March 20th, 2008
11:04 AM ET

The Fifth Anniversary of Women and War

The story of Keri Christensen (featured here on CNN.com) should upset all Americans. She is a patriot. She is also one of an estimated 180,000 women who have courageously served in combat in Iraq and Afghanistan since 9/11.

Women make up 11 percent of Iraq and Afghanistan veterans, and 15 percent of the military as a whole. Despite DoD and Army policies that prohibit women in combat, there are more female service members serving in Iraq and Afghanistan than in previous conflicts, and a greater portion are situated
in combat roles.

But, like so many others, Keri is now facing another fight. Today, she is back at home in Denver struggling to overcome mental health injuries . And five years after the start of the Iraq war, Keri is not alone...

By now, many Americans know that mental health problems can be crippling for veterans, increasing the risk of divorce, unemployment, even homelessness and suicide. A recent news report offers a dire warning:

"Veterans aged 20 through 24, those who have served during the war on terror... [have] the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age."

This shocking data only highlights the tremendous need for quick action to treat troops' mental health problems. PTSD is treatable, especially if it's caught early. We can (and must) help hundreds of thousands of veterans just like Keri.

Unfortunately, the Department of Defense's system for screening troops - a bunch of paperwork followed by a phone call - doesn't catch most of the people who will need treatment. We vets have known this for years. A recent study in the Journal of the American Medical Association agreed.

The study looks at the paperwork forms on 88,000 soldiers to see who needed treatment and who actually got care, and came to some disturbing conclusions.

1) Asking a troop just back from Iraq to fill out another form is not the same as screening them for PTSD. The report concludes:
"Surveys taken immediately on return from deployment substantially underestimate the mental health burden." That's why it's crucial that troops get mandatory, in-person interviews with a mental health professional. And not just when they come home, but months later, when the long-term effects of combat have had time to become visible.

2) Mental health issues are family issues. In the six months after getting home, there was a four-fold increase in troops' concerns about "interpersonal conflicts" with family and friends. The military needs to do a better job of reaching out to troops' families, so they can help get their loved ones into treatment.

3) National Guardsmen and Reservists are facing a special set of issues, and their concerns need to get heard. 42.4 percent of National Guardsmen and Reservists were identified as needing mental health treatment, compared to 20.3 percent of the active duty. These troops are more likely to have family and financial problems result from their deployment, and when they get home, they go straight back to work in a civilian job. No wonder they have higher rates of stress. We need to get them the care they need, starting with stronger job protections and better family support for deploying reserve troops.

4) Troops need more time to access care. Far more troops admitted a mental health problem when interviewed after six months than when they just got home. Of those who received a referral for mental health treatment, 39 percent still had not seen a mental health professional 90 days after their second interview. That's nine months after their return. The military and the VA need to prepare for the time-lag between troops coming home and their entry into the mental health care system.

As the authors of the JAMA study conclude, there is an "enormous opportunity" for the military to "intervene early before soldiers leave active duty." That includes thousands of women who have bravely fought and suffered wounds right alongside their male counterparts–and sometimes also face the incredibly stress of a sexual assault and/or trauma.

60,000 veterans were diagnosed by the VA with Post-Traumatic Stress Disorder. ³Of those, 22 percent of women suffered from military sexual trauma,¹ which includes sexual harassment or assault, compared with just 1 percent of men.² 

In 2007, there were 2,688 sexual assaults reported. This followed a 24 percent jump in 2006, and a 40 percent increase in 2005. The overwhelming majority of service members who report sexual trauma are women.
The VA has clearly seen a connection between mental health injuries and sexual assault.

But more research is necessary to understand the connection. Although the number of female veterans is rising, there is still a knowledge gap when it comes to the unique needs of female veterans. In IAVA's 2008 Legislative Agenda, we call for a more comprehensive approach to treating female service members¹ psychological injuries, including funding for an independent research study of the scope of sexual harassment and assault in the military, and an analysis of the effectiveness of the military¹s response to the problem.

We know the consequences if we fail to act. The only question is whether we have the political will to help these heroes like Keri before it's too late.

