In a USA Today interview last week, Lt. Gen. David Fridovich talked openly about his secret battle with drug addiction. A popular and widely respected military leader, Fridovich is particularly courageous because admitting personal struggles, such as drug addiction or living with post-traumatic stress disorder, runs counter to the prevailing military ethos.
As a retired general explained in the story, "Nobody wants to show weaknesses. You want to be perceived as perfection."
Tragically, this may continue after our service men and women return home.
According to a new report conducted by the RAND Corporation and funded by the New York State Health Foundation, New York State veterans who served in Iraq and Afghanistan are at high risk for major depression and post-traumatic distress disorder and many are not getting the care they need. Since October 2001, approximately 2 million U.S. troops have been deployed to Iraq and Afghanistan and an estimated 85,000 of the troops have returned to the New York area.
The numbers of those who are suffering are staggering.
Some 22 percent of the veterans had a probable diagnosis for mental health disorder, either post-traumatic distress disorder or major depression. Their risk for major depression is two-to-four times higher than a comparable group of non-veterans. For post-traumatic distress disorder, their risk is eight times higher than that of non-veterans. An additional 34 percent indicated need for mental health treatment.
Despite the fact that over half of veterans had a mental health need, only one third of those in need sought mental health treatment. More striking, only half of those seeking treatment received "minimally adequate" care.
Families also suffer. Deployment results in tremendous strain. Reintegration, too, requires great adjustment. Nearly half of spouses surveyed reported having problems dealing with their veteran spouse's mood changes upon their return home.
What is stopping our veterans from receiving the mental health help they need?
The survey respondents cited a number of barriers, including perceived medication side effects, concerns that seeking help could negatively impact their career or fear of losing the respect of their supervisor or coworkers.
The conclusion of the study is that the Department of Veterans Affairs (VA) alone cannot handle the responsibility for veterans's health and well-being. Both the VA and civilian providers need to be prepared to meet the mental health needs of the veteran population and their families.
So what are the next steps to address the important findings from this report? We need:
1. More extensive outreach and education to veterans and their family members about mental illness, available treatment and other resources and where to get help
2. Expanded and more responsive VA and community-based mental health services
3. Improved quality of mental health care being delivered by the VA and civilian-based providers
4. Stronger, more coordinated partnerships between the federal VA, state and local government and community-based providers
5. Education and training for VA and civilian-based providers on the unique needs and experiences of veterans
6. More effective coordination of available resources
Now that we are clear about the need and what to do about it, you might wonder how we can confront the complex needs of veterans and their families in the current fiscal climate. But don't we owe it to our veterans -- who courageously put their lives on the line for our nation -- to address not only their physical, but also their psychological wounds?
The cost not to take action is much too great.