Having your wars & eating them too: solving the international veteran crisis

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anthony

Founder
We live in a time in which nations are sending unprecedented numbers of allied troops to combat zones in the name of terrorism prevention, the full cost of which is staggering and unforeseen. Post Traumatic Stress Disorder (PTSD) has hit record numbers and garnered record attention, and it is the primary culprit for high suicide, homelessness, divorce and substance abuse in global combat veteran populations.

The here and now

Since 2000, the cost to allied nations for these military operations has surpassed 5 trillion dollars, and treating those injured both physically and mentally continues to hemorrhage billions more. It is approximated that 30% of combat veterans will return demonstrating either partial or full symptom expression of PTSD.

Combat veterans are glorified for having served their country in combat, focusing attention on this group, especially where the public sees combat veterans homeless and unsupported in the aftermath of their service. Military trauma is the largest statistical group for PTSD, as they are concentrated within organizations such as Veterans Administrations (VAs) and therefore easily studied.

There are far greater numbers of PTSD from childhood and sexual trauma than combat trauma, yet combat veterans have excessive rates of homelessness and suicide due to the lack of both governmental and social support systems available to adequately cater the currently astronomical influx of need.

Think of it like this: civilians with PTSD are naturally spread amongst a country, states, cities and towns. They often have a structure of family and friends around them. The military operates in large clusters. Soldiers often call their base locations home. VAs are normally established close to military bases, further isolating support for combat veterans.

At present there are billions of dollars spent on a multitude of programs and studies in an effort to find and solve the PTSD veteran crisis. With all this money spent, you might think progress is being made, yet the results don't reflect the cost or effort to date. There are programs that work, and there are known factors with high success rates, yet these are often dismissed due to time requirements or, worse, funding, as funding keeps going to new trials and programs.

So what are the problems that need to be solved?
  • Thousands of returning soldiers are suffering complex, treatment resistant trauma due to multiple operational tours.
  • VAs are under-equipped to deal with the returning PTSD quantities.
  • The efficacy of pharmaceuticals is inconsistent, causing more problems than they fix for the majority yet being used as the first line treatment protocol.
  • There is a shortage of effective programs to first treat self-medication.
  • There is a shortage of trauma therapists to effectively treat the number of those affected.
  • Effective therapies require years, a decade even, to be truly effective per individual.
  • Federal disability schemes are stretched to funding limits with PTSD sufferers.
  • Stigmatization strains reintegration within society both socially and for employment.
  • Collateral damage is done to the veteran's family.
Problems are fairly easy to identify. The above list is far from exhaustive in presenting issues for combat veterans with PTSD. I'm an Australian combat veteran, and whilst the suggestions here are just that, I don't speak for the entire world's combat veteran community. I consider myself lucky, as Australia has quite an exceptional combat veteran support system and associated programs in place. I hope other combat veterans add their own comments to what they feel could be simple, effective solutions to the present issues.

By no means is the following discussion a total solution to the above problems, and some of the solutions address and intertwine several of our listed problem areas.

Repeated tours broaden PTSD complexity

Just like a child within a toxic home environment, surrounded by abuse with nowhere to go, a soldier resides in a similar situation when deployed within a combat zone. For six to twelve months, this is traumatic for many soldiers as an isolated tour, yet when compounded by multiple tours -- such as six on, six off, six on, six off -- the repeated exposure provides little relief towards re-adjustment or effective downtime following a combat tour. Most will remain in an activated and ready state, knowing they redeploy again, let alone that they will most likely start pre-deployment training within 3 months, further reducing downtime.

The simple solution to the entire problem? Stop sending troops into ridiculous wars that make little tactical sense. The deceit, lies and conflicting information from all the recent wars does little towards credibility to support troop deployments. Defend your country; don't invade others. A simple solution to the entire problem!

Saying that, politicians and secret agencies can't get enough deceit and power, so troop deployments need to be radically changed to curb repeated, extreme exposure to combat. A ratio of 1:3 should be used for all deployments. For every month deployed, you spend three months home, reintegrating in general duties, training, courses, social life, family and so forth.

Simply put, most deployments are six month in duration for economical and tactical reasons, making every rotation 18 months home. That leaves a minimum of 15 months to decompress, deal with any psychological issues that present, then begin pre-deployment again.

