By definition "Post-traumatic stress disorder (PATS) Is a mental health condition that's triggered by a terrifying event ? either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event" (PAP, 2000). PATS is diagnosed used the Diagnostic Statistics Manual (ADSM). To summarize the diagnosis, "Diagnostic criteria for PATS include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: Intrusive recollections, avoiding/numbing symptoms, and hyper-arousal symptoms" (PAP, 2000).
Most importantly, diagnosing PATS takes over a month and final diagnosis isn't reached until after six months. This means that a person can experience these symptoms for p to a month without being diagnosed. History The history of PATS can date back to pre- industrial times. But, it most notably came to age in the 20th century. During World War l, this mental condition was known as solution fast. Often times, it would cripple a soldier leading him off the battlefield and sent home. Soldiers named and defined the term themselves. The symptoms were fatigue, tremor, confusion, nightmares, and impaired sight and hearing.
Doctors diagnosed shell shock when a soldier was unable to function and nothing appeared to be wrong physically. The "shell shock" diagnosis was initially reserved for notations that follow a concussive shock delivered by high explosives to the head or spine (Young, 1995). Sadly, shell shock was considered cowardly (Young, 1995). It was a debatable illness and highly stigmatize disease because soldiers are supposed to be tough. In WI, American physicists gave shell shock a new name, battle fatigue. This new name for shell shock was still not universally accepted.
Leaders of the American Army still showed no sympathy for this mental illness. The general consensus was that if the soldiers aren't physically injured then they need to get out of the hospital and return to war. But in 1946, the National Mental Health Act was passed. This provided expansion of mental health facilities in America for veterans. Most notably, the Veteran Affairs (VA) hospitals mostly cared for battle fatigued soldiers (Young, 1995). During the Vietnam War, the ADSM-II was released. The ADSM- II literally had no diagnosis for combat stress even though the ADSM- I had "gross distress disorder".
The Vietnam War was the first time the U. S. Tested the strategy of twelve month deployments. In earlier wars, soldiers didn't return home from war until the war was over. This was the reason PATS had such a delayed onset (Meager). Vietnam veterans returning home from war found it impossible to seek medical care from the Veteran Affairs office due to this (Meager, 2007). The Veteran Affairs medical staff had a difficult time treating soldiers from the Vietnam War because they couldn't find reliable data since the name of the symptoms changed every major war.
According to Meager, psychologists, Vietnam veterans, and anti- war activists huddled together to push PATS in the ADSM-III in 1980. PATS was first defined as being triggered by "events that were unusual". Just having an official name prompted scientist to begin studying everything behind the disorder (Meager, 007). Scientist and physicians have now added a great amount of new diagnosis criteria to the ADSM-IV, as mentioned in the introduction. Today, the United States Army is all volunteers. Soldiers now sign up for a specific amount of time.
Meaning, when the soldiers deployment is over, the soldier is still in the Army. During the Vietnam War, soldiers were drafted from the U. S. Population. The soldiers would serve a specific amount of time in theatre and return home to their families. The importance of this is that these volunteer soldiers face multiple deployments during their contracts unwillingly. A veteran of the Iraq war saw this as an "attempt to turn our fighting men and women into Rumba- like killing machines" (Meager, 2007, peg. 95). But, the United States Army battles to reduce the mental cessation of killing via "Total Control".
This program concluded that trained soldiers are more likely to shoot at an enemy only after being fired upon. Unfortunately, preventing psychological problems seems ineffective in this "Total Control" concept" (Meager, 2007). Many types of efforts are being made by the United States Army to combat PATS. In 2004 at the beginning of Operation Iraqi Freedom, Operation Stress Control was initiated. This was a Joint mission between the Army and the Marines to treat mentally ill Iraq to treat American soldiers emotional, cognitive, and behavioral components of combat stress (Meager, 2007).
