There is a discussion underway at the Pentagon about whether war veterans returning home with Post Traumatic Stress Disorder (PTSD) should be awarded the Purple Heart. Here is an article about this discussion. I am truly torn on this issue. I know PTSD is a real thing, I've seen it up close in with many of my friends from Vietnam and more recently with my nephew returning from Iraq (who by the way was awarded a Purple Heart for physical wounds he received in battle - he didn't want it). But, is PTSD the sort of thing we should be giving a medal that has in the past been reserved for those physically wounded in battle? Does it lessen the significance of the Purple Heart? Combat is a traumatic thing and it affects everyone and anyone involved in it. Some more severely than others, but still. Is it the same thing as losing an arm or a leg? I honestly don't know. So, the question I pose here for debate is the following:

Should the military award a Purple Heart to combat veterans with PTSD? ( the why or why not is implied)


Aquilla

Should the military award a Purple Heart to combat veterans with PTSD?
No. While the severity of your wounds during war isn't an issue when you're considered for a purple heart, psychological problems arising from war isn't what Washington, FDR, JFK and Truman wanted to recognize as eligibility expanded to include civilians acting under orders.

PTSD warrants years and years of medical attention. We have tens of thousands of Iraq and Afghanistan veterans seeking medical help, perhaps because the stigma associated with PTSD, depression, etc. isn't as strong as Fortunato thinks it is, and a record number of them being diagnosed with mental health problems while Veterans Affairs tries to cover up the suicide risk! Some active duty members don't get help because they're afraid their careers will be hurt. Gates addressed this by changing a security clearance form. I don't know if the policy will work in practice, but at least the bureaucrats are trying to mitigate the stigma.

If Fortunato wants to do more to help suffering veterans he should talk to Gates about the military's need to address the number of veterans suffering from mental health problems today and years after we're out of Iraq/Afghanistan. We shouldn't worry about veterans that may not seek help because of social repercussions when we can't adequately care for veterans that already sought treatment. Making sure we have the capability to treat every veteran with the same level of care is more valuable and more difficult to attain than a piece of cloth and medal.

This is an problem that has been with us for a long time, the mental toll of war came to the fore, but was still stigamatised, in WW1. It is real but because it is a mental issue it carries a heavy stigma. Try telling your boss you have to take time off work for a mental health problem, and what is the short term and the long term reaction of the boss and the organisation?

Yes - Why? because with this level of mental damage, the person who went to war is lost forever, they are not coming back. The person who comes back is profoundly changed and damaged. but it won't happen

Why not - because its a mental health issue.

Lets take another grey area - concussion injuries... You can be disabled from a concussion injury, knocked out for 5-30 seconds, it doesnt leave a visible mark , not even visible on a CTscan, but the symptoms develop a week later and your life is wrecked forever. Are they getting purple hearts? Not according to these criteria

Derek - Two Uncles who both should have been diagnosed PTSD both civilian both Merchant Marine

Should the military award a Purple Heart to combat veterans with PTSD?

I'm not sure a Purple Heart is appropriate. Wouldn't a Bleeding Heart medal be better? After all, it has been liberals sounding off about this for centuries that has made the military pay attention. Wars really mess people up. The physical wounds heal and the vets compensate for lost limbs. Actually, the tech on prosthesis limbs has really taken off. The tech on psychological wounds involves drugs that have bad side effects and aren't well understood.

So make a new medal. Make it in a shape of a heart, put a crown of thorns around it, red and gold ribbon, red on gold medal. Also pay our soldiers better because it's disgusting how much more the mercenaries get. And boost up VA bennies.

We could also use that flashy pen they had in the movie MIB. It would really cut down on the homeless vet problem.

But overall, be more careful about waging war. We shouldn't be needing more medals.

Should the military award a Purple Heart to combat veterans with PTSD?

I've been thinking about this topic for a few days now, since I read the article in the news. And it has taken me that long to reconcile my opinions on this.

Although PTSD should be addressed as a legitimate and widespread mental health issue, and addressed at the highest levels of military command and medical levels.........I don't believe it to be in the same category as combat trauma injuries. A physical trauma injury is going to affect all soldiers similarly, whether an IED, RPG, gunshot or grenade. PTSD is going to effect - or not effect - some soldiers and not others. The physical wound can always be life threatening, by virtue of trajectory and other factors; PTSD isn't commensurate in that regard. The injury and the diagnosis [or mis-diagnosis] of it leave too many gray areas. I am glad that the discussion is taking place, and I hope that more treatment becomes available to service members who are diagnosed with PTSD, but I don't believe this to be the right course of action. I'd much rather see more funding go to the VA since we seem to have unlimited funds to send men to war, we should spend proportionate funds to care for them after the machine has used them up.