If militaries want to think long-term, then they need to get onboard such rotation intervals. Losing experienced combat veterans works against every military, so looking after them is in the best interest for all involved.

VAs are under-equipped

VAs are far under-equipped to deal with the present influx of PTSD combat veterans. Wait times can be many hours for what should be a one-hour appointment. Moreover, it can take months just to make that appointment.

Group therapy is failing to treat the individual traumatic components of each combat veteran. Whilst group therapy has merit, it also has outcome limitations.

VAs in the United States are under-funded, using over-worked, tired, frustrated employees. The solution is that funding should be focused on the problem, not wasted on diverse experimental options. The solutions are already present -- effective therapies that provide 60 to 80% recovery, with more time needed for some.

Money could wisely be spent allowing combat veterans to seek Va-funded therapy through local, private trauma therapists who deliver approved trauma therapy techniques to treat the trauma. That may be hard to hear for some in the United States, as that is socialism vs capitalism. Is every man for themselves really helping the problem? No, no it's not.

In Australia and the United Kingdom, it is helping the problem. Combat veterans are not abandoned to be homeless and ignored. Instead they have government support in place for treatment and disability funding while seeking treatment. Getting people healed and back to being productive members of society is in every country's best long-term interest.

Pharmaceuticals are not the answer

Psychiatrists are using pharmaceuticals to treat PTSD with little evidence to support the efficacy of such a treatment regimen. Pharmaceuticals have an approximate 25% success rate, far less than trauma therapies. Sure, they're cheaper than therapy, but they cause far more issues than they fix.

Most combat veterans treated with pharmaceuticals will be on several medications. Why? Because one will cause other problems, so then psychiatrists are prescribing medications to treat the symptoms that another medication created. Seriously? This is a sign of just how bad pharmaceuticals are, in that the solution is giving a pill to a problem created by a pill. How is this okay? Pharmaceuticals are creating more problems than they solve.

Shortage of effective pre-treatment programs

Acceptance and Commitment Therapy is a foundational treatment protocol that has history to demonstrate and support efficacy in treating substance abuse with PTSD. Why are billions being spent on experimental, radical, obscure attempts to find other solutions for treating the veteran crisis when the solutions already exist? Put the billions of dollars toward training staff to deliver the techniques to the affected combat veterans. More will get solved in a shorter period than what is happening now.

Pre-treatment is not about stopping substance abuse but limiting its use to make therapy overall more effective. Hell, the effectiveness of pre-treatment can be used as a marker towards having full trauma treatment paid for at a physician local to the combat veteran.

Shortage of effective therapists

Therapists are not created equal. This focus on hiring therapists and tossing them within a VA is antiquated, to say the least. You limit a therapist's potential to learn and treat trauma by exposing them to nothing other than combat trauma. Limits become imposed on their learning and techniques. They become desensitized and become less effective at treating their client.

The solution is not to create a military therapist but to support therapists in private practice, where they have a mix of clients and therefore have a mix of treatments they're using and assessing for effectiveness. Furthermore, they aren't becoming burnt out on the atrocities of combat trauma and aren't being screwed into provide their service for next to nothing.

A happy therapist makes a good therapist. Pay them well. Treat them well. Ensure they have diversity of clientele, and ensure they have mandatory exposure to ongoing learning and techniques.

Effective therapies take time

Eye Movement Desensitization and Reprogramming (EMDR) took 20 years to develop and evolve into one of the most effective treatments for trauma. The billions being spent towards idiotic studies and programs by governments needs to stop, and we must repurpose this money towards actual available treatments that work.

I am advocating training more therapists in EMDR, Prolonged Exposure (PE), Trauma Focused Cognitive Behavioural Therapy (TF-CBT), ACT, and getting these treatments used as first line treatment for PTSD instead of tossing pharmaceuticals around. Using this money to fund the longevity treatment durations required to effectively change 60-80% of returning troops suffering PTSD to completely healed, functional civilians once again. This just makes sense.

Yes, this is socialism at work, but let's be honest, it's truly needed to treat the veteran crisis happening globally. The money is being spent already, but instead of being wasted, it can be used to truly treat the problem, not just look as though something is being done.

Federal disability stretched to the limits

Disability awarded to combat veterans has climbs to dizzying highs. Throwing money at veterans is not going to solve their problems nor the overall problem. Disability schemes will eventually break governments. This issue has far reaching economic impact for all countries concerned, as we are a global economy today.