Founder and Executive Director of Iraq and Afghanistan Veterans of America.
Paul Rieckhoff, Iraq Veteran, Founder and Executive Director of Iraq and Afghanistan Veterans of America. (www.IAVA.org), author of Chasing Ghosts (www.PaulRieckhoff.com)

Filed under: Iraq • Paul Rieckhoff • PTSD
soundoff (14 Responses)
  1. xtina

    I echo Lisa above's comment to just say no to a government that can't even take care of the health of a small segment of the population taking care of the general population. In fact that will turn us overnight into a socialist state. Not a good idea

    March 20, 2008 at 7:13 pm |
  2. Lisa

    I read an article a few months back that (bottom line) rather than treat the psyche issue (i.e., PTSD), they military (don't remember which branch) actually had the audacity to say the soldier had the mental disorder PRIOR to enlisting and therefore the military branch did not have to treat the disorder.

    First, if the soldier had a psyche issue PRIOR to enlisting - what the heck was the military branch doing to accept the enlistment?! Screening, boot camp, etc. didn't reveal this minor detail?

    Second, who cares? Bottom line, the soldier was accepted, deployed and returned with the PTSD. Accept responsibility. Treat it. It was exacerbated by the deployment. The soldier put his/her life on the line for this country. One would think we owe them quick non-red tape treatment.

    We are talking about an age group that grew up on TV and videogames. An actor dies on show and pops up on another. With videogames, just hit "reset" and start fresh/anew. We haven't really differentiated that reality is a bit different. Now let's also take into account the studies that the brain doesn't really get the "risk" thing until around age 25.

    I think our military is failing these young people by not making them actually comprehend and understand the realities of war. We further fail them by not providing the proper and prompt treatment upon their return (if they happen to be lucky enough to return in one piece).

    Finally, if the military has this type of red-tape and denial of treatment (think Agent Orange in Viet Nam, PTSD for the first Gulf War vets, etc.) - do I really want the government to have a national health care plan? If they can't manage the military HMO, have problems with Medi-Care, I would shutter to think what damage they would do with a national health care initiative.

    All that being said, it is very apparent that our govenment only supports the troops while they are deployed. Once home, they simply get lost in the system and forgotten. Supporting our troops means supporting them not only while deployed but also upon return and thereafter. Something our government (and current President) seem to lack the concept of.

    March 20, 2008 at 4:12 pm |
  3. Annie Kate

    I've heard it said that when all the costs are added up for the Iraq war it will be over a trillion dollars. That amount to me is staggering. Unfortunately, though I don't think that trillion included funding to help the veterans once they return home. If we can spend a trillion dollars on items that kill why can we not seem to budget and implement an effective program to help our veterans once they return home? We need to keep people aware of stories like Kari's in an effort to raise awareness and support for the military to deal effectively with PTSD not only for the veteran but for the family members it impacts as well.

    Annie Kate
    Birmingham AL

    March 20, 2008 at 3:47 pm |
  4. Daniel Christopher

    Reintegration issues seem to be often overlooked when addressing the effects of the war in Iraq and Afghanistan. It is refreshing to see such a well-researched and thought out piece on one of these issues that is affecting so many of those that have served our country. Mr. Rieckhoff has an incredibly important job in making sure that these veterans are not over looked. PTSD is a problem in every war and must be the most difficult part of coming back. Apparently, our government is not handling this problem in the most efficient way possible, and, as the author points out, another form to fill out is not a way to deal with the problem. Awareness on a greater scale is only the first step to changing the system. Hopefully, these discussions continue and realize a system that truly addresses these problems.

    March 20, 2008 at 3:21 pm |
  5. xtina

    Im sorry for Keri, and she should get the best of care for what she's suffering; however I sense the media puts stories out there like this to garner anti-war sentiment. Are you using Keri's story to make people feel guilty? I still think free nations have an obligation to seek out evil and Islamic terrorism where it starts and to destroy it there, to take pre-emptive action. Thanx

    March 20, 2008 at 1:57 pm |
  6. Jan from Wood Dale, IL

    It is my understanding that multiple and extended tours have increased the probability of developing adverse psychological reactions. I've seen some statistics that 1 in 8 returning soldiers suffers from PTSD.

