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The Honolulu Advertiser
Posted on: Sunday, April 22, 2007

Veterans' 'invisible wounds' need care

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When a structure is left standing after an earthquake, many assume that it is has withstood any trauma. But that doesn't mean there isn't unseen damage. And left undetected and ignored, that damage can eventually have devastating effects.

This is true of our troops after serving in Iraq and Afghanistan. Thousands return home seemingly uninjured, but with psychological wounds that can last a lifetime. Post traumatic stress disorder, traumatic brain injuries and a multitude of other service-related mental health conditions these are the "invisible wounds" that so many soldiers carry home with them.

And the time for them to receive the adequate and timely care they deserve is grossly overdue.

Many fail to seek help for these wounds out of shame. The true shame, however, lies with our government's treatment of those who do seek help, as evidenced by the Walter Reed scandal. Numerous reports have revealed that soldiers with serious mental conditions were denied care by the Department of Defense, and that they were repeatedly asked to justify their injuries to receive the help they deserve.

In Fort Carson, Colo., there have been allegations of commanders denying soldiers access to mental health services, and instead ordering them redeployed for additional tours in Iraq. Other cases involved soldiers with PTSD being diagnosed with "personality disorders." Because the Army considers this a "pre-existing" condition, the veterans were denied disability benefits and healthcare.

These disturbing cases were detailed in a recent letter to the General Accounting Office by numerous U.S. senators, including Barack Obama, Barbara Boxer, Joe Lieberman and Daniel Akaka. In it, they urged the GAO to review the Department of Defense's treatment of troops affected by service-related mental health conditions. An investigation is the least that can be done. But accountability and policy changes must follow for it to bear any significance.

In the meantime, for the thousands of veterans who have been left to languish untreated, changes must be made immediately.

Sen. Akaka has introduced legislation, S. 383, that would extend automatic VA health care eligibility from two to five years, largely because of the delayed onset of symptoms of PTSD and other mental health disorders. The bill will be considered in the Senate Veterans Affairs Committee legislative hearing in late May. Currently, if war veterans display PTSD more than two years after leaving active duty, they are no longer eligible for care. This is insufficient time. The bill allows a more practical timeline for these "invisible wounds" to surface and be treated. It should be passed.

On Wednesday, the Veterans Affairs Committee is scheduled to have a crucial hearing on mental health to identify the problems within the system. In preparation, Akaka sent staff members on oversight trips to numerous facilities including Boston, San Francisco, Salt Lake City and San Diego. Trips to Hawai'i and Guam are scheduled for this week. Interviews with clinicians, researchers and staff were conducted to replicate best practices and hone in on specific deficiencies. No doubt, there will be many.

Again, the hearing will be crucial, but it must be followed by accountability and substantial policy changes.

The Pentagon recently announced that it would be extending tours of duty for Army troops. Many soldiers have received reduced training to expedite their arrival in Iraq. Unprepared and stretched thin, these troops will be even more vulnerable to psychological trauma than ever before.

Congress and the White House continue to grapple over funding a war whose demands continue to grow, and whose end remains elusive. The nation's focus is on timelines and troop numbers, while soldiers are returning seemingly uninjured.

War creates hidden injuries that are no less debilitating than physical ones. The men and women who bear these wounds deserve the support they need to heal. And it's our government's moral obligation to see that they get it.