for Wall Street substantial theft has a personal value equal to that of a deity or golden calf or David. For military officers who believe they are minor deities or at least on the deity's staff but without the literacy for grand theft or Ponzi, peanuts are all that opportunity offers. I don't believe this is a PTSD issue, either.

My theory is that regardless of the war, past or present, these type of "PTSD" incidents are de rigueur of the current (post-Vietnam) veterans, veteran organizations, politicians and the media. They were always there and in numbers reflecting the volume of veterans from any war.
I have researched the deaths of veterans in my area from 1945 to 1950. The number of shattered lives and families, crimes committed, and deaths by alcohol and auto amazed me. I think we hear about it currently, beacause it is talked about so much. "Post Traumatic Stress Disorder", as an affliction with that title, has been 'in the system' but for less than 30 years.

PTSD has always existed. Vietnam Vets had it. WWII vets had it. Civil War vets had it. War sucks. It is traumatic. It effects the people involved. Some get better. Some do not.
PTSD was not well understood until behavioral health specialists started studying it after Vietnam. The creation (and politization) of the term came about in the early eighties and the creation of what became the Department of Veterans Affairs.
The "PTSD story" is often a hook in news stories, because it ties one person's problem with our wars in Iraq and Afghanistan. There might be slightly more PTSD today than in Vietnam because of the All Volunteer Force and a small slice of troops who have deployed too often without enough down time (or dwell time) but I doubt the rates are much different.
Vietnam, Korea, and WWII vets had problems when they returned. They drank. They got in fights. They beat their wives. We now understand that some of those behaviors might have been related to problems with PTSD. Or they might have just been people given to such behavior regardless. Some people get better. Some people do not.
The reason the military talks about such things and that it is discussed so often in the press and among ourselves is that we are trying to deal with this. We are understand PTSD much better now than we did in previous eras. The Marine Corps was teaching its Infantry Officers about PTSD in its "Killology" class years before September 11th. The other services are catching up and everyone understands it better now, but we are still learning. The system is getting better, with counseling and leadership that understands the problem more. But the system is imperfect.
I don't think that the guys who fought in Fallujah or the Korengal are any less tough than the guys who fought in the Argon or Chosin. I would not dare to make a comparisonout of respect for the vets of any era. We all did our bit and did the best we could to move on with our lives afterwards. Some of us had it rougher than others. Some of us adjusted better than others.
There is not more PTSD, just more PTSD coverage.

FG42,

You raise some interesting points. I don't have the answers per se, but let me contribute the limited reaserch I've done on this issue.

While your father-in-law (and my own great uncle) may have been in the ETO for nearly 4 years, they were not in sustained combat during all of that time. Right off the bat, that was one huge difference between then and today's 1:1 deployment cycle. The WWII Division with the most days of cumulative combat time was the 32nd ID - 654 days. It is worth noting that this time adds up to well less than 2, 1 year deployments to OIF/OEF. So, while the intensity of combat today may be less than WWII, initial first term soldiers are frequently seeing cumulative combat exposure that exceeds the time endured by the most exposed division in WWII. There is no rear area, there is no (legal) outlet for sexuality and there is no beer.

As early as 1943 we knew that prolonged tours had a devastating impact on the morale and neuropsychiatric health of infantrymen. Post war research showed that based on ETO casualty rates, 180 days of cumulative combat exposure represented the "burn out" point for front-line troops. In WWII, soldiers with >180 days of cumulative combat exposure had psychiatric casualty rates higher than new replacements.

The individual replacement system (seen in Korea and Vietnam) was designed in the wake of WWII as a means of decreasing psychiatric casulaties. Despite its mixed record in Vietnam, as late as 1988 articles in Army professional journals expressed doubt that we would ever return to a unit based rotation system.

Well, it's 2011 and we are stuck with a unit based rotation system. This system puts the well being of the unit over the individual soldier. The unit based system relies on things like stop-loss, the redeployment of soldiers with less than a year back stateside and the multiple deployment of first term soldiers and Marines.

