients who have been diagnosed with a personality disorder, she said, weren't given any psychological test. Rather, she said, the diagnosis was based on a roughly 45-minute interview.

One troubling case:

For nearly a year after his return from Iraq in August 2005, former Pvt. Jason Harvey had gone without any follow-up evaluations at Fort Carson after screening positive for possible post-traumatic stress disorder and a traumatic brain injury, his records show.

After a suicide attempt in May, records show that the 23-year-old was diagnosed with depression and post-traumatic stress disorder, but in late June the Army tried to discharge him with a personality disorder. Harvey said he was told by a staff psychologist in a joint meeting with his commander that if he did not agree to an honorable discharge, the commander would pursue a punitive discharge. "They played me like a fiddle," Harvey said, adding he was wrongly told the medical retirement fell under the same category as post-traumatic stress disorder. In fact, it is a nonmedical discharge.

Also at Fort Carson, after two tours in Iraq, Schmidt, 22, told a psychologist he was feeling violent impulses as a result of marital difficulties. The decorated soldier is on guard constantly and "quick to anger" when he had not been that way before, said his mother, Patrice Semtner-Myers. Schmidt said his Army psychologist, Dr. Michael Pantaleo, made the diagnosis after several meetings lasting between 15 and 30 minutes each and never asked him questions about his behavior before joining the Army. Pantaleo did not return calls seeking comment.

Schmidt was discharged "without a dime in his pocket," his mother said. "The soldiers are often too stupid to know what they've done" when they accept the disorder or seek it, Wilson said. "They go out and discover the state police department really isn't interested in someone discharged with a personality disorder or find they have trouble getting security clearances."

Some military psychologists appear to be violating guidelines in the Diagnostic and Statistical Manual of Mental Disorders, the psychiatric manual used by the military. If a soldier complains of mental problems after returning from combat, a personality disorder is supposed to be ruled out for an unspecified amount of time because some of its characteristics, such as problems interacting with others and substance abuse, overlap with some of the hallmarks of post-traumatic stress disorder.

The Pentagon "is not familiar with the rules, or they are choosing to ignore them," said Paul Sullivan, director of programs for Veterans for America, a Washington-based nonprofit.

Every branch deals with these types of discharges differently:

Determination of personality disorder

Medical guidelines for each service:

Army: Requires a psychologist's findings.

Navy: Vague language; not clear that determination must come from a mental health professional or command.

Marines: Similar to Army rules but two forms of documents required. Same doctor must render findings on a Marine's impairment and on written nonmedical evidence to show examples of inability to function in the corps.

Air Force: Alone in requiring oversight where commanders fail to act on appropriate findings. Commander must have decision reviewed by discharge authority.

This is an issue that clearly deserves a closer look.

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Monday, January 15, 2007

Back from Memphis - Journalism That Matters

After dealing with some technical difficulties that prevented me from posting while I was away in Memphis attending both the Journalism That Matters sessions [pictures] and the National Conference for Media Reform [pictures] from Thursday through Sunday, I'm finally back online...and boy do I have some updates to deliver!

Friday night I posted a quick commentary at ePluribus Media on the happenings in Memphis, focusing on the movement of traditional and independent editors and journalists, J School educators, media reformers and citizen journalists working together to improve the news reporting process in these times of great change.

The next day I covered the Press at War & War on the Press panel, which included Eric Boehlert, Sonali Kolhatkar, Geneva Overholser, Paul Rieckhoff, and Helen Thomas. Listen to the full audio recording of it, now available at the Free Press conference website, and look for my full post on the panel tomorrow.

Wednesday, January 10, 2007

Soldier’s Heart Veterans Return Retreats and Programs

Dr. Edward Tick has written one of the definitive books on the effect of war on its combat veterans. I can't recommend War and The Soul: Healing Our Nation's Veterans from Post-traumatic Stress Disorder highly enough. But Dr. Tick is not merely writing about the process of reintegration -- he's busy traveling the country (and world) bringing his message to those who need it most.

This past weekend, Dr. Tick and his wife Kate Dahlstedt (also a psychotherapist), conducted their first Soldier’s Heart Veterans Return Retreat in Albany, N.Y., their home base. Later in the month, Dr. Tick brings his important skills to the Midwest in a series of programs hosted by the University of Wisconsin-Parkside and the Lake House Health & Learning Center in Racine, Wisc.