The ADSM-V was added in May 2013. The manual still contains mostly the same data from the ADSM-IV. The changes are seen in the length of time it takes for diagnosis. It appears that PATS is here to stay in the medical world. Significance of PATS The main reason I'm interested in this mental health topic is because I served in the military and hate to see the greatest people of my generation suffering from their heroic actions. These men and women signed up to fight an unknown enemy on foreign soil after the disastrous events of September 1 1 the, 2001. Some of these soldiers were deployed three times in one contract.
These soldiers are exposed to death, injuries, and extreme conditions. When the soldiers come home, they are exposed to nightmares, panic attacks, flashbacks, and negative symptoms that are triggered by normal everyday transactions. The significance of PATS lies in the statistics. The correlation between PATS and suicide is far too high. A study found that the higher the amount of traumatic events a soldier witnesses, the more alienable the person is to suicide (Friedman, 2004). The suicide rate in active duty soldiers and veterans is the highest it's ever been.
During the Iraq war soldiers were committing suicide at a rate of 16 suicides per 100,000 soldiers. At home, soldiers were committing suicide at a rate of 11 per 100,000 soldiers (VIVA, 2009). Therefore, the Army is seeing veterans commit suicide before, during and after the war. This is largely agreed to stem from PATS. Vietnam, Iraq, and Afghanistan veterans committing suicide account for 20 percent of all suicides in the United States. In addition, veterans account for 13 percent of the population. The suicide rate triples from veteran to civilian peers (VIVA, 2009).
It is important to note that it is impossible to have an exact estimate of the suicide rate in veterans. The Department of Defense does not keep a record of this statistic (Meager, 2007). This makes sense because an organization does not keep records of facts they don't want to know. It is up to the families and coroners to label each suicide with veteran status to add to the statistics. Another issue is that we see homeless people committing suicide. It would be impossible to know if they were a veteran. Stigma from Culture and Perception In the United States, it seems as if every mental disorder has a tremendous amount of stigma.
Stigmas surrounding mental illnesses found in civilian society carry over to the military. Veteran personal don't seek treatment because they are afraid of the consequences (Friedman, 2004). It is estimated that close to fifty percent of Iraq and Afghanistan war veterans with PATS will not seek treatment because they will be seen as weak by fellow soldiers (VIVA, 2009). Unfortunately, this stigma exists through past experiences of their peer's treatment towards PATS (Meager, 2007). Soldiers who have PATS are twice more likely to claim this stigma than soldiers without PATS.
I would like to add my personal perspective. While serving in the military, any form of medical treatment was discouraged by first line leaders and peers. The first step in treatment is declaring to your First Sergeant that you want to go to "sick call". This is a request to seek treatment from a physician. This is done at 5:30 in the morning. Soldiers must wake up extra early and confess their illness to a non- physician before seeking treatment. This is a systematizing experience because a soldier's First eve a physical or mental issue, it may set you back from a promotion.
In addition, if you went to "sick call" too often, you were labeled as a "sick call ranger". This is a negative term in the military. A soldier is considered weak if he or she seeks medical treatment. Often times, soldiers who had the flu, a swollen ankle, or a mental issue did not seek treatment because they were scared it would affect their career and reputation. The culture of being strong and masculine is obvious in the United States military culture. Case Study of PATS I would like to share a personal case study of PATS. I served with many great men and women in the Army from 2009- 2013.
I still keep in touch with many fellow soldiers. In a recorded telephone call, I interviewed former Staff Sergeant Anthony Poll. Staff Sergeant Poll served in the Army from 2005-2011 as a forward observer. He was responsible for calling in airstrip's and artillery strikes on nearby enemies in Iraq. He served three tours in Iraq during his six year stint in the military. He was diagnosed with PATS from the VA hospital after he was honorably discharged from the Army. I wanted to find out why he never sought treatment for PATS while serving. Anthony Poll said to me, "l didn't seek treatment because I was afraid I wouldn't be promoted.
