Analysis: Greeks Count Mental Health Cost Of A Country In Crisis



Taken from  Reuters  which is located   HERE.

(Reuters) – Behind every suicide in crisis-stricken countries such as Greece there are up to 20 more people desperate enough to have tried to end their own lives.

And behind those attempted suicides, experts say there are thousands of hidden cases of mental illness, like depression, alcohol abuse and anxiety disorder, that never make the news, but have large and potentially long-lasting human costs.

The risk, according to some public health experts, is that if and when Greece’s economic woes are over, a legacy of mental illness could remain in a generation of young people damaged by too many years of life without hope.

“Austerity can turn a crisis into an epidemic,” said David Stuckler, a sociologist at Britain’s Cambridge University who has been studying the health impacts of biting budget cuts in Europe as the euro crisis lurches on.

“Job loss can lead to an accumulation of risks that can tip people into depression and severe mental illness which can be difficult to reverse – especially if people are not getting appropriate care,” Stuckler said.

“Untreated mental illness, just like other forms of illness, can escalate and develop into a problem that is much more difficult to treat later on.”


Youth unemployment in Greece is more than 50 percent and evidence of peoples’ disaffection is becoming more visible.

The sight of groups of youths hanging around the streets getting high on illicit drugs is not uncommon in Athens, while a Greek pensioner who hanged himself in the capital on Wednesday was found with a note saying he had always worked hard but had got himself into debt.

Greece is in its fifth year of recession and the prospects for many are bleak. Economists reckon the austerity measures Greece is battling with – cuts the health minister characterized as being made with a butcher’s knife rather than a scalpel – offer it slim hope of recovery any time soon.

Those who have jobs are being hit with wage cuts or pay freezes, and live in constant fear of being the next employee to face the chop. Research has found this feeling of profound insecurity can do more psychological damage than anything else.

Peter Kinderman, a professor of clinical psychology at Britain’s University of Liverpool, says the mental health impact of all this turmoil will be rapid and dramatic.

“Instead of seeing a slow increase in the epidemiology of mental illness, what we’re seeing is what we predicted – that these economic impacts have rapid significance for our way of thinking about the world,” he told Reuters.

And while economic crises may have mental health effects, mental illness in turn has increasingly significant economic effects – raising the prospect of a vicious cycle.

According to a paper prepared for the World Health Organisation (WHO) in 2011, the economic consequences of mental health problems – mainly in the form of lost productivity – are estimated to average between 3 and 4 percent of gross national product in European Union countries.

And because mental disorders often start in young adulthood, the loss of productivity can be long-lasting, experts say.


Stuckler says there is a “critical window” for connecting people in need of psychiatric help to the services that could benefit them, and talks of a “high risk phase” when vulnerable young people haven’t been able to realize what they hoped to do, and then feel like they’re being left behind in a recovery.

“You don’t want them to sink into being chronically unemployed,” he said. “Because that ends up increasing the costs and pressure on the welfare system further down the line”.

In Greece, suicide rates are already rising rapidly, albeit from a low starting point. Suicides rose by 17 percent between 2007 and 2009, and by 40 percent in the first half of 2011 compared with the same period in 2010, according to a report in the Lancet medical journal last year.

And judging from the experience of financial crises elsewhere, unemployment, poverty and insecurity will also lead to upward trends in demand for mental health services just as they are being cut back.

“Some people can be very profoundly affected … and end up unhappy and depressed for very long periods for time,” said Kinderman. “And I suspect some of the casualties in an economic downturn may undergo such fundamental changes in the way they understand themselves and the world, that that way of thinking will last.”

Peter Lloyd Sherlock, professor of social policy at Britain’s University of East Anglia, suggests looking to history for lessons. He points out that in Argentina, which experienced a dire financial downturn from 1999 to 2002, there was a 40 percent increase in consultations in mental health facilities in 2002, according to government data, and there was also a sharp increase in prescriptions of antidepressants.

