If you've been reading my last few posts, you know that we've been revealing some medical studies that demonstrate the prevalence of PTSD (a.k.a. adrenaline poisoning) in returning service men and women.  On a particular note, we have learned that the bulk of the symptoms in our combat-exposed warriors have a tendency to manifest 3-6 months after they return from the "combat box."

Additionally, we've learned that treating this by-product of combat stress is difficult for many reasons.  First, our warriors are reluctant to seek help.  Secondly, the symptoms of intrusive thoughts, avoidance, and hypervigilance have a tendency to become masked by traumatic brain injuries and other external wounds.  Finally, there is the heavy reliance by military and veteran health physicians to prescribe pharmaceutical compounds.  They do this in the face of a growing shortage of mental health professionals available to effectively work with our soldiers, sailors, marines, and airmen.

I called this series Counting Flash To Bang Time, as you may recall, using an analogy.  I set it up like this:

In the military, there is a technique for estimating distance.  It's known as counting "flash-to-bang" time.  It works like this:

An explosion takes place and immediately you see the "flash" of the explosion.

Start your timer...

Sometime later (depending on your distance from the explosion) you hear the "bang."

Stop your timer!

What many of us know, if we have ever observed several explosions from a distance, is that the bigger the flash, we can expect and even louder bang when the sound waves finally reach us.  So in this final piece, in my 3 part series, I am going to attempt to make the BIGGEST FLASH of all...this in an attempt to bring attention to the hard reality of the coming effects (or BANG) that we will soon face in the mental health arena of the military.  By the way, there is no need to start your timers, because the clock started ticking back on October 7, 2001, with the start of Operation Enduring Freedom and our invasion into Afghanistan.

Truth In Numbers

Taken from a 2009 article published in The Marine Corps Times, I learned that over 2 million warriors have deployed into combat operational areas.  This report tells us "in the eight years since the Sept. 11, 2001 terrorist attacks, American troops have deployed almost 3.3 million times to Iraq and Afghanistan, according to Defense Department data.

The numbers, as of October 2009, show that more than 2 million men and women have shouldered those deployments, with793,000 of them deploying more than once.

Here’s a look at how the numbers break down by service:

• Army. More than 1 million soldiers have deployed since the beginning of the wars. These 1 million soldiers have completed 1.5 million deployment events, with 352,700 deploying more than once.

In October 2009, 172,800 soldiers were deployed to the war zones.

• Navy. More than 367,900 sailors have deployed since the beginning of the wars, with 147,200 deploying more than once. In all, the sailors have logged 595,700 deployments.

In October 2009, 30,000 sailors were deployed.

• Marine Corps. More than 251,800 Marines have deployed since the start of the wars, completing 392,900 tours. More than 106,400 have deployed more than once.

In October 2009, 20,900 Marines were deployed.

• Air Force. More than 389,900 airmen have deployed since 2001, with 185,500 going more than once. In all, airmen have completed 771,400 deployment events.

In October 2009, 31,500 airmen were deployed.


• Coast Guard. More than 4,370 Coast Guardsmen have deployed since 2001, with 650 deploying more than once. The Coast Guard has 5,333 deployments on file, and in October 2009, 438 were deployed."

Do The Math

In June of 2004, the first study into military personnel returning from combat operations revealed that 1 in 8 warriors presented with PTSD.  Additionally, this report indicated that less than half of those really suffering from this problem actually

sought help from mental health professionals/paraprofessionals.  This number skyrocketed in 2008, where an Article in The Army Times revealed that an independent study, conducted by the RAND Corporation,  showed that 1 in 5 combat veterans presented with PTSD and/or TBI.  Even today, we are seeing state-sponsored studies showing a 1 in 4 veterans are showing signs of depression and PTSD.  

The RAND report indicated that only half of those soldiers that asked for help actually received "minimally adequate care."  The reality here is that the problem is growing and our current methods of dealing with it are failing.  If our current number of deploying combatants continues for the next 4 years, and treatment modalities continue on their same dismal pace, we can expect to have close to 1 million men and women scarred with the long-term emotional and cognitive challenges.

Show Me The Money

This study by The Rand Corporation is the first analysis of its kind.  When we look at the financial impact of this war, the study says that direct medical care, lost productivity and suicide among veterans of the wars in Iraq and Afghanistan ultimately could cost the nation $4 billion to $6 billion for PTSD, and $591 million to $910 million for TBI.

In the meantime, the report found the military may be wasting tens of thousands of dollars treating service members with methods that have not been proven effective, specifically the use of psychiatric drugs that have never been independently tested on people with PTSD.  

Four to six billion dollars down the drain?  Want to know something else?  The current 2011 Veterans Affairs budget estimate for mental health is currently 5.2 billion dollars.  Is that just a coincidence or is it possibly a sign of things to come?  Can you imagine a doubling of health care dollars in less than 5 years?  Can you imagine the additional problems that will surround this issue when we account for homelessness, substance abuse, and suicide?homeless_veterans

I've tried to make as much of an impression on my readers with these last 3 posts, in an attempt to demonstrate how HUGE this problem is going to be in a very short amount of time.  Recent trends seem to be slowing for suicide and PTSD, but that does not mean we are out of the woods.  These trends may very well be influenced by the withdrawal of forces from Iraq.  With a surge beginning in Afghanistan, we are still waiting for the data to come in on our current disposition.   

The encouraging news here is that early intervention is beginning to emerge as an important first step.  More studies are beginning to demonstrate improved outcomes when our warriors seek treatment as soon as they notice changes in their moods and routines.  This allows treatment "in theater" where our combat brothers and sisters maintain support from their comrades.

Take Away

The challenge still remains in removing the stigma of seeking help.  Let's unite now and fight for our deserved victory before the impending bang creates a new stigma, a vision of failure.

Warrior, out!