In Vietnam, a first termer never had to go back unless they reupped or volunteered to. Not so today. Also, the transition to the AVF ushered in the era of the 4 year enlistment contract as the "norm" (up from a 2 year draftee contract and the 3 year RA volunteer). This ensures that first term soldiers and Marines can deploy multiple times before getting the chance to say "no more." This is important. A first term 11B in 1968 just had to survive 365 in Vietnam before getting a chance to exercise his informed decision to "stay" or "go." Today in the 101st or 10th Mountain, you survive your 365 days and all you have is another 365 days to look forward to before you can ETS. This really messes with the head. The light at the end of the tunnel is a looong way off.

Also worth noting is the change in 1984 that increased the total Military Service obligation (MSO) for all personnel from 6 to 8 years. This means that kids who did 2 combat tours in their initial 4 year hitch aare almost guaranteed to be recalled during their 4 year IRR time to go back again.

These are just a few, random data points that I wanted to share.

...wish I had a good answer. There's some easy delineations to be made and some not so easy ones.

First easy one is that PTSD or shell shock or battle fatigue existed in much greater numbers than people realize in all those earlier wars you cited. But the guys who survived it and were functional didn't talk about it, and those who survived it but weren't functional probably aren't in the circles we all travel in. They're part of the dysfunctional populace in homeless shelters and VA hospitals.

Second easy one is that like politics all wars are local. In other words it doesn't matter how many guys died in WWII or Vietnam, the stressors that soldiers experience in combat are all local in nature and relevant. In Iraq and Afghanistan it doesn't matter that only (only?) 5000+ people have died...esp. if every day you or your buddy is getting blown up by IEDs. It's scary, it's day to day, and it doesn't go away. And then you go home, redeploy and do it all over again.

Things start to get dicey after that. Your father-in-law may have done 4 years in Europe but he didn't do 4 years straight in combat. They tended to rotate units off the line back then and they recognized that 90 days was about what they could do before they were psychological casualties. The warfighters today tend to have more stop and go than that but they also probably have more 'threat' time in total. (This is dicey because it gets really hard to draw comparisons).

As for the amenities our soldiers have (which I've advocated against here before), there is a cost benefit to that too. The first obvious, but somewhat incongruent, one is that instant communication back home isn't all good. Soldiers don't get to get away from their problems at home, they are waiting for them on the Skype when they get back from patrol. They get a whole set of different stressors - like the bills that can't be paid or the problems with Johnny Jr. As late as '96 in Bosnia it still took me 30 days to get mail and hear about my girlfriend's issues, now you get that immediately. They also tend to rely on going to the computer instead of talking to their mates about what happened that day - which may be one of the most important factors in preventing this problem. History (and Dave Grossman) tell us that campfire stories and the lack of night fighting in earlier wars were inherent to the idea that soldiers decompressed after each day's fight. They shared their concerns, and realized (most importantly) that they were ALL undergoing the SAME thing.

Because we are more insulated and isolated as a society, because our soldiers retreat to the phone banks or Skype, they may not be getting the decompression they need. It's great to talk to the wife, but the fact is you won't generally share what happened with them because a) they don't understand b) you don't want to scare/worry them. So Johnny is marching alone. Because you are alone there is stigma associated with asking for help too.

Another factor in this decompression was travel times. In WWII your FIL probably took a month on a boat to get back to the U.S. That's a long time to decompress and come to grips with your demons. And you did that trip in the company of your squad mates. Now it's 24 hrs to a warzone by plane and we don't do an adequate job of forcing decompression back stateside - the last place you want to be is on post, you want to be drinking and sexing (sorry it is what it is). Or you want to be with family, anywhere but with the guys you spent the last year with.

Finally I'll say that technology and medical science has done us some questionable favors along the way. Soldiers in body armor, or who receive rapid medical care are surviving wounds they probably shouldn't. That's obviously in God's hands but it's clear with more survivors of more grevious wounds that commensurate mental health problems will come along with it.

I could go on and on offering ideas on why PTSD seems more prevalent, but my summary is a) it probably is no more prevalent just more recognizable and diagnosed b) if it is more prevalent it is because a myriad of social factors, which I don't think include "toughness." These wars are different than those preceded. Not harder, not easier, just different.

In the end as I stated in a previous post, PTS is a normal thing, it is how we react individually and collectively that sets the conditions for PTSD. There's alot more attention to things now, and greater understanding but we don't have all the answers by any means.