Previous research has found that people who fall into unemployment and poverty have a significantly greater risk of mental health problems – and men are at especially increased risk of mental illness, suicide or alcohol abuse during hard times.

Evidence cited in the WHO report suggests the more debt people have, the more likely they are to have mental disorders.

“If the Greek economic woes were to continue for 10 years or more, probably the most important overall effect on mental and physical health will actually be a big increase in inequality,” Lloyd Sherlock said.


But does economic depression always mean more psychological depression?

Not necessarily.

Public health experts point to some countries, such as Sweden and Finland, which in times of crisis managed to avoid increases in mental illness and suicide rates by investing in employment initiatives to help get people back on their feet.

In the early 1990s, Sweden underwent a severe bank crisis which sparked a rapid rise in unemployment, but suicide rates were broadly unaffected. In contrast, Spain, which had multiple banking crises in the 1970s and 1980s, saw suicide rates rise as unemployment rates did.

Some experts say a key differentiating factor was the extent to which resources were budgeted for social protection, such as family support, unemployment benefit and healthcare services.

Looking ahead to what he hopes may be less fragile financial times for Greece, Kinderman sounds an optimistic note. While there’s a risk of long-term psychological problems for some, he says, evidence also suggests the majority of people can bounce back if and when economic prospects brighten.

“If you have economic recovery, many people could spark back up into a more optimistic and more self-assured frame of mind relatively quickly,” he said. “The message for politicians is get the bloody economy right and we’ll start functioning again.”


Chato B. Stewart: Humor As A Gift To Deal With Mental Illness

I ran this article for the first time in 2009 and have run it once a year since then.  This is one of the most popular articles I’ve had the pleasure to print. Allan  5-2012

Chato Stewart has been afflicted with major depression and bi-polar disorder.  I have used his cartoons on the blog as I believe humor can be a tool in combating mental illness.  Chato graciously agreed to write something for the blog and I pray you might come away with a few insights and a smile on your face.  Allan

Hi, my name is Chato and I live with a mental illness and I can evict him!  I’m what you might call a mental health humorist .  I’ve been married to the same woman for 18 years and we have 4 rug rats and a dog.  I love my wife and kids dearly and like every good parent we have our moments.  Here is a cartoon I did that reflected a moment of my life with my kids…

To some people when they hear the words “Mental Health” or “Mental Illness” some times they just want to run! When diagnosed, we might have felt why would God do such a thing to people?  Well, it’s not God but rather our own inherited Adamic sin… Yes, it goes back to Adam and Eve!  We are imperfect and with that imperfection comes all sorts of aliments, diseases and eventual death.

It is estimated that more than 330 million people worldwide suffer from serious depression.  What do you think the number would be if you add the host of other disorders that many of us live with today?  In the billions, no doubt.

How can a man or woman maintain their faith in the wake of mental illness?  Is there something new? Well, look back in time for a moment.  Did you know even many of  God’s faithful prophets dealt with symptoms that can only be described as depressive and anxious and even suicidal??!!

So for me, I find comfort in reading the Bible to help maintain my battle of mental recovery.  I read this the other day and found that it helped reinforce my faith.

Support From the Christian Congregation

The Bible admonishes all Christians to “speak consolingly to the depressed souls” and to “be long-suffering toward all.” (1 Thessalonians 5:14) How can you do this? First, it is important to understand the distinction between mental and spiritual illness. For example, the Bible writer James indicated that prayer can make the spiritually indisposed one well. (James 5:14, 15)  Nevertheless, Jesus acknowledged that those who are physically ailing need a physician. (Matthew 9:12) Of course, it is always right and helpful to pray to Jehovah about any concern, including our health. (Psalm 55:22; Philippians 4:6, 7) But the Bible does not state that increased spiritual activity in and of itself will cure present medical problems.

Discerning Christians, therefore, avoid implying that depressed people are responsible for their own suffering. Such remarks would be no more helpful than those offered by Job’s false comforters. (Job 8:1-6) The fact is that in many cases depression will not improve unless it is treated medically. This is especially so when a person is severely depressed, perhaps even suicidal. In such cases, professional attention is essential..

