Catastrophe (37 page)

Because of the repeated deployments to which Iraq veterans are subject, the nature of the war, and the all-volunteer military, past indicators of PTSD may not be applicable to the Iraq War. Experts are concerned that the incidence may be vastly greater than anyone has thought.

The prevalence of PTSD threatens to strain the financial resources of the Veterans Administration. In 2005, the
Washington Post
reported that “In the past five years, the number of veterans receiving compensation for…PTSD has grown nearly seven times as fast as the number receiving benefits for disabilities in general, according to a report this year by the inspector
general of the Department of Veterans Affairs. A total of 215,871 veterans received PTSD benefit payments last year at a cost of $4.3 billion, up from $1.7 billion in 1999—a jump of more than 150 percent.”
⁵⁶¹

But the
Post
noted that this increase did not really factor in the full impact of the Iraq and Afghan wars “because the increase is largely the result of Vietnam War vets seeking treatment decades after their combat experiences.”
⁵⁶²
When the Iraq and Afghan vets return, the impact is likely to be enormous.

Even as many soldiers don’t seek treatment for PTSD, others are inclined to conclude grimly that it can never be cured. As Chris Frueh, the director of the VA clinic in Charleston, South Carolina, told the
Post
, “we have young men and women coming back from Iraq who are having PTSD and getting the message that this is a disorder they can’t be treated for, and they will have to be on disability for the rest of their lives.”
⁵⁶³

This unjustified pessimism could lead to the creation of a permanent class of veterans who think themselves disabled and live on government pensions. Those who are granted 100 percent disability status from the Veterans Administration get about $2,300 per month.
⁵⁶⁴
And, the
Post
reports, “once veterans are declared disabled, they retain that status indefinitely.” As Frueh notes, “the [Veterans] department’s disability system encourages some veterans to exaggerate symptoms and prolong problems in order to maintain eligibility for benefits…. My concern about the policies is that they create perverse incentives to stay ill. It is very tough to get better when you are trying to demonstrate how ill you are.”
⁵⁶⁵

Frueh warned that this system sets up an “adversarial relationship” between doctors and returning soldiers over whether to assign a disability status for their PTSD.
⁵⁶⁶

But most people agree that the more serious problem is that some patients never get the help they need—because, as Frueh told the
Post
, “they are unwilling to undergo the lengthy process of qualifying for disability benefits, which often requires them to repeatedly revisit the painful episodes they experienced.”
⁵⁶⁷

Some, like Steve Robinson, accuse the Veterans Administration of deliberately failing to diagnose PTSD in returning soldiers to avoid the cost of disability payments. Robinson said, “what they [the VA] are trying to do is figure out a way not to diagnose vets with PTSD. It’s like telling a patient
with cancer, ‘if we tell you you don’t have cancer, then you won’t suffer from cancer.’”
⁵⁶⁸

The RAND Corporation study, like both the Pentagon and
The New England Journal of Medicine
studies, found that only about half of those suffering from PTSD or major depression get help.
⁵⁶⁹

“If PTSD and depression go untreated or are undertreated, there is a cascading set of consequences,” said RAND project coleader Lisa Jaycox. “Drug use, suicide, marital problems and unemployment are some of the consequences. There will be a bigger societal impact if these service members go untreated. The consequences are not good for the individuals or society in general.”
⁵⁷⁰

Why don’t returning servicemen and women seek treatment? RAND reports that “many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional” but that “even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities.”
⁵⁷¹

RAND recommends that “the military create a system that would allow service members to receive mental health services confidentially in order to ease concerns about negative career repercussions.” “We need to remove the institutional cultural barriers that discourage soldiers from seeking care,” RAND project coleader Terri Tanielian said. “Just because someone is getting mental health care does not mean that they are not able to do their job. Seeking mental health treatment should be seen as a sign of strength and interest in getting better, not a weakness. People need to get help as early as possible, not only once their symptoms become severe and disabling.”
⁵⁷²

Unfortunately, even when the Pentagon finds that servicepeople are suffering from PTSD, it does not always refer them for counseling. A 2005 study by the Government Accountability Office found that “only about one in five Iraq and Afghanistan war veterans who screen positive for combat-related stress disorders are referred by the Pentagon for mental health treatment.”
⁵⁷³

Fox News reports that many current and former government officials are concerned about the ability of the Pentagon and the Veterans Administration to handle the new flood of PTSD cases.

