Introduction
Posttraumatic stress disorder afflicts large swaths of the US defense forces. The problem is increasing due to multiple deployments of American forces. While the Department of Defense (DoD) and the US Department of Veteran Affairs (VA) are taking steps to mitigate the dangers posed by PTSD on American society, greater synergy and collaboration can be instituted. While the percentage of service personnel afflicted from PTSD is huge, care must be taken to separate those claiming disabilities purely from the economical viewpoint.
Thesis Statement
Posttraumatic Stress Disorder (PTSD) needs to be tackled with greater synergy and collaboration between the DoD and VA, with better screening mechanisms to extend critical care to genuinely afflicted cases.
Annotated Bibliography
American Psychological Association. (2007). The psychological needs of US military service members and their families: A preliminary report. Retrieved 07 Oct 2014, from http://www.ptsd.ne.gov/publications/military-deployment-task-force-report.pdf
The US Government constituted a Task Force under the aegis of the American Psychological Association to examine potential risks to the psychological wellbeing of service members and their families, to determine the context and impact of the deployment cycle and to recommend changes at the policy, program and practice levels. The Task Force discussed the programs in place within the Department of Defense (DoD) and Veteran Affairs (VA), and offered recommendations to improve the system of providing psychological care to veterans. The Task Force found that there was no comprehensive and coordinated program in place to provide psychological care to affected soldiers and their families. The quality of care varied across different programs. Once soldiers made a transition to veteran status, they experienced a drop in the quality of psychological care. The Task Force identified the lack of availability of skilled caregivers, the prevalent stigma surrounding psychological help and the lack of accessibility to psychological care due to geographical and administrative reasons as the chief barriers to psychological care. The report recommended greater centralized oversight, more extensive research, community outreach and increased numbers of service providers as possible solutions. The Task Force Report, when read in conjunction with the RAND report, provides a holistic background to the problem facing the services.
Library of Parliament, Canada. (2013). Post traumatic stress disorder and the mental health of military personnel and veterans. Background paper. Publication No. 2011-97-E. Ed. Pare, J.P. Retrieved 07 Oct 2014, from http://www.parl.gc.ca/Content/LOP/ResearchPublications/2011-97-e.pdf
The Paper prepared for the Library of Parliament of Canada provides a suitable background to the subject of posttraumatic stress disorder. The paper defines PTSD in scientific terms, relating it to trauma and stressor –related disorders. The paper traces the acknowledgement of PTSD as an ailment, a metamorphosis from the usage of the generic terminology of ‘shell-shock’. The paper explores the potential ill effects of PTSD, ranging from absenteeism to suicide. An analysis of PTSD across the service personnel of Canada, US and Australia reveals that the service personnel of the USA suffer the most from PTSD, probably because members of the US Armed Forces have been deployed for longer rotations and in closer proximity to the enemy. This interpretation of the higher incidence of PTSD dovetails with the research of Sundin et al, who find that the infantry is the most afflicted with PTSD. The paper provides a suitable background to the subject, and the contrast between the incidence of PTSD between US forces and its allies could set the stage for analysis of PTSD amongst members of the US armed forces.
McNally, R.J., & Frueh, B.C. (2013). Why are Iraq and Afghanistan war veterans seeking PTSD disability compensation at unprecedented rates? Journal of Anxiety Disorders 27, 520-526. Retrieved 07 Oct 2014, from http://mcnallylabcom.ipage.com/beta/wp-content/uploads/mcnally-frueh-2013-jad-disability-rates1.pdf
The Institute of Medicine (IOM) study was commissioned by the National Defense Authorization Act, 2010 to study prevalent efforts of the DoD and VA to combat PTSD. The study acknowledges the growth in the study of the neurobiological aspects of PTSD. The study analyses the initiatives taken by the DoD and VA to arrest PTSD, and explores the complementarities and synergies in approach. The study explores the framework of preventive measures in place to avoid the onset of PTSD amongst service personnel and the screening mechanisms designed to identify personnel afflicted by PTSD. The study then focuses on diagnosis and treatment protocols. The study investigates symptoms occurring together with PTSD, such as depression, chronic pain, violence and unemployment. The study recommends that the DoD and VA investigate the efficacy of programs in place to counter PTSD and argues in favor of an annual screening process for PTSD. The study highlights the importance of innovation and research to counter PTSD and recommends a closer integration of DoD and VA efforts in this regard. The study is useful to point out the way forward in combating the incidence of PTSD afflicting service personnel and veterans.
