[Congressional Record (Bound Edition), Volume 153 (2007), Part 2]
[House]
[Page 1935]
[From the U.S. Government Publishing Office, www.gpo.gov]




   WHEN THEY COME HOME: MEETING THE MENTAL HEALTH NEEDS OF OUR TROOPS

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 4, 2007, the gentleman from Pennsylvania (Mr. Tim Murphy) is 
recognized during morning hour debates for 5 minutes.
  Mr. TIM MURPHY of Pennsylvania. Mr. Speaker, over 17 percent of 
soldiers returning from Iraq, higher than any other measured military 
conflict, meet the criteria for post-traumatic stress disorder, or 
PTSD. Predeployment mental health screening, availability of treatment, 
perception toward treatment and public attitudes of the soldiers' 
actions all affect the vulnerability and prognosis for this disorder.
  PTSD is a severe anxiety disorder that develops after a traumatic 
event involving physical danger. It is also called ``shell shock'' or 
``battle fatigue'' in other wars and is particularly prevalent among 
soldiers who have experienced wartime combat. Symptoms can include 
insomnia, irritability, inability to concentrate, panic, terror, dread, 
despair, grief and include daytime recollections, traumatic nightmares 
or combat flashbacks. Most persons exposed to severe trauma do not 
develop symptoms. Onset can be immediate but more commonly occurs from 
a few months to years after the event.
  Currently, the Department of Defense provides mental health services 
for 180 days following discharge and the VA offers its health care 
services, including mental health, to veterans at no cost for 2 years 
following discharge. Afterwards, veterans may continue to receive 
mental health treatment but are subject to copayments.
  Unit support while still deployed helps reduce symptom risk. Once 
soldiers return home these supports end, but ongoing support is 
essential to reduce the risk, from families, friends, veterans, the VA 
and our society as a whole. Many with early symptoms of PTSD, however, 
isolate from social contact and do not benefit from these supports.
  In the current war in Iraq, unlike Vietnam, society as a whole is 
generally able to separate support for the soldier from support for the 
war. However, as criticism for the war increases and the public 
questions the purpose and outcome of this war, a significant question 
remains as to the impact upon the soldier's mental health of these 
expressions of doubt. For those at risk for PTSD and since hopelessness 
may raise the risk, society's comments of the situation may increase 
the soldier's sense of personal blame and lead the soldiers to question 
if they did their job well. Or they may develop a sense of 
worthlessness and guilt that their fellow soldiers lost their lives for 
a cause that was not supported by the country. Further research must be 
done to explore this link, but it also raises an important issue. Not 
only is there a concern for a stigma for the war action itself but also 
getting help. The majority of soldiers who need treatment for PTSD and 
mental health symptoms do not seek help for fear of being seen as weak, 
for fear of being treated differently by their commander, or fear of 
future harm to their career.
  Pictures, commentary and news coverage of this war affects not only 
recent combat veterans but extends to those of prior wars. A survey of 
70 Vietnam veterans stated that 57 percent reported flashbacks after 
watching reports about this war on television, and almost half faced 
sleep disorders.
  Mr. Speaker, there is a need for specialized military mental health 
services. As of May last year, of the 5 percent of Iraq and Afghanistan 
soldiers who may have been at risk, only 22 percent sought help from 
mental health providers. The rest sought help from primary care 
doctors, many without mental health training.
  The National Defense Authorization Act of last year created the 
defense task force on mental health. Within a year, they are to submit 
a report to us with a long-term plan to improve the effectiveness for 
Armed Forces who have experienced multiple deployments. But Congress 
can improve the Department of Defense referral process for mental 
health evaluations by psychiatrists/psychologists to better meet the 
needs of our troops. As chronic PTSD symptoms can continue for years, 
the VA should extend the 2-year universal coverage period for mental 
health services for our Nation's soldiers when they return from active 
duty and combat. And we need to study the effects of the 24-hour media 
exposure on the occurrence of PTSD symptoms upon returning veterans 
from Iraq and Afghanistan. Congress can also increase public awareness 
of PTSD to reduce the stigma for returning veterans and for them to 
take advantage of mental health services at the VA.
  Working together, we can ensure that none of our Nation's veterans 
suffering with PTSD are left behind, but above all as Members of 
Congress we have to make sure that the things we do and say respond to 
the caveat to first do no harm.

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