Joe Biden's reference to mental health issues highlights human costs of long, overseas deployment

President Joe Biden on Tuesday got to give the speech that each of his three predecessors had hoped they could: the one announcing the end o...

President Joe Biden on Tuesday got to give the speech that each of his three predecessors had hoped they could: the one announcing the end of the war in Afghanistan.

In his speech, the US president speaking of the withdrawal from Afghanistan, said, “And I was not going to extend a forever exit.”

Under heavy criticism from his countrymen about his handling of the evacuation, he said it was inevitable that the final departure from two decades of war would have been difficult, with likely violence, no matter when it was planned and conducted.

In his speech, he also said those who favour remaining at war also fail to recognise the weight of deployment, with a scourge of post-traumatic stress disorder, financial struggles, divorce and other problems for US troops.

It is perhaps poignant that the president opted to speak not only of the financial losses that the country has incurred, but also speak of the untold miseries in the form of mental and emotional hazards that the US troops have suffered in this ‘long war’.

Afghanistan a trigger

Many wonder what it is about the Afghanistan deployment that triggers mental health issues for soldiers.

According to Dr Sara Rubin, a psychiatrist with the VA Connecticut Healthcare System PTSD/Anxiety Disorders Team, the country’s rugged terrain, the smaller military units that served there, and fewer resources resulted in a sense of isolation, which exacerbates PTSD.

Women troops deployed in Afghanistan also had to battle the extreme patriarchy and misogyny in the country, adding to their mental woes.

Moreover, the conditions in Afghanistan itself made the situation even worst -- no electricity, no plumbing and a basic lack of facilities, which most take for granted.

As one soldier rightly put it, "In Afghanistan, there is no front line, no enemy soldiers in uniforms. Death constantly hovers in the hot air."

PTSD among US troops

For many US soldiers who returned home from their Afghanistan deployment, a part of them never did.

According to research released by the International Society for Traumatic Stress Studies, 40 percent of the veterans who returned from Afghanistan suffer from PTSD.

While PTSD is complicated enough on its own, many veterans also battle depression, anxiety, relationship issues, financial pressures and substance abuse, making their diagnosis and treatment that much more challenging.

Studies also show that PTSD can lead to suicide ideation and behaviour, and when combined with a secondary mental health condition, the risk increases significantly that the veteran may die by suicide.

In fact, a 2018 statistic released by the Department of Veteran Affairs showed that 18 veterans die by suicide in the US each day.

The pullout has only compounded issues for veterans. Many are struggling with doubts about what they were fighting for, why their friends died, and whether it was all useless.

Some are coping to compartmentalise their experiences, acknowledging they were sent to do a job even as they remember losing friends and seeing Afghans suffer.

According to a report in the Daily Beast, calls to suicide hotlines have increased alarmingly, veterans of the war in Afghanistan openly admitting that they’re facing some of their darkest days.

The United States Department of Veterans Affairs said that as of 25 August, the Veterans Crisis Line had received approximately a 6 percent increase in calls since 13 August, when news broke that the Taliban had gained control of half of Afghanistan’s provincial capitals.

Matt Helder was a young lieutenant in a US Army 2nd Infantry Division artillery battery in Kandahar in 2012. His best friend Sean was killed by an IED bomb planted by a road.

Now, watching images of the Taliban take over Kabul “has been surreal but not completely unexpected”, said Helder, 33, who recalls seeing weaknesses of the Afghan army.

“We were taking one step forward and two steps back. We were there for a year and then we’d hand it off to the next group,” Helder told Al Jazeera.

US defense secretary Lloyd Austin, who served as an officer in the US army until retiring in 2016 and commanded US forces in Afghanistan, acknowledged the pain US veterans are feeling as they struggle to reconcile 20 years of fighting the Taliban with its return to power.

“I know that these are difficult days for those who lost loved ones in Afghanistan and for those who carry the wounds of war,” Austin said in public remarks at the Pentagon on 18 August.

“Afghan war veterans aren’t some monolith. I’m hearing strong views from all sides on this issue. And that’s probably the way that it should be,” Austin said.

Alcohol and substance abuse

And it’s not just PTSD and depression that soldiers are struggling with. Many veterans battle substance and drug addiction.

A 2017 study examining National Survey on Drug Use and Health data found that, compared to their non-veteran counterparts, veterans were more likely to use alcohol (56.6 percent vs 50.8 percent in a 1-month period), and to report heavy use of alcohol (7.5 percent vs 6.5 percent in a 1-month period). The study also showed that 65 percent of veterans who enter a treatment program report alcohol as the substance they most frequently misuse.

In the case of drugs, a government report noted that more than 10 percent of veteran admissions to substance use treatment centers were for heroin (10.7 percent), followed by cocaine at just over 6 percent.

Lending a helping hand

The US has set up several helplines and counselling centres for veterans in need of help with their mental health issues.

In addition to that, President Joe Biden on 26 August signed into law a pilot program to connect veterans struggling with post-traumatic stress disorder with service dogs.

The Puppies Assisting Wounded Servicemembers for Veterans Therapy Act — PAWS — requires the Department of Veterans Affairs to establish a five-year program to provide service dogs and training to veterans with PTSD.

A report shows that participants paired specifically with service dogs trained for PTSD had fewer suicidal behaviours and ideations within the first 18 months compared to people with emotional support animals.

Biden also signed a bill into law on 30 June that aims to increase access to mental health services for veterans in rural areas. The "Sgt. Ketchum Rural Veterans Mental Health Act of 2021" requires the Department of Veterans Affairs to expand its Rural Access Network Growth Enhancement program. The programme provides intensive case management services to veterans living in rural areas with serious mental health issues. The law also requires that the VA conduct more research into rural mental health services and identify areas that need improvement.

Realising that the withdrawal could be triggering for many veterans, who are currently questioning their service and the sacrifices, the Defense Department also sent out a list of mental health resources available to service members and their families.

“You are not alone,” the US department wrote. “Remember that what is happening now does not minimize or negate the experiences of all who served overseas. Countless service members answered the call of duty and did what was asked of them. Service is never for naught.”

With inputs from agencies

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India World News: Joe Biden's reference to mental health issues highlights human costs of long, overseas deployment
Joe Biden's reference to mental health issues highlights human costs of long, overseas deployment
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