Put Up or Shut Up

by David Isenberg | November 10th, 2009 | |Subscribe

One will not be able to celebrate Veterans Day this week without considering the tragic killing of 13 and wounding over 30 at the Army base at Fort Hood, Texas last Friday. The shootings by U.S. Army Maj. Nidal Malik Hasan rightfully strike people as particularly horrific. There is something about soldiers who are about to be deployed to war zones being shot at by one of their own that is particularly obscene; especially when that man is a psychiatrist, a medical professional who operates under the code of do no harm.

Yet whatever the ensuing investigation uncovers about the motivations of Maj. Hasan we must also face up to the fact that the American military has a significant mental health issue.

When I last wrote about this  in September I noted that the psychic casualties are staggering. The situation has not gotten better.

The Los Angeles Times reported yesterday that military leaders acknowledge rampant psychiatric problems in their midst. According to the Army, the suicide rate among soldiers in Iraq is five times that seen in the Persian Gulf War and 11% higher than during Vietnam. The Army reported 133 suicides in 2008, the most ever. In January of this year, the 24 suicides reported by the Army outnumbered U.S. combat-related deaths in Iraq and Afghanistan.

The Marine Corps also reported an increase in suicides in 2008, to 41. The Army and Marine Corps have provided most of the troops in the two wars.

Ironically, Hasan had been chosen to be part of an ambitious plan to treat U.S. troops in Afghanistan who need psychological counseling where counselors are often not available. As a result, the Pentagon is flying record numbers of therapists and other mental health workers into combat areas.

USA Today reported yesterday that where psychologically damaged troops in far-flung places cannot reach a therapist, the military now flies therapists to them in numbers not seen before.

Col. Carl Castro, a psychologist and director of Army Military Operational Medicine, says “flying mental health care providers exclusively to service members who need help is unprecedented. It’s almost like the EMTs (emergency medical technicians) that you see on the interstate when they block the road and land the helicopter. It’s just never been done.

And now we must face up to the fact that many of those in the military mental health community charged with provided treatment to the afflicted are suffering their own mental stresses and traumas. Even if one does not accept that mental health professionals can experience their own post traumatic stress disorder (PTSD) by treating those who do, it is certainly the case that good counseling and support for those mental health providers is critically important. And already we are seeing reporting that the military has failed in this regard, just as it has often failed to help veterans suffering physical and mental wounds.

Salon reported Sunday that with the U.S. fighting two wars, an acute shortage of trained personnel has left therapists emotional drained and overworked, with limited time to prepare for their own war deployments.

A military mental health task force in 2007 expressed concerned about the stress on nondeployed mental health personnel because of the shortage, which it said was leading to high attrition rates. “A vicious cycle has formed that will probably continue to worsen before it improves,” the report said.

Bob Herbert put it quite eloquently in his New York Times column on Sunday when he wrote:

The rest of us need to look very closely at the stress beyond belief that is being endured by so many other men and women in the armed forces — men and women who are serving gallantly and with dignity, who have not taken out their frustrations on one another, and who deserve better from the broader society.

Simply stated, we cannot continue sending service members into combat for three tours, four tours, five tours and more without paying a horrendous price in terms of the psychological well-being of the troops and their families, and the overall readiness of the armed forces to protect the nation.

The breakdowns are already occurring and will only get worse as the months and years pass and we remain engaged in the conflicts in Afghanistan and Iraq. None of this is the military’s fault. There have not been nearly enough people willing to serve in the all-volunteer armed forces to properly staff two wars that have already gone on for the better part of a decade.

I spent some time on the West Coast recently interviewing doctors and researchers studying the enormous problem of troops returning from Afghanistan and Iraq with some form of mental health disorder, most commonly depression and post-traumatic stress disorder, or P.T.S.D. The caseloads are off the charts, and very often the P.T.S.D. or depression (or both) are accompanied by substance abuse, problems with anger management, domestic violence and family breakdown.

These are not weak men and women we are talking about. This is the toll that the horror of combat, especially repeated doses of it, takes on people — even those who are young, physically fit and mentally sound.

The same day former U.S. senator and Vietnam veteran Max Cleland, who lost both legs and an arm in that war, had an op-ed in the New York Times. He wrote:

When we are at war, America spends billions on missiles, tanks, attack helicopters and such. But the wounded warriors who will never fight again tend to be put on the back burner.

