Combat Degrades Some Troops' Mental Health, Report Says
By Gerry J. Gilmore
American Forces Press Service
WASHINGTON, July 1, 2004 – A first-of-its-kind Army medical report that queried
Afghanistan and Iraq combat veterans shows that front-line action has adversely
affected the mental health of some service members.
The report, titled, "Combat Duty in Iraq and Afghanistan, Mental Health
Problems and Barriers to Care" appears in the July 1 issue of the New England
Journal of Medicine.
About 6 percent of the soldiers and Marines who participated in the anonymous
study say they've experienced mental health problems after combat tours in
Afghanistan or Iraq, Dr. William Winkenwerder, assistant secretary of defense
for health affairs, told reporters during a June 30 Pentagon roundtable.
However, "the vast majority" of service members surveyed for the report,
Winkenwerder noted, "seem not to be having any significant mental health
concerns or problems."
That's not to say, he pointed out, that those surveyed didn't experience stress
during their tours in Afghanistan or Iraq. "These are the folks that were in
the most intense types of (ground) combat situations," Winkerwerder noted.
Army Col. (Dr.) Charles Hoge, a principal author of the study, accompanied
Winkenwerder at the press conference and said the report contains "no
surprises," but that it "puts numbers to what we already knew."
Hoge, chief of the department of psychiatry and behavioral sciences at Walter
Reed Army Institute of Research, told reporters the new report shows "those
soldiers and Marines who had higher levels of combat exposure – frequency and
intensity of combat – had higher rates of mental health concerns."
Winkenwerder said the report also says some returning combat veterans suffering
from depression, anxiety or post-traumatic stress disorder aren't seeking
medical help.
"We believe," he said, "that there are adequate services available" to identify
and assist combat veterans experiencing mental health issues.
However, Winkenwerder noted, one main barrier preventing access to those
services "is the perception of stigma that some individuals have about coming
forward to get that care and counseling." Providing more education about mental
health care, he noted, should help to persuade more service members to seek
help.
The report is unique, Winkenwerder said, because of its use of near-real-time
data. For example, combat-stress studies conducted on the Vietnam War, he
pointed out, used data gathered years after the conflict ended.
"There's a lot of work to be done," Winkenwerder acknowledged, in finding ways
to enable service members to better cope with the stresses of combat.
Mental health teams are embedded in units in Afghanistan and Iraq to assist
troops, Army Surgeon General Lt. Gen. (Dr.) James Peake, who participated in
the press briefing with Winkenwerder and Hoge, noted to reporters.
Troops experiencing mental health issues can also access confidential
counseling via the Defense Department's "Military One Source" program, the 24-
hour-a-day service for service members and their families when they need quick,
professional assistance with any kind of problem.
High quality training, Peake noted, can help prepare service members for the
realities of combat.
Army Chief of Staff Gen. Peter Schoomaker, Peake pointed out, is a special
operations combat veteran who's focused on "the issue of tough, realistic
training" across the force. To illustrate, Peake described his recent visit to
a medical training site in San Antonio.
"We're putting in a live-fire range for convoys," Peake explained, "so that the
medics and the combat service supporters" get a more realistic feel for wartime
operations.
"We do want to take care of our soldiers," Peake said, noting combat can occur
anywhere on today's nonlinear battlefields.
Citing recent Centers for Disease Control and Prevention research, Winkenwerder
noted some people seem more predisposed to develop depression, anxiety or post-
traumatic stress disorders as a result of negative childhood experiences.
"Is there a point," Winkenwerder asked, "at which one could intervene during
late adolescence, or during early accession time into the armed services to
begin to … build mental resiliency?
"We're looking at what might be able to do that," he said.
Biographies:
Assistant Secretary of Defense for Health
Affairs Dr. William Winkenwerder
Army Chief of Staff Gen. Peter
Schoomaker
Army Surgeon General
Lt. Gen. (Dr.) James Peake
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