A Plague on the Nation

Post-War Suicides May Exceed Combat Deaths, U.S. Says (Update1)
2008-05-05 14:15 (New York)


    (Adds Pentagon's comments in eighth, ninth paragraphs.)

By Avram Goldstein
    May 5 (Bloomberg) -- The number of suicides among veterans
of wars in Iraq and Afghanistan may exceed the combat death toll
because of inadequate mental health care, the U.S. government's
top psychiatric researcher said.
    Community mental health centers, hobbled by financial
limits, haven't provided enough scientifically sound care,
especially in rural areas, said Thomas Insel, director of the
National Institute of Mental Health in Bethesda, Maryland. He
briefed reporters today at the American Psychiatric Association's
annual meeting in Washington.
    Insel echoed a Rand Corporation study published last month
that found about 20 percent of returning U.S. soldiers have post-
traumatic stress disorder or depression, and only half of them
receive treatment. About 1.6 million U.S. troops have fought in
the two wars since October 2001, the report said. About 4,560
soldiers had died in the conflicts as of today, the Defense
Department reported on its Web site.
    Based on those figures and established suicide rates for
similar patients who commonly develop substance abuse and other
complications of post-traumatic stress disorder, ``it's quite
possible that the suicides and psychiatric mortality of this war
could trump the combat deaths,'' Insel said.
    Post-traumatic stress disorder, known as PTSD, is the
failure to cope after a major shock, such as an auto accident, a
rape or combat, Insel said. PTSD may remain dormant for months or
years before it surfaces, and in about 10 percent of cases people
never recover, he said.

                      Difficult to Predict

    ``We don't yet know how to predict who is going to be the
person to be most concerned about,'' Insel said.
    The Pentagon didn't dispute Insel's remark.
    ``The department takes the issue of suicide very seriously,
and one suicide is too many,'' said spokeswoman Cynthia Smith in
an e-mail.
    The department has expanded efforts to encourage soldiers
and veterans not to feel stigmatized if they seek mental health
treatment, Smith said.
    Soldiers who'd been exposed to combat trauma were the most
likely to suffer from depression or PTSD, the Rand report said.
About 53 percent of soldiers with those conditions sought
treatment during the past year. Half of those who got care were
judged by Rand researchers to have received inadequate treatment.
    Failure to adequately treat the mental and neurological
problems of returning soldiers can cause a chain of negative
events in the lives of affected veterans, the researchers said.
About 300,000 soldiers suffer from depression or PTSD, the report
said.

                        Treatment Options

    Researchers aren't sure whether it's appropriate to treat
such patients with selective serotonin reuptake inhibitors, a
class of medications that include Prozac, and other anti-
depressants, Insel said. His institute is examining that question
and novel treatments for PTSD, including using so-called virtual
reality technology.
    The psychiatric association reported last week that a survey
of 191 military members and their spouses found 32 percent said
their duty hurt their mental health, and six in 10 believed
seeking treatment would damage their careers.
    More than 15,000 psychiatrists are attending the
professional group's meeting.

*T
For related news:
For stories about war: {NI WAR <GO>}
Today's most popular health-care stories {MNI HEA <GO>}
*T

--With reporting by Rob Waters in San Francisco. Editors: Angela
Zimm, Andrew Pollack

To contact the reporter on this story:
Avram Goldstein in Washington at +1-202-624-1982 or
agoldstein1@bloomberg.net.

To contact the editor responsible for this story:
Reg Gale at +1-212-617-2563 or rgale5@bloomberg.net.



[TAGINFO]

NI US
NI HEA
NI DRG
NI MEDICAL
NI SCIENCE
NI GOV
NI HHS
NI IRAQ
NI SCIENCE

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-0- May/05/2008 18:15 GMT