Further, there are many soldiers who do not want the associated stigma of having PTSD. Nobody wants a Purple Heart to begin with, but there is less shame for most in uniform when they can at least point to a physical trauma [the whole chicks dig scars mentality comes into play]. Soldiers are going to feel stigmatized while in the military for having a medal awarded for [in the minds of some] not being able to hack it. With physical trauma, the Purple Heart recipient will only have to endure the emotional impact of the obligatory "you forgot to duck" jokes. They may likewise be stigmatized when looking for post service employment.



This one I can attest to personally. Concussion injuries do meet the criteria for award of the Purple Heart. The military [by necessity] has made some progress in the identification and treatment of concussions and MTBI (Mild Traumatic Brain Injuries). Everyone involved in a concussion producing event is automatically screened for MTBI. New helmets, not yet widely fielded, have sensors to detect the level of concussive force from a blast. Nobody to my knowledge, myself included, that has been diagnosed with a concussion injury has been denied a Purple Heart.

edited to add:

In the news today, some PTSD related news out of the VA.

An internal e-mail written by a Veterans Affairs Department employee suggested avoiding a diagnosis of post-traumatic stress disorder for veterans and instead considering a diagnosis that might result in a lower disability payment.

A copy of the e-mail was distributed Thursday by the groups Citizens for Responsibility and Ethics in Washington, a congressional watchdog group, and VoteVets.org. The e-mail dated March 20 had been forwarded to VoteVets.org, an Iraq and Afghanistan war veterans lobbying group opposed to the Bush administration's handling of the war and veterans issues.

It also said, "Additionally, we really don't or have time to do the extensive testing that should be done to determine PTSD."
Yahoo

I'm not sure which is worse, the first portion that I bolded, or the second portion.

Should the military award a Purple Heart to combat veterans with PTSD?

Of course.

Mental wounds and physical although differ in appearance are altogether the same.
If a soldier needs to spend time in a hospital for physical wounds, how is this different than spending time in a mental institution, or stuck at home because of his mental state?
The severity of PTSD changes, and it can be a depression or a mental breakdown.
Another question, how is a mental breakdown different than a physical breakdown?
The only difference is that PTSD starts from the inside, and works its way out. A physical wound is much more easy to honor, much more easy to set an example of a fallen soldier hurting for his country.
The difference is merely from the inside or out.

All of the following symptoms of PTSD are examples as to what can happen to soldiers with PTSD:

"persistent re-experiencing of the traumatic event(s).

avoiding experiences or people that trigger memories of such event(s).

increased arousal, to include nervousness, over-reaction to sudden noises, difficulty sleeping, and nightmares
bouts of "inappropriate" rage and-or depression.

difficulty relating emotionally to others.

feelings of extreme alienation and meaninglessness.

isolation from others

in the most extreme cases, persistent thoughts of murder and-or suicide. "
Source:http://bringthemhomenow.org/stand/ptsd.html

NOTE: This quote has been altered for portions of it that don't relate to the topic.


If a soldier commits suicide because of PTSD, or inflicts wounds upon themselves, how does that differ from being wounded or killed in combat?

Unfortunately PTSD is often fatal - More Military personell who fought in the Falklands war in 1982 have died from suicide than Argentinian weapons. And that was a short politically uncomplicated war.

A diagnosis method you cant cheat on is clearly what is needed (cheat as in fake you dont have it)

Thanks for the correction - On further research( which I should have done) it appears the forces are becoming definitely more enlightened to this than the public is to this prevalent type of injury in both Military and civilian life. But I gather that a mTBI does not get into the casualities figures Dept Defense release to the public. So the DoD thinks brain damage is not important or too sensitive? A screening of one unit of about 2000 personell returning to the U.S. found 1000+ to be at risk and revealed over 200 required further specialist treatment for mTBI. If this was civilian mTBI in the UK I was told you can expect 75% to 80% report to have no symptoms after 9 months but 25% will be affected permanently IRC. Some reports have put the ratio of permanent injury as being higher in the military casualites.
Even so over 2% of personell in Iraq (or any other war) being permanently brain damaged in the line of duty more than 20,000?
I now see that some units are screening before and after combat - even better -

• but are we going to like the result?
• will it be /has it been made public?
• will the public really want to know and do something for those so injured.

What has this got to do with PTSD? if we can break down the barriers for mTBI then I believe PTSD stands a much better chance.