This is inexcusable, and it comes with frightening moral costs. There are estimates that 35 percent of the soldiers who fought in Iraq will suffer post-traumatic stress disorder. I’m sure the numbers for Afghanistan are similar. Researchers have found that nearly half of those returning with the disorder have suicidal thoughts. Suicide among active-duty soldiers is on pace to hit a record total this year. More than 1.7 million soldiers have served in Iraq and Afghanistan. Imagine that some 600,000 of them will have crippling memories, trapped in a vivid and horrible past from which they can’t seem to escape.

It is time for America to put up or shut up. Either it cares about its military men and women who are making unbelievable sacrifices or it doesn’t. If it does it will start putting its money where its mental health mouth is. And if not, then it can continue doing just what it is doing now.


  1. SBGirl wrote,

    Helping Fight PTSD.


    Visit Often!

    Comment on November 10, 2009 @ 10:03 pm

  2. J.W. Mason wrote,

    Mr. Isenberg makes a cogent argument for not just military commanders (from the commander-in-chief himself, President Obama to the JCS and many layers below) but ALL military professionals (yes, including recruits and enlisted) to enact a paradigm shift and stop thinking of mental health problems (to include clinical depression, PTSD, and a whole range of legitimate maladies) as we did in the old days—as a character flaw or evidence that someone lacks the “right stuff.’ In fact, our greatest commander-in-chief President Abraham Lincoln (who fought against the Black Feet indians) suffered life-long depression and suicidal ideations (after the death of his mother at age 9, the demise of his first love Ann Rutledge at age 22 in 1837 and after the deaths of his children at various times in his life). The Defense and Veterans Affairs departments have to do a better job (and Congress has to appropriate more money OR redirect funds for antequated missile defenses and other wasteful platforms into) funding and mitigating these very serious long-term (i.e. life-long) mental health effects suffered by our warriors. This means that American people need to realize that the appropriations for wars in Afghanistan and Iraq are reflecting INSUFFICIENT funds when we factor in this tremendously expensive but obviously essential expense—treating our soldiers BEFORE deployment (to build valid, safe coping mechanisms), during their tours (and yes, Isenberg hits the nail on the head, that we need to REDUCE the number of tours), in-between their tours, after their tours and MOST IMPORTANTLY, after they’ve completed their service years! If we include these hundreds of billions of dollars in our annual war funding appropriations (or projected war funding for future conflicts), it will be another reason to be extremely cautious about committing our most valuable treasure (our people, our fighting men and women) for often minimal or questionable long-term geopolitical reasons. And, ANOTHER THING THAT HAS TO CHANGE ABOUT MILITARY CULTURE is something that the mainstream and even alternative media have missed about the Fort Hood murders—how is it possible for America to spend tens of billions for homeland security and screen people and yes even employees of institutions they are entering for weapons or bombs at airports, government buildings, corporate headquarters, schools, heck—even the Holocaust Museum or other historical or cultural sites around this nation BUT WE DON’T PREVENT military personnel from bringing an arsenal of weapons onto a U.S. military base? Da—why the hell not? Okay, I know about military culture. Why would base security stop and “harass” a major or even enlisted personnel entering a base and search their car, etc? He/She is “one of us!” No one envisions that a military professional would EVER harm another military professional. I fully understand the long-standing sentiment and it applies all over our nation not just at Fort Hood. BUT people, we now live in a world where terrorism, suicide attacks, truck and car bombs are pervasive. Ah, but while those things happen elsewhere that threat still has not materialized wholesale in the U.S.A. This is wrong-headed and DANGEROUS THINKING. The military has to change that culture. Why do soldiers need firearms on a military base? Obviously, military weapons are needed in various training and exercise scenarios on or around military bases BUT no one needs to have a personal weapon at a military base. Do we allow people to bring weapons into political events, concerts, etc? We don’t want personal weapons brought into other government facilities so why do we allow them on military bases? Okay that is part of the machismo that characterizes part of the military mindset—we’re all aware and unfortunately too accepting of this paradigm. IT NEEDS TO CHANGE and NOW is a great time to start! While there are scenarios where we would still experience these mass shootings, after we change the two paradigms I’ve mentioned above it will be MUCH HARDER to carry out successful and murderous shootings involving our most valued treasure—our young men and women warriors.

    Comment on November 11, 2009 @ 5:24 am

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