PTSD has been observed as far back as ancient times, and was a reported medical phenomenon for centuries. In fact, many psychologists linked the symptoms of PTSD to victims of train accidents. However, I think we only really began to understand it within the post-Vietnam era.

Did the World War Two era get PTSD? Absolutely. If I recall from one of my battlemind fitness classes, a very large portion of veterans who saw close combat during the Second World War exhibited signs of what we would now call PTSD. However, it was merely referred to as "shell shock" or "battle fatigue". In fact, my mother's uncle exhibited signs of PTSD after his experience during the Second World War, yet the family generally referred to it as "shell shock" and not PTSD.

I suppose that a greater awareness of PTSD leads to better identification of the symptoms, and a greater willingness to self-refer one's self for experiencing it.

"My question is this: Why does the current military seem to have such a high incidence of non-combat, psychological problems, compared to past wars?"

You would think, from current figures, that rates of breast cancer and mitral valve prolapse have been shooting up this decade, but the numbers are higher because (a) dignosis is made easier due to more sensitive (and cheaper) testing regimes and (b) the results of more sensitive and cheaper testing regimes raise awareness among diagnosticians to look for these and a host of other formerly hidden illnesses.

My brother, a leading PTSD clinician, is treating more Iraq and Afghan vets each year because (a) they need help more now than ever before and (b) that need is driving them from the shadows, where they formerly barely made do owing to military career or simply manhood issues. For what it's worth, Marines are probably least likely to seek timely treatment. Cops too.

The first officially sanctioned "combat fatigue" cases in U.S. Army annals were diagnosed in mid 1943 on New Georgia. The malady did not exist until it had a name and an agreed pathology. But of course it did exist, from time immemorial. If you use PTSD as a lens for history, you see it plainly, for example, in behaviors commonplace in the post-Civil War "wild" parts of the exuberantly celebrated Wild West.

Of course, PTSD is not just the result of war. Bad parenting is a nearly perfect predictor. So is a near-miss car accident. Degree and sustainability contribute, especially to severity.

The good news is that amazing outcomes are in the offing if PTSD victims seek treatment and stick with it.

One of the best books on PTSD is "Achilles in Vietnam" by Jonathan Shay. This book looks at PTSD through the lens of The Iliad and, just as interestingly, looks at The Iliad through the lens of PTSD. It explains Achilles and his actions in The Iliad as the story of a PTSD sufferer in a way that illuminates many of Achilles' hard to explain actions in The Iliad. One example is Achilles' desecration of the body of Patroklus, followed by breaking down in remorse and returning Patroklus' body to his father Priam. Further, it uses the accounts in The Iliad to illuminate the experiences of contemporary PTSD sufferers. The book does something really remarkable, in that in makes contributions to both classical studies (a centuries old field) with its new interpretation of Achilles and to psychiatry. Dr. Shay developed these ideas during his several decades of work with at the VA with Vietnam veterans, with groups of whom he read The Iliad.

What this fairly conclusively demonstrates is that PTSD has been with humanity throughout history, and that ancient cultures recognized and dealt with it in their own way. This terrific book should be much better known and on any decent military leaders' reading list.

Patroclus was Achilles' buddy. Hector (Priam's son) killed Patroclus and Achilles in turn killed Hector and then desecrated Hector's body.

And yes Shay is mandatory reading for anyone who wants to learn more about PTSD.

You're right. My fingers type faster than my brain moves.

The preacher that preform my wedding, one time told of having shell shock while at Iwa Jima. He mentioned the caves.

Also alot of fiction written after WW II talks of men affected by the war including "The Shadow"

And a draftee force is better equipped to deal with PTSD how?

Either the AVF is a damned superb professional force ... or we're wasting our money on an experiment with mercenaries. Trial by combat seems to be a legitimate test of armies. This one ain't winning no matter how much we dilute and dumb down the meaning of victory.

The argument for a draft is an argument for the traditional brake on imperial intentions, the mandatory caution our Founding Fathers wrote into the Constitution ("...raise an army...") as precaution against mindless executives. Had we a draft, we would have prosecuted the Afghan War with dispatch and left town. Had we a draft, the odds of the Iraq war approach zero. Had we a draft, the army in the field would be an American Army and not a bunch of hired guns.