Sure, money needs to be there to support veterans during treatment, but the problem is that money is not being equally used towards the treatment and the affected. To reduce the overall occurrence of disability, governments need to ensure money is being effectively spent on providing treatment to the affected. It's quite simple really -- to get your disability payments you must be attending therapy and actually partaking towards recovery. Once deemed recovered by the therapist, aid towards re-employment training and then full employment opportunities.

Disability is then used effectively, and those who are truly resistant after years of therapy then remain on disability. Keep providing them the support they need, and you have lessened the longevity burden by a minimum of 60% annual funding. Well... unless you keep sending troops into idiotic wars, that is.

Reintegration employment stigmatization

A more pressing problem for veterans, especially those who are functional, employable, have healed and are ready to transition to employment once again, is that PTSD awareness has now reached employers. These employers have inaccurate beliefs of PTSD sufferers and are now discriminating when learning of military history on resumes. Employers are now asking questions that are not allowed to be asked relating to mental health. They are passing over combat veterans on the premise that PTSD may become an issue for them as an employer.

If governments get their act together and do manage to change the present strategy of treating combat veteran PTSD, then an awareness media campaign would also need to be launched -- or incentives to hire combat veterans, period -- to thwart the inaccurate stigma associated with PTSD.

Families are collateral damage

Lastly, the forgotten in all of this is the family behind the veteran. They need access to government-assisted support in relation to combat veterans. Parents, siblings and spouses need help in how to best help their affected combat veteran. They need self-care support. They need access to educational tools to help get their combat veteran back on track in life, towards stability and employment.

Family play a larger role than therapists in assisting their loved one back to health, but they can't do it alone. With an approximate 80% divorce rate for serving personnel, the PTSD divorce rate is much higher. Having combat veterans abandon their family, or vice versa, is not helping the veteran, family, community or economy. A snowball effect occurs with far reaching impact.

Whether online support structures are in place for education, access to free copies of popular PTSD relationship books, phone counseling support, even video conferencing and online support groups, all of these resources assist supporters to band together, help each other, and help themselves towards helping their veteran.

Conclusion

There are some rather large problems that presently are only getting worse. Things need to change as the current approach is a dismal failure. We have effective treatments available. They just need time, money and locality implementation for effectiveness: more official resources freely available online, campaigns targeting the stigma of PTSD and use the truth to blanket the myths that propagate the discrimination and maybe even incentives to employ combat veterans.

What can you add towards solving the veteran PTSD crisis? Do you feel there is a larger problem at play that we haven't mentioned? Please share your thoughts and maybe, just maybe, someone that matters might take initiative and implement the change needed to fix the issue.
 
S

shimmerz1

Until the sons and the daughters of the decision makers are actively involved in war and have to live through the ensuing psychological/physical damage that is done to those who serve, I expect that things will not change. We all know this because we live it, eat it, sleep it, breath it. As it sits, there is no motivation for those who eagerly jump on the ‘war bandwagon’.

A natural consequence of war is loss. Tragic losses. I personally believe that those who insist that others serve in a war that they believe to be just and true should have personal experiences with those losses.

Most members of Congress have little direct military experience
 

Pencil

MyPTSD Pro
Banking, oil, arms. These are the things that make the world go around. The article touches on that, and then at everything else with regards to war.

My father was a WWII veteran. I have no doubt that he was fundamentally and irrevocably damaged when he got back – and he was gone for 3 years. His five children are irrevocably damaged. How on God’s green earth can therapy even start to undo the damages of war? Is it even human, normal, ethical to expect it to?
 

anthony

Founder
You would be surprised just how effective it is… it just takes time is all, just like it does with complex childhood trauma. Same thing for the most part in relation to therapy duration and regulation issues, just different in which symptoms are typically the problem, and which regulate ineffectively.

All trauma can be healed… PTSD is different, and should not be confused with healing trauma. PTSD is a battle and in that I would agree, that anyone who endures complex levels of trauma is likely to endure PTSD symptoms a good portion of their life. Some recover, some do not, some are not affected at all. Resilience is an amazing field of study and showing answers to many things.
 
S

Susan1

Anthony, you raise some interesting points. I too am Australian and a veteran and while I agree that we have veteran entitlement systems that are very good, the hoops many have to jump through to get them are overly arduous. Thankfully, PTSD is now excluded from those hoops.

