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According to the military newspaper Stars and Stripes, service-members with "a psychiatric disorder in remission, or whose residual symptoms do not impair duty performance" may be considered for duty downrange. It lists post-traumatic stress disorder (PTSD) as a "treatable" problem.
PTSD is an anxiety disorder that can develop after exposure to an event or ordeal in which grave physical harm occurred or was threatened, according to the National Institute of Mental Health. A person having a flashback may lose touch with reality and believe that the traumatic incident is happening all over again.
"It's just terrifying," said Dr. Karen Seal, a clinician at San Francisco's Veterans Affairs (VA) Medical Center who treats soldiers suffering from post-traumatic stress disorder and other psychological illnesses.
Seal told IPS that patients under her care have been deployed despite serious mental health conditions.
"I feel like writing them a medical excuse," she said, "but that's not my responsibility as a VA clinician. Because I'm a VA provider, I don't have the authority to do that."
According to a study co-authored by Seal and her colleagues at the Center, about one- third of the more than 100,000 returning veterans seen at VA facilities between Sept. 30, 2001 and Sept. 30, 2005 were diagnosed with mental illness or a psycho-social disorder such as homelessness and marital problems, including domestic violence. Over half suffered from more than one disorder.
Other researchers suggest those statistics may only represent the tip of the iceberg. Many veterans, they note, don't come forward to seek care. The stigma associated with post- traumatic stress disorder may account for part of this gap, they say.
In addition, according to recent report by Linda Bilmes of Harvard's Kennedy School of Government, waiting lists for returning veterans are "so long as to effectively deny treatment to a number of veterans."
In the May 2006 edition of Psychiatric News, Bilmes notes that VA Undersecretary of Health Policy Coordination Frances Murphy wrote that when services are available, "waiting lists render that care virtually inaccessible."
There is also the issue of geography.
"One of the disconnects and failures in planning for this war is that the Veterans Administration is essentially configured in an urban way," Bilmes told IPS. "That makes a lot of sense for recruiting specialists and staffing the facilities. However, recruiting for the military in this war tends to come primarily from small, rural America. So, what we don't have is enough mental health care for veterans in these rural communities when they come home."
Last Thursday, the VA's Inspector General issued a report estimating that 1,000 veterans under its care commit suicide every year.
The report also found that vets are at increased risk of suicide because many VA clinics don't have 24-hour care or adequate mental health screening, and lack properly trained personnel.
The report, which was requested last year by Rep. Michael Michaud (D- Maine) said clinics should work harder so veterans can seek treatment without feeling stigmatized, and recommended additional screening for patients with traumatic brain injury, a type of brain damage caused by projectiles like roadside bombs which many are calling the "signature injury" of the Iraq war.
"The problem is that traumatic brain injury, which is an anatomic, physiologic problem, sort of intermingles with post-traumatic stress disorder," Dr. William Schecter, the chief of surgery at San Francisco General Hospital, explained to IPS. "This is going to be a lifelong challenge for the individuals who have suffered these injuries."
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