November 27, 2008

PTSD Rates: Part One

Thanksgiving on Combat Outpost Cherkatah, Khow...
Image by The U.S. Army via Flickr
Combat Saturation

I am just now starting to sift through the sea of case law and journal articles on the considerations of PTSD and criminality, unfortunately I think that there will be an ever increasing need for individuals well versed in the pitfalls of combat trauma and difficulties in reintegration. I feel as you do that something needs to be done to address this issue head on, such as a Veterans Court much like the one just established in Minnesota. Additionally, we have only begun to see the tide of returning veterans with psychological troubles facing criminal charges.

Never before in the history of American warfare have we seen such high numbers of soldiers who have been under unimaginable stress. In WWII 18% (Flashback, 2006, p. 73, War Psychiatry, n.d., p. 15; Grossman, 2007) of our soldiers actually engaged in combat, with Vietnam it was 30-40%, today 68% to 86% have actually engaged in combat (Veterans for common Sense and Veterans United For Truth, Inc, 2007, item 54, National Center For PTSD Fact Sheet, n.d., paragraph 2, and Hoge, 2004). Not only have more soldiers engaged in combat, they have been in combat longer with an average of 2 to 3 tours of duty (, 2005, Veterans for America, 2008). Many have been on 5 tours and some as much as 6. As high as 80-90% (Journal of the American Medical Association, 2006, paragraph 5) have seen someone get killed, or been in a combat zone, we have reached "Combat Saturation."

Today 15% (300,000; Rand, 2008) of our soldiers and veterans have been diagnosed with PTSD and this seems like it may be a smaller number compared to other wars. 30% PTSD rates in Vietnam, 15% to 25% of combat soldiers "...nonfatal battle casualties...[were] neuropsychiatric" as reported in WWII by the Surgeon Generals report (as cited in War Chronicle, 1944) and 15-20% of Gulf War I vets reported to have PTSD.

It took Vietnam veterans up to 10-20 years before their symptoms reached the point of becoming debilitating. The implications for our modern veterans will have monumental deleterious effects in the next 10 years, it has been projected that PTSD rates in today's wars will reach 50-60%. We will be inundated with mentally ill veterans who have few options and no where to turn and they will run afoul with the law.


  1. Is the relatively low % of diagnosed cases today due to increasing military restrictions on this diagnosis? I can't imagine that that number really reflects what's going on, especially not in light of the other facts and statistics you quoted.

  2. You would be correct on both accounts. The military has tightened up the qualifications for what qualifies as a service connected disability. We now have service members that have been injured by roadside bombs and by dodging mortar sounds that do not qualify for service connection compensation because they were not directly engaged in combat. Talk about cost saving measures. And the onset of most PTSD cases will be delayed due to the nature of the mental wounds and the indoctrination of the military. In about ten years we will see the largest increase of veterans with mental illness then we have ever seen. The world will be astounded as to the unique nature of this war verses its impact on our veterans and our nations inability to respond to the oncoming pandemic. Our veterans will be shattered unlike they have ever been.

  3. Scott,
    Excellent work.

  4. PTSD

    On false pretext they sent me off
    To murder and create,
    But there, ´twas hard to hold aloof
    Vacuity of hate,
    And now the matter rests with me
    But I don´t rest at all,
    And it may be PTSD
    But I´m not blessed at all.

    We are the men "that don´t fit in,"
    There´s no more fitting now,
    Because nobility struck tin
    With which men did endow
    Their fantasy, as left a mess
    All scrambled in my mind,
    So I was left with PTS
    And D not far behind.

    The army sez that my SD
    Existed pre post-trauma,
    So not a dime will give to me
    Except I have my Momma
    To tell me, hold my temper down
    But she has never been there,
    Where cognizance emerged full-blown
    Smack in the midst of sin there.

    I thought that I could be a hero,
    That I could go to school,
    But concentration nearly zero
    Has made me look the fool,
    And I may know the alphabet
    My teachers taught to me,
    But first, in their disorder, set
    Now PTS and D.

    I never knew the kind of rage
    As in my brain inhabits,
    But not a player on the stage
    It is not shooting rabbits
    That got me to an awful fix,
    Though you might find it funny,
    PTSD plays funny tricks,
    I wouldn´t hurt Bugs Bunny--

    And yet at minor provocation
    I´d take a schoolbus out--
    It´s all because I served a nation
    That didn´t have a doubt:
    Derangement by rage reinforced
    Has got me drinking liquor,
    But while I cauterize the worst
    Hostility grows thicker.

    So all young men who go to war,
    Although your cause be noble--
    They´ll show you that esprit de corps
    But leave you with the trouble,
    A peck of trouble, as with P
    Preceding T and S,
    And then at last a final D,
    To lodge at your address.

    Wherever you may go, and with
    Self-medication helping,
    There is no helping with the myth:
    Hostility keeps whelping
    Despite nobility pronounced
    On all the TV stations--
    PTSD, when they have pounced,
    One´s burden, not the nation´s.

    --I.M. Small

  5. Hey brother, Welcome home. You are not alone, we are in the face of one wondering near. I am here, so we see all that can be.

    I hope you appealed your VA decision to deny you benefits. Many appeals are won, do yourself a favor and find someone to help you with this endeavor and to help find your way back from inside your head. Tis never a good place to be.

    Much love brother. Keep fighting and do not give in to the beast within your mind.

  6. Updated info, Hoge, 2004 on the percentage of soldiers who actually engaged in combat,

    Veterans for America, 2008, on multiple tours.


Please share your comments, stories and information. Thank you. ~ Scott Lee