Click on 'Article Link' below tags for more...

On this past weekend's retreat, from the Albany Times Union:

They had seen the hell of war and they had all been damaged by it in ways large and small, visible and not visible. Now they were coming together to heal. ... The wounds on display were raw and searing, close to the surface, whether the veteran fought five decades or five months ago. "This history keeps repeating itself, and we're saying we're not going to let it happen again," said Hugh Scanlen, 59, of Fort Davis, Texas, a gunner on an Army helicopter in Vietnam.

"I'm seeing vets from Iraq on the streets now and they're lost," he said. "I'm watching them go through what I went through, and that's not right."

Scanlen said he denied his own PTSD symptoms through two failed marriages and a string of personal problems before he began seeking treatment. "I'm here because we're not doing enough to help our troops coming back from Iraq now," said Scanlen, who hugged Ron and wrapped an arm around the shoulder of another Iraq vet named Peter.

Ron and Peter, who asked that their last names not be used, had come to the retreat reluctantly after prodding from their wives. Tears flowed as the women stood beside their men throughout Friday's heart-wrenching moments of catharsis. They described their husbands as depressed, isolated, irritable, unemployed, broken in spirit and adrift. They had urged their spouses to attend the retreat in an effort to get some help and to save their troubled marriages.

Other 'Soldier's Heart' programs are springing up across the country, in Washington and Indiana and Colorado, just in the nick of time.

Tick, author of "War and the Soul" and other books on problems facing veterans, predicted a surge of returning Iraq war veterans in need of treatment. He augments his treatment with nontraditional methods such as leading vets on healing journeys back to Vietnam and Iraq, or participating in Native American rituals and studying ancient Greek texts for enlightenment on archetypal healing paradigms.

Tick's holistic approach can be encapsulated in a new term he's coined for the far-reaching symptoms of PTSD. "Post-terror soul disorder," he calls it. "It is our culture that is disordered by war. It is a communal affliction," he said.

Details on southeastern Wisconsin's upcoming events with Dr. Tick:

Jan. 25, 2007: War and the Soul workshop from 9 a.m. to 4 p.m. at University of Wisconsin Parkside, Kenosha, WI. $75 tuition includes lunch. Call the univeristy (262) 595-2312.

Jan. 25: Public forum for veterans, family members and others from 6 to 8 p.m. at University of Wisconsin-Parkside Union Cinema. No charge. Call (262) 595-2312 for information.

Jan. 26: War and the Soul: Training for Clergy from 9 a.m. to noon at Lake House Health & Learning Center, 932 Lake Ave., Racine.$30 tuition or donation, with CEU certificate provided for clergy members.

Jan. 26: Potluck and Conversation with Ed Tick for veterans, family members and friends from 6 to 8 p.m. at Lake House Health & Learning Center, 932 Lake Ave., Racine. Bring dish to share if you are able. Donations welcome but not necessary. Call (262) 633-2645 to reserve or for information.

Jan. 27-28: "Reconciliation Journey, A Process of Healing for Veterans, Family and Community” healing experience and professional training from 9 a.m. to 5 p.m. Saturday and 9 a.m. to 4 p.m. Sunday at Lake House Health & Learning Center, 932 Lake Ave., Racine, WI. Tuition is $200 for professionals, with sliding scale for veterans and family if they cannot afford the full fee; 13 hours of CEUs will be provided for professionals at extra nominal charge. Call (262) 633-2645 to reserve your space or for more information.

Additional events can be found at Dr. Tick's Sanctuary: Mentoring the Soul website.

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Surge -- And Strain

An op-ed in today's Boston Globe:

General Peter Pace, chairman of the Joint Chiefs of Staff, says it would take two years just to recruit, train, and equip 10,000 new troops. Thus to accomplish a surge, the armed forces must look to existing units. Virtually all the nation's active-duty ground-force units, and many from the Guard and Reserve, have already spent a year or more in Iraq or Afghanistan. There are only two ways to get more brigades into Iraq: Extend the deployment of units that are already there, or accelerate the return of units that have been there recently. Temporarily increasing the force in Iraq by 20,000 is likely to require a combination of both. The Bush administration's surge could stress the Army and Marines to the breaking point.

