We put vets, military families at risk

"Let us strive...bind up the nation's wounds, to care for him who shall have borne the battle and for his widow and his orphan."

-- Abraham Lincoln: Second Inaugural Address, March 4, 1865

The post-combat mental health care provided by the Department of Defense and the Veterans Administration was "created for a military that no longer exists. Today's system was designed for the 19-year-old, single GI," according to a statement by Bobby Muller, president of Veterans for America, at April's historic joint meeting of the Senate Veterans' Affairs and Armed Services Committees.

Current programs and services were developed in the aftermath of the Vietnam War, when troops typically served one tour-of-duty, and the wound-to-kill ratio was 3-to-1. A recent Pentagon report indicated that the length of tours is an important factor contributing to elevated levels of combat stress. It also found that soldiers who were deployed for more than six months were 1 1/2 times more prone to depression or anxiety than those serving shorter tours.

Repeat, extended deployments of up to 15 months or more are the norm for the 1.6 million troops who have served in Afghanistan or Iraq, where the wound-to-kill ratio is 16-to-1. Being wounded or seeing someone wounded is a significant factor in the development of post-combat mental health problems. Those who have served multiple tours are 50 percent more likely to suffer from acute combat stress.

According to a recent report on the long-term costs of veterans' medical care, "36 percent of the (Iraq) veterans treated so far -- an unprecedented number -- have been diagnosed with a mental health condition."

The most conservative estimates project that at least 350,000 veterans of the "war on terror" will struggle with post-traumatic stress disorder or a diagnosable mental disorder. But these are not the veterans of your father's day.

Active duty troops who have been deployed since 2001 are, on average, 27 years old; the average age of Guard and Reservists is 33. Approximately 60 percent have family responsibilities. At least 700,000 children have had a parent deployed overseas, but there are scant resources for the stressed kids who are exhibiting social, emotional, behavioral and academic problems.

Nearly 50 percent of troops killed in Iraq have left spouses and children behind, but there are precious few programs offering grief counseling for Gold Star families. Support for family members acting as primary caretakers for their severely injured veterans, including those with polytraumas and traumatic brain injury, is virtually non-existent.

Since 2001, 160,000 female troops have been deployed, and 10 percent of them are single mothers. Women combat veterans are at an elevated risk for PTSD, and often suffer military sexual abuse. But the VA has just two gender-specific in-patient treatment programs.

The VA has barely begun to grapple with the multiple and unique post-combat challenges of almost 400,000 citizen soldiers, the largest ever deployment of Guard and Reservists in U.S. history.

As the wife of a Washington State National Guardsman who fought in Iraq, I have seen firsthand the psychological wounds the war is inflicting in the troops and their loved ones. Yet treatment options are non-existent, insufficient or unavailable. Tens of thousands of veterans have timed out of the two-year window of care guaranteed by the VA. In addition, there are projected cutbacks for veterans care in 2009-2010 and beyond -- just when the demand for immediate assistance may crest.

The untreated effects of combat-related trauma last a lifetime, and long-term consequences include: unemployment, depression, divorce, domestic violence, chemical dependency, poor physical health, homelessness, "accidental death," suicide and even murder.

Thousands of U.S. veterans, children and military family members now meet the definition of an at-risk population: being endangered, as from exposure to disease or from a lack of parental or familial guidance and proper health care.

But government agencies, particularly under the Bush administration, do not have a good track record of quickly and creatively responding to communities in crisis. The private and philanthropic sectors and grass-roots organizations do. Together, we can build a rural retreat in Western Washington to provide support, care and services for the battles that begin when the war comes home.

While the government is playing catch-up, the lives of our veterans, the well-being of their families, and the very fabric of our communities hang in the balance.

Let's build them the sanctuary they deserve.