Post-Traumatic Stress Disorder (PTSD) is an invisible wound and soldiers with PTSD should be considered for Purple Heart medals, the National Alliance on Mental Illness (NAMI) urged yesterday as it launched a special report Parity for Patriots: The Mental Health Needs of Military Personnel, Veterans and their Families. The authors added that accountability for suicide prevention and the elimination of stigma should go all the way to the very top in the military.

Veterans looking for mental health care often find the Veterans Affairs medical system difficult to get into. According to the new report, over 1.3 million US veterans of working age have no health insurance – this problem is particularly prevalent among veterans aged under 35 years.

Most veterans do have access to conditions caused by military service for up to five years through the Department of Veterans Affairs, their access to free care becomes a problem with mental conditions that take some time to become apparent (delayed onset), such as depression or PTSD.

NAMI Executive Director Michael J. Fitzpatrick, said:

“NAMI is drawing a line in the sand with the Department of Defense. Troops with invisible wounds are heroes. It’s time to honor them. It will also strike a tremendous blow against the stigma that often discourages individuals from seeking help when they need it.”

The report mentions that:

  • Approximately one fifth of all active servicemen and women experienced some kind of mental condition, including PTSD and/or depression
  • Every 36 hours, an active duty soldier ends his/her life through suicide
  • Every 80 minutes one veteran (ex-serviceman or woman) ends his/her life through suicide
  • Of all the children of military personnel who have been deployed, one third have had mental problems, such as anxiety, acute stress reaction or depression
  • Of all the spouses who live with military personnel, at least one third lives with a partner who has a mental disorder
  • The number of suicides within the National Guard and Reserve forces has risen, even among those who have never been on active duty and cannot receive care through VA (Department of Veterans Affairs) because they are not eligible

USS Missouri veterans
Veterans, Pearl Harbor, 2003 – Former crew members of the Battleship Missouri- End of World War II ceremony

The authors urge the powers that be to widen the Department of Veterans Affairs’ service capacity. They add that the US Department of Health and Human Services should fully implement the mental health insurance parity law which came into force in 2008.

Fitzpatrick said:

“Simple things make a difference. Give veterans rides, watch their children or grant them extra time off from work in order to make it possible for them to get treatment. Our troops don’t leave wounded comrades behind. Don’t leave veterans or their families behind.”

The warrior culture of “toughing it out”, which is common among active duty service members, makes them more reluctant to ask for mental health treatment. The authors say trends are improving, however, a significant number of people in need of help resist seeking it out because they believe it will either undermine their career prospects or delay their return home.

Although military leaders have been told to encourage their service members to seek out health as soon as possible, too many are still torn between asking for help and “seeming weak”. The authors quote a non-commissioned Army officer who had said:

“Our post-deployment mental health screening took place with the entire unit sitting down with the chaplain, and the chaplain asking if we had any problems, and the commanding officer saying that no one had any problems.”

There still is family reluctance to seek out care for themselves. The military communities are tight-knit places – embarrassment and concern for affecting the service member’s career prospects put many family members off.

The authors point out that although the system is now trying to promote seeking help as a sign of strength, the change is not fast enough.

The authors quote Deborah Mullen, wife of Admiral Mike Mullen, former chairman, Joint Chiefs of Staff, as having said:

“Spouses tell me all the time that they want to get mental health assistance. As incorrect as this is, they really do believe if they seek help it will have a negative impact on their spouse’s military career.”

The NAMI report says the US Department of Defense needs to be more forceful in ending discrimination linked to the “invisible wounds of war”. It is vital that the stigma that still surrounds mental illness be eliminated, or at least considerably reduced so that servicemen and women, veterans and their families can receive prompt and effective treatment for PTSD, depression and other mental health conditions.

The authors wrote:

Military leaders throughout the chain of command should be required to focus on preventable psychological injuries and deaths, which should be part of their efficiency reporting process. Suicides are preventable just as are the heat and cold injuries of service members for which leaders are routinely relieved of command.

(Purple Heart for psychological wounds) Posttraumatic stress and other mental health injuries, that are the result of hostile action, including terrorism, should be eligible for award of the Purple Heart with the same level of appreciation and recognition as those awarded to warriors with visible wounds.

American citizens have much to learn from service members, veterans and their families – they are educated and exist in a culture of service and heroism. If they have access to tools that cure them of their invisible wounds of war, they can then start helping others.

The Purple Heart is a military decoration given by the U.S. military in the name of the President of the country to soldiers who have been either killed or wounded. Along with the Badge of Military Merit, its forerunner, the Purple Heart takes the form of a heart made of purple cloth.

Purple Heart case
The Purple Heart – awarded for servicemen/women injured or killed on or since April 5, 1917

The Purple Heart is the oldest military award given to US servicemen and women – the only earlier award was the Fidelity Medallion, which is now obsolete.

Written by Christian Nordqvist