WASHINGTON – Early studies of the emotional ravages of the Iraq war on combat soldiers have spurred some veterans' health advocates to question whether Americans and the U.S. government are truly prepared for the devastating and far-reaching mental health effects of war.
“We are not prepared for the body count we are seeing, mental health or otherwise,” said Sue Bailey, former assistant secretary of defense for health affairs during the Clinton administration. “America’s mood is not prepared for this.”
“The [Veterans Administration] is not geared up and the [Department of Defense] is not geared up," said Rick Weidman, spokesman for Vietnam Veterans of America (search). "That’s why some of us have been talking, and you are going to see a major front of veterans saying we need this fixed and we need this fixed now.”
According to a study published July 1 in the New England Journal of Medicine (search), 15- 17 percent of combat soldiers surveyed upon their return from Iraq exhibited signs of anxiety, major depression or other mental health problems.
These numbers are significantly higher than in the Persian Gulf War (search), point out mental health and veterans experts. They attribute the lower numbers in 1991 to a shorter war — 42 days — and enemy engagement that came mostly from strategic air assaults, not urban warfare (search).
"Because of the nature of this war, there will be more people with mental problems than in the Persian Gulf War – it will be more like the Vietnam War (search),” said Lawrence J. Korb, former assistant secretary of defense under President Reagan and senior fellow for the Center for American Progress (search).
Government officials and some experts say that between the new mental health teams available to troops in Iraq, and a more proactive outreach to soldiers when they get home, the government is better prepared than ever.
“There have been real advances in having the capability to deal with things in real time, in combat,” said Bailey.
"I can tell you we have been anticipating, or monitoring very closely, what we think the influx will be," said Alfonso Batres, chief officer for readjustment counseling services at the Veterans Administration (search). "What is different today is that we are really being proactive in trying to reach this group."
According to the NEJM study, during the war in Iraq, 95 percent of Marines and Army soldiers surveyed had been shot at, 56 percent had killed an enemy combatant and 94 percent had seen bodies and human remains.
“There are no clear enemy lines, non-stop pace, the war surrounds the soldier 360 degrees. The enemy can be man, woman or child. This is an extremely stressful situation,” said Stephen Robinson, executive director of the National Gulf War Resource Center (search).
Robinson said men and women who in the past would have died in the field have survived thanks to advanced body armor, but in many cases the soldiers are living with severe, life-altering injuries or are watching their friends grapple with them. In other cases, many of the less injured are National Guard and Reservists who are being sent back to the theater two and three times.
According to the Pentagon figures on Monday, 1,032 men and women have died in Operation Iraqi Freedom and 7,245 have been wounded. Of those latter figures, more than half could not return to duty within 72 hours and many resulted in one or more amputations and head injuries due to roadside bombs and patrol ambushes, according to reports.
Several experts gathered in Washington, D.C., on Sept. 14 to discuss what they call the “hidden toll” of the war — men and women suffering from symptoms of post traumatic stress disorder (search). Symptoms can range from chronic fatigue and confusion to violent mood swings and serious depression.
Though PTSD is as old as war itself – as recently as World War I it was called “shell shock” – veterans’ advocates blame the government for not learning its lessons, particularly after Vietnam.
“When we start seeing homeless veterans on the streets, self-medicating, families starting to break up – the toll – you won’t be able to hide that. It will be felt by families across America,” said Robinson.
"The military and the Veterans Administration are there and ready to support the veterans coming home and we will continue to do so," said Dr. Thomas Burke, an Army colonel and head of mental health policy under the assistant secretary of defense for health affairs.
Batres added that the VA starts seeing soldiers when they are still convalescing in the military hospitals and even have former Iraq and Afghanistan soldiers conducting outreach services in new peer-to-peer counseling.
He said the VA has met with 10,262 veterans from Iraq and Afghanistan. Of that number, 4,314 came to them through local VA centers, and of that number, 25 percent had symptoms of PTSD.
Kaye Baron, a clinical psychologist who has worked with about 75 returning Iraq veterans through her private practice outside of Ft. Carson Army Base in Colorado, said she fears a stigma is still attached to mental health care, and therefore, an unwillingness remains to make mental health services more accessible.
“I have some very significant concerns about us being prepared, or more importantly, being aware or honest as a society to acknowledge that these soldiers are going to have problems, whether they admit it or not,” she said.
Baron and others said the NEJM report underestimates the numbers of soldiers affected by the war and the traumatic experiences they've been through. They also complain that despite claims otherwise, the military and VA are not effectively reaching out to soldiers. And without such efforts, most soldiers will not seek help, but will turn to other more destructive outlets.
“The military wants to deny that war hurts people and the society wants to deny that war hurts people,” Weidman said.
Burke told FOXNews.com that multiple levels of mental health services are available before, during and after a soldier is deployed overseas, which not only take into consideration the myriad war-related effects on a soldier, but the need to reach out to those who might be hesitant to seek help.
Thus, a new program that allows soldiers to seek help online and through a toll-free hotline number.
"We strongly encourage soldiers to take advantage of the resources available to them," said Burke, who called the NEJM study important, but "not surprising" given the level of combat exposure cited.
Baron said the report suggested that about 25 percent of returned soldiers were drinking excessively. “I know from walking and talking to people that more like 75 percent are indulging in excessive alcohol to self-medicate, to escape,” she said.
Barbara Critchfield, a long-time counselor at Shoemaker High School, where nearly 80 percent of the student body has parents deployed overseas through nearby Fort Hood, Texas, said students have begun to talk about returning parents’ behavior.
“Some talk about fathers, who all they want to do is drink and sleep — we know there is PTSD,” she said. “I don’t know how far-reaching it is, they might be isolated incidents, I don’t know.”
She said community mental health services are scrambling to hire more personnel and do more. “I think no one was expecting it to be what it is,” she said.