PTSD and Purple Heart requires knowledge

American soldiers who suffer post traumatic stress disorder would be awarded Purple Heart medals, usually given to those who are wounded in action, under a controversial plan being actively considered by the Pentagon. 40,000 American troops have been diagnosed with PTSD since 2003.

By Tim Shipman

Nine decades after soldiers were executed for "cowardice" brought on by what was then called shellshock during the First World War, veterans of Iraq and Afghanistan may be the first to have their mental injuries treated the same as battlefield wounds.

US Defence Secretary Robert Gates has urged Pentagon advisers responsible for battlefield awards to study the proposal after Army psychologists said widening the criteria for a Purple Heart would increase the acceptance of soldiers suffering from PTSD, and persuade more to seek help for their problems.

Pentagon figures show that 40,000 troops have been diagnosed with post traumatic stress since 2003 but it is classified as an illness not an injury, making it ineligible for a Purple Heart under current rules...




Officials say one in eight combat troops in Iraq and one in six of those in Afghanistan are taking prescription antidepressants like Prozac or sleeping pills.

John Fortunato, a military psychologist at Fort Bliss, Texas first suggested Purple Hearts for PTSD last month. "These guys have paid at least as high a price as anybody with a traumatic brain injury, as anybody with shrapnel wound," he said.

Mr Gates immediately proclaimed it an "interesting idea" that needed to be looked into." But the plan has sparked a fierce and impassioned debate among the US military, with a flurry of comments in the pages and on the websites of publications like Stars and Stripes and the Army Times.

Ray Kimball, an Army major who helped found the Iraq and Afghanistan Veterans of America support group, is a strong supporter. He believes the move would have "huge impacts on the perception of mental health issues in both the Armed Forces and society as a whole".

He said: "PTSD is a combat wound. We already treat it as such for the purposes of medical evacuation, readiness for combat, and post-service disability assessments. So let's take it one step further."

But an anonymous Army intelligence officer told Army Times: "It's an insult to those who have suffered real injury on the battlefield."

The veterans group whose mission is to help those who have won the Purple Heart is opposed to the proposal because the medal is supposed to be awarded to those wounded as a result of enemy action. Jack Leonard, of the Military Order of the Purple Heart who won the medal in Vietnam, told Stars and Stripes that there would always be confusion about the origins of post traumatic stress.

"Did it occur in boot camp? Did it occur because of the rough air flight into theatre? Or did it occur because an individual saw the results of the Taliban massacre of a village? I can't answer that," he said.

Mr Leonard said that his own father suffered from PTSD fighting in the Second World War and again in Korea and was close to suicide at the end of his life but he insisted it was right that his father did not receive a Purple Heart. "There's no physical manifestation that he ever shed blood," Leonard said.

Older veterans groups like the American Legion and the Veterans of Foreign Wars agree. For the most part it is those with experience of fighting the war on terror that are pushing for a change.

But even some older veterans have been convinced. Marine Master Sergeant Jack Perry told Marine Times: "I have suffered from PTSD every day for the past 35 years. I am a Vietnam vet, I'm 58 and I have been clinically diagnosed with PTSD. I never once thought I should have received the Purple Heart.

"But after reading the article and knowing and understanding what I have lived with and went through, I am appalled at anyone who believes PTSD is not a war wound and does not deserve to be awarded the Purple Heart."

Earlier this month Col. Lorree Sutton, an Army psychiatrist who runs a new facility to treat PTSD, revealed that she has persuaded senior military officers to record video testimonies of the their own emotional struggles after combat. The videos will be posted on YouTube and MySpace later this year to try to reduce the stigma of PTSD.
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I've been posting on this for a while now and as I always point out, trauma is Greek for wound! Knowledge of what PTSD is key to addressing this issue. The Purple Heart was not created for a wound, but was changed to be given for being wounded in combat. Can you think of anything else more traumatic than combat? So what's the issue here? Lack of knowledge of what PTSD is, what causes it and to stop treating PTSD as a wound of a lesser degree.