WASHINGTON, DC—Properly diagnosing head injuries and post-traumatic stress disorder (PTSD) continues to be a challenge for the military because there is still so much unknown about the brain, a top DoD official told a Senate committee. “Our science on the brain is just not as great as it is for other parts of our body, and researchers are struggling today to find the linkages and to learn everything they can about the brain. Because of this, we are going to see some misdiagnoses,” said Gen Peter Chiarelli, Army vice chief of staff.

Chiarelli’s remarks came in response to concerns voiced from members of the Senate Armed Services Committee about an NPR report that alleged poor diagnosis and treatment of servicemembers suffering with brain injuries.

Chiarelli, in testimony at a hearing before the Senate Armed Services Committee on suicide, brain injuries, and other combat-related psychological health concerns, defended the military, stating that PTS and head injuries often co-exist in an individual, making treatment difficult. When soldiers have suffered because of an inability to identify the appropriate treatment, it is not because military health professionals do not care. “I promise you it is not for a lack of trying or care on the part of doctors.”

Committee Chairman Sen Carl Levin, D-MI, expressed concern about the increasing number of troops returning from combat with PTSD and TBI injuries, and those who may have experienced concussive injuries that were never diagnosed. “Studies indicate that mild traumatic brain injury, or concussion, is associated with PTSD, depression, and anxiety. These conditions, in turn, may contribute to the increase in the number of suicides.”

Addressing Psychological Health and Suicide

Other officials testified about service suicide rates. The Army reported 162 active duty suicide deaths in 2009, with 244 across the total Army and 1,679 known attempted suicides.

From January through mid-June 2010, the Army has experienced a reduction in suicides among active duty soldiers compared to the same period in 2009, however there has been an uptick in suicides among the reserve component soldiers.

In written testimony, Chiarelli noted that the decrease in active duty suicides seems to indicate that the Army’s refocused efforts are beginning to work, while the increased number in the reserves “may reflect the Army’s more limited ability to influence soldiers once they return home.”

The Marines reported 52 suicides in 2009, up from 25 in 2006. Attempted suicides in the Marines increased from 103 attempts in 2007 to 146 in 2008, and 164 in 2009.

Caucasian men who are between the ages 17 to 25 are among those most at risk. “We recognize that our prevention efforts must continue if we are to turn the trend of the last few years around,” said Gen James FAmos, assistant commandant of the Marine Corps.

The Air Force reported it was on track for a higher suicide rate than the previous year with 45 airmen having committed suicide so far in 2010, compared to 33 during the same period last year. The Air Force has found that nearly two-thirds of the airmen who committed suicide were not in the care of a mental health professional, despite efforts to reverse stigma in seeking mental health assistance.

The Navy reported 46 active duty sailor suicides and six selected reserve sailor suicides in 2009. From January through May 2010, there have been 13 suspected active duty suicides compared to 20 through May 2009.

Chiarelli said that one way to help servicemembers struggling with mental health issues is by expanding online access to health-care professionals. Being able to receive mental health support online would reduce the stigma that servicemembers often feel when they seek help at a clinic. It would also help Reserve and Guard members in rural areas who do not live near care.

A study conducted last year by the Army at Tripler Army Medical Center found that young soldiers preferred online counseling versus face-to-face. The goal of the Army is to create a network of counselors and certified mental healthcare providers with computers set up for behavioral health evaluations online when soldiers return from combat.

VA also utilizes online help for veterans. In July 2009, it established Veterans Chat, which enables veterans and their family members to chat online anonymously with a trained VA counselor. If the counselor determines that the user needs immediate help, the counselor can transfer the individual to VA’s Suicide Prevention Hotline, where they can receive further assistance.

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