While it has taken me a long time to rebuild my own faith, I am happy to be assured from the Bible that I’m not alone and it can be done.

Do you remember reading the scripture about faith?  Went something like, “Faith without works is dead.”  Well, this goes the same with living with a mental illness.  If we don’t take action toward our own recovery, then we might be a statistic.

See, sadly we who live with mood disorders and psychiatric disabilities and co-occurring disorders have 20% higher suicide rate!  In order to avoid falling into that number, we need to want to get better.  We need to stop being the victim and become the advocate for our own health.  How? It all starts with one little word… HOPE!

Once we can find hope again, then we are on our road to recovery…  I like to think of the movie “What About Bob” when I talk to people about recovery.  If you have seen the movie, you’ll understand the “baby steps” idea, but really that is something we have to do… Take Baby Steps!  If you have not seen the movie, it’s worth the rental.

See, I love to laugh; I love to make others laugh too.  I have always tried to “find the funny” while dealing with adversity in my life.  It can be hard and on many occasions I just couldn’t.  Still the power behind a laugh or in humor can be enormous and healthy as well.

It took me till I went to the bottom of the proverbial bucket of life in order to find a way to use humor as not only a coping skill for me but a way to help others.

I went through a familiar process many of us go through with being diagnosed with a mental illness.  Medication side affects and the occasional psychotic breaks and the trips to the local Crisis Stabilization Unit.   I could go on and on about all the bad stuff that happened but that’s not important.  What is important is that struggling with mental illness allowed me to tap into some limited artistic abilities with my sense of mental health humor to be about helping myself in my recovery and make thousands laugh as they live with their lot in life.

While on vacation in the Crisis Stabilization Unit (CSU) in March 2008, I started to journal, but it came out like a comic book… I just drew cartoons about my stay  and did cartoons for the kids in the Juvenile ward.  The kids loved them so much.  It made them laugh and gave them something to color.  When my vacation was over, I had a thought. Wow, I knew humor can really help heal, but I never thought of it when it comes to the seriousness of mental health. Thinking about it more, I wondered why we don’t see cartoons about mental health from our perspective? You know, the more I thought about it, I could not find many cartoons how we, as consumers see events and things might be funny or humorous in a cartoon. I searched the web and only found a few but mostly they were about the therapist, or psychiatrist or a joke with someone on a couch…

So, I thought some more, and I will quote the kids’ Animated film, Robots, “See a need, fill a need.” I could help fill the need by drawing cartoons about a subject that many people would want to avoid talking about… Mental Health! Maybe with the cartoons, I can help a few consumers by putting a smile on their faces using humor to heal.  So, after making sure this idea was not some grandiosity symptom of my Bipolar Disorder I set about making and drawing the cartoons.

That was over a year and half ago and my website, blog and cartoon-a-thon sites has had over 175,000 unique visits to view my catalog of over 200 cartoons.  With 60,000 coming to see some of the cartoons above that I drew for the May 2009 Cartoon-A-Thon. This was the second year for the cartoon-a-thon for Mental Health Awareness Month and I can’t wait till next year.

The cartoons are not for everybody, but each one I’ve drawn has helped me personally. Art therapy has kept me balanced and focused on being well.  This by itself makes the cartoons  successful.

The idea has never changed.  It’s simple and it works! Yes, using humor as a positive coping skill for mental illness is a great tool to have. I know the cartoons wont change the world, but maybe I can change the way some of us live with mental illness and to be able to find humor in it. Mental Illness is serious but does not mean the way we deal with it has to be.  So it is my goal to help a few of my peers to be able laugh and find humor, even if it’s one cartoon at a time.

Chato B.  Stewart
Mental Health Advocate – Cartoonist – and a few other  things!
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Differentiating Between Asperger’s And Obsessive-Compulsive Disorder

Taken from the  International OCD Foundation   which is located    HERE.

