Dr. Kathleen Chard, director of the PTSD and Anxiety Disorders Division at the Cincinnati Veterans Affairs Medical Center
The Army is devoting an increasing amount of energy to battling stress and mental illness in soldiers in returning from combat, but still struggles with the problem, a panel of experts told the AUSA Annual Meeting and Exposition on Oct. 10.
As the wars in Iraq and Afghanistan wind down and the Army begins a “strategic reset,” service leaders will face numerous challenges, said Gen. Peter Chiarelli, the vice chief of staff of the Army. “And none is of greater consequence than the challenges associated with the health, wellbeing, and discipline of our soldiers, army civilians, and families.”
Chiarelli said that “one of the most important lessons” of the wars has been that many of the emotional and social problems that soldiers returning from war struggle with – from reckless driving to substance abuse to suicide – are linked. “This represents a huge readiness issue for the Army,” he said.
Two years ago, of the soldiers who were seriously wounded, 35 percent had a traumatic brain injury or post-traumatic stress disorder. Today, that figure is 66 percent, Chiarelli said.
Yet, the Army continues to struggle with how to help those soldiers. Part of the problem is that psychological and neurological science is not as far advanced as other areas of medicine, Chiarelli said, noting that no one criticizes the Army for how it deals with soldiers who lose limbs. “We're good at mechanical injuries... but when it comes to the science of the brain, it's much less advanced,” he said.
Part of the problem is also the culture of the military, said Brig. Gen. Colleen McGuire, commanding general of the Army Criminal Investigation Command and leader of the Army Suicide Prevention Task Force. When a soldier acts up, she said, “More than likely, the commander will take action against him, not knowing that he in fact may be ill. And so, as we look at trying to take care of our soldiers and instilling order and discipline in our force, are we also compounding the problem by holding them accountable when in fact they're ill. One of the things we're grappling with is, how do we take care of the soldier and still hold him accountable?”
Recent studies have shown that the perceived stigma among soldiers of receiving treatment for a mental illness is even worse than being diagnosed with the illness, said Kathleen Chard, director of the PTSD and Anxiety Disorders Division at the Cincinnati Veterans Affairs Medical Center. And that makes it more difficult to treat soldiers with brain injuries and PTSD, she said. “We know that if we can get them into therapy, whether it be two weeks after they suffered their traumatic injury or twenty years, thirty years, forty years. We can help them regain their life. We can get rid of the symptoms of post-traumatic stress. But first we have to get them there,” she said.
“It's not a lifetime curse to have suffered from a traumatic brain injury, nor is it a lifetime curse to suffer from post-traumatic stress,” she said. “The curse is our failure to reach people and get them into care.”