Averting their eyes from troops' psychological scars

The Baltimore Sun

The Pentagon has decided that soldiers who suffer from post-traumatic stress disorder (PTSD) do not deserve the Purple Heart. "PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event," Defense Department spokeswoman Eileen Lainez told Stars and Stripes. "It is not a wound intentionally caused by the enemy from an 'outside force or agent.'" In short, the psychological wound does not merit the same medal the nation would award for a physical one; witnessing your buddy blown apart by a 107-mm rocket is not as significant as taking shrapnel from it.

Anyone who has kept an eye on the Bush administration's conduct of the military operations in Iraq and Afghanistan - and that's an ever-shrinking number of Americans - would understand why the Pentagon wants nothing to do with Purple Hearts for PTSD. This isn't as much about upholding standards as it is about maintaining, in classic military style, the status quo in the face of overwhelming evidence that increasing numbers of troops are surviving combat but with severe psychological trauma.

According to RAND Corp. estimates, about 320,000 veterans of Iraq and Afghanistan sustained brain injuries by 2007, while close to that number - about 300,000 - reported symptoms of PTSD or major depression. (An estimated 1.8 million Americans have served in Iraq and Afghanistan.) The last thing an administration waging a long, costly and unpopular war wants is for the number of casualties from that war to run into the hundreds of thousands; that's far more Purple Hearts than budgeted.

The Purple Heart ruling is in keeping with what Aaron Glantz, author of a new book on the neglect of veterans during the George W. Bush years, calls the official shortchanging of service members who were sent to fight.

"The Bush administration was never seriously interested in helping veterans," Mr. Glantz concludes in The War Comes Home. "The sorry state of care for Iraq and Afghanistan war veterans is not an accident. It's on purpose. After the invasion of Iraq in 2003, the Bush administration fought every effort to improve care for wounded and disabled veterans. At the root of that fight was its desire to hide the true costs of the war in order to boost public support."

And, says Mr. Glantz, rejecting PTSD claims is one way of making sufferers not only ineligible for benefits but also fit for multiple tours of duty, something vital to an all-voluntary military challenged to reach recruitment goals.

Mr. Glantz, who did some reporting from Iraq during the first three years of the war, interviewed dozens of veterans. His disturbing book describes a bureaucracy that mistrusts those it accepted into service and subjects them to long waits for benefits. Some committed suicide while waiting, or when they learned they had been slated for another tour. Mr. Glantz and other researchers believe the nation's annual number of suicides among all veterans, estimated at 5,000 per year, will grow in the wake of Iraq and Afghanistan.

The government is particularly ill-equipped to handle veterans with layers of psychological problems from multiple tours, Mr. Glantz concludes. Many veterans with PTSD are reluctant to seek help because of the stigma attached to that disorder. But even when they make the decision to see a doctor about it, one might not be available. Pentagon data show fewer mental health professionals in military service five years after the invasion of Iraq, and the American Psychological Association concluded in 2007 that the U.S military lacked adequate resources at 38 installations around the world.

Mr. Glantz describes a cynical tactic for dealing with some PTSD claims - declare "personality disorder" as a pre-existing condition that can lead to discharge from service. "Since psychologists can't possibly care for all the damaged soldiers sent to them," Mr. Glantz writes, "there is an incentive to thin some of the backlog by quickly diagnosing soldiers with personality disorder." Commanders, Mr. Glantz says, will push for discharge based on "personality disorder" just to get soldiers suffering from PTSD out of units facing multiple deployments as the war drags on. And these are troops who were deemed fit for service when they volunteered. After they've been in combat and claim PTSD, we declare them damaged goods and send them home - no medals for their nightmares.

Dan Rodricks' column appears Sundays on this page and Tuesdays in the news pages. He is host of the midday talk show on WYPR-FM. His e-mail is dan.rodricks@baltsun.com.

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