“We are not prepared for the body count we are seeing, mental health or otherwise,” said Sue Bailey, assistant secretary of defense for health affairs during the Clinton administration. “America’s mood is not prepared for this.”
⁵⁷⁴

“The [Veterans Administration] is not geared up and the [Department of Defense] is not geared up,” said Rick Weidman, a spokesman for Vietnam Veterans of America. “That’s why some of us have been talking, and you are going to see a major front of veterans saying we need this fixed and we need this fixed now.”
⁵⁷⁵

But just as soldiers are reluctant to report psychological trauma to their officers or even to the Veterans Administration, the VA itself has a palpable bias against taking mental issues seriously.

The Pentagon, facing the deadly increase in military suicides, seems to be doing better. It has set up Defense Department Centers of Excellence for Psychological Health and Traumatic Brain Injury under the command of Army Brigadier General Loree Sutton. The centers are designed to “establish quality standards for: clinical care; education and training; prevention; [and] patient, family and community outreach.”
⁵⁷⁶
They are to be staffed by behavioral health consultants and nurses and will be open 24/7. The Pentagon says that the centers “can deal with everything from routine requests for information about psychological health and traumatic brain injury, to questions about symptoms a caller is having, to helping a caller find appropriate health care resources.”
⁵⁷⁷

General Sutton’s office has also launched a program called Real Warriors, in which “service members can talk about and listen to the stories of those who sought help for psychological injuries or traumatic brain injuries.”
⁵⁷⁸
By focusing on “the story of real warriors facing real battles both on as well as off the battlefield, with wounds both visible and invisible,” General Sutton hopes to stimulate soldiers and veterans to seek help and cope with their problems.

To show that PTSD is not some new fad, Real Warriors features the ancient Greek play
Ajax
by Sophocles, in which “a warrior who has been deployed for several years tries to kill his commanding officer, but ends up killing himself.”
⁵⁷⁹

But the Veterans Administration itself is less sensitive to PTSD. Presi
dent Obama’s budget request for the 2009–10 fiscal year increases Veterans Affairs spending by $15.1 billion, raising it from $97.7 billion to $112.8 billion.
⁵⁸⁰
This should be more than enough money to deal with the vast PTSD problem among returning veterans. But the priorities the Veterans Administration has identified in spending the funds show a blind spot when it comes to PTSD.

One would hope that this massive increase in spending would include lots of money for PTSD treatment. But the Veterans Administration, though lauding the extra money, made no mention of PTSD or any other psychological counseling as it recounted the benefits of the extra funding.

So where is the money going? The VA says it will be used to expand VA health care eligibility to half a million “deserving” veterans over the next five years.
⁵⁸¹
It notes that the new budget “provides greater benefits for Veterans who are medically retired from active duty”
⁵⁸²
and praised its increase in educational support. The VA lauded the additional “specialty care” funded in the budget and listed “such areas as prosthetics, vision and spinal cord injury, aging, and women’s health.”
⁵⁸³
It applauded the new attention to homelessness among veterans. The VA celebrated the expansion of its services in rural areas. In fact, it listed every conceivable use of the new money—
except
for treating PTSD, suicidal tendencies, or severe depression. Those words were never mentioned!

ACTION AGENDA

The old-school Veterans Administration knows what to do about those who have lost arms or legs in combat. But it doesn’t know enough about those who have suffered grievous psychological scars—despite all that we should have learned as a country from the true horrors suffered by the returning veterans of the Vietnam War. This problem needs attention before it leaves an entire generation of our veterans emotionally crippled.