For the individuals affected, extended tours and repeated deployments raise troubling mental-health concerns. Nearly 20 percent of Iraq veterans are already returning home with serious mental-health problems, including post-traumatic stress disorder and brain injuries that may go undiagnosed.

An Army survey released last month suggests that such problems will increase as more soldiers are required to serve in Iraq longer than planned. Soldiers cited the length of deployment and family separation as the top non-combat sources of stress in their lives. Repeated deployments made things much worse; 18 percent of soldiers with at least one earlier deployment said they were under acute stress, compared with 12 percent of those who are on their first tour in Iraq.

The author of the piece is Cindy Williams, principal research scientist in the Security Studies Program at MIT and a co-editor of Service to Country: Personnel Policy and the Transformation of Western Militaries.

Click on 'Article Link' below tags for related posts...

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The Soldiers Project Founder to Speak in Ventura County

Listed on my recent pro bono transition resources post, the Soldiers Project is doing great work to help our returning troops. The founder of the organization, which provides complimentary counseling services for southern California OEF/OIF vets and their families, will be speaking at the Thousand Oaks Library in Ventura County on Wednesday, January 24, 7:00 P.M - 8:30 P.M. hosted by the Global Exchange Ventura County Supporters.


Post Traumatic Stress Disorder ("PTSD")
Do you understand it?? Learn how this often misdiagnosed condition affects the lives of soldiers and their families and hear from an expert on the most frequently suffered condition afflicting the military in Iraq and Afghanistan

Judith Broder MD is a psychiatrist and a psychoanalist. She is involved with a group of therapists in Los Angeles called the Soldiers Project. The group was founded by Dr. Judith Broder who was touched after seeing a play about combat trauma. Services are given absolutely free. She is a member of the L.A Institute and Society for Psychoanalytic Studies and on her teaching staff as well. She has a private practice in Los Angeles.

Phone Joanie McClellan at 805-241-8855 for more info.

Tuesday, January 09, 2007

Ed Schultz Show: Reintegration Program Discussion Wednesday

Important program slated for tomorrow, Wednesday Jan 10, on the Ed Schultz Show:

Hear Ed's invite
How do families prepare for military personnel coming home from Iraq? Captain Aaron Krenz of the National Guard joins us to talk about a new reintegration program.

The discussion revolves around the ground-breaking work being done by Krentz and the Minnesota National Guard to help military families prepare for 2,600 of their loved ones coming home from Iraq beginning in March. What are they doing to help?

Minnesota State University is offering a first-of-its kind Family Reintegration Academy program to family members of the 1st Brigade Combat Team throughout the state of MN. The first training date took place two days ago in Moorehead, and I'm anxious to see how well it was received.

UPDATED: Jan 10 2007 - 21:53
Podcast of Capt. Krentz interview now available.

Click on 'Article Link' below tags for much more...

Press Release from Minnesota State University-Moorehead:

For 2,600 returning Minnesota soldiers…

Life in a combat zone is pretty much black and white: pull the trigger, don’t pull the trigger; take a risk, don’t take a risk; obey orders, give orders; terror, exhaustion; live, die. Not so in civilian life, where a more mundane set of circumstances casts a gray ether of indifference over even the most insignificant decisions. So how does a soldier––who’s spent more than a year making life and death decisions daily while fighting off stretches of boredom and exhaustion––adjust to civilian life after a tour of duty in Iraq or Afghanistan?

It’s a good question that the Minnesota National Guard is trying to resolve when 2,600 of its citizen soldiers return home this spring, the largest deployment since World War II. “Fortunately, Minnesota is at the forefront in making an effort to integrate its National Guard soldiers back into civilian life,” says MSUM alum Capt. Aaron Krenz, operations officer for the 1st Brigade Combat Team, 34th Infantry Division’s reintegration team. “It’s a pilot program that other states will be looking at.”

Gov. Tim Pawlenty echoed that sentiment last fall at the Minnesota Summit on Returning Veterans: “Our goal is to make this the most veteran-friendly state in the United States.”

MSUM is also playing its part, hosting the Minnesota National Guard’s first Family Reintegration Academy on Jan. 6, aimed at the spouses, children and families of soldiers who will return in March, April and May. It’s part of a larger overall program that all of these transitioning soldiers will be required to participate in two, 30, 60 and 90 days after arriving home [links to brochures on program details, dates, and places].