At the time, I wanted to make the military my career and I thought that I would be seen as a weak soldier if I talked about that stuff. " This is one case that proves the stigma surrounding PATS and the military. Next, I asked Staff Sergeant Poll why he left the military, because at the time he told me it was becoming too physically tolling on his body. He claimed, "l left the Army because I was having nightmares and panic attacks. I knew I had it (PATS). I didn't think I could lead men into battle while suffering from it. I had many dark days where I thought I couldn't survive through it.
I figured I could leave the Army and seek treatment since being in the Army with it (PATS) is impossible". Sadly, this seems to be a recurring theme in the Armed Forces. During the interview, it was obvious that Poll believed he would have never been promoted to Staff Sergeant if he had sought treatment for PATS. Medication, appointments, and stigmas would have keep Poll off the deployment list and training schedules. I was surprised Staff Sergeant Poll volunteered for this interview, but he told me that being out of the military helps in the treatment of
PATS. Not every PATS story like Staff Sergeant Viol's is simple. For example, Joshua Lee Movie provides the world with a traumatic experience with PATS. He refused to seek treatment after returning from war because of the stigma of disclosing it to the Army. Like Poll, he believed that it would put his career at risk. In addition, he wanted to become a police officer but believe it would be impossible after they found out he had PATS. Sadly, he committed suicide six months after returning home from his eleven month deployment to Iraq (VIVA, 2008).
Staff Sergeant Poll and Joshua Lee Movies story are Just two case studies that show the significance of the PATS problem. The stigma surrounding the PATS in the military is too high. The culture of trying to be labeled as strong and defiant is crippling many soldiers. In 2012, active duty suicides were more than combat related deaths in Afghanistan. Most of these deaths were contributed to PATS (VIVA, 2008). The Department of Defense is enforcing many campaigns to combat this stigma, but it starts with the leaders of every individual unit to fight the systematizing culture.
Socio-cultural Context the United States for many different reasons. Considering the socioeconomic diversity of the people coming into the armed forces helps us get a better grip on PATS (Collar, G. , & Lend, D, 2012). Collar and Lend argue that most U. S. Recruits come from a low socioeconomic class. The lower classes do not have money for college and the United States Army is seen as the last resort to a steady life for many high school graduates. The Army offers many incentives to Join such as signing bonuses, free college, and free health care. (Collar, G. & Lend, D, 2012) On page 136," The decision to enlist as a last resort alternative because of economic hardship rates a sense of forced military service in which deep-rooted motives such as patriotism, honor, sense of duty, and an overall true excitement about volunteering for service in a time of war can be artificially present(Collar, G. , & Lend, D, 2012). " Arthur Galilean in his article "Rethinking Psychiatry' offers that most mental disorders are most prevalent in the lowest classes of society, poor people. In addition, minority groups such as Hipic and African American are at higher risk for mental disorders (Galilean, 1988).
I can conclude that the recruits that come from the low lass in the United States are more prone to PATS because deeply rooted motives such as patriotism and honor are sometimes artificial. Often times, leaders have to tell their soldiers to do things that are morally wrong such as firing near children or killing innocent people. When soldiers with artificial patriotism experience this, their trauma is far higher than that of a fellow soldier who believes he or she is doing the action for their country. In addition, many recruits could have multiple mental illnesses present before Joining the Army.
For example, when I enlisted in the Army I was never given a thorough psychological exam. I was given a thorough physical exam where doctors would try to find anything physically wrong with me. I was stripped down to my underwear and told to walk, bend, and sit in different unique positions. This made sense to me because the Army would save money on future health expenses of incoming soldiers. But, it was interesting to me that the Army never gave sat me down with a psychiatrist. A recruit is told to disclose any mental health history, but if the military is a last resort option many recruits simply lie.
