Assault At Fort Hood: A Symbol of the Military's Mental Health Crisis
Our military is stressed, stretched and overwhelmed.
The tragic event at Fort Hood, where a military psychiatrist opened fire on unarmed American soldiers, killing 13 and wounding 42, has shaken our confidence. People are left wondering how and why this could happen. How is it possible our soldiers are not even safe at their own American military base? Were there warning signs which were overlooked? Sadly, the answer is yes. Reports have surfaced that Hasan communicated with Islamic extremist groups, and he clearly had displayed mental health issues during his training which were not properly addressed.
How often are the soldiers significant mental health problems overlooked? What diagnoses are the most common? As a psychiatrist looking at the situation, I am wondering why does it take this kind of incident to bring about change?
Post traumatic stress disorder (PTSD) and substance abuse are the most common mental health diagnoses among soldiers. The incidence of substance abuse has doubled since 2003.
In June 2007, the pentagon released a report on the American troops returning from Iraq and Afghanistan. The conclusion was there are a frightening number of troops suffering from significant psychological problems: 38% of the army soldiers returning had some type of mental health disorder (PTSD, substance abuse, depression, anxiety, etc), 31% of marines, and 49% of National Guard members. The RAND Corporation did a study and found almost 20% of the soldiers suffered from PTSD or major depression.
The troops who are deployed and those that have been in active combat are at the highest risk for both PTSD, substance abuse, and depression. The soldiers are under tremendous stress and Marine Corps Sergeant Major Carlton Kent was quoted as saying alcohol use is an indicator of their stress and the US needs to reduce the number of troops that are deployed.
"We're seeing a lot of alcohol abuse" stated General Peter Chiarelli, the army's vice chief of staff when he addressed top officers about the army's increasing number of suicides. He wrote a memo about the alcohol abuse in May 2009, urging commanders to not only refer their troops to the Army Substance Abuse Program, but have punishments instituted for positive drug and alcohol tests. Despite hundreds of positive tests in the soldiers, some with repeated failed tests, very few received treatment and most did not have any paperwork processed for possible discharge.
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