Ten sites have been organized around the state to host these sessions. “We’re partnering with community providers, businesses and government agencies across the state to create a safety net,” he said. “We’ll provide all of them with professional help dealing with difficulties they may face at home, work, school or in their private lives.”

Krenz, a 1996 MSUM criminal justice graduate and former linebacker for the Dragon football team, was chosen to be a major player in the reintegration team because he encountered a few problems himself after returning home from a year’s tour as commander of Alpha Company, 1/151 Field Artillery that trained Iraqi police forces in southeast Baghdad.

Krenz left behind a 9-month-old daughter and his wife Monica, who developed her own routine for running the household while her husband was overseas. “Things change over a year, and we were both exhausted from our ordeals,” Krenz said. “My challenge was finding out how to fit back into my family and my family’s challenge was how they would adjust to me.”

The hurdles for other returning soldiers can be more exacting. “Take a typical Humvee turret gunner whose job was to patrol the streets of Baghdad,” Krenz said. “Most of these guys are very young. But the responsibilities and risks they faced were enormous.” Few of the civilian jobs they’ll return to, he said, match the responsibilities, the adrenaline rush or the intense emotions of being in a combat zone—whether it’s teaching school, flipping hamburgers or running a company.

“Readjusting can be frustrating,” he said. “But I know this: after facing the possibility of death daily, when these soldiers return they want to live life to the fullest. That’s why we want to funnel that passion into education, jobs and family.” Not the darker avenues, which can range from drugs and depression to traumatic stress and homelessness.

Minnesota Adjutant Gen. Larry Shellito, another MSUM alum (’68 accounting, ‘72 business administration and ’79 master’s degree in education) pointed out that since Sept. 11, 2001, more than 11,000 Guard members have been deployed to 33 nations, with about 1,100 returning from Iraq. “We want all of our soldiers to know here’s how we can help you,” he said. “You get a welcome home, a hug and a kiss and a week later, you’re in the house all alone, and that’s when reality can set in. What we’re working on is providing preventive medicine instead of just waiting to see what happens.”

A Vietnam veteran with more than 30 years of military service, Shellito said “The genesis of this program goes back 30 years when the same people came back and no one gave a damn.” MSUM’s part in this reintegration program will basically be to provide facilities and coordinate day care during the sessions taking place on campus.

Krenz, who grew up on a farm in Wheaton, Minn., joined the Minnesota National Guard in high school. He spent most of his service time as an enlisted soldier with an artillery battery in Ortonville. After completing officer training in 2003, he’s been commanding the battery in Marshall, Minn. In civilian life, Krenz is a Clay County youth counselor. But for the time being, he’s been activated in Moorhead to coordinate the reintegration program for one of the largest inflows of new combat veterans in the state’s history. ...

“This pilot program will be successful and I hope catches on throughout the nation” Krenz said. “These veterans deserve our best efforts.”

Three cheers and a big Hoorah for the great state of Minnesota and to all those involved with getting such a program off the ground!

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Sunday, January 07, 2007

Combat Stress/Reintegration Resources: Helplines, Places to Turn, Free Military Family Counseling and Veteran Retreats, PTSD Information

Are you looking for some help for yourself or a loved one?

There are so many groups and individuals willing to listen to your problems or concerns, offer guidance, treat you to a free reintegration retreat or even come to your aid if you're really struggling with a difficult issue -- homelessness, suicidal thoughts as a result of your combat stress, or fear for the safety of you or your family members.

If the situation is tough, or just a momentary stumper like having trouble with understanding your military benefits, someone is out there for you. See the long list of options below.

Friday, January 05, 2007

Sen. Jim Webb Leads Charge to Improve GI Bill

While not directly related to PTSD, restoring the educational benefits of today's GI Bill to WWII-era levels will certainly improve the lot for our returning troops -- and may very well reduce some of the post-deployment stress and strain that many of them face as they make their way back into our society. Improvements such as those introduced by freshman Sen. Jim Webb [D-VA] yesterday will provide these men and women a solid pathway to a better present -- and future.

With full tuition, room and board, and a monthly stipend of $1,000, they will have the opportunity to focus a bit on themselves, confident in the knowledge that we care about them and want to ensure their success. The WWII generation demanded no less be given to their soldiers and sailors, airmen and Marines upon their return home. Why should we?

