U.S. Just Beginning to Deal With War Wounds, Mullen Says

By Fred W. Baker III
American Forces Press Service

Sept. 16, 2009 - The United States is just beginning to deal with the long-term implications of caring for servicemembers and their families whose lives have been changed by the wounds of war, the chairman of the Joint Chiefs of Staff said here today.
Navy Adm. Mike Mullen told those gathered for a forum on dealing with war injuries that the challenges of providing that care for troops and their families is just now beginning to be understood by the military's top leaders.

Hundreds of thousands of servicemembers have returned from eight years of war in Iraq and Afghanistan with wounds that range from minor to severely debilitating. Many have left the military and, relatively easily, moved on to college, job training and careers.

Others, though, require much support to help them rebuild their lives. Education, jobs, health care, housing, financial and emotional support are only a few of their needs.

The United States will face the challenge of fulfilling those needs for decades as many young, seriously injured servicemembers return to their communities, Mullen said to a few hundred people gathered at the 2009 Defense Forum Washington.

"When they go home after the parade, ... their dreams haven't changed," Mullen said. "And their struggles are represented by the requirements and the desires they have to raise their family, go to school, send their kids to school, own a home."

The chairman said the process of providing long-term care and reintegrating the servicemembers and their families into their communities will take a multifront approach by the military, other government agencies and the private sector.

"How do we create a system throughout America that recognizes these challenges ... in a way that ... sustains their needs for the rest of their lives given the sacrifices that they have committed themselves to and the challenges that face them?" Mullen asked.

Mullen said a lot of good work and research is being conducted. But while the military and other governmental and private agencies have made huge strides toward caring for troops and families, said he added, he still is frustrated with the pace of change within the government.

"We've got to move this as rapidly as we can," he said.

He called on both the Defense Department and Veterans Affairs to work more closely together. But, he added, community-based support is necessary to sustain servicemembers and their families for their lifetimes, especially as their needs change.

"These are 20-somethings who are wounded. These are 20-something spouses, with a couple of children who have 50, 60, 70 years to live. That's where the sustained effort has got to come in," Mullen said.

Besides the care for the obvious wounds, the chairman acknowledged that both military and civilian doctors are just now beginning to understand how to identify, treat and prevent unseen injuries such as traumatic brain injury and post-traumatic stress disorder. Multiple deployments and multiple explosions take their toll, he said, and not all of the symptoms of injuries are immediately apparent.

One servicemember Mullen spoke to in his travels had survived 30 explosions, he said.

"This is different from a car crash. This is different from a football injury. This is different from being a boxer. We don't know yet how different it is, except that it is," he said.

When you factor the brain injury in with other post-traumatic stress symptoms, treatment has to be a layered approach, he said.

"We don't know yet how to pull that apart so we can treat that injury effectively," he said.

Reintegration problems because of post-traumatic stress have plagued veterans of the Vietnam War. Statistics point to a high rate of homelessness and incarceration among that population of veterans.

Mullen, a Vietnam veteran, visited a year ago with about 20 homeless vets from the wars in Iraq and Afghanistan. He said the onus of preventing the same problems with these veterans is on the United States now.

"Shame on us if we don't figure that out this time around to make sure that doesn't happen," he said.

Besides wounded servicemembers, Mullen said, he has seen signs of post-traumatic stress even in the families. He cited children who have seen their parents deploy multiple times during their childhood, noting that some children go off to college and don't know their dad.

"We have put tremendous pressure and stress on families," he said.

The chairman said the United States is just now laying the base for the care to come, and he urged those at the forum to look for best practices within other organizations. Rather than compete, he said, organizations should emulate what works, taking solutions that are evident now and working to implement them.

In the end, Mullen said, caring for wounded servicemembers and their families will fall well beyond the boundaries of the military and spill far into the community.

"We can't do it alone. These are America's citizens ... who are going off and doing our country's bidding without question and they are sacrificing and we owe them," Mullen said. "This is a debt. ... It needs to be the first check we write."