In recent years clinicians have continually seen a rise in Asperger‘s Disorder (AD), especially among child and adolescent populations. Whether this rise is due to an actual increase in AD or merely a result of improved definitions and increased awareness is unknown. In 1994, AD was first added to the DSM-IV (Kirby, 2003), therefore, it is only recently that parents and professionals are more aware of this disorder. AD is a complex disorder that resembles OCD in several ways; therefore, it becomes increasingly important to have an understanding of AD so one can better differentiate it from OCD. The purpose of this article is to help individuals, family members, and professionals better understand how these disorders are similar and how they can be differentiated from one another. A couple of case examples will be used to illustrate certain behaviors before we go on to the specific characteristics of the two disorders. For consistency purposes, the male gender is used throughout this paper because males outnumber females in AD. However, one should note that this is not the case with OCD.

Case Example 1

Matthew is a 9-year old boy.* He performs well academically in school. In class, he pays excellent attention; however, his teachers have noted some underlying anxiety regarding his academic performance. For example, Matthew takes a long time to complete tests and writing assignments. His teachers report that he is well behaved and follows classroom rules, but at the same time, Matthew will report to his teacher when his peers do not demonstrate the same behavior. Additionally, Matthew becomes agitated or upset when he is rushed and is unable to complete an assignment. At home, mornings and evenings are particularly difficult for Matthew.

He takes a long time getting ready for school, e.g., brushing his teeth a long time, dressing and redressing, going in and out of the room, etc. Also, he gets to bed later than he should making mornings even more difficult. He reports that he is unable to fall asleep because of “certain thoughts” and his bedtime rituals. Matthew’s mother is concerned with her son’s outbursts of anger. These fights usually occur around dinnertime when Matthew does not have his own way, such as, having his plate and silverware washed again before his food touches it. Matthew’s mother has also become increasingly concerned about her son’s peer relationships. She feels that Matthew is having difficulty making friends. As his friends become more interested in sports, Matthew has less in common with them and has started to spend more time alone.

Case Example 2

Eric is a 12-year old boy. Eric’s academic performance is strong. He is currently taking advanced coursework in mathematics and science. Eric’s teachers are impressed with his language ability in these areas. He uses adult words and has an advanced vocabulary surrounding science and history. Recently, Eric has been having trouble in school. More specifically, Eric only wants to read, write, and research specific topics, such as European history. If his teacher asks him to write about something else, Eric becomes very upset and argues with the teacher endlessly. In exasperation the teacher usually allows him to write about whatever he wants. Other times he is sent to the principal’s office. Additionally, Eric becomes irritable when things are out of the routine, for instance if he has to read a book different from the one he had been told to originally. Eric has one or two friends, but does not usually initiate social contact with children. Eric frequently needs to be redirected by his teacher to complete his work. In addition, he often requires extra time to complete his exams. Eric often appears anxious in school and when he feels this way he will continually ask the teacher questions and seek reassurance from her. At home, Eric demonstrates difficulty completing his homework assignments. He becomes fixated on one small aspect of his assignment and then runs out of time to complete the rest. After school, Eric can spend hours reading about history and will engage in hours of discussion about the topic. He enjoys comparing one history book to another. He will line up his books in alphabetical order and then analyze each one of them. Eric prefers “sameness”. He enjoys eating the same kind of foods over and over again. He also prefers soft fabrics and puts his clothing on each morning in a particular order.

