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Col. Thomas Burke (U.S. Army) is director of mental health policy for the Department of Defense. Here, he talks about PTSD, combat stress and the percentage of troops affected by one or the other in the Gulf, Afghanistan and Iraq wars. He also discusses the stigma surrounding seeking psychological counseling, how access to care can differ between career military and reservists and what is being done to provide mental health treatment. "We are always trying to [improve] our understanding of the soldiers problems: physical, mental health problems. We're always trying to make the system better, more responsive, to make sure that there's going to be enough resources and capacity in the system to take care of whatever problems the soldiers have during deployment, after deployment, after they leave the service." This interview was conducted on Dec. 28, 2004.
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Drawing on his 20 years counseling combat veterans as mental health counselor for the VA in Vermont as well as his service in the Vietnam War into which he was drafted at 19, Jim Dooley offers a clear-eyed overview of soldiers' experience in war, the psychological and emotional impact, and the great problems many have in readjusting to being back home. "What we're saying is that you have no idea what the other part of the world is like, and I do. And you should know it. If I have to know it, you should know it. And I think that's where the anger is. It's that their value systems have been fundamentally changed by that experience. And they keep that value system the rest of their life." This interview was conducted on Oct. 5, 2004. [View video of Dooley talking about the impact of his Vietnam combat experience.]
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He is executive director of the VA's National Center for Post-Traumatic Stress Disorder. In this interview he explains what PTSD is and why it is by no means the only post-traumatic psychiatric problem affecting many combat veterans. Another problem he says, "is alcoholism and substance abuse." In discussing the many issues surrounding mental health treatment for troops, he talks about the effectiveness of immediately treating troops on the front lines, why killing is or isn't key to triggering traumatic reactions, the relationship of suicide to PTSD and whether Guardsmen and Reserve troops are having a tougher time psychologically in Iraq compared to career military. This interview was conducted on Oct. 7, 2004.
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Lt. Col David Grossman (U.S. Army-Ret.) is a former Army Ranger and has written extensively on the psychological impact of combat and killing. In this interview, he talks about how killing relates to PTSD and the deficit that he sees in the military's training. He tells FRONTLINE the soldier has been trained to kill, "but if this training just tricks you into killing, the magnitude of the trauma can be significant. Because you're having to live with something … that you didn't want to do." He also discusses why critical incident debriefing in the theater of war is key in helping soldiers cope with trauma, and also explains why killing affects some people more than others. This interview was conducted on Nov. 22, 2004.
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He is a psychiatrist and chief of mental health services for White River Junction VA Medical Center in Vermont. Here, he talks about PTSD and his concerns that there aren't enough resources to treat returning Iraq veterans suffering from this mental illness. He says, however, that he's confident returning veterans "will find more effective resources than they did 30 years ago" and outlines one of them, the new cognitive processing therapy being used in PTSD treatment. Talking about the many veterans he has treated over the years, Pomerantz shares some stories about how, as they grow old, they seek to come to terms with combat experiences, especially killing. "I think it's one of the most powerful pieces for most of the people that I've treated who have been in close combat situations. I had one World War II veteran I remember -- to the day he died he could still describe the face of the man he was about to kill. … I've not ever met a person who killed others who was not affected." This interview was conducted on Oct. 5, 2004.
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Cmdr. Dennis Reeves (U.S. Navy-Ret.), a Navy psychologist for 22 years, spent eight months in Iraq forward deployed as a mental health counselor. He talks in some detail here about the war environment he witnessed or heard about in his talks with the men, and how the troops developed coping mechanisms. He also describes the counseling and crisis intervention that he and colleagues provided the Marines, in particular, debriefing and talking sessions called "Warrior Conservation." And, he discusses some of the common problems troops will face when they return home. This interview was conducted on Nov. 3, 2004.
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A Gulf War veteran, Steve Robinson is executive director of the National Gulf War Resource Center, an independent support and advocacy group for veterans of the Gulf War and Operation Iraqi Freedom. He explains how the military and the government are failing to adequately help troops and veterans needing mental health services and why he is skeptical about new initiatives being started, such as in theater combat stress control teams. He warns that if far more isn't done, the cost will be enormous when Iraq war veterans begin coming home with emotional problems over the next three to five years. "What we're calling for ... is a refocus on getting face-to-face contact with the veterans. Handing them a piece of paper and saying, 'Here's a number you can call,' is not the kind of care they need. ... If we would proactively meet every single veteran that comes back and give them a face-to-face clinical encounter with someone who is educated about [their] special needs … we could save this nation billions of dollars over the next 50 years for any long-term disability payments that may come out of not treating PTSD." This interview was conducted on Oct. 13, 2004.
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posted march 1, 2005
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