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Psychological scars of war

iraq_troops03-14-2006bHow do wars impact the soldiers who fight them?

An astounding 37% of Iraq and Afghanistan veterans entering US Veterans Affairs hospitals between 2002 and 2008 received mental health diagnoses, according to a new study of 290,000 veterans in the American Journal of Public Health.  Over one in five (22%) were diagnosed with post-traumatic stress disorder (PTSD), 4 to 7 times the pre-Iraq rate; 17% were diagnosed with depression.  Some veterans were diagnosed with both or other conditions.  Those with greater combat exposure were more likely to suffer from PTSD.

Meanwhile, an investigation by the Colorado Springs Gazette, entitled, “The hell of war comes home,” found a sharp rise in violent crime among Iraq War veterans.  One former soldier, Anthony Marquez, “used a stun gun to repeatedly shock a small-time drug dealer in Widefield over an ounce of marijuana, then shot him through the heart.”  Since 2006, ten members of Marquez’s 3,500-soldier unit have been arrested for murder, attempted murder, or manslaughter.

The battalion is overwhelmingly made up of young men, who, demographically, have the highest murder rate in the United States, but the brigade still has a murder rate 20 times that of young males as a whole.

The killings are only the headline-grabbing tip of a much broader pyramid of crime. Since 2005, the brigade’s returning soldiers have been involved in brawls, beatings, rapes, DUIs, drug deals, domestic violence, shootings, stabbings, kidnapping and suicides.

The 15,000-word, two-part article tells haunting stories from the war:

“Toward the end, we were so mad and tired and frustrated,” Freeman said. “You came too close, we lit you up. You didn’t stop, we ran your car over with the Bradley.”

If soldiers were hit by an IED, they would aim machine guns and grenade launchers in every direction, Marquez said, and “just light the whole area up. If anyone was around, that was their fault. We smoked ’em.”

Other soldiers said they shot random cars, killing civilians.

“It was just a free-for-all,” said Marcus Mifflin, 21, a friend of Eastridge who was medically discharged with PTSD after the tour. “You didn’t get blamed unless someone could be absolutely sure you did something wrong. And that was hard. So things happened. Taxi drivers got shot for no reason. Guys got kidnapped and taken to the bridge and interrogated and dropped off.”

What must be done?

Obviously, reducing violence would be the surest way to prevent PTSD.

Beyond that, mental health screenings for returning veterans would “help overcome a ‘don’t ask, don’t tell’ climate that surrounds stigmatized mental illness,” according to another American Journal of Public Health study.  A 126-page report on the Fort Carson violence recommended “enhanced reintegration support” including protecting soldiers seeking behavioral health or substance abuse treatment from “humiliation or belittlement.”  The base has reportedly “doubled its number of behavioral-health counselors and tightened hospital regulations to the point where a soldier visiting an Army doctor for any reason, even a sprained ankle, can’t leave without a mental health evaluation.”

Behavioral health care isn’t Cadillac care. Advocates hoped that awarding the Purple Heart to soldiers suffering from PTSD might “normalize” the illness, but the Pentagon decided in January to reserve the Purple Heart for physical injuries.

As we figure out how to care for people coping with “deadly echoes” of exploding grenades and dismembered bodies, perhaps we ought to start counting the domestic victims of these injured soldiers among the casualties of war.