The Pentagon’s decision not to award the Purple Heart to troops who suffer from post-traumatic stress disorder (PTSD) was a tough call _ but the right one. Now the federal government should follow up that good call with another one: making sure that troops who suffer with PTSD get the support and help they need.
This won’t be easy because many with PTSD, an anxiety disorder caused by experiencing traumatic events, are reluctant to seek treatment. It is this stigma, in fact, that led the Pentagon to consider awarding the Purple Heart to PTSD sufferers in the first place. At a news conference last year, the director of a Texas PTSD treatment center asked Defense Secretary Robert Gates if he would support giving the award to victims of PTSD. Gates wasn’t dismissive. Instead, he said it was ‘clearly something that needs to be looked at.’ Military experts studied the issue and concluded recently that PTSD sufferers didn’t qualify for the medal.
The Purple Heart is awarded to troops killed or injured in action during warfare. Even though PTSD is often triggered by the stress of combat, it isn’t a physical wound and therefore doesn’t qualify for the medal. It is seen as a ‘secondary effect’ of the mind-numbing situations that soldiers endure during fighting that kills and maims friends, buddies and civilians along with the enemy. The distinction isn’t meant to minimize the damage of PTSD, but to clearly define what the medal is for.
Doctors classify PTSD as a mental disorder, a designation that can be highly subjective. There is no blood test for PTSD, and ‘no neurological map clearly defines it,’ one doctor said. It is well-known that there are wide discrepancies among Purple Heart recipients. One soldier might get the medal for courageously risking his life to defend others, while another soldier gets it for being injured while sheltering in a foxhole.
The Pentagon decided that the distinction between physical and emotional injuries should be maintained in part because of the great subjectivity of PTSD. More to the point, though, is that those who want the Purple Heart for PTSD sufferers say they do so as a way to erase the stigma associated with the disorder. If the medal is awarded to PTSD sufferers, these critics argue, more PTSD sufferers would seek treatment voluntarily.
This is the crux of the matter. But the solution isn’t to give these troops a medal. A better answer is to erase the stigma by treating the disorder. But some caregivers deny that PTSD is real and avoid treating it. Worse, the government fails to adequately fund PTSD treatment, even when soldiers are brave enough to seek help.
Awarding the Purple Heart to people with PTSD would be a false solution to a real and vexing problem. The Pentagon has done well to determine the right answer to the first part of the dilemma _ but all will be for naught if the government doesn’t put all of the pieces in place to solve the whole problem.