Battleland

Memorial Day 2012: Advancing or Retreating?

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I posted my first piece on Time’s Battleland a year ago, troubled by the disconnects between the verbal thanks to America’s veterans — and the rising problems with unemployment and homelessness.

This is too reminiscent of the post-Vietnam era, despite all the improvements in the military in screening and early intervention. Since then, after my first Memorial Day as a retiree and veteran, I see many improvements, but some low points.

First of all, veterans have really ballooned into the national conscience.

First Lady Michelle Obama’s “Joining Forces” initiative has helped rally the nation, especially important in the employment arena. Organizations like Give an Hour, the Boston Red Sox Home Base program, The Mission Continues, and many others continue to thrive and grow.

Another real plus are the major efforts by the Substance Abuse and Mental Health Services Administration. The SAMHSA “Policy Academy” is a state-by-state assessment of the needs and resources for veterans. Here in the District of Columbia, the efforts are organized into five arenas: economic security; adequate housing — including ending homelessness; education; health; and the criminal justice system. Other states are also drilling down into questions about what are the gaps and resources, and asking, very concretely: “How can we help?”

Personally I am proud of two major publications, which I edited, Combat and Operational Behavioral Health and Canine-Assisted Therapy in Army Medicine, both available for free on-line.

There are numerous other outstanding educational products, including those from the Defense Center of Excellence, Medscape (free subscription required)Massachusetts General Hospital and the National Center for PTSD.

The American Psychiatric Association had a great military program this past May.  Interestingly in that last meeting, it was not the statistics on the rates of PTSD and suicide that garnered the most audiences. These statistics are old news now. But the workshops on “ Working as a Civilian Contractor at a Military Base” and “Personal Experiences in the Combat Zone” were overflowing.

The papers are full of efforts to help homeless veterans, including female vets, an often-overlooked population.

Another bright spot: the repeal of “Don’t Ask, Don’t Tell.”

Yet, yet, with all this welcome public and academic interest, the problems are still there.  Many vets are still unable to get meaningful employment.  Both active duty and reserve troops are committing suicide at an unacceptable rate.

Meanwhile military mental health workers are very tired, themselves having deployed frequently, and having spent years now with the service members.

There have also been some very dark spots. The controversy over PTSD diagnoses at Washington state’s Fort Lewis (now Joint Base Lewis McCord) has shaken Army psychiatry. Nevertheless, I think the dialogue is useful: what is the best way to diagnose PTSD, which lacks a simple test, and pinpoint those seeking to either conceal or embellish symptoms? Indeed, should it even be called PTSD?

And of course the Afghan massacre, allegedly by Staff Sergeant Robert Bales, which led to SGT Psycho headlines.

So if we were in a baseball game, would we be ahead? We’re plainly still in the game, but much more needs to be done. While I’ve said them before, they’re worth repeating:

– Veterans still need jobs.

– The U.S. still needs to grow the work force of trained therapists.

– The military still needs to honor the “no stigma” policy they preach.

– The Veterans Administration still needs to be more accessible.

– The American public still needs to take care of their combat-scarred sons and daughters.

Fingers still crossed that Memorial Day 2013 will see progress on most, if not all, of these fronts.

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