Having the chance to go to school without worry over food or shelter or piled-on bills will greatly, greatly improve the current outlook and the future prognosis of today's service member.

It will also go far in improving our nation, too.

Click on 'Article Link' below tags for more...

From the American Chronicle:

The “Post-9/11 Veterans Educational Assistance Act of 2007” (S.22) is designed to provide veterans with a level of educational benefits identical to those provided to service members at the end of World War II.

The new benefits package included in Webb’s legislation would include coverage of tuition, room and board, and a monthly stipend of $1,000. Existing law – known as the Montgomery GI Bill – provides financial support of up to $800 per month for veterans’ educational expenses, but does not necessarily cover the full cost of higher education or career training. In addition, existing law requires participating service members to pay $1,200 in their first year of service in order to qualify for the benefit.

“The Montgomery GI Bill served this nation well during peacetime, but times have unfortunately changed,” Webb said. “The demands placed on soldiers and sailors in this post 9/11 era are much greater than when Congress established the current program. With many of our military members serving two or three tours of duty in Iraq and Afghanistan, it is past time to enact a new veterans’ education program modeled on the World War II era GI bill.

Webb goes on to say that the bill, S.22, was assigned a low number -- meaning that it is a top priority piece of legislation. He believes that enriching the GI Bill to WWII levels will be good for the soldier, yes, but also good for the nation:

Webb stressed that the GI Bill of the World War II era is universally credited with sparking economic growth and expansion for a whole generation of Americans, and he predicted that his proposal holds similar promise for today’s modern economy.

“Our nation has never erred when it made sustained new investments in higher education and job training,” he said. “The bill I have introduced today is not only the right thing to do for our men and women in uniform, but it is also strong tonic for an economy plagued by growing disparities in wealth, stagnant wages, and the outsourcing of American jobs.”

Please contact your senators today to ask them to sign onto this bill. It's time to get the engines of change moving in the right direction again.

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Iraq War: Deadly Trigger for Previous Wars' Veterans

This war's casualties are not merely limited to those currently serving in the military.

Journalist Julie Sullivan files another report on combat PTSD well worth a quick read. You may remember her name. She was the force behind last year's massive Oregonian report on war's effect on our returning veterans. Appearing in March 2006 (coinciding with the third anniversary of the start of the Iraq War) the series (along with a follow-up by Sullivan) stood out among the many news reports filed at the time -- a time marked by our mainstream press finally beginning to report more fully and realistically on all aspects of our wars in the Middle East.

Her latest piece presents another account of how this century's wars can negatively affect not only those returning from the 'Sandbox' in Iraq or the mountains of Afghanistan, but veterans of the previous century's wars, too. This account can be added to far too many others that I've found reported in the press...

Click on 'Article Link' below tags for more...

From Newhouse News Service:

[Vietnam veteran Thomas Laing] coped -- until the war in Iraq. Images of flag-draped coffins, uniformed soldiers with missing limbs, and an increasingly unpopular war brought back Tom's own experiences with such devastating force that his wife finally sat down at her computer. In a July 26, 2004, letter to the U.S. Department of Veterans Affairs addressed "To whom it may concern," Lolly poured out the most intimate and harrowing development in their long and wounded marriage:

"My name is Laurel Laing, wife of Thomas Laing. We have been married 37 years. Since the start of the Iraq war Tom has had increased nightmares, night sweats and acting out. He has become more short tempered and withdrawn from his family, work and daily activities of a normal life. Tom is restless and he cries when the news announces that we have casualties and soldiers are dying. He says this War is turning out to be another Vietnam.

"On April 28 around 2:30 a.m. we were sleeping and all of a sudden someone had their hands on the top of my head it felt like it was moving to the right in a fast direction and that my neck was going to be snapped. I yelled out some awful noise and the movement stopped. I turned around and looked at Tom who was on his knees breathing so hard and saying `so sorry, I'm so sorry, I could have killed you.

"I thought I was in Vietnam."

This is hardly the first such incident reported in the press. Some have been even more heartbreaking:

He never was inclined to talk much about the damage, at least not to his wife and children. They knew -- it was obvious -- that a land mine in Vietnam took large portions of both of the Rev. Alan McLean's legs 38 years ago.

