Support the troops: renewing angst over Massachusetts v. Laird and endowing service members with effectual First and Fifth Amendment rights.

• Author: Bejesky, Robert
• Position: III. Large-Scale Harm Faced by Troops C. Posttraumatic Stress Disorder through Conclusion, with footnotes, p 479-520

3. Posttraumatic Stress Disorder

   Being deployed into a combat zone for a prolonged duration subjects American troops to the risk of developing traumatic stress-related injuries. (176) Names historically employed that are equivalent to today's medical classification of PTSD have included "operational fatigue," "combat exhaustion," and "traumatic war neurosis." (177) PTSD is caused by being constantly endangered (178) and experiencing a traumatic event related to military combat, which materializes into an intense emotional and reoccurring fear, nightmares, flashbacks, or mental symptoms that impair normal life functions. (179) Records document that soldiers experienced PTSD symptoms during the American Civil War, (180) World War I, (181) and the Vietnam and Korean wars, (182) and estimates have maintained that between 37% and 70% of American troops deployed into World War I, World War II, the Vietnam War, and the Korean War may have had PTSD or similar psychological conditions. (183)

   Military leaders historically treated troops with combat-related psychiatric symptoms as cowardly instead of with dignity as an injured person, (184) but there was an improved understanding of the illness, implementation of preventive measures, and administration of additional assistance after the Vietnam War. (185) The common experiences among Vietnam War veterans (186) led the American Psychiatric Association to recognize PTSD as a mental disorder in 1980, (187) and it has become the most prevalent category of veteran injury and frequent reason for attrition from the military. (188)

   An estimated 20% of Iraq War veterans and 11% of troops deployed to Afghanistan experienced PTSD (189) and Dr. Roye-Byrne of the University of Washington explained that "[n]europsychiatric symptoms in soldiers deployed in Iraq constitute[d] a looming public health threat." (190) To confront psychological consequences of combat and mental stress of combat, the VA hired hundreds of additional physicians who specialize in mental health (191) and the Pentagon spent $120 million in preventive psychology programs to assist troops with emotional recovery (192) because PTSD can debilitate healthy emotional behavior for years after a war (193) and require lifelong treatment. (194)

   Veterans have reportedly had difficulty attaining disability compensation for PTSD (195) because of the apprehension that PTSD symptoms can be exaggerated or falsified. (196) The process mandates the claimant-veteran to sustain the burden of proving the existence of a combat-related stressor event during military service (197) and an emotional behavioral change after the event. (198) For some veterans, evidentiary problems have arisen over whether they were involved in the stressor event of combat. (199) However, if the veteran is successful in proving a PTSD disability that diminishes the capacity to engage in gainful employment or social functions, (200) the degree of disability payment is determined by the extent of impairment (201) and compensation is set at 10%, 30%, 50%, 70%, or 100% of full disability. (202)

   Updates of the swelling epidemic aggregated concomitant with the burgeoning efforts of Americans and Congress to withdrawal troops from Iraq. (203) Over the first six years of the Iraq War, the Military Health System determined that there were 39,365 cases of PTSD, (204) but others opined that the illness was so common (205) that between 100,000 and 500,000 troops should have been receiving compensation. (206) Veterans for Common Sense and Veterans United for Truth filed a lawsuit against the Department of Veterans' Affairs and alleged that there was a '"widespread breakdown of the [VA's] adjudication and health care systems for veterans experiencing PSTD [sic],"' "'prolonged administrative delays in processing PTSD claims,'" and impediments to the legal process and delays in obtaining relief. (207) Of the estimated number of veterans who returned from war with a mental health problem, only about (40) % sought medical care, (208) which may signify that the lengthy process of asserting claims and appealing adverse decisions can deter veterans (209) or that veterans do not seek medical care because of the fear of stigmas associated with being labeled a PTSD sufferer or encountering negative repercussions in personal and professional life. (210)

   Perhaps at least partially attributable to PTSD, there have been lasting psychological consequences for veterans, including psychiatric disorders, memory impairment, emotional outbursts, criminal and impulsive behavior, alcoholism, resort to illegal drugs, abuse of prescriptions drugs, and propensity for aggression and violence. (211) Approximately 75% of veterans with PTSD have also had substance abuse problems (212) and a higher percentage of suicides are found among PTSD sufferers. (213) Several thousand veterans attempt suicide each year (214) and in one year following the Iraq War, two-thirds of the ninety-seven Army soldiers who actually did commit suicide had been deployed to Afghanistan or Iraq. (215) PTSD can be an insanity defense in criminal proceedings and a mitigating circumstance in sentencing proceedings. (216) The fact that PTSD should be a defense in criminal proceedings seems to be well-substantiated by statistics.

