Traumatized Soldiers Need Better Care

With the military’s health care system badly overtaxed and extended tours of duty putting soldiers and military families under great stress, experts are looking at whether mental health services available to veterans are adequate. A new report from the President’s Commission on Care for America’s Returning Wounded Warriors underscores the need for better mental health care and interventions. Because domestic violence and sexual assault have long been serious problems in the military, violence prevention experts are paying attention.

A series of domestic homicides at Fort Bragg in 2002 put a spotlight on the problem, in particular because some of the perpetrators had recently returned from tours of duty in Afghanistan. The misperception that seeking counseling would harm military careers may have been a contributing factor, experts said at the time.

Since then, numerous incidents and reports have demonstrated that violence against women is a serious problem in the military. Congress created two task forces to address the problem: The Defense Task Force on Domestic Violence, and the Joint Task Force for Sexual Assault Prevention and Response. Both formulated plans to help the Department of Defense address these issues. Some recommendations were adopted, but others were not fully funded or implemented, observers say.

Violence against women remains a huge problem. The Pentagon recently reported that incidents of sexual assault increased from 2005 to 2006, and there were 2,947 alleged sexual assaults involving members of the Armed Forces in 2006.

Commission on Care

Now, a new presidential commission is examining the care received by wounded U.S. soldiers returning from the wars in Iraq and Afghanistan. "This war is creating a huge strain on soldiers and military families, and some returning service members and their family members may be at risk," said Family Violence Prevention Fund President Esta Soler.

The Commission agrees. After holding seven public hearings and visiting military bases and VA (Veterans Affairs) and private medical facilities, the President’s Commission is recommending fundamental changes to the military health care system, including aggressive steps to prevent and treat post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) – two key injuries in the current conflicts.

The Commission was formed in March after the Washington Post disclosed poor conditions for returning veterans at Walter Reed Army Medical Center. Former Senator Robert Dole and former Health & Human Services Secretary Donna Shalala lead it, and members include wounded Iraq veterans, the wife of an injured soldier, and health care and VA experts.

Its report, issued in late July, says, "A sizeable fraction of service members returning from Iraq and Afghanistan suffer from PTSD. Best estimates are that PTSD of varying degrees of severity affects 12 to 20 percent of returnees from Iraq and six to 11 percent of returnees from Afghanistan. To date, 52,375 returnees have been seen in the VA for PTSD symptoms." Multiple deployments increase the risk of PTSD.

The Commission recommends that the VA: provide care for any veteran of the Afghanistan and Iraq conflicts who has PTSD; rapidly improve prevention, diagnosis and treatment of both PTSD and TBI; and work aggressively to reduce the stigma of PTSD.

"We need to put services in place to meet the emotional and mental health needs of soldiers and their families, so they will have the best possible chance to heal and to lead productive lives," Soler added. "With more women in the services than ever before, it's especially important that we make sure to meet the needs of all our veterans. And we need to do a better job of preventing assaults against female soldiers as well as civilians, at home and in war zones, and treating those who are victims."

The Commission on Care also recommends:

  • Immediately creating comprehensive recovery plans to provide the right care and support at the right time in the right place by using a patient-centered recovery plan for every seriously injured service member;
  • Completely restructuring the disability determination and compensation systems;
  • Significantly strengthening support for families, including expanding respite care and extending the Family & Medical Leave Act for up to six months for parents and spouses of the seriously injured;
  • Rapidly transferring patient information between the Department of Defense and the VA through a new My eBenefits web site that provides a single information source for patients; and
  • Recruiting and retaining first rate professionals for Walter Reed Army Medical Center through 2011.

"These are bold, innovative recommendations that are doable and can be acted upon quickly," Secretary Shalala said. "Our motto is 'put patients and families first.' The system should work for the patient, instead of the patient working for the system."

The Commission on Care’s new report, Serve, Support, Simplify is available at For more information on services available to victims of violence associated with the military, visit To read the Military Services Sexual Assault Annual Report, visit
The U.S. Department of Defense Mental Health Task Force report on troops serving in Iraq and Afghanistan is available at

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