If you are fighting a war with depression, bi-polar illness, or schizophrenia to odds of you evolving PATS would seem high. Relating PATS We can relate PATS from war in other avenues such as the effects of the drought in Australia to farming men. Margaret Olsson and Jenny Kent explore the link between rural masculinity and poor mental health outcomes in their article "The Big Dry'. Masculinity in these farming men was a great quality to possess when water was plentiful, but when a drought took place masculinity was extremely unhealthy (Olsson & Kent, 2006).
This statement ties into soldiers because masculinity is a great trait to possess while fighting a war, but when the war is over a soldier must overcome their salinity to seek treatment for PATS. When the "Big Dry' hit Australia, farming men had to face an impending doom by either selling their farm or working countless hours tending to their farm. But, the masculinity in the Australian farmers kept them from selling their farms. This resulted in men working tirelessly on their farms with and many committed suicide or abused alcohol (Olsson & Kent, 2006).
In correlation, some men returning from war are faced with the impending doom of PATS. Instead of going to a physician, soldiers try to be immaculate about this issue. Often time's, suicide and substance abuse is the result of their masculinity. It is the masculinity and stubbornness of Australian farmers and soldiers returning from war to try to fight mental illnesses on their own. This leads to suicide and/or substance abuse. The drought in Australia and the mental illnesses that follow can be summed up by what is called isolating.
It is a new term that was coined by Glenn Albrecht as "a form of psychic or existential distress caused by environmental change. " Many analogies can be drawn between isolating and PATS. Albrecht argues that people feel distressed when they perceive their environments as harmful (Albrecht, 2007). This relates to PATS in war because when mentally ill soldiers return home from war, they perceive their local environments negativity. This means that the soldier believes their home environment has changed negatively. Soldiers have a feeling of, "nothing will ever be the same" when returning home from war.
This is followed by depression, substance abuse, and trauma if not treated. In addition to the effects of the drought on Australia farmers, PATS can be related to the historical trauma in the Flathead Indian tribe of Montana, United States. Dry. Maria Yellow Horse Breather says historical trauma is "cumulative emotional and psychological wounding over the lifep and across generations, emanating from massive group trauma (Breather, 2011). " Dry. Theresa O'Neal in her book "Disciplined Hearts" discusses the structural violence in the Flathead Indian tribe that has always instigated historical trauma.
The Flathead Indians have had their culture stripped away by the Euro-American culture due to institutionalized misunderstandings. Therefore, historical trauma exists in Iraq and Afghanistan war veterans. This is showed through to history of PATS, an emotional and psychological wounding throughout all wars. In addition symptoms of PATS have existed throughout all wars resulting in massive group trauma. Conclusion The Veteran Affairs Office still hasn't lived up to its mission statement that it will do everything it can for the United States Veteran.
Every year, the Veteran Affairs office underestimates the number of new PATS patients. For example, in 2006 the VA expected 2,900 new cases from Iraq and Afghanistan veterans. But, the hospitals saw a staggering 17,827 new patients for PATS. The quality of care for United States veterans is hindered by the shortage of trained mental health providers and an inadequate screening process. (VIVA, 2009) PATS develops over a long period of time. Catching the illness earlier is the key to treatment (Young, 1995).
In addition, the United States civilian treatment of soldiers when they return home from battle is critical in the development of PATS. Soldiers from the Vietnam War returned to negative welcoming which seems to help the development of PATS. It was shown through Vietnam veterans that Just having someone supporting them showed the most progress in their treatment of PATS. Now, Iraq and Afghanistan veterans are honored at sporting events, television commercials, and movies. This helps the soldier disassociate from the cause of the war helping him or her readjust to society (Friedman, 2004).
It is time for the Department of Defense and Veteran Affairs to do for his country is good enough to be given a square deal afterwards". The Department of Defense needs to increase funding of the Veteran Affair's office as the war in Afghanistan is dwindling down and the Iraq war is over. Of course a broken bone is easy to fix, but a broken mind takes time. The Department of Defense needs to flood the VA with mental health physicians and fund new studies in the treatment of PATS. If not, the United States will lose a great amount of the greatest men and women of the millennial generation.