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Gloria Lin
Kevin Davis
Government 2
16 October 2016
Post-Traumatic Stress Disorder and the VA Hospital
Approximately 8% of the United States population suffers from Post-Traumatic Stress
Disorder (PTSD) annually. This number is significantly higher within the veteran community and
varies depending on the individuals engagement. Of the Vietnam Theatre veterans, one-third of
all males and one-fourth of all females suffer from lifetime PTSD according to the National
Vietnam Veterans Readjustment Study (Price). Ten percent of veterans from the Gulf War and
twenty percent of those who served in Operation Iraqi Freedom and Enduring Freedom had
PTSD (How Common is PTSD?). Although efforts to treat and alleviate the symptoms of this
disorder have improved dramatically from the early days, the fact that upwards of 75% of
veterans with PTSD are still in the treatment centers after four years demonstrates that there is
room for improvement. Veterans diagnosed with PTSD often develop other mental disabilities
that detrimentally affect their lives as civilians and lead to alarmingly high suicide rates.
Improvements to the VA system are of the utmost importance. The lack of accessibility is
impeding veterans from acquiring the necessary aid causing further debilitation of the mind and
body which affects assimilation into society and correlates to shockingly high suicide rates.
The primary obstacle for veterans trying to get treatment for PTSD is physical access to
the hospitals. Veterans face a range of barriers to care, from geographic barriers to facilityspecific problems... (Commission on Care). For many veterans, the simple act of getting to their
assigned VA hospital is rendered virtually impossible by distance as well as difficulty in finding
transportation. For some, the trip to the VA hospital is a day long endeavor encompassing around
150 miles (Lawrence). This is more than enough to dissuade veterans, with or without PTSD, to
attempt the journey. Another major impediment is the lack of office hours and lengthy waiting
periods. Currently, a veteran must wait more than 30 days or live more than 40 miles from a VA
facility in order to obtain private care through the VA (Griffin). The thirty day waiting period
is intolerable for those who suffer from PTSD. Even if ineffective prescriptions and therapy
programs needed to be modified or discontinued, veterans are forced to continue under that

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regiment until they can finally reach the hospital. In that time period, their condition could
deteriorate even more and possibly lead to death. In the Phoenix area alone, 293 veterans have
died waiting for VA care (Miller) and in 2008 the wait-time in processing VA disability
benefit appeals reached 563 days (Sandoval). The VA is simply not equipped to deal with the
demand placed on them. From FY09 to FY11, the VA experienced a 29% rise in disability
claims and has struggled keeping pace with this rise...post-9/11 veterans are filing for disability
benefits at a higher rate than any generation before them... (A National Veterans Strategy: The
Economic, Social and Security Imperative.). The rapidly changing and constantly evolving
warfront has significantly increased the number of veterans requiring medical care but the VA
system failed to adapt to and combat this development. Their incompetence is costing millions of
dollars while veterans mental and physical health continues to decline.
The presence of PTSD is often a catalyst for the development of other mental disorders
and addictions. Traumatic experiences create stressors and in response to these stressors, the
persons reaction involves fear and horror (emotions), helplessness (a learned behavior), or
denial (cognitive alterations and ego defenses)... (Wilson 8). Furthermore, 83% of veterans
with PTSD are estimated to have a co-occurring disorder (Chesnek). The effects of PTSD often
manifest in the form of other disorders such as depression, anxiety, and antisocial disorder.
Veterans also have a higher risk of developing drug and alcohol dependency. The combination of
all these factors greatly stymies a veterans assimilation into civilian life. The presence of PTSD
in conjunction with other psychosocial disorders negatively impacts a veterans ability to get a
job, an important factor in re-establishing a civilian life. In Resnick and Rosenhecks study
veterans with PTSD were 19% less likely to be employed at discharge (Resnick) a number
higher than that of homeless veterans and those with substance use. PTSD patients are seen as
unstable no matter the severity of their diagnosis. Physically, veterans with mental disorders
suffer disproportionately more from ailments such as hearing problems, tendonitis, spinal issues,
and obesity among others (Chesnek). PTSD also triggers changes in perception and response to
that change is often handled poorly. The effects of trauma can produce changes in worldview,
beliefs about human nature, patterns of intimacy, interpersonal relationship, and conceptions of
oneself and personal identity (Wilson 12). Families and friends of PTSD patients often have to
deal with unhealthy and, at times, violent behaviors such as domestic and child abuse (Chesnek).