Here are the people to write to:

• Obama’s newly appointed secretary of veterans affairs is Eric K. Shinseki. He can be reached at the Department of Veteran Affairs: 1-800-827-1000.
  
• The chairman of the Senate Committee on Veterans is Daniel K. Akaka. His address is P.O. Box 50144, Honolulu, HI 96850, and his phone number is 202-224-9126.
  
• And, in the House, the chairman is Bob Filner. He can be reached at:
  

House Committee on Veterans’ Affairs

335 Cannon House Office Building

Washington, DC 20515

202-225-9756

As we said in the introduction, the time for action is now!

Barack Obama may be our president, but he’s not a dictator. He has a lot of tough votes ahead of him in Congress, and he needs to win them. If he wants to continue to hold on to power, he will have to bring enough of his minions back to Congress in 2010 that he’ll still be calling the shots in Washington.

It’s up to us to play defense against Obama’s radical agenda. We need to mobilize to pressure the weak links in his congressional majority whenever crucial votes are coming up. The ultraliberals in Congress, such as Congresswoman Maxine Waters and Senator Barbara Boxer, aren’t worth pressuring. They couldn’t be more delighted with Obama’s socialist agenda. But the moderates—or at least those who run as moderates—from the Democratic Party can be pressured. And they must be!

We suggest that you set up an e-mail club with your friends and family so that you can instantly reach out to dozens or even hundreds of people and get them to send e-mails, letters, and phone calls to these moderate Democrats, pressuring them to vote against Obama’s agenda.

Scan down the list of congressmen and senators at the end of the War on Prosperity chapter. See which ones come from your district or state. Make a special point of pressuring them.

Then go to www.dickmorris.com and share your e-mail address with us. In addition to sending you our columns and newsletters, we’ll keep you posted on when key votes are taking place on the issues discussed in this book—so that you, in turn, can use
your
e-mail list to get your friends and family to pressure those key members of Congress.

There will be several special elections between now and November 2010. These races—and the scheduled governors’ contests in New Jersey and Virginia—will give us a real chance to send a message of discontent and opposition to the Obama agenda. By beating the Democratic candidates in these races, we can make it clear how badly his agenda contrasts with the views of the American people!

When these races come up, we’ll recommend independent expenditure groups to which you can contribute, helping them target the vulnerable races and win them.

And, when 2010 comes around, we’ll be working full-time on reversing the Obama majorities in Congress so as to roll back his socialist program.

This is no time for apathy or alienation or hopelessness.

It’s a time for action.

The stakes literally could not be higher.

We would like to begin by thanking Morgan Buehler for her wonderful and prompt research. This is our second book with her. She also worked with us on
Fleeced
. And we hope to do many more with her.

We would like to thank James McGann for his help with research on the Canadian health system and earmarks, Frank Gaffney for helping us to grasp the intricacies of the threat posed by Shariah Law, and Barry Elias for his economic wisdom and advice.

Thanks to Chuck Brooks for his patriotism and his inputs on Shariah law and terror policies and to Ken Lee of the Canadian Conservative Party for his info on the health care system there.

We also thank Maureen Maxwell, Tom Gallagher, and Irma Gallagher for all their help.

Sandy Frazier, the best book PR person around, is helping to make this book a success as she did with
Outrage
and
Fleeced
.

Cal Morgan, our editor for the past seven books (all best sellers) is doing something right and we are grateful.

Our thanks to Opensecrets.org, the web site of the Center for Responsive Politics, for making the political system transparent.

And, finally, to Jonathan Burnham, Kathy Schneider, Christine Boyd, Tina Andreadis, Kate Blum, Josh Marwell, Doug Jones, Brian Grogan, Cindy Achar, John Jusino, and Brittany Hamblin at HarperCollins, for bringing the book swiftly to print.