In direct response: there seems strong correlation between the incidence of PTSD and the number of deployments and the duration of the conflict. Still engaged in Iraq and Afghanistan well past being our longest war ever, the AVF can take the full load of blame for the high incidence of PTSD onto itself and its failed concept. Had we a draft, a war of this length - especially for such small stakes - is inconceivable.

Starbuck,

The issue is that the current AVF must maximize the deployment days from a minimum number of people. This puts the unit's numbers ahead of what is good for the soldier, the unit and the Army. We have deployed thousands who first line leaders knew should never have been deployed (see: front page of today's WaPo for the latest installment). We have deployed soldiers in the throes of medical, emotional and family crises.

The AVF and the 4 year enlistment and 8 year MSO it necessitated, ensures that first term enlistees will see repeated combat deployments before they have a chance to bow out and go home with honor.

As stated above, in many CMFs and units, a 4 year hitch = 2 combat deployments on active duty and likely a 3rd in the IRR. With the USMC 7 month deployments, this adds up to even more. Is this asking too much and is it immoral? My answer is yes on both counts - especially since we've known since 1943 that >180 days in combat really messes with your head!

A draftee/volunteer hybrid force would mitigate the toll of repeated and prolonged deployments. The 2 year term for draftees and 3 year term for volunteers along with Army policy ensured that soldiers would not be sent back unless they affirmatively volunteered to reup, extend or go back.

40 years later we are handcuffed by the AVF and condemning first term soldiers to possibly 3 deployments in their 8 year MSO. This is a hell of a lot of sacrifice for so few. The moral policy is to allow our young soldiers to serve a tour and then decide whether its time to go home with honor or stay in the Army. Instead, there is no light and the end of the tunnel and we do everything legally and pharmacologically we can to get them back in combat as soon as we can.

Of course, Viet Nam was a war fought with a draftee Army, and it appears to meet all the criticisms you levy against the current war:

- It was long
- We lost it
- The Soldiers who fought it suffered high rates of behavior health issues

So even if one takes your dubious assertions at face value, it is clear that something is at work here besides draft/AVF

How many people are being mobilized out of the IRR?

I've heard of VERY few -- and those were specialists with low density/high demand skills, and almost exclusively officers (doctors, pilots, linguists, CA guys, etc).

But you are correct that a brand new enlistee can expect to do 2 years deployed in a 4 year enlistment.

But I think 3 is exceedingly rare unless the Soldier extends or reenlists.

The US forces in Vietnam were primarily volunteers. The casualties were also.
I believe we had a little more protest action in the street against an unpopular war in the '60's and 70's when the draft was in place, than we have seen in the last decade.

RBB,

IRR Recalls have been pervasive throughout the combat arms community since about 2005-06. A first-termer in CMF 11 or 13 with four years in the IRR, can almost take a recall to the bank these days. That doesn't mean they will all go. If you file a delay or exemption for an IRR recall, you have a better than even chance of it being granted. Still, a lot of guys are getting recalled and many are deploying.

Anecdotally, at Armyocs.com, I've seen almost every recently seperated FA 1LT/CPT get a recall notice within 18-24 months from ETS. We've also seen a recall rate for Signal and MP officers as well.

Others may be able to add more, but since 2006 I would say that between 1/3 and 1/2 of deploying officers with USAR units have been IRR recalls.

The cupboard is bare. There are systemic holes in the USAR and ARNG force structure at the mid-career NCO and officer level and IRR is being leveraged to fill them.

"- It was long" ... but not as long as either of the current two wars, and it was public pressure that brought about its end. In contrast, the Afghan War has been predicted to last 'decades' and the AVF itself seems powerless to alter that.
"- We lost it" ... because the war was ill-cncieved, the Army lost its soul, and the officer corps crafting our strategy was witless.
"- The Soldiers who fought it suffered high rates of behavior health issues" ... among them high drug use permitted by a leaderless Army.

