More bush Casualties

The number of Iraq and Afghanistan war veterans seeking treatment for post-traumatic stress disorder from the Department of Veterans Affairs jumped by nearly 20,000 — almost 70% — in the 12 months ending June 30, VA records show.

More than 100,000 combat veterans sought help for mental illness since the start of the war in Afghanistan in 2001, about one in seven of those who have left active duty since then, according to VA records collected through June. Almost half of those were PTSD cases.

The numbers do not include thousands treated at storefront Vet Centers operated by the department across the country. Nor do they include active-duty personnel diagnosed with the disorder or former servicemembers who have not sought VA treatment.

About 1.5 million U.S. troops have served in Iraq or Afghanistan. Of those, 750,000 have left the military and are eligible for VA health care.

The nearly 50,000 VA-documented PTSD cases far exceed the 30,000 military personnel that the Pentagon officially classifies as wounded in the conflicts. The discrepancy underscores the view by military and civilian health officials, such as Lt. Gen. James Campbell, director of the Army staff, that troops tend to ignore, hide or fail to recognize their mental health wounds until after their military service.

PTSD cases often surface long after troops leave combat. A VA study in 1988, 13 years after the last U.S. troops left Vietnam, showed that 31% of the 3.1 million male Vietnam veterans had PTSD at some point after their service.

The total of mental health cases among war veterans grew by 58% from 63,767 on June 30, 2006, to 100,580 on June 30, 2007, VA records show. The mental health issues include PTSD, drug and alcohol dependency and depression. They involve troops who left the military and sought health care from the veterans department.

Mental health is the second-largest area of illness for which Iraq and Afghanistan veterans seek treatment at VA hospitals and clinics. It follows orthopedic problems and is increasing at a faster rate, the VA says.

The reality of troubled veterans is finally hitting the department, says Sen. Jack Reed, D-R.I., a former soldier and member of the Senate subcommittee that oversees VA spending. "They're trying to catch up with a moving train because before … they weren't getting the resources they needed," Reed says.

The department says it began responding in 2005 to war-related needs, gradually increasing by 4,000 to nearly 11,000 the number of mental health specialists, spokeswoman Alison Aikele says.

"We are seeing the increase (in mental health cases), and we are preparing to deal with it," says Antonette Zeiss, the VA's deputy chief of mental health services.

The VA's challenge is to provide PTSD care, which is complicated and expensive, where veterans need it, says Joy Ilem, a Disabled American Veterans health specialist. Delays in treatment, she says, put veterans at risk for drug or alcohol abuse or even suicide.