RURAL ROUTES/Margot Ford McMillen

Repair the Whole Body

At a time when the news shows are happy to report on the accomplishments of soldiers with new prosthetic limbs or bodies that have been miraculously repaired after battle, the shooting by an Army psychiatrist, of more than 100 rounds into a group of soldiers at Fort Hood has, at last, shed light on yet another hidden cost of sending folks into the adrenaline rush of combat. It is time we take this cost seriously, not only for those directly affected, the families of the mentally ill, but for all of us.

Military men famously have difficulty re-integrating into civilian life. Wives and children can affirm that, and a Rand Corporation study in 2009 estimated that 20% of service members return from combat psychologically damaged, with depression or nightmares, addictions, hyper-vigilance and emotional numbing that prevents them from re-connecting with society.

It gets worse with every deployment, especially when the deployments are so close together that the men can’t adjust to their real lives. In May, in Baghdad, a soldier gunned down five fellow soldiers at a stress clinic. The suicide rate among veterans in their 20s was twice that of suicides in the general population in 2006, a record high, the Veterans Administration reported. An estimated 25% of the homeless population is made of former military men.

Part of the point of military life, after all, is to condition people to a new culture that consists in large part of fear and defensiveness. Whether young or old, soldiers take their new culture to heart. The bonding can save their lives in the short run but stay with them forever. Their behavior changes. If this wasn’t part of the experience of living with a group, there’d be no point in sending kids off to the gentler experiences we encourage — summer camp, for example, or college. The mind changes with continuous exposure to anything.

A few years ago, I collected oral histories and data from the state asylum in our county seat and wrote part of one of the few histories of mental health care in this country. It was hard to get data because mental health patients in Missouri are protected by privacy acts, but someone needs to do some further work in the history of mental health care. Based on my small amount of research, it was striking how the population of the asylum rose in the years after each war. The population of this asylum, following national trends, peaked in the early 1950s, filled with veterans and their family members. Even more striking was the news that all the reported violent incidents in the 1970s and 1980s involved hallucinations of Vietnam veterans.

Until the 1980s, treatment of mental diseases was the responsibility of state asylums. The best of these were caring communities where patients helped prepare food, raise gardens, make furniture and so forth. The worst were snake pits with overworked and stressed staff, places where society’s most embarrassing people were abandoned.

During the Reagan years, the asylums were dismantled. This was partly an economic decision, because new therapies are effective but expensive. Today, mental health treatment is often in the hands of the Departments of Corrections, as part of the penal system. In the military, the branches try to take care of their own and return the fighters as quickly as possible to their units. This makes it hard to know exactly how many men are being treated and what they are suffering from.

But a veteran doesn’t have to be institutionalized to have difficult times. One young wife of a Desert Storm veteran told me that, even though she still went to gatherings and meetings, her husband was afraid to go out. He felt like he didn’t know how to act, like he had lost the ability for ordinary civil discourse. He was getting better but she said, “I had no idea his service would become a lifetime condition.” She hopes he can be an effective Dad when their new baby comes.

Since 2001, nearly 1 million soldiers have deployed to Iraq and more than 300,000 of them have served multiple combat rotations, most lasting 12 to 15 months. Currently there are 160,000 soldiers in those war zones, and of those, nearly 30,000 are on at least their third or fourth tour, Pentagon data show.

Mental illness has always been a secret disease, hidden by families but bearing social expenses. There is, for example, the embarrassment of a family with an anxious member that acts in bizarre ways. For reasons that go back to the beginning of human history, mentally ill persons are hushed, if not shunned.

Today, there are some amazing, but expensive, medications for mental illness. For those in treatment, blood tests must be given regularly to guard against breakdown of internal organs. Somebody needs to keep track of that data and somebody needs to pay for it.

But if we’re going to send kids into combat, we have to treat their mental conditions just as we’d replace legs or arms lost in battle. For them, it’s an urgent matter of care, and for society it’s a crisis.

Margot Ford McMillen farms and teaches English at a college in Fulton, Mo. Email: margotmcm@socket.net. She was co-author, with Richard L. Lael and Barbara Brazos, of Evolution of a Missouri Asylum (University of Missouri Press, 2007).

From The Progressive Populist, December 15, 2009