   Half of the 480,000 returning Vietnam veterans suffering from PTSD had been jailed at least once and 35% had been incarcerated more than once. (217) Even though the Vietnam War had ended nearly two decades earlier and the Gulf War had occurred one year prior, in 1992, the Federal Bureau of Prisons held 71,000 inmates and 10,000 were military service veterans, while at the state level, there were 127,500 veterans incarcerated in 2004, which "account[ed] for approximately 10% of the entire prison population." (218) The statistics are stunning because only one-half of 1% of the American population served in the military over the last decade. (219) If a high percentage of veterans committed crimes and they would not have perpetrated crimes without having PTSD or some other emotional or physical impairment after enlistment, the situation begs for explanation and policy improvements.

   The military promotes the perspective that military service forges leadership skills, personal responsibility traits favored by the private sector, and the translatability of military careers into private sector positions. (220) Recent surveys reveal that employers certainly want to hire veterans, (221) but over 70% of hiring managers found it challenging to translate military experience into the foundational skills that would be well-suited for business. (222) In 2010, the U.S. Department of Labor reported that 11.8 million veterans, or 7.7% of the labor force, were unemployed and seeking work. (223) There is a distinction between commanders and officers who hold elevated positions in the military hierarchy and combat troops who may be more apt to assume dangerous risks by executing military directives. (224) It may be the former category, rather than the high-percentage of unemployed, that Fortune magazine referred to in a cover story entitled: "Battle Tested: How a Decade of War has Created a New Generation of Elite Business Leaders." (225) A high percentage of these leaders may have the pedigree of graduating from military service academies, which cost American taxpayers an average of $400,000 per graduate. (226) Meanwhile, the troops who are very likely to be risking their lives in combat may not have the same educational background.

4. Exacerbating Troop Injuries? Depleted Uranium Exposure

   If there are ill-health effects from exposure to depleted uranium (DU), American troops may have suffered as a result of the Pentagon's weapons. DU is a byproduct of enriched uranium; highly radioactive isotopes are formulated to generate nuclear power (or perhaps produce bombs). The less radioactive DU is separated (227) and can be used to manufacture artillery shells with increased firing range and explosive power and to fortify armor in tanks. (228) If there are adverse health effects from exposure to DU, it is even more unfortunate that so much emphasis was situated on needing to initiate war to impede peril from nuclear enrichment programs allegedly possessed by a foe, when there was insufficient scrutiny affixed to the harm caused to both friend and foe from DU-laced missiles and bombs, (229) which might even be viewed as small nuclear weapons. (230) Similarly, a commentator recently opined that if one calculates the possible long-term and widespread health deterioration from DU exposure, Syrian President Assad's recent abominable use of chemical weapons may not have been as fatal as the United States' use of DU in Iraq. (231) The Pentagon has never confronted an enemy that has used DU and largely denies that there are health risks to troops. (232)

   The U.S. experimentation with DU began in the 1970s and the U.S. military and many scientists maintained that exposure to DU is safe, but scientists began to undertake research of health and environmental harm from DU in the mid-1990s, (233) which was after the 1991 Gulf War and the first large-scale use of DU on the battlefield. (234) Those who emphasize ill-health effects from DU maintain that there is no safe limit of DU exposure. (235) DU poses toxic and radioactive environmental and human health risks when particles absorb into the groundwater and earth, (236) are airborne and can be inhaled, (237) and circulate and endanger troops in tanks. (238) Studies maintain that radiation-exposed civilians and American troops have a high risk of experiencing lung disease, cancers, kidney disease, leukemia, lymphoma, bone and breast cancer, and neurological disabilities; exposed parents may also have children with birth defects. (239) Health symptoms suffered by troops following the 1991 Persian Gulf War have been called "Gulf War Syndrome," (240) and have included lupus-like...