"So even if one takes your dubious assertions at face value, it is clear that something is at work here besides draft/AVF..." Sure. But as long as the AVF is sacred we will do nothing to overhaul a losing military and reform a broken Army. Current PTSD rates are a symptom of a military that has serious dysfunctions ... and the military we have is the AVF. It lives in splendid isolation and does pretty much what it wants. If it weren't so incredibly expensive and if we didn't actually need a military capability that we could count on, the AVF might be tolerable. But it's broken, the signs show it, it's sapping our economy, and it worries those who concern with potential need for a military aside the current gavotte.

RBB,

You raise some great points and they segue nicely into my next rant target: Point-of-sale (enlistment) MOS reservation.

This is the first protracted war in the modern era that we have fought with soldiers who selected their job/MOS in a vacuum before spending a single day in uniform.

To this day, the USMC, Navy and USAF all bring in some portion of their entering enlisted cohorts on "undesignated" contracts. This means that these recruits learn their career fields during initial entry training. Usually, these personnel are the more borderline applicants with lower AFQT scores and, in some cases, GED holders. Not the Army!

The Army unveiled point-of-sale MOS reservation in the late 70's as a marketing ploy to attract enlistments. The theory was that you could join the Army and be guaranteed a job before basic training. This was meant to distinguish the Army from the Navy, USAF and USMC where some portion of enlistees would not learn their career field until after being in service.

Point of sale job reservation is a great theory in peacetime, but I question its value/efficacy in wartime. It leads to self-selecting, unrepresentative cohorts in certain career fields (e.g. the increasing number of rural whites in Infantry, the precipitously declining number of blacks in Artillery and the heavy minority population in CSS jobs).

Why on God's name are we enlsiting soldiers who will likely deploy 3 times during their MSO and letting them pick their MOS before spending a day in uniform? Why should the Army have no say in the MOS/duty designation of its soldiers after observing their reactions to stress in an IET environment? This is madness. Why does someone enlist for Infantry in 2011? What are the motivations? No one has studied this and how the motivations have changed since, say, 2003. Is this the cohort who we want/need executing COIN at the tactical level. Joining the Infantry because it "looks cool", or because one wants to "prove they are a man", or to avenge 9/11, are all really bad reasons in a strategic, personnel management sense. The Army needs to regain some control over who enlists for what job and why.

Given today's PERSTEMPO and its demands, the Army should once again have some say in who serves where, in what capacity and in what MOS after observing new soldiers in IET. Taking civilians off the street and guaranteeing them an MOS with no relation to their temperment, resillience or personality is a really bad idea.

I've seen similar groupings as well in certain MOSs. I've also heard that soldiers who score lower on the ASVAB (or similar tests) tend to have fewer coping mechanisms for PTSD, depression and similar illnesses.

By the way, the "Stress Card" was largely a myth.

I'd love to actually meet a lot of you sometime.
Best,
Tom

And until Commanders can be convinced there's actually a problem with their troops, they'll apparently continue denying their own issues until it catches up with them in the Wal-Mart parking lot.

Truly, my sympathies with each of those officers. The more responsible you think you're supposed to be, the more you try to hold it in... the worse it eats you up.

National Guard documentation I have shows that most of the soldiers killing themselves in the last 4 years have been predominately in the Rust Belt and Midwest - not the states you are referencing JG. Not saying you're wrong just saying the info I have doesn't support that from a NG perspective.

The glaring exceptions were WA and OR. According to one psychologist who I linked to earlier...these guys should be pounding Vitamin D, esp in the nasty winter. Makes sense to me.

Crappy economy, no jobs, no sunlight, or lots of rain. Can't help.

Hunter,

Interesting thought on the rust belt. I wonder if most of the cases were from Pittsburgh, or the smaller towns that wind up subject material for Bruce Springsteen songs. If it's the latter, there's not much difference between 'Man of Constant Sorrow' and 'The River.' It's hard to define the characteristics. It wouldn't necessarily surprise me if the populations are different in their aggregate responses to combat, though. For as much as the NG have done, even they will admit they weren't meant for this kind of duty-- it's certainly not what many of them signed up for.