Re you comments about medication: 80% of those suffering from PTSD also suffer from three or more comorbidities with depression being most prevalent. Depression is a corrosive condition and adds another significant and onerous burdan to the individual suffering PTSD. It needs to be addressed in order for other treatments or management strategies to be effective. Currently, pharmacogical treatment is the only effective way to combat depression for many whether it is PTSD-related or not. Medication does have a role in treatment but it must be carefully monitored and a good psychiatrist can achieve that.

I agree 100% that more needs to be done to find effective management strategies for the injury. But money also needs to be spent educating the public about the injury and how to effectively support family and friends with PTSD in order to remove its stigma. PTSD is a complex – and feared – injury and just as illnesses in the past that illicited fear have been demystified, so too must PTSD be. Working with veterans, the behaviours and attitudes I see them subjected to by ‘knowledgable’ and ‘educated’ members of the public – including health care workers – are destructive and perpetuate perceptions about mental illness that persist from the early-twentieth century. Money must also be directed at the public face of PTSD in order to protect sufferers, help combat the social isolation many experience (which may be cintributed in part to the effects of stigma) and educate those making the decisions about how the public purse will be distributed.

Spot on re families. They are the forgotten victims of the injury and, again, I have seen terrible behaviours visited upon wives and children because of a father’s PTSD and a lack of public knowledge about the injury. Again, removing the stigma associated with PTSD would do much to help. We can’t underestimate education as one of the pieces in a whole of society approach to the injury.
 

anthony

Founder
Hey Susan, yer, I do remember all the paperwork when I was going through DVA red tape. What a nightmare. I was watching mates I deployed with be rejected for petty reasons, whilst mine got approved, as it seems they had no petty reasons to reject it. Mind you… one thing my friends did discover was to not put everything and anything on a claim, as many suggested at that time, to be recognised for service based injury. Physically, I was healthy as a horse, still am… it was purely PTSD screwing me over, so mine went through without issue as a result of not having any other issues, it seems.

I totally agree that education of the publics perception need be upped. Mental health stigma is well… just so unknown at any given time. People have tolerance for it, yet if longevity based, that tolerance turns to stigma too often as they don’t understand why you haven’t gotten over it by now. I had that stigma until I got PTSD… so unfortunately I’m not sure anyone can really be given an idea of having PTSD, or other mental health condition, until they endure it themselves. I believe that is what is needed for the majority to understand a condition, to empathise… yet even that has stigma with recovery time. If someone is depressed, recovers in a few months, then they believe every depressed person should be capable of the same.

I think mental health has a lot unknown, even how to curb the stigma issue effectively and not just toss money in its direction with ad campaigns, hoping something sticks. Some real test and adjust foundation needs to be laid first IMHO… then toss the money at what shows great results.
 
F

Future Goodwill

I think that one of the key points is the topic of the “stigma” of PTSD, and the difficulty of getting past that stigma for adequate employment. I am at that point now. I have been turned away for everything from a truck driver, which I already have my class a CDL. To going into a law enforcement position at a state agency I worked for in the past. Now this agencies clinic that does the physicals wants all of my records from the V.A. To “review”. I am so pissed at this point. I have been battling the V.A. For the correct rating so I can at least feed my family and pay the bills but my now six year battle continues. Now I cannot get a job that is sufficient to what I had before my last deployment. Am I suppose to just work at Goodwill as part of their charity handicapped staff, because that is how I feel? Because of all of the added stress my PTSD can only be getting worse. I am out of ideas. When people tell me thank you for your service I can only assume they wish me to get back in my box I will soon live in.

Anthony, you raise some interesting points. I too am Australian and a veteran and while I agree that we have veteran en...
It sounds like the Aussie V.A. System is as lackluster as the one here in the U.S. The stigma I presume must be worldwide when it comes to allied forces veterans of Iraq and Afghanistan. To quote the great philosopher Linkin Park, “When the rich wage war it’s the poor who die”!
 
