Catastrophe - Dick Morris [135]
But the Post noted that this increase did not really factor in the full impact of the Iraq and Afghan wars “because the increase is largely the result of Vietnam War vets seeking treatment decades after their combat experiences.”562 When the Iraq and Afghan vets return, the impact is likely to be enormous.
Even as many soldiers don’t seek treatment for PTSD, others are inclined to conclude grimly that it can never be cured. As Chris Frueh, the director of the VA clinic in Charleston, South Carolina, told the Post, “we have young men and women coming back from Iraq who are having PTSD and getting the message that this is a disorder they can’t be treated for, and they will have to be on disability for the rest of their lives.”563
This unjustified pessimism could lead to the creation of a permanent class of veterans who think themselves disabled and live on government pensions. Those who are granted 100 percent disability status from the Veterans Administration get about $2,300 per month.564 And, the Post reports, “once veterans are declared disabled, they retain that status indefinitely.” As Frueh notes, “the [Veterans] department’s disability system encourages some veterans to exaggerate symptoms and prolong problems in order to maintain eligibility for benefits…. My concern about the policies is that they create perverse incentives to stay ill. It is very tough to get better when you are trying to demonstrate how ill you are.”565
Frueh warned that this system sets up an “adversarial relationship” between doctors and returning soldiers over whether to assign a disability status for their PTSD.566
But most people agree that the more serious problem is that some patients never get the help they need—because, as Frueh told the Post, “they are unwilling to undergo the lengthy process of qualifying for disability benefits, which often requires them to repeatedly revisit the painful episodes they experienced.”567
Some, like Steve Robinson, accuse the Veterans Administration of deliberately failing to diagnose PTSD in returning soldiers to avoid the cost of disability payments. Robinson said, “what they [the VA] are trying to do is figure out a way not to diagnose vets with PTSD. It’s like telling a patient with cancer, ‘if we tell you you don’t have cancer, then you won’t suffer from cancer.’”568
The RAND Corporation study, like both the Pentagon and The New England Journal of Medicine studies, found that only about half of those suffering from PTSD or major depression get help.569
“If PTSD and depression go untreated or are undertreated, there is a cascading set of consequences,” said RAND project coleader Lisa Jaycox. “Drug use, suicide, marital problems and unemployment are some of the consequences. There will be a bigger societal impact if these service members go untreated. The consequences are not good for the individuals or society in general.”570
Why don’t returning servicemen and women seek treatment? RAND reports that “many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional” but that “even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities.”571
RAND recommends that “the military create a system that would allow service members to receive mental health services confidentially in order to ease concerns about negative career repercussions.” “We need to remove the institutional cultural barriers that discourage soldiers from seeking care,” RAND project