Doctor: Vets Need More Basic Training

Health

Doctor: Vets Need More Basic Training
A Veterans Administration psychiatrist and researcher offers a revamped model for treatment of returning soldiers that looks to training and education as much as therapy and pills.

By: Ryan Blitstein May 17, 2008


With mental-illness rates climbing as high as 40 percent among American veterans of the wars in Iraq and Afghanistan, conventional wisdom holds that the U.S. must spend more on therapists for returning soldiers. In an upcoming article, a Veterans Administration psychiatric researcher suggests a different approach: Focus on services like job training and housing assistance.

Many veterans returning from Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom, like those coming home from Vietnam a generation ago, experience difficulties re-adjusting to civilian life. Particularly in Iraq, the mental perils of combat are exacerbated by unpredictable urban warfare and constant risk of roadside bombs.

Rates of post-traumatic stress disorder tripled among one sample of post-9/11 deployed soldiers compared with peers who did not face combat. As many as four in 10 may require mental health treatment, and several hundred have already become homeless, often after psychological or substance abuse problems made it difficult for them to function.

Dr. Daniel Luchins, a longtime University of Chicago psychiatry researcher, last June became chief of Mental Health Research at Chicago's Jesse Brown Veterans Administration Medical Center, part of the Veterans Health Administration, the largest medical system in the United States. Luchins' introduction to the VA came via a three-month stint treating mentally ill inpatients, primarily middle-aged Vietnam vets. Like many of their brothers-in-arms, they suffered from a variety of issues: "These people were homeless, strung out on heroin, alcoholics — whether they had PTSD or not is a minor issue compared to the sheer enormity of their psychosocial problems," Luchins said.

While millions of Vietnam veterans are thriving in civilian life, men such as those Luchins saw are one reason mental illness accounted for 28 percent of military hospital bed-days during the 1990s. Hundreds of thousands of veterans live on the streets, comprising one-quarter of the U.S. homeless population. As Luchins began treating veterans of current conflicts, he wondered what went wrong for so many Vietnam vets and whether the VA was doing enough to prevent such tragic outcomes from striking his youngest patients.
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