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Michael

New Here
Until the sons and the daughters of the decision makers are actively involved in war and have to live through the en...
Yeah, I only knew of one buddy who died in the Military. It was a real wake up call for me. Danger close, as I was serving in the Persian Gulf. He died in the USA Iowa turret explosion. His Mom told me he was pulled out like charcoal, unrecognizable. We went to Basic, and Air together. He was on the bottom bunk. Terrible. It all went down hill from there. Especially because he told me that he had a bad feeling in basic, that he was going to die, and wanted me to help him get out of the Military. Yeah, Just one buddy, but one too dam many for me. Ya know? I had a heightened awareness in the gulf. Very jumpy all the time. I drank as much as I could. Got poisoned from it. Continued to drink after I got out. Dam shame.
 

Michael

New Here
Has anyone considered the reality of fighting this ugly Terror? Take Good and Evil, period. Let say the Coalition forces are Good, and the Terrorist are Evil, right? What does it take to fight evil all over the world? Time? You got it. For the rest of our existence, we will be fighting terrorism. We will be fighting evil. Nothing wrong with that…If we realize it’s for generations to come. There is no such thing as a cure all for any type of evil, unless it’s brought before God. In my opinion, If I’m gonna fight the Devil, I’m gonna need to be an apple in God’s own eyes. It’s gonna take his power to help me defeat such an adversary. We can gather up many allies against this fight, but if our Countries are not good in the sight of God, then what chance do we have? It takes a lot of prayer and perseverance to destroy such an enemy. We can’t do it alone, without God by our side. Impossible. This is my take on the wars we have now, and the wars yet to come. God first. Re group. Destroy. Any questions?
 

anthony

Founder
Not sure God is the solution to fighting terrorism, considering terrorism is typically based on religious beliefs. Their name for God, whatever that version is. One God, many different names, all being addressed differently and all in some belief that their God is there to help them beat the other.

If you wanted to discuss the definition of insanity, then putting God into the equation of fighting religious conflicts is probably a good start.
 
A

Angel1

Try telling the VA that PTSD is a life long battle. They refuse to give veterans the medication they need. They’ll give you anti depressants but it’s not depression and some people like myself are severely allergic to most of the poison they are willing to give you that causes obesity and illness, severe side effects. I get so frustrated because they know what works for me and anti depressants make me suicidal. That’s what they want to prescribe. So I don’t sleep for weeks and I’m in agony from a spinal cord injury. They might as well just tell us to check out, they don’t want to help us. The less of us who are around the less they have to worry about actually being a doctor instead of just pushing chemical meds that are killing us so they can get their kick backs and bonus checks from the drug companies. They say it is because of the drug addicts abusing them. I have 10 years of no drug abuse and excellent history of this medicine helping me. It’s like they seen I was doing better and decided I wasn’t worthy to have a half way normal life. We can make money off of them if they aren’t sick and begging for help so they can accuse us of wanting drugs!! I just want to sleep and be able to deal with the panic attacks and anxiety. How can we do that in Effexor and Amitriptaline or antidepressant fogs. They can see what they are doing isn’t working. They let me have a halfway normal life with 3-4 hours of sleep each night seen I was able to function better and then said they couldn’t prescribe anything but the poisons because some one else od’d on that medicine. So I have to give up my ability to have a decent life. They say that evangelical Christians and veterans are the biggest threat to national security I heard. You think that’s why they are insisting on our taking these poisons instead of effective medicines? I’m beginning to think so. I asked for an MRI and my VA dr put me in rehab!! No meds and no MRI he lied and said I had threatened to kill myself! He lied because he didn’t have the time to get me a real spinal cord dr and he’s too incompetent to read an MRI. I’m not suicidal. If I took the meds he insisted I take I would be. Does anyone else out there feel like they are trying to kill us off? I wasn’t even hateful to the dr just told him it has been 36 years I know I can’t take those meds. I want to be back on what works… Anyone have any advice for me. I’m having to see a civilian psychiatrist hoping she can help me so I won’t have to take pain meds every day. Not sleeping makes the nerve pain excrutiating. Veterans get second hand Drs when I believe we deserve better than that if people are sincere about being thankful for our service. Give us decent health care and before we die waiting on getting an appointment. Just saying!
 

LuckiLee

MyPTSD Pro
"Treatment resistant trauma due to multiple operational tours" do tell, @anthony. My guy has been everywhere since the Ukraine boarder in 86. Eleven "conflicts" (news to me , i thought it was eight) and three wars. It seems like he's hit his plateau in therapy. Not getting worse but not much improvement either. He continues with his therapy, group therapy and meds though. Do you have any ideas "outside the box" that may help? Thanks for all you do!! ✌
 
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