November/December 2005
PTSD/SUBSTANCE ABUSE COMMITTEE REPORT |
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The Downhill Spiral
Continues |
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BY TOM BERGER, CHAIR |
With the number of American soldiers killed in Iraq having topped
2,000, those fortunate enough to return face the task of putting
the war behind them and resuming their lives. Some are getting
reacquainted with wives and children they left behind a year or
more ago. Many face the task of catching up on bills or fixing
homes that have gone in need of repair. Some lost jobs or had
their businesses falter while they were gone. More than a few have
found they have returned home with their war anxieties.
“They are witnessing far more traumatic experiences than they did
in the first Gulf war,” said Terri Tanielian, a senior military
health policy analyst for the Rand Corporation. Longer
deployments, fiercer engagements, and more casualties have left
Iraq war veterans more vulnerable to psychological trauma than
Gulf War veterans, Tanielian said. She said many veterans may be
shunning counseling services offered by the military out of a
misplaced sense of honor. “Their training is to go on with the
mission and put on the brave face,” Tanielian said.
A
recent article in USA Today noted that more than one in
four American troops have come home from Iraq with health problems
that require medical or mental health treatment. According to the
Pentagon’s first detailed screening of service members leaving the
war zone, almost 1,700 returning this year said they harbored
thoughts of hurting themselves or that they would be better off
dead. More than 250 said they had such thoughts “a lot.” Nearly
20,000 reported nightmares or unwanted war recollections; more
than 3,700 said they had concerns that they might “hurt or lose
control” with someone else.
The survey results, which have not been publicly released, were
provided to USA Today by the Army Center for Health
Promotion and Preventive Medicine. They offer a window on the war
and how the ongoing insurgency has added to the strain on troops.
Overall, since the war began, some 28 percent of Iraq
veterans—about 50,000 service members this year alone—returned
with problems ranging from lingering battle wounds to toothaches,
and from suicidal thoughts to strained marriages. The figure
dwarfs the Pentagon’s official Iraq casualty count: more than
2,000 U.S. troops dead and more than 15,220 wounded as of early
November. A greater percentage of soldiers and Marines surveyed in
2004-05 said they felt in “great danger” of being killed than
those surveyed in 2003 after a more conventional phase of
fighting. Twice as many surveyed in 2004-05 had fired a weapon in
combat.
At the same time, months after VA officials told Congress that
they expected the processing time for veterans’ disability claims
to drop, agency internal reports indicate little or no progress.
Records show that the department is struggling in its attempt to
reduce veterans’ waiting time, in part because the productivity of
VA employees nationwide is only three-quarters of what it
expected. In some regional offices, it is far lower. The delays
mean tens of thousands of veterans who were injured serving the
country are waiting far longer to have their cases decided than
lawmakers—or the VA—would like.
In March, the department came under fire from lawmakers for poor
service. VA Secretary James Nicholson told Congress he expected
processing times to drop to 145 days for the fiscal year, a target
that had been changed from prior goals that aimed to bring the
average to 100 or fewer days. For the first 11 months of the 2005
fiscal year, which ended Sept. 30, the department’s average time
to process disability claims was 167 days, one day slower than
last year, according to a VA report obtained by Knight-Ridder. The
average for August claims was 169 days.
Michael Walcoff, a top official in the VA’s benefits division,
said that Nicholson fully expected the department to meet its
goals but that staff productivity had suffered throughout the
year. “The secretary had very high expectations for us,” Walcoff
said. “I am concerned about productivity. I believe we have the
capacity to be more productive than we have been this year.”
Many claims for disability compensation, which pays veterans for
injuries sustained while serving in the military, take far longer
than the average. The VA report said 4,300 cases from August had
taken longer than a year to decide. And while some categories of
claims have shown improvement in the last two years, others showed
a “marked deterioration in performance,” and on balance things
have not improved at all, the report said. As a result, the
backlog of pending claims is rising—just the opposite of what the
department had anticipated. Only last year, VA officials said the
backlog should drop to 250,000 claims nationwide. Instead, it is
now greater than 350,000.
The downhill spiral continues. |