Military May Consider PTSD Worth a Purple Heart

Defense Secretary Robert Gates offered cautious support for such a change on a trip to a military base in Texas this month. "It's an interesting idea," Mr. Gates said in response to a question. "I think it is clearly something that needs to be looked at."

The Pentagon says it isn't formally considering a change in policy at this point, but Mr. Gates's comments sparked a heated debate which says, can psychological traumas, no matter how debilitating, be considered equivalent to dismembering physical wounds?

Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.

"These guys have paid at least as high a price, some of them, as anybody with a traumatic brain injury, as anybody with a shrapnel wound," John Fortunato, who runs a military PTSD treatment facility in Texas, told reporters recently. Absent a policy change, Dr. Fortunato told reporters, troops will mistakenly believe that PTSD is a "wound that isn't worthy."

Military historians believe that the syndrome now known as PTSD -- usually characterized by nightmares, sleeplessness and anxiety and for some, eventually suicide. Vets lose marriages over PTSD, become addicted to drugs and alcohol, suffer from depression, and some eventually take their own lives due to the torment.

Today, PTSD is emerging as one of the signature problems of the long wars in Iraq and Afghanistan, which lack clear front lines and pit U.S. forces against enemies who operate out of densely packed civilian areas.

A recent California-based research institution Rand Corp. study concluded that 300,000 of the military personnel who have served in Iraq or Afghanistan have symptoms of the disorder, which can sometimes lead to suicide. The report found tragedies closely linked to the development of PTSD: Half of the 1.6 million troops who spent time in the two war zones had friends who were seriously wounded or killed, while about 45% saw dead or wounded civilians.

Many military personnel are reluctant to seek counseling for PTSD because they are afraid that seeking help would harm their careers. A recent survey by the American Psychiatric Association found that 75% of military personnel felt that asking for assistance would reduce their chances for promotion. "There's a real fear that admitting to mental illness will mean being stigmatized," said Carolyn Robinowitz, the organization's president.

The Pentagon's Mr. Gates has worked hard to dispel that stigma, recently pushing through a rule change allowing military personnel to get counseling for PTSD without having it negatively affect their security clearances. The question of whether veterans suffering from PTSD should be eligible for the Purple Heart is a deeply emotional issue for military personnel and their families and would clearly begin to remove the stigma and help thousands and thousands of war vets begin to heal and get the treatment they so deserve.