Statistics, Effects and the Realities of Multiple Deployments

Image via Wikipedia

If you found this site looking for combat PTSD statistics you have hit the jackpot! Please take your time and read the post, vote in the poll and I encourage you to give your feedback. I will respond later with the results in another article.

I finally found the data that I have been looking for. I have been scouring the internet for raw statistics on how many deployments soldiers have been on. I actually found it by not looking for it. I was checking out the website Veterans for America (VFA) and came across some reports on the strains on the Guard units fighting in Iraq and Afghanistan.

For our WWI and WWII vets it was to suffer in silence, for our Korean and Vietnam vets the denial of such suffering, and for my generation of Desert Storm vets the myth of the "Jarhead" movie as a common experience and of the denial of the Gulf War Syndrome (which was recently acknowledged by the US government) and now with our modern veterans, the effects and realities of multiple deployments.

Preliminary self-reported rates of PTSD from OIF and OEF have reached 15% already according to Hoge et al. (with a 15-40% lifetime rate after combat; Hoge and Castro, 2005 para. 2) and we continue to have naysayers saying the problem could not be as bad as we say it is. How many times have our veterans been on the receiving end of this same kind of generational denial and recrimination?
Rand (2008b) reports,

[O]f the 1.64 million service members who had been deployed for OEF/OIF as of October 2007, we estimate that approximately 300,000 individuals currently suffer from PTSD or major depression and that 320,000 individuals experienced a probable TBI during deployment (p. xxi).

These figures taken with the above place estimate levels of PTSD today in soldiers and veterans of our nations modern wars at 23%.

The data on multiple tours was quite disturbing, due the fact that soldiers and veterans who have more than one deployment have significantly higher rates of mental health problems. Quoted directly from the horses mouth, the Mental Health Advisory Team (MHAT) V, the military's own research arm reports,

Soldiers on multiple deployments report low morale, more mental health problems, and more stress-related work problems. Soldiers on their third/fourth deployment are at particular risk of reporting mental health problems (MHAT V, 2008, Sec. 2.2.2, No. 8).

VFA reported on October 8, 2008 that 1,321,019 soldiers had been deployed to wars abroad, 796,483 (60%) had been deployed once, and that 469,095 soldiers had been deployed 2 to 3 times (36%), and 55,441 (4%) had been deployed 4 to 6 times. With multiple tours our modern veterans will become exponentially more vulnerable to join the ranks of the walking wounded.

In the monograph, a truncated report, titled “Invisible Wounds of War,” recently published by Rand (2008a),

Early evidence suggests that the psychological toll of these deployments—many involving prolonged exposure to combat-related stress over multiple rotations—may be disproportionately high compared with the physical injuries of combat. Concerns have been most recently centered on two combat related injuries in particular: posttraumatic stress disorder and traumatic brain injury. Many recent reports have referred to these as the signature wounds of the Afghanistan and Iraq conflicts. With the increasing concern about the incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise (p. iii).

The report adds,

The pace of the deployments in these current conflicts is unprecedented in the history of the all-volunteer force (Belasco, 2007; Bruner, 2006). Not only is a higher proportion of the armed forces being deployed, but deployments have been longer, redeployment to combat has been common, and breaks between deployments have been infrequent (Hosek, Kavanagh, and Miller, 2006). At the same time, episodes of intense combat notwithstanding, these conflicts have produced casualty rates of killed or wounded that are historically lower than in earlier prolonged conflicts, such as Vietnam and Korea. Advances in both medical technology and body armor mean that more servicemembers are surviving experiences that would have led to death in prior wars (Regan, 2004; Warden, 2006). However, casualties of a different kind—invisible wounds, such as mental health conditions and cognitive impairments resulting from deployment experiences—are just beginning to emerge (p. 2).

The Psychiatric Times reports a “gathering storm” due to the estimate that 70% of soldiers and veterans will not seek help from federal agencies (DoD or the VA), placing an undue strain on private facilities and practitioners. With this in mind the public sector of mental health has little to no preparation for the oncoming onslaught of help seeking veterans and soldiers.

At the website VA Watchdog, a reprint story on a Massachusetts commission found that veterans were not “receiving adequate treatment and readjustment assistance.” A summation of a member of the commission, state Rep. Harold P. Naughton,

said the public also should understand that the operational tempo of the current wars has exposed troops to combat for upward of 200 days at a time, far longer periods of uninterrupted combat exposure than most troops experienced in World War II or Vietnam (VAWatchdog.org).

The much reported mental health screening process during processing from combat duty has little to no effect on reporting the actual numbers of soldiers who have received psychological damage.

More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program (Hoge, Auchterlonie, and Milliken, 2006, p. 1023).

Hoge et al. (2006) goes on to ponder the reasons for such high numbers of non-diagnosed veterans,

This study shows that approximately one third of OIF veterans accessed mental health services in their first year after deployment, 12% per year received a diagnosis of a mental health problem, and an additional 23% per year were seen in mental health clinics but did not receive a diagnosis. It is not clear why there was such high use of mental health services without a mental illness diagnosis (p. 1030).

Hmmmmm, let me take a wild stab at it. Take it from a combat veteran who had attempted to receive help for PTSD through the combative VA system 7 times over 15 years. The systemic denial of veterans benefits has a strong bureaucratic resistance to give any compensable diagnosis coupled with “protecting the budget.”

Compounding the issue for veterans and soldiers receiving help for mental health issues is the stigma attached to such help. Stereotypical views within the military culture still hold a pervasive foothold in the minds of soldiers as to the nature and problem of psychological wounds.

Similarly, Hoge et al. [2004] found that of the soldiers and Marines who met the criteria for being diagnosed with a mental health problem, only 38 to 45% indicated an interest in receiving help: furthermore, within the previous year, only 23 to 40% reported actually receiving professional help (Brit, Greene-Shortridge, and Thomas, 2007, p. 1).

I witnessed this mentality of denial when looking into the eyes of my primary care and mental health personnel as I cycled through suicidal ideation, several episodes of psychosis, severe depression, addiction, homelessness, unemployability and complete disengagements from reality, society and loved ones. Proof positive of this phenomenon, quoted from the infamous email from a VA hospital’s PTSD program coordinator, Norma Perez,

Given that we are having more and more compensation seeking veteran, I’d like to suggest that you refrain from giving a diagnoses of PTSD straight out. consider a diagnosis of Adjustment Disorder, R/O [rule out] PTSD (Citizens for Responsibility and Ethics in Washington).

Repeated deployments will have unforeseen consequences for our veterans and soldiers. Never before in the history of warfare have we exposed our soldiers to such prolonged combat and sustained redeployments with little to no down time needed for decompressing stressed out psyches. Combine this with the governments slow to respond, cavalier attitudes and dismissal of the magnitude and scope of the problem, our veterans and soldiers suffer in silence and when the killing, death and deprivation becomes to much to bare, they take their own lives in alarming rates.

It is perplexing to realize that we keep having to do the same thing over and over again with the issues that our veterans encounter. To educate the public of the plight our veterans face on a daily basis, while combating the governments complete denial, as our veterans die each day.