October 23, 2007
The Honorable Robert M. Gates
Secretary of Defense
Washington, D.C. 20301-1000
Dear Secretary Gates:
We are writing to request a full accounting from the Department of Defense on the number of psychological injuries sustained by service members since October 2001 and how the military reports on and invests in treating these less visible psychological injuries. Recent media accounts indicate that the number of service members seeking care for Post-Traumatic Stress Disorder (PTSD) from the Veterans Administration (VA) jumped 70% over a 12-month period, or an increase of some 20,000 cases. In addition, reports of the total number of cases of PTSD treatment at the VA since 2001 - 50,000 cases - far exceed the number of wounded documented by the Pentagon.
While the literature suggests that symptoms of psychological injuries such as PTSD often surface after the initial trauma, these reported numbers not only underscore the increase in demand for mental health resources among our veterans, but suggest that many of our brave active duty service members are sustaining less visible psychological injuries at a time when the military faces a severe shortage of behavioral health personnel. As a result, many of our warriors may lack access to care just at a time when early treatment could be beneficial. In light of the fact that mental health care is now the second largest area of VA treatment sought by Iraq and Afghanistan veterans, it is incumbent on the military to ensure it is providing adequate treatment before our warriors ever separate from service. Especially in combat theaters, where recent reports also suggest a spike in suicides, we must ensure service members facing the stress of combat operations have access to resources and care for psychological injuries.
For these reasons, we ask that you provide the following information:
* What is the total number of cases of PTSD among active duty service members documented by each military department since October 2001? Please distinguish between those cases that were diagnosed in and out of a combat theater. Is this number reported in the Pentagon's regular compilation of wounded/injured figures, whether or not cases require a medical evacuation? Of this number, how many received treatment from a mental health professional?
* What is the total number of other reported psychological injuries documented by each military department since October 2001? Please distinguish between those cases that were diagnosed in and out of a combat theater. Is this number reported in the Pentagon's regular compilation of wounded/injured figures, whether or not cases require a medical evacuation? Of this number, how many received treatment from a mental health professional?
* What procedures and referral mechanisms are in place in each military department for a service member who may want to seek counseling in a combat theater? How are service members currently trained to identify symptoms of combat stress?
* What is the approximate number of mental health staff, differentiated by specialty, deployed in Iraq and Afghanistan, by calendar quarter and military department, since October 2001? Of this number, on average how many are embedded with units in forward operating areas?
* What is the number of mental health staff, differentiated by specialty, for each major mobilization and demobilization Army and Marine Corps site? Please provide the number of military personnel assigned to each of these installations.
* What incentives are in place, or being considered, to attract additional behavioral health specialists, differentiated by specialty?
* For Fiscal Year 2002 through 2007, what has been the total annual expenditure, by quarter and military department, on mental health care for active duty service members? Of these totals, how much was expended for staffing, both for military personnel and private contractors?
Caring for the mental health of our service members should be as important as caring for their physical wounds. Thank you for providing this information to our offices by November 13, 2007.
United States Senator
Christopher S. Bond
United States Senator