“On October 26, 2009 at the Washington, DC Defense and Veterans Affairs Summit, Brigadier General Sutton enthusiastically described a “must-see” dramatic presentation of “a theatre of war” giving 200 performances around the country. And, without taking a breath, she described a real warrior as someone who “will always place the mission first, never accept defeat, never quit and never leave a fallen comrade.” Then, as if to minimize her responsibility, says, “reintegration from war has not changed in 2500 years.” With a pleasant demeanor, Brigadier General Loree Sutton was able to render the psychological complexities of modern war and its consequences simultaneously without pain and without suffering.
On August 12, 2009, two months earlier, the Ninth Circuit Court of Appeals listened to counsel passionately describe the Department of Veteran Affairs as being “non-responsive” to veterans with brain injury and posttraumatic stress disorder (PTSD). In the case - Veterans for Common Sense v. Shinseki, Veterans with brain injury and PTSD are suing the VA because; among their concerns is the fact that, more than 85,000 veterans are on waiting lists for mental health care. Since the collaboration between the Department of Veterans Affairs and General Sutton’s Center of Excellence is direct, as it should be, with regard to mental health care, the General should take great pause when hearing the latter statistic.
Almost one in five military service members returning from Afghanistan and Iraq suffers from brain injury, PTSD, and/or depression. As recently as November 16, 2009, Army Vice Chief of Staff General Peter Chiarelli said, “[w]e are almost certainly going to end the year [with a] higher [suicide rate] than last year…” General Chiarelli continued by recognizing a causal link with undiagnosed brain injury and PTS[D] and refers to them as “real injuries that require treatment by a doctor.” As a result, every American faces a brutal self-examination as to what they owe these veterans; and General Sutton’s platitudes do not help this determination. The brain of each of these injured veterans, the essence of human life, has been attacked. Starting with the Vietnam War, soldiers now survive injuries where death was once a certainty. Growing evidence, unfortunately, shows that survival will be the easiest part of their struggle. Without proper medical care and new laws securing a more effective and relevant public policy, full recovery for many veterans is just unattainable.
The wars in Afghanistan and Iraq have created a fissure in American society, a split that is not just political but also experiential - between the people who have been directly affected and those who have not. Brigadier General Sutton does not get this… and consequently asks that all Americans strengthen their resilience, much like what the Israeli’s have done for decades, adding that this effort will require a new outlook for the military. Sutton ignores the fact Americans unanimously agree the number and needs of this cohort of returning veterans is unprecedented as veterans will receive care not just for their immediate physical and mental injuries, but also support and sometimes intervention with the everyday challenges of life for years, possibly decades to come. General Sutton’s Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) is not significantly improving this outcome.
On September 24, 2009, an article in the British newspaper The Guardian titled, “Revealed: the hidden army in U.K. prisons,” described how Britain’s delayed concern about brain injury, PTSD, and chronic depression among Iraq and Afghanistan soldiers has raised great concern. The article cites a new study statistic, “[t]he number of former servicemen in prison or on probation or parole is now more than double the total British deployment in Afghanistan…” Why is this point so prevalent now and not in previous wars? First and foremost is the fact that brain injury is the signature wound of the Afghanistan and Iraq wars; and, second, severe brain injury is easily recognized by the non-medical professional, but mild to moderate brain injury and PTSD, a common by-product of brain injury, is not.
Add to this the breakdown in the nuclear family and its corresponding network of familial support. An example of which is the Schiavo v. Schiavo guardianship dispute in the Florida Second District Court between Theresa Marie Schiavo, her parents, Robert Schindler, Mary Schindler and Theresa’s husband, Michael Schiavo.
Former New York Senator Hillary Clinton created an answer through her legislation S. 2921, authorizing certification for paid family caregiver personal care attendants for veterans and members of the Armed Forces with TBI. Although it never became law, this legislation approached the problem of veteran long-term care by compensating certified caregivers with the belief that caregivers can prevent a major crisis.
Still on the horizon, however, is the question of legal representation/form of punishment for veterans suffering from brain injury, PTSD, and/or Chronic Depression not considered by General Sutton. A standard, involving two questions, will ultimately be required: (1.) is there an existing effective treatment modality for the medical condition affecting the veteran? (2.) is there an appropriate guardian associated with the veteran and if so, what is their opinion? If the answer to the first and second question is “no,” courts must make all determinations in a light most favorable to the veteran.” When it is shown, through supporting testimony; i.e., medical records, letters, etc., that a veteran’s mental health has been affected by war related trauma, the veteran should immediately be transferred into federal custody. State punitive facilities do not have the necessary treatment programs that can diagnose and aid these fallen heroes.
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