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A vicious cycle then begins. The patient acts in a violent manner which could result in
withdrawal of support. Consequently the behavior worsens and escalates in many cases.
The lack of a social support network and diminishing sense of self-worth along with
other risk factors have resulted in alarming suicide rates among veterans. Of the 147,763 suicides
that occurred in 21 states over the course of three years, veterans accounted for 22% of those
deaths ("Media Misleads on Military Veterans Suicide Study"). A different study in 2005
confirmed these numbers by identifying that 1,821 suicides among former or current military
personnel, comprising 20% of all suicides, in the 16 states (Sudarararaman 6). The role of
PTSD in veteran suicides is undeniable. A study was conducted on refugees, a demographic that
often witnesses the same horrors as soldiers do. In a study of 149 refugees from war-torn
countries, PTSD developed as a result of ...both personal experience of and/or forced witnessing
of combat atrocities (including explosions or missile impacts in urban areas), imprisonment
(including isolation), torture and inflicted pain, sexual violence, witnessing others' suicide, and
of summary and/or mock executions...posttraumatic stress disorder (PTSD) was diagnosed in
79% of all casesthe prevalence of suicidal behavior was significantly greater among refugees
with principal PTSD diagnoses (Ferrada-Noli). If PTSD has such an overwhelming effect on
noncombatant populations, then the implications for veterans are even graver. They not only
witness those atrocities, they have to commit some of them at times. The claimed correlation
between PTSD and suicide is corroborated by William Hudenko and his associates. In their
research, suicide ideation was most prominently influenced by PTSD which was one of six
diagnoses that were shown to have significant correlation with suicide rates (Hudenko).
Moreover, since many other disorders can be traced back to PTSD (e.g. depression), its kill rate
is potentially even higher than the projected numbers. With Post-Traumatic Stress Disorder being
the root cause of a majority of veteran suicides, it is imperative that the VA system be better
prepared and equipped to treat these patients in a timely and effective manner.
With a budget close to surpassing $200 billion, many are questioning if the funds for the
Department of Veterans Affairs, and indirectly the VA Hospital, could be better spent elsewhere.
Corrupted personnel within the network have squandered the money allocated to the system as
exposed by the various VA scandals over the years. The primary motive for the executives

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dishonest acts - such as manipulating wait times so that they appear shorter - was to cash in
bonuses and to boost their own eligibility for promotion. It is for this reason that the VA
Accountability Act of 2015 was proposed and passed in House of Representatives. It provides for
the ...removal or demotion of employees of the Department of Veterans Affairs based on
performance or misconduct, and for other purposes (H.R. 1994). The individual in question
will have the right to challenge the accusations but they would receive no monetary support
during this time in any form. In addition to those measures the act will enforce strict performance
standards. Employees who fail to meet those standards will be reevaluated and dealt with
accordingly. Although this act cannot completely eliminate corruption, it will force executives
and employees to stay in line lest they lose their entire career. Another argument against
increasing VA funds arises from the source of the fund. Some argue that taking away from
military spending would put active military personnel at risk. A strong military is the backbone
of the United States. It is necessary for defense in a world where threats to Americans are ever
increasing. Taking from the military budget would severely undermine American relations
abroad, both diplomatically and militarily. However, the U.S. military is in possession of a
budget rapidly approaching $600 billion (U.S. Department of Defense). In 2015 the United
States spent more on the military than the next seven countries combined (Stockholm
International Peace Research Institute 16-21) and increased 31% between 2000 and 2014
(Congressional Budget Office). To take $3 billion from that budget is virtually inconsequential.
The military and its engagements are the reasons why veterans have such severe mental issues
and PTSD once they return to civilian life. Should the loss of $3 billion force the military to
rethink its operations, there would be better prioritization of important matters. Thus exposure to
unnecessary conflicts is limited which would then reduce the chances of veterans developing
severe, life-long PTSD.
Posttraumatic Stress Disorder negatively impacts veterans in all aspects of life; it causes
mental and physical pain and hinders the individuals attempts at assimilating to civilian life. The
ramifications of PTSD on society cannot be ignored as well. In order to help these veterans who
have unwaveringly served our country, the VA hospital system must be reformed and PTSD
therapy treatments improved upon. Ultimately, this would elevate not only the standard of living
for veterans but for the United States as a whole.

