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The psychological toll of Operation Iraqi Freedom and Operation Enduring Freedom “could well be [our] generation’s Agent Orange syndrome,” one veterans’ advocacy group warns. A bill to increase federal spending on mental health treatment for our troops is under consideration in the House. Its sponsor says returning soldiers could suffer post-traumatic stress disorder (PTSD) at rates “roughly comparable” to Vietnam War veterans.
With the Department of Veterans Affairs being pushed to treat a new generation of veterans, it now seems a good time to reassess our psychological care of Vietnam’s veterans. What did our work with them teach us about effective rehabilitation?
There is no simple answer. We can never know how many Vietnam veterans were afflicted by PTSD, but some suggest that care provided through the Veterans Administration (now the Department of Veterans Affairs) medical centers—despite the best of intentions—played a role in many veterans’ becoming chronic psychiatric patients. This resulted, some clinicians speculate, from a confluence of practices considered state-of-the-art in the’70’s and ’80’s, when Vietnam veterans first began to seek care. Many VA Veterans Affairs mental health workers commonly believed--—and many still do—that participation in war automatically results in post-traumatic stress disorder. In communicating this notion to veterans, they set up the expectation of illness. In addition, treatment itself was regressive, involving the incessant re-telling of war stories with insufficient emphasis on practical problem-solving. Finally, generous Veterans Affairs entitlements for chronic PTSD may have created financial incentives for veterans to claim psychological disorders and reduced the motivation to recover.
A panel of mental health experts, military experts, and Veterans Affairs officials will discuss the Vietnam generation’s lessons for veteran rehabilitation and how to apply those lessons to the treatment of new veterans.