A major difference I see between NG and Active Duty hardship cases is the level of support when you get home. The recent NYT story about Deustche Bank foreclosing on a NG soldier highlights the issue. http://www.nytimes.com/2011/01/27/business/27foreclose.html

If that had happened near an active duty base, the local JAG would have cleaned the bank's clock. It would have been taken care of within a week. The wife would have called the husband, the husband would have told his commander, the commander would have gotten the FRG on the ball and the on-post community services folks would have loaded the gun for the JAG. None of that existed for these folks. The soldier in this instance might not have gotten any farther than the commander, because the command relationships on attached NG folks get so screwed up. We spend a month just trying to figure out who "gets" to help the guy.

That's in combat. The "War is a Racket" post kind of shows how much more difficult it can be at home. My heart goes to the NG guys on that one. The Active Duty troops get left behind. Those guys never really get picked up.

With regard to the 'winter blues' and 'Vitamin D' schtick, they've been pushing that junk for years. http://edition.cnn.com/2009/US/02/05/army.suicides/

It scares me that COL Platoni, quoted in that article, might have treated someone. Regardless, if Vitamin D and sunlight are the silver bullets for this thing, why are we hooking guys up with everything from zoloft to ketamine instead of prescribing them three weeks at a spa where they can get all the eggs and bacon they want and 30 minutes in the tanning bed daily? I throw a fifty square foot flag on that, and you get three guesses what the word is on it.

Check into a doc named Candace Pert and her book "The Molecules of Emotion." The basic gist is that you make over 200 chemicals in your body that affect your mental/emotional health. So I'm not saying a little sun can't help. I'm personally a big believer in exercise, and while I never tried it, I think there is something to Yoga or other meditative practices. Inner space is less well understood than the far reaches of the cosmos. You can get into hormone interractions all day, but at the end of that day, all those compounds come together to make a human being. You fight fire with fire, you need a genuine human being to deal with a genuinely human problem.

Vitamin D certainly isn't a panacea.

I've mentioned before that my deployment and subsequent experience with soldiers going through this prompted me to spend most of last year researching a journal article (TBP in Jul '11) on the subject of suicide and (to lesser extent) PTSD, so I am coming at it with lots of info fresh in my mind. But my article focuses on my area of expertise, training. The journal I wrote for kept pressing me to attack the problem from the perspective of "bad medicine" and the use of SSRIs and anti-depressants in general. That's understandable, it's what that journal tends to focus on, but it's outside my area of expertise so I was and am unwilling to speak too much to the points of using drugs to treat this stuff.

All I will say is that the evidence is that using these kinds of drugs (with their frightening Black Label Warning) seems not to be the best course of action. Which leads me to absolute agreement with your final statement that meditation, drugs, yoga, relaxation (and a million other things) even Vitamin D might help but human beings need human beings to resolve this problem.

All that said here's some numbers as of 1 Oct 2010 covering 2007-2010 NG suicides cumulative by state:
Highest
MN: 15
OR: 13
OH: 12
MO: 8
AR: 8
MI: 8
PA: 8
IA: 8
WA: 8
IN: 8
Lowest
CO: 0
CT: 0
DC: 0
DE: 0
KY: 0
MT: 0
NH: 0
NJ: 0
NV: 0
VI: 0

More on suicide:

# Rate/10000 Year of data
Army 140 2.02 2008
Air Force 38 1.15 2008
Marines 41 1.9 2008
Navy 41 1.16 2008
US 33,300 1.09 2006
National Guard 1.6 2008

Age of suicide: All are predominately 18-24 (NG -44%, Active - 43%, US Population - 34%) followed by 25-29.
Method: All are predominately gunshot (NG, Active, US Population) followed by hanging.

Hunter--

any adjustments for deployments from those states and/or types of units?

Another observation is that Oregon lacks an active duty military installation of any size along with corresponding health facilities and military community. The closest is Lewis-McCord in Washington.

You asked "any adjustments for deployments from those states and/or types of units?"

I'm not sure what that means, but I'll do what I can to answer it. The data I posted here was pretty much raw data, so I don't think there were any adjustments made.

Part of the problem here is that tracking of the problem is much harder than perhaps it should be. There are far too many entities - all making money - trying to chase down the information...it's disparate, disjointed, and disconnected.

