Veterans may be starting to answer test questions more truthfully, leading to more accurate mental health testing in the military, according to Duluth Vet Center Outreach Specialist Chris Roemhildt. Dishonesty in test responses makes it difficult to diagnose post-traumatic stress disorder (PTSD) and is just one of the possible reasons for the lack of treatment.
The Post-Deployment Health Reassessment (PDHRA) Program, the military’s current method of testing for PTSD, involves a pre- and post-deployment test. Roemhildt, who works primarily with Iraq and Afghanistan veterans with PTSD, said that he is seeing more honesty now in the PDHRA than he has in the past.
This heightened truthfulness may or may not account for the higher percentage of Iraq and Afghanistan veterans receiving Veterans Affairs (VA) services then the general veteran population. According to the VA Office of Policy and Planning, in 2008, 36 percent of all U.S. veterans received VA benefits and services, as opposed to 52 percent of OEF/OIF (Operations Enduring Freedom and Iraqi Freedom) veterans.“I think the command is being a lot better at conveying to their troops that it is important to be honest,” Roemhildt said. “Not just for the sake of their mental health or their health at that exact time, but also looking 20, 30 years down the line. If they are still having problems or if those problems have gotten worse, there will be documentation behind that.”
According to the National Center for PTSD, an organization under the VA umbrella dedicated to PTSD research, PTSD occurs in about 11-20 percent of Iraq and Afghanistan War veterans, 10 percent of Gulf War veterans and 30 percent of Vietnam veterans.
A recent study published by Management Science however, estimated the rate of PTSD in Iraq War veterans at much higher: 35 percent.
The mental health services available to veterans in Minnesota include counseling and other resources from the U.S. Department of Veterans Affairs and the St. Louis County Veterans Service Office. Nonprofits such as the Minnesota Assistance Council For Veterans (MACV) also offer help.
Many other hindrances besides faulty testing prevent veterans from getting help for PTSD.
Sam, a Vietnam-era veteran who served in the U.S. Marine Corps from 1974 to 1981, didn't receive treatment for his PTSD until 35 years later, when he was drinking, using, and at his "lowest moment."
“I tried to look for help; I had no knowledge,” said Sam (who asked that we not use his last name because of the stigma attached to PTSD). “I didn't know about MACV till a friend told me. The other government agencies that were out there to help you are so bound up in red tape that it’s a joke. The system’s broke.”
Roemhildt and Steve Saari, the regional director at Duluth MACV, agreed that this “red tape” is a significant hurdle facing veterans.
“I think the biggest thing is probably the time period involved for things to happen,” Saari said. “When you're in the military, you're used to getting things done and getting them done now.”
“With some of these guys you only get one trip to the plate with them,” he said. “They'll come in and they're having issues, and if they don't get some type of service right away they might never come back … and that's happening consistently across the board."
Another obstacle that both Saari and Roemhildt pointed out is pride.
“You've been trained since day one in the military to suck it up and handle it or you’re out of here,” Saari said. “So when they get out they go, ‘Well, I’ve gotta make sure I do whatever it takes to make it happen without help from anybody else.’”
Roemhildt added the “stigma” associated with mental health and military members also keeps people from seeking out or even accepting available services.
“If you are having issues, a lot of times individuals will get somewhat ostracized within their own units,” he said. “So it takes a lot for a combat veteran to say ‘I’m having problems, I need help.’”
Roemhildt said that veterans may also worry that accepting mental health services will affect their current or future career paths.
“Some of these guys are still in the units,” Roemhildt said. “Some of them have security clearances, some of them are police on the civilian side.”
The question remains if all of these barriers tell the whole story, or if a lack of resources is also an issue.
In 2010, approximately 28 percent of Minnesota’s 381,309 veterans received various types of treatment at a VA health care facility, according to the VA Office of the Actuary. In Minnesota in 2009, the VA spent over $97.6 million on veterans health care and services, according to the Minnesota Department of Veterans Affairs Annual Report.
“There are a lot of resources,” Roemhildt said. “The VA has a mental health section that has psychiatrists, psychologists, nurse practitioners … Anyone that's deployed, when they come back, they can have five years of free medical coverage.”
Sam shared this view, saying, “Those programs have been there for many, many years. The problem is, if you don't know who to talk to or you don't know where to go, you'd never know they exist.”
With MACV directing him to the available resources, Sam was able to receive treatment for his PTSD through an eight-week course at the VA’s inpatient program.
He said he is glad there are more resources for young veterans now than there were when he got out of the Marine Corps in 1981.
“The kids that are coming home today at least are made aware before they get out that there is assistance out there,” he said.