When it comes to war, the wounds we cant see can take the longest to heal. Sometimes the wounds never heal because theyre never reported.
A recent RAND Corp. study, a comprehensive look at the psychological and cognitive injuries among service members who have returned from Iraq or Afghanistan, reported that nearly one in every five veterans is battling depression or post-traumatic stress disorder (PTSD). Many slip through the bureaucratic cracks and go without necessary treatment. The RAND researchers concluded that modern warfare might kill fewer soldiers than traditional battles but leaves them with deeper psychological scars.
As psychoanalysts, we are also troubled by another finding in the RAND report: Many service members are reluctant to seek treatment because they fear their medical information will be used to restrict their military careers or cause them to be viewed as weak or unreliable. Since commanders have access to a service members military medical records, veterans have to decide if seeking mental health services will put their military futures at risk. As one Marine cited in the RAND report put it: You dont want people to think youre weird, so you bury it.
To show how seriously they take the privacy problem as an impediment to veterans willingness to seek care, the RAND researchers core recommendations included providing opportunities for service members to seek mental healthcare in confidential, off-the-record settings. This extraordinary recommendation, which we support wholeheartedly, conflicts strikingly with some current healthcare proposals in Congress that insist that, in order to promote quality care, a patients entire health record must be accessible and easily shared in a centralized electronic information system without the patients permission and over his or her objection. The evidence simply does not support this claim. The experience of our veterans mirrors the findings of HHS that more than 2 million Americans each year fail to seek treatment for mental illness because of privacy concerns.
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