For my paper it was far too difficult to get a consistent vision of how big the problem is. each service tracks differently, then there is NG and Reserves, and verified and unverified, then there's people who were in the service but aren't now... it's a dumb nightmare.

Here's a quote from an early draft of my TBP manuscript (it's been pared down dramatically in the final version):
"Part of the solution to this problem includes a more holistic outlook on the problem of PTSD and suicide prevention. In researching this problem I was stunned by the lack of cohesiveness in the military services’ approach to the crisis. Each service has multiple task forces and agencies involved in prevention, behavioral health, and care. One Military Health System website in conjunction with the Centers for Disease Control and Prevention and National Institute of Mental Health lists twenty-two different suicide prevention resources on one web link, with many more buried within the primary links.
According to another source, The Army Suicide Prevention Task Force is reviewing more than 600 programs related to health promotion, risk reduction and suicide prevention. There is a deluge of information but no consensus on its implementation.
In another example, a pullout in a major National Guard magazine featured six different telephone numbers to seek assistance for soldiers, friends, and family to seek help for a soldier with depression or suicidal thoughts. Unfortunately, some of the agencies reached by these numbers are poorly staffed, or the responses feature recordings that refer the caller to 911! With so many disparate, unconnected efforts, it is small wonder that the efforts are failing.
Certainly each service has some different, specific challenges but it is hard to believe that the issues of PTSD or suicide vary that greatly from one military organization to another. There must be significant economies of scale or consistency of vision and application being lost here. A cursory look at these resources also shows their focus on the reactive treatment and care of service members who are already suffering the effects of PTSD or suicidal tendency."

In 2009 the military instituted a 5 year $50 dollar study on this. That's alot of time and alot of bones. In 2010 they released what I presume to be the first of many reports. (Sorry can't find the link at this moment). If you read this you can't help but sardonically laugh. 76 recommendations, most of which had little to do with the soldiers suffering the problems...most suggesting the establishment of another committee or bureau to further study the issue. Bottom line: Lots of study - which is important - not as much forward movement.

Thanks Hunter. When I first read it, I thought those numbers were proportional.

The "Best Defense" conversation regarding PTSD has moved on from this thread, but I thought I'd post for the record that I thought Hunter's arguments and data regarding suicide in the National Guard was very well presented. It's extremely hard to compare data among the 54 states and territories, much less the rest of the Army, and I'm excited at the prospects presented by his article to be published later this year.

I thought far more potentially helpful that Ricks' original aside, which quoted a 1972 (?!) journal article about National Guard and reserve troops as "older, less experienced and less educated soldiers [who] were are high risk for the development of psychiatric symptoms."

Full argument posted at link below, but I'm not sure that comparing the Vietnam- and OEF/OIF-era National Guard is very useful. Or logical.

Thanks for the conversation!

http://www.redbullrising.com/2011/02/sometimes-you-get-bull.html

You're no Admiral.

Mr. Quang: I'm sure that ARVN (as well as VC and NVA) vets have what we're calling now "PTSD." But as you suggest, they don't seem to bring it out into the open like we're seeing among US vets....life indeed just went on. Besides the factors you mentioned, I wonder if that's also partly due to cultural reasons. Maybe the Vietnamese are more fatalistic. They just accepted their fate and tried to move on. Over the past 3 years I've been doing research in Hanoi on the bombing of the North, and both I and visiting US vets always express wonderment at the cordial welcome from former NVA vets -- and the answer we get from the Vietnamese is always that the past is the past, and that it's time to move on.
(By the way, I enjoyed your book tremendously. It spoke to me, as a former Marine officer and a descendent of immigrants in Hawaii).

but I still recommend the novel/memoir "The Sorrows of War," about a former North Vietnamese soldier with a king-size case of PTSD.
Best,
Tom

as he told me when we met in 2005 at Texas Tech's Vietnam Center. His is a fine work indeed. The son of "The Perfect Spy," the late Pham Xuan An who befriended Neil Sheehan, the late David Halberstam, and all of The Five O'Clock Follies regulars, graduate from Duke Law School. It's a beautiful thing man. Win a war and have your enemies take care of your children's higher education. Only in America!

I have a very cool picture with Bao Ninh but kept under wraps while campaigning for Congress in Little Saigon.