Iraq and Afghanistan Veterans of America (IAVA). (2009). Invisible wounds: Psychological and Neurological injuries confront a new generation of veterans. Williamson, V., & Mulhall, E. (Eds.). Retrieved 07 Oct 2014, from http://iava.org/files/IAVA_invisible_wounds_0.pdf
The IAVA report takes off from the RAND report in its analysis of the incidence of PTSD afflicting service personnel. While acknowledging the RAND report, the IAVA report goes into greater detail about the contributory factors of PTSD. The report highlights that long tours and multiple deployments exacerbate the incidence of PTSD. The report highlights the added strain on female troops. The report describes the effect of PTSD manifested in divorces, substance abuse, homelessness and suicide. A critique of the DoD efforts to combat PTSD is a unique aspect of this report, as it highlights staffing shortages, insufficient training and poor evaluation of combat troops as contributory factors to the incidence of PTSD. The report is unique in its critique of the DoD and the details of the impact of PTSD on the armed forces.
RAND Corporation. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Tanielian, T. & Jaycox, L.H. (Eds.). Retrieved 07 Oct 2014, from http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG720.pdf
The RAND Corporation commissioned a monograph in 2008 to fill gaps in knowledge about the mental health of US servicemen returning from deployments in Iraq and Afghanistan. The study focused on PTSD, Traumatic Brain Injury and reactions to trauma. The study inquired about the prevalence of these conditions amongst soldiers, the attendant costs and the institutionalized care system in place. The study found that at least one third of soldiers displayed one of the three mental health conditions, with 5% soldiers suffering from a combination of ailments. Only half of those afflicted had sought medical help. Quality care was restricted to a few patients. Unless treated, those afflicted would be impaired from leading healthy lives over their lifetime. The study assessed the cost of treatment to amount to approximately $ 900 million and attributed more costs to loss of productivity. The study identified gaps in treatment and care, and recommended an increase in the cadre of caregivers. The study pointed out policy changes required to encourage veterans to seek care and advocated the institutionalization of evidence-based treatment and care. The RAND study is comprehensive and can provide a major bulwark of any study on PTSD.
Sundin, J., Fear, N.T., Iverson, A., Rona, R.J., & Wessely, S. (2009). PTSD after deployment to Iraq: Conflicting rates, conflicting claims. Psychological Medicine 40, 367-382. Retrieved 07 Oct 2014, from http://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Sundin2010-ptsddeploymentiraq.pdf
The researchers address the question as to why the rates of PTSD are reported differently in UK and US media. They find that research methodology varies between the two countries. They also found a greater prevalence of PTSD post deployment as compared to the pre-deployment phase. PTSD rates were lesser across generic samples of them military population as compared to the infantry. The researchers did not find a change in incidences of PTSD between enlisted men and officers. The report provides a pointer to the fact that deployment on the ground is a big factor in the development of PTSD, and the infantry is therefore the most affected. This finding could serve to be a pivot in the treatment of the subject, yielding solutions about how to treat soldiers on repatriation to the country.
References
American Psychological Association. (2007). The psychological needs of US military service members and their families: A preliminary report. Retrieved 07 Oct 2014, from http://www.ptsd.ne.gov/publications/military-deployment-task-force-report.pdf
Library of Parliament, Canada. (2013). Post traumatic stress disorder and the mental health of military personnel and veterans. Background paper. Publication No. 2011-97-E. Ed. Pare, J.P. Retrieved 07 Oct 2014, from http://www.parl.gc.ca/Content/LOP/ResearchPublications/2011-97-e.pdf
McNally, R.J., & Frueh, B.C. (2013). Why are Iraq and Afghanistan war veterans seeking PTSD disability compensation at unprecedented rates? Journal of Anxiety Disorders 27, 520-526. Retrieved 07 Oct 2014, from http://mcnallylabcom.ipage.com/beta/wp-content/uploads/mcnally-frueh-2013-jad-disability-rates1.pdf
Iraq and Afghanistan Veterans of America (IAVA). (2009). Invisible wounds: Psychological and Neurological injuries confront a new generation of veterans. Williamson, V., & Mulhall, E. (Eds.). Retrieved 07 Oct 2014, from http://iava.org/files/IAVA_invisible_wounds_0.pdf
RAND Corporation. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Tanielian, T. & Jaycox, L.H. (Eds.). Retrieved 07 Oct 2014, from http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG720.pdf
Sundin, J., Fear, N.T., Iverson, A., Rona, R.J., & Wessely, S. (2009). PTSD after deployment to Iraq: Conflicting rates, conflicting claims. Psychological Medicine 40, 367-382. Retrieved 07 Oct 2014, from http://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Sundin2010-ptsddeploymentiraq.pdf
