ARECENTLY released Pentagon survey found that 30 percent of soldiers who have experienced heavy combat in Iraq also experienced mental health problems. The fraction is lower, but still high, for soldiers serving outside high combat areas -- 20 percent. Lengthy deployments and inadequate time for rest and relaxation magnify the intensity of the conflict. And those who serve multiple tours are yet more likely to suffer from post-traumatic stress disorder (PTSD) and other mental ailments. Yet soldiers who return from grinding combat in Iraq or Afghanistan with sometimes debilitating mental illnesses often have to contend with outdated rules and bureaucratic hassles to get the compensation and treatment that they deserve -- and sometimes do not get either.
Sens. Barack Obama (D-Ill.) and Pete V. Domenici (R-N.M.) offered one way to better the system last week. The legislators introduced a bill that would require the Department of Veterans Affairs to offer outreach and support to returned soldiers. To ensure that these services are widely available, the VA would contract with local health centers to provide services to veterans in areas far from VA facilities. It would also organize groups of veterans to conduct peer outreach to minimize the stigma some attach to mental health treatment.
More reforms are necessary. The Institute of Medicine, an advisory group that the VA asked to assess its treatment and benefits policies for PTSD, reports that the government's system for assessing disability benefits for those suffering from mental disorders is inconsistent and dated and may even discourage patients from getting the help they need. In particular, the institute stresses, the assessment of benefits for those suffering from PTSD is tied to whether a patient has a job. This probably discourages PTSD sufferers from seeking employment -- an important part of returning to normal life -- while preventing those who work from getting care they need.
The Pentagon should improve NCO training and mental health surveillance in the field. The VA's benefits adjudication system, meanwhile, must consider more than just a PTSD patient's fitness for work, hardly the only indicator of mental fitness, and gear the system to encourage veterans to get the help they need.