They knew that the single detonation in 1967 triggered ongoing waves of psychological temblors when McLean heard helicopters or when war footage appeared on the news. They knew that the decorated veteran was profoundly distressed by the Iraq war, an anxiety that ran as deep as the former Marine's patriotism.

But they didn't know about the .45-caliber pistol. Or the suicide note in his laptop, written but never printed out, seven days before he used that pistol. In it, McLean, the popular rector of St. Luke's Episcopal Church here, apologized to his wife, Betsy, and his children for not being stronger. The war in Iraq, he said, unbearably amplified his nightmares.

He said he'd had enough. "35 Marines died today in Iraq, only slightly more noticed than my legs," the former second lieutenant typed on Feb. 4. ... With his final decision to call 911 from his church office and turn his pistol to his chest on Feb. 11, McLean, 62, became a casualty of two wars, his family members said.

"I underestimated the power of the war to take his life," said his daughter, Mary Watkins, 29, of Tacoma. "And I really feel that though my dad's been in Wenatchee, the war in Iraq killed him."

Other profiles of this trigger have been filed. Another tragic suicide of a Vietnam veteran who was not coping well with depression set off by the Iraq War was reported in Newsweek in October 2006:

Scott Cameron and Dennis Kanke had a lot in common. Residents of Duluth, Minn., both fought in Vietnam and returned home with traumas that lingered for decades. Both clawed their way out of the pit with the help of therapy and medication. And both fell back into it when the Iraq invasion began more than three years ago, with war scenes on television triggering nightmares and flashbacks. "It all came rushing back," says Cameron, a sinewy 56-year-old who took a bullet in the spine in 1969 and went on to have more than 40 operations.

When the depression got really bad, Cameron checked himself into a trauma clinic in 2004, where he spent nine weeks with other war veterans affected by Iraq. Kanke, by contrast, coped by shutting off TV news and occasionally reaching out for help from friends. In August of that year, Cameron got a call from Kanke, who wanted company on his boat. "I'd been on the road for two hours and couldn't drive anymore. I told him to go to sleep and I'd see him in the morning," Cameron recalls.

Instead, Kanke poured a can of gasoline over himself and lit a match, dying in a hospital three days later. ... On the night of his suicide, after talking by phone to Cameron, Kanke roused [his wife] Carol and pushed her out of the house before setting himself on fire. She says she watched the fire from the outside, then tried to douse her husband with a garden hose. "We had a wonderful life. But when the war started, he just got more and more depressed. He didn't handle things' going wrong very well," she says. Now she's hoping her husband's story will help other veterans spot the symptoms and avoid his fate.

Washington Post covered the deadly trigger the Iraq War has become in a report last year:

More than 30 years after their war ended, thousands of Vietnam veterans are seeking help for post-traumatic stress disorder, and experts say one reason appears to be harrowing images of combat in Iraq. Figures from the Department of Veterans Affairs show that PTSD disability-compensation cases have nearly doubled since 2000, to an all-time high of more than 260,000. The biggest bulge has come since 2003, when war started in Iraq.

Experts say that, although several factors may be at work in the burgeoning caseload, many veterans of past wars reexperience their own trauma as they watch televised images of U.S. troops in combat and read each new accounting of the dead. "It so directly parallels what happened to Vietnam veterans," said Raymond M. Scurfield of the University of Southern Mississippi's Gulf Coast campus, who worked with the disorder at VA for more than 20 years and has written two books on the subject. "The war has to be triggering their issues. They're almost the same issues." ...

PTSD researcher John P. Wilson, who oversaw a small recent survey of 70 veterans -- nearly all from Vietnam -- at Cleveland State University, said 57 percent reported flashbacks after watching reports about the war on television, and almost 46 percent said their sleep was disrupted. Nearly 44 percent said they had fallen into a depression since the war began, and nearly 30 percent said they had sought counseling since combat started in Iraq.

"Clearly the current Iraq war, and their exposure to it, created significantly increased distress for them," said Wilson, who has done extensive research on Vietnam veterans since the 1970s. "We found very high levels of intensification of their symptoms. . . . It's like a fever that has gone from 99 to 104."

Every incidence of violence or suicide or depression an additional support for our need to be cautious and sure about the types of war we wage. Our political leaders have failed in this regard enormously.

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