    Unlike some other wars, where many women served in war zones, they were somewhat restricted to non-combat duties. Because our military resources are so limited, our service women have been utilized differently. It would be my guess that many of these sexual assaults are not taking place in base camps, but while on patrol.

    It's stories like this that CNN should be running on each of their shows, and re-run them next month when General Petraeus and Amb. Crocker report to Congress on the progress in Iraq.

    March 20, 2008 at 1:25 pm |
  7. Tammy

    As a counselor, it frightens me to know that our soldiers and their families are not getting adequate mental health treatment. I do not even want to imagine the consequences of this long-term. As a cousin and friend of US soldiers, I cannot even begin to tell you how this panics me. I have a picture of my cousin taken before he left for Iraq the first time. That man who left is not who came back to us. I realize combat changes a person, but this goes beyond change. When I look at his photos during and after his tours, it's as if I see a ghost of who he used to be. He has never talked about his experiences in Iraq with me. He normally talks about everything major that upsets him. My professional gut instinct says something is wrong. My older cousin gut instinct knows something is wrong. These are the casualties that won't get written in the reports or told in the news long-term. These are the costs the Bush administration didn't plan for or didn't care about (I'm beginning more and more to believe it's the second instead of the first). These are the things you need to keep reminding America about. These are the things you need to ask the presidential candidates about, especially John McCain if he's planning to keep us over there for 100 years if necessary. It's lives of Americans at stake. And they deserve a whole lot better than what the nation they served and lost pieces of their lives for is currently giving them back.

    March 20, 2008 at 1:17 pm |
  8. Carol B., Virginia

    Clearly, the environment needs to be safer for female soldiers. Shouldn't the crime be dealt with at the time?22 percent is a high number and they shouldn't have to fear retribution for reporting what happened. It's unfortunate for both male and female soldiers that PTSD is still seen as a weakness and not a serious psychological effect from war or other traumatic life events. However, if it's not a physical injury you can see, it might interfere with the mission or multiple deployments, yes?

    March 20, 2008 at 12:37 pm |
  9. Tina

    I was saddened by the report last night regarding the female soldier. I am glad you reported that things are improving for her and I pray that continues. She has beautiful children who need her love.

    Cindy mentions our government is failing our soldiers. Yes maybe we could mention that those employees seem to be failing many of our soldiers, but remember the government is US. We the people. We the people provide the funds necessary for this employment and programs. So do they need more money? Or do they need employees who actually care about the people they are serving and less about their "job". That is a very tough question to answer because that job allows them to live a lifestyle. A lifestyle that is increasingly more expensive to live. Got to have a new car, got to have a nice house, got to wear the fantastic styles, got to have the latest.

    Lesli asks what is different today. The difference is ourselves, our communities and our lives. We appear to be competing with each other. Constantly being told via media and marketing that we need more, deserve more and the lifestyle we want requires material things – houses, cars, clothes and money.

    After WW2 we gave to help each other. We wanted to help each other. A very familiar feeling from 9/11. I was not as angry at those who did that to us and I was hurting for those families. I was more willing to give of myself and my gifts to help others. Bad things happen to good people, people take advantage of everything they can. But can the good people help the good people; and yet continue to do so when others take advantage.

    Candidates are raising millions of dollars for a JOB. Why can't, don't we raise millions in the same way for these types of injustices and as Americans take care of each other. Personal responsibility can not be ignored, but there are people who need support, resources and help. This needs to include also a smile, some genuine caring for the end results and quite often a Thank You.

    March 20, 2008 at 12:31 pm |
  10. Ham

    This is a pretty good argument against socialized medicine... when the gov runs something... this is what you get.

    When I got back I filled out my forms... and recieved several calls requesting more information based on my answers... they also were very insistent about ensuring I knew I could make appointments to discuss or question any issues I was having. I've never taken them up on it... didn't feel I needed it... but it was nice knowing so many were there for me if I did.

