There's stress, and then there's post-traumatic stress syndrome

The news that 22,000 veterans called the military's new suicide hotline in the past year was somewhat disturbing. Even more troubling was the U.S. Department of Veterans Affairs' estimate that 6,500 veterans actually commit suicide every year.

Such statistics hardly support the view that the military wants the American public to have of its personnel. Witness the Army's newest slogan, "There's strong, and then there's Army strong."

Self-destructive behavior by veterans is often a consequence of post-traumatic stress disorder (PTSD). An article published in The Seattle Times on May 28 described service members with PTSD as feeling constantly under threat, having nightmares about their wartime experiences and growing emotionally numb. Both they and their loved ones suffer the consequences.

Fortunately, the Pentagon has finally realized that PTSD is a real syndrome, rather than just a tendency by some soldiers to complain about their circumstances. Perhaps the fact that nearly 40,000 troops were diagnosed with PTSD after serving in Iraq and Afghanistan between 2003 and 2007 helped military officials reach this conclusion. Even so, Army Surgeon General Eric Schoomaker says current estimates of PTSD cases are low, and that up to 30 percent of deployed soldiers have the condition.

As terrible as having PTSD can be for a veteran, a subset of such victims suffers an even greater affliction: traumatic brain injury. These individuals typically had the misfortune of being close to a bomb or other explosive weapon when it detonated, resulting in serious injury to the brain.

Veterans with traumatic brain injuries often experience a host of cognitive and emotional difficulties, requiring substantial help from others to readjust to civilian life. Unlike many other injuries, traumatic brain syndrome does not necessarily improve significantly with time.

However, like other serious medical injuries, caring for someone with a traumatic brain injury can be very expensive. According to a recent study by the RAND Corporation, the cost can run anywhere from $27,000 to more than $400,000 annually, depending on the severity of the injury.

With its reliance primarily upon hospital-based treatment, the VA system has neither the facilities nor the personnel to serve 50,000 to 100,000 veterans suffering from PTSD and traumatic brain injuries. With its experience in serving traumatized individuals, as well as its geographical and cultural accessibility, the nation's community mental-health system could be of tremendous assistance in helping serve veterans with PTSD.

To be sure, additional resources would be needed for community mental-health providers to assume this additional responsibility; but the VA system would need even more such resources, since it lacks any significant outpatient and case-management infrastructure to meet these needs.

America faces a train wreck when our men and women in uniform finally return home in large numbers. Seriously traumatized veterans will be forced to rapidly readjust to families, jobs and civilian life while concurrently struggling with both the physical and emotional repercussions of war that accompanied them back to the United States.

They will need our help, and they will have earned it. Hopefully, we will prove as diligent in meeting their needs as they have in meeting those of our country.