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Works Cited
Books:
Wilson, John P., and Terence Martin. Keane. "PTSD and Complex PTSD." Assessing
Psychological Trauma and PTSD. New York: Guilford, 1997. 8, 12. Print.
Bill:
VA Accountability Act of 2015, H.R. 1994, 114 Cong., 1 (2015). Print.
Periodicals/Magazines:
Ferrada-Noli, M., Asberg, M., Ormstad, K., Lundin, T., & Sundbom, E. " Part 1: PTSD
diagnoses, psychiatric comorbidity and assessment of suicidal behavior." Journal of
Traumatic Stress, 11, 1, 1998, 103-112.
Resnick, SG, and RA Rosenheck. "Posttraumatic stress disorder and employment in veterans
participating in Veterans Health Administration Compensated Work Therapy" Journal of
Rehabilitation Research and Developnment, 45, 3, 2006, 427.
Reports:
Commission on Care. Final Report of the Commission on Care. Rep. N.p.: Commission on Care,
n.d. Commission on Care. Commission on Care, 30 June 2016. Web. 08 Sept. 2016.
<https://commissiononcare.sites.usa.gov/files/2016/07/Commission-on-Care_FinalReport_063016_FOR-WEB.pdf>.
Sandoval, Kristin Nicole. "Health Care In The US Department Of Veterans Affairs: Critical
Issues And Strategic Progress." SJSU ScholarWorks. San Diego State University, 2015.
Web. 7 Sept. 2016. <http://scholarworks.sjsu.edu/cgi/viewcontent.cgi?
article=8105&context=etd_theses>
Sundarararaman, Ramya, Sidath Viranga Panangala, and Sarah A. Lister. CRS Report for
Congress: Suicide Prevention Among Veterans. Rep. no. Order Code RL34471.
Washington, DC: Congressional Research Service, 2008. Print.

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Chesnek, Amanda D. "Posttraumatic Stress Disorder and Returning U.S. Veterans: A
Comprehensive Review of the Literature and Its Implications." Southern Illinois
University. Southern Illinois University, 11 Oct. 2011. Web. 8 Sept. 2016.
<http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1230&context=gs_rp>
Websites:
"A National Veterans Strategy: The Economic, Social and Security Imperative." A NATIONAL
VETERANS STRATEGY: (n.d.): 7. Institute for Veterans and Military Families. Syracuse
University, Feb. 2013. Web. 7 Sept. 2016. http://vets.syr.edu/wpcontent/uploads/2013/02/National-Strategy-PublicationFINAL.pdf
Congressional Budget Office. "Growth in DoD's Budget From 2000 to 2014." Congressional
Budget Office. Congressional Budget Office, 12 Aug. 2015. Web. 14 Oct. 2016.
<https://www.cbo.gov/publication/49764>.
"Department of Defense (DoD) Releases Fiscal Year 2017 Presidents Budget Proposal." U.S.
Department of Defense. U.S. Department of Defense, 9 Feb. 2016. Web. 22 Oct. 2016.
<http://www.defense.gov/News/News-Releases/News-ReleaseView/Article/652687/department-of-defense-dod-releases-fiscal-year-2017-presidentsbudget-proposal>.
Griffin, Drew. "Billions Spent to Fix VA Didn't Solve Problems." CNN. Cable News Network, 6
July 2016. Web. 18 Sept. 2016. <http://www.cnn.com/2016/07/05/politics/veteransadministration-va/>.
"How Common Is PTSD?" PTSD: National Center for PTSD. U.S. Department of Veterans
Affairs, 3 Oct. 2016. Web. 22 Oct. 2016. <http://www.ptsd.va.gov/public/PTSDoverview/basics/how-common-is-ptsd.asp>.
Hudenko, William, Beeta Homaifar, and Hal Wortzel. "PTSD: National Center for PTSD." The
Relationship Between PTSD and Suicide -. U.S. Department of Veterans' Affairs, 7 July
2016. Web. 18 Oct. 2016. <http://www.ptsd.va.gov/professional/co-occurring/ptsdsuicide.asp>.
Lawrence, Quil, and Martha Bebinger. "VA Data Show Disparities In Veteran Benefits
Spending." NPR. NPR, 13 Jan. 2015. Web. 17 Oct. 2016.

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<http://www.npr.org/2015/01/13/376134776/va-data-show-disparities-in-veteranbenefits-spending>.
"Media Misleads on Military Veterans Suicide Study." Military Suicide Research Consortium.
Military Suicide Research Consortium, n.d. Web. 6 Sept. 2016.
<https://msrc.fsu.edu/news/media-misleads-military-veterans-suicide-study>
Miller, Jeff. No Excuse for VAs Litany of Excuses. veterans.house.gov. House Committee on
Veterans Affairs, 21 August 2016. Web. 8 September 2016.
<https://veterans.house.gov/news/editorials/no-excuse-va-s-litany-excuses>
Price, Jennifer L. "PTSD: National Center for PTSD." Findings from the National Vietnam
Veterans' Readjustment Study -. U.S. Department of Veterans' Affairs, 23 Feb. 2016. Web.
17 Oct. 2016. <http://www.ptsd.va.gov/professional/research-bio/research/vietnam-vetsstudy.asp>
Stockholm International Peace Research Institute. "Military Expenditure by Country, in Constant
(2014) US$ M., 20062015." SIPRI Military Expenditure Database (n.d.): 1621. STOCKHOLM INTERNATIONAL PEACE RESEARCH INSTITUTE. Stockholm
International Peace Research Institute, 2016. Web. 14 Oct. 2016.
<https://www.sipri.org/sites/default/files/Milex-constant-USD.pdf>.