    As far as this being different from other wars I doubt that's true. Just more attention... Vietnam vets had a lot of stress... I suppose WW2 vets did as well depending on what they saw... but people didn't open up as much back then it seems. In fact... most didn't talk about it at all.

    March 20, 2008 at 12:19 pm |
  11. Adam

    This is an interesting article with facts I hadn't thought about, sadly, until now. The war in Iraq is something I totally do not understand or agree with, and I know that many of the admirable men AND women serving our country do not agree with it either, but feel they need to out of some sort of obligation. But obligation to what? I find is very sad that the vice president (NOTE: lower case) of the United States of America can reply, "So?" when told that two-thirds of Americans do not support this, for lack of a better word, DUMB administrations decision to invade Iraq, resulting in the deaths of tens of thousands of people, Americans and others. I have never served in any branch of the armed forces, but I do suffer from mental health problems, such as depression and nervousness, and can only say that I truly feel for those brave souls who come home to the USA with so much emotional baggage that they didn't ask for. I long for the day when I can once again say that I am proud to be an American.

    March 20, 2008 at 12:16 pm |
  12. Lesli

    I am glad you aired this segment last night on the female vet. I was not surprised by the sexual asault statistics. Nor was I surprised that the military said her complaints where withough merrit. It does matter whether its military or civilian, sexual harrasment is very common place. The problem with the military is you can't walk away from it like you can in civilian life.

    My thoughts and prayers are with Keri C. On of my girlfriend's husband was in Desert Storm and Somolia. It has caused havok in both their lives and their childrens.

    I have to wonder what is so different from in this war that there is so much trama and resulting suicide,. Compared to WW1 and WW2 where my father in law served in one and my husband's grandfather in the other. Neither man ever talked about their experiences once the arrived home, and both had healthy long lasting relationships with their families afterward. There was no outward signs of trauma or stress. What is different about the wars or the way in which our vets handled the aftermath?

    March 20, 2008 at 11:56 am |
  13. T.E

    I'm not sure why there is this big hype about the "5th Anniv." of the Iraq war. We should be beating down the White House door begging the "President" to send our troops home. 4000 dead , even more who've lost limbs and mental stability isn't that enough. I can't see anything positive that has happened their since this all began. I think it is time that "our" government take care of "our" problems and leave other countries to care for themselves. It seems to me that the "Noble War" as President Bush called it, hasn't help much. I think the people of Iraq was better off 5 years ago than they are now. We've lost family and friends there and so have the people of Iraq. Just imagine if you were a little child and in one day your whole life changed for the extreme worst because another country thought you'd be better off if they invaded to help liberate you. Is this "Noble War" really worth the price of so many innocent lives. If I'm not mistaken I don't recall another country in helping us with our poor economy or awful educational system. And what about our healthcare. I haven't read in any history books or encyclopedias that any country lead campaigns against the USA to liberate the slaves and the Native Americans here in America. I'm not sure government realizes that the minority citizens such as Afro. Americans, Hispanic, Native Americans, Asians, etc. need their help. When is the government going to start the "War on Terror" on American soil. We have our own home grown terrorist to think about(KKK and other extremist groups). I think the next time we decided to put on our Super Hero cape and try tosave another country, our " leaders" should ask this question first – Is the country we are about to invade and destroy asking for our help or are we demanding to save a country who is not asking to be saved?

    March 20, 2008 at 11:50 am |
  14. Cindy

    It seems that the government is failing our vets once again. If these soldiers did what they were asked and risked their loves why can't they do the right thing and take care of them? Do they honestly think that filling out paper after paper is going to do anything to really help this person suffering from serious traumas mentally or physically? All it does is make them disgusted in the system and turns them away from the help that they really need. We need to step up and make it easier for them to get help for these problems. But what can we expect...look at how this government has been run thus far! Hopefully something can be done to change it.

    Cynthia, Covington, Ga.

    March 20, 2008 at 11:15 am |