Anchorage Daily News

Huge numbers of U.S. soldiers are returning from combat with "invisible wounds" -- psychological trauma and brain damage -- and they aren't getting the care they deserve, according to a major Rand Corp. study.

Of the 1.64 million troops who have served in Iraq and Afghanistan, up to 300,000 have suffered some version of post-traumatic stress disorder (PTSD). As many as 320,000 have suffered some level of traumatic brain injury (TBI), ranging from mild concussion to severe head wounds.

Yet the study found that only 53 percent had sought treatment for PTSD -- and only half of those had received treatment the study found "minimally adequate."

For TBI the figures were worse -- 57 percent of those reporting a possible brain injury had not seen a doctor for evaluation.

The danger in these numbers is in the toll of afflictions that go untreated.

At its worst, untreated PTSD can lead to lost jobs, homelessness, broken families, domestic violence and suicide.

Suicides among veterans of the wars in Iraq and Afghanistan eventually may outnumber the combat deaths, the U.S. government's top psychiatric researcher, Dr. Thomas Insel of the National Institute of Mental Health, said this week.

And the Department of Veterans Affairs is under fire now for under-reporting the number of suicides among all veterans.

This is not the way to treat those who devote their lives to serving our country.

Improvised explosive devices (IEDs) have increased the number of head injuries, and the stress of battle, separation from families and the torments of fighting insurgencies on foreign ground in multiple deployments have made PTSD common.

But why do so many not seek treatment?

They fear the side effects of medications. They fear harm to careers. They fear they'll lose security clearances. They prefer to seek help from families and friends instead. They fear that co-workers or fellow warriors wouldn't trust them.

The fears are natural enough. The very definition of a soldier is that of a tough, resilient spirit in a well-honed body. No good soldier wants to be seen as weak or unreliable, no matter how unfair the tag.

The tag needs to change.

What soldiers, military commanders and the public need to understand is that PTSD strikes men and women of great character and toughness, strikes men and women who already have proven themselves equal to a task most of their fellow citizens want no part of.

TBI is different. It's an invisible but physical injury. Sometimes it produces the same kind of self-destructive behavior.

Signs of weakness? No. Wounds of war.

The Rand study, "Invisible Wounds," had good recommendations. The U.S. health system needs to deliver more professional, rigorous care. Soldiers need to know it's safe and appropriate to seek help. Treatments should employ methods that are proven to achieve results. The country needs to invest more in research and planning for more effective care. Paying for it won't be easy, but it's a debt of honor for honorable service.

These invisible wounds need to be treated as effectively as the more obvious wounds of bullets and shrapnel. That's healing work for the home front, and no vet or active duty soldier should have to go without.

BOTTOM LINE: PTSD and TBI are wounds of war no less real than those more obvious -- and no less demanding of treatment.

ADVERTISEMENT