Compared with other American wars, the conflicts in Iraq and Afghanistan seem to be producing victims at a high rate. A recent RAND Corporation study estimated that three hundred thousand veterans of America’s post-9/11 wars—nearly twenty percent of those who have served—are suffering from P.T.S.D. or major depression, and many more cases are expected to surface in the years ahead. This elevated rate is generally attributed to the rigors of a long war being fought without conscription: multiple deployments and heavy use of National Guard and reserve units. And on the ground, at unit level, the discouragement of anyone with stress symptoms from asking for help is intense. The same RAND study found that, mainly because of the stigma still attached to P.T.S.D., only half of those afflicted have sought treatment.
The suicide rate among veterans and active-duty military personnel has been rising as well. The number of soldiers who killed themselves last year was the highest since the Army began keeping records, in 1980. When Dr. Ira Katz, the Department of Veterans Affairs chief of mental services, learned earlier this year that preliminary internal reports suggested that a thousand veterans in V.A. care were attempting suicide each month, he sent a colleague an e-mail saying, “Shh! … Is this something we should (carefully) address ourselves in some sort of release before somebody stumbles on it?” Another e-mail, written in March, 2008, by Dr. Norma J. Perez, a P.T.S.D. program coordinator in Texas, said, “Given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out.”
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