The first case example is that of OCD and the second of AD. AD is at the mildest and highest functioning end of what is known as the Pervasive Developmental Disorder spectrum. As described by Treffert (1999), the disorder is characterized by normal speech development in childhood (e.g. single words by 2-years of age and use of communicative phrases by 3-years of age). Despite nor- mal verbal development, an individual’s speech may be repetitive or of unusual voice quality. For example, a child may repeat back what you just said, or he may repeat his own words. Furthermore, the child may demonstrate poor turn-taking skills during conversation and may dominate the conversation, especially when it concerns his special area of interest. Nonverbal skills in individuals with AD are also impaired. For example, individuals may not express a full range of facial expressions. At times, it may appear as though the child is looking through you and he evidences poor eye contact. Failure to develop social relations is another characteristic of this disorder. Some believe that the insufficient conversational and nonverbal skills lead to poor social relationships. Children with OCD do not lack the social skills as those with AD do. However, in some instances a child with OCD may develop poor relationships with his/her peers. This may occur when a child’s obsessions and compulsions occupy a lot of their time, which can lead to social withdrawal. Furthermore, if the compulsions are severe the child may be unable to hide them from his friends, which could lead to teasing. The child may also develop poor self-esteem because he views himself as being different from other children, but overall children with OCD have normal peer relationships (Fruehling, Johnston, & March, 1998). Children with OCD can follow social rules, but they may adhere to an adult moral code and become upset when their peers do not follow certain rules (Neziroglu & Yaryura-Tobias, 1997).

Without training, guidance, or instruction AD children will demonstrate difficulty adhering to social rules, such as not talking while others are talking or knowing when to appropriately end a conversation. Many AD children will also demonstrate poor motor coordination and clumsiness.

For example, elementary school children with AD may have penmanship problems and experience difficulty with activities during physical education class (Williams, 1995).
As demonstrated by the case examples, there are several similarities between OCD and AD including: shifting, incompleteness, emotions and compulsions. In both disorders the children have strong academic skills. Children with AD often demonstrate strong rote reading skills, calculation ability, and excellent memory (Bauer, 1996). Neziroglu and YaryuraTobias (1997) also report that children with OCD usually have above average academic ability. Both children will rarely feel relaxed and they will spend most of their day feeling anxious. In AD, this is especially true if the child does not know what to expect next or is overwhelmed by stimuli such as loud noises. In OCD, the child is anxious in regards to their obsessive thoughts and whether or not they are performing their compulsions correctly. Both children may experience incompleteness and require extra time to complete assignments at school and home. For the AD child, this is because they are distracted by internal and external stimuli. Therefore, they need an adult near by to redirect them to the task at hand. For the OCD child the reason differs. The child may take a long time to complete a task because they are concerned with perfection and/or doing a task until it feels right (i.e., doing it a set amount of times). Therefore, they may rewrite a paper, erase frequently, or reread the same passage repeatedly.

Children with both disorders will demonstrate a need for sameness. Usually the child with AD chooses to eat the same food each day, wear the same clothing, or play the same video game, whereas the child with OCD is looking for sameness in his/her daily routines. If the OCD child exhibits the “sameness” of the AD child it is for a different reason. Both children desire control over their environment so that they may perceive it as safe and predictable. However, children with OCD may eat the same foods each day because they are “safe” or not contaminated. In children with AD the reason varies. Children with AD have sensory issues, so they may not like certain textures, smells, fabrics, or sounds (Kirby, 2003). Sometimes children with OCD may also complain of not liking the feel of the seam on their socks, or be concerned with smells that are “dirty”.

Both children will demonstrate difficulty with shifting or transitioning between tasks. For the OCD child, this is because of the need for symmetry or balance. For example, if a child is working a home- work assignment on the computer and he is called for dinner, he will want to complete the entire assignment before he begins eating. If he does not complete the assignment, he will continue to feel anxious. Another example may include a child in school who has to tap the left side of the desk the same amount of times as he tapped the right side of the desk. Individuals with AD are resistant to change in their routines, prefer “sameness,” and have difficulty transitioning between tasks. For example, the child may like to always have breakfast before getting dressed and then having the parent take the same route to school each morning. An AD child may become overly upset with even the smallest changes in his environment, such as, the teacher switching the types of crayons used in the classroom. Repetitive activities are a defining characteristic of this disorder. These activities are preferred and engaged in at length. Similarly, the individual often has an intense preoccupation with one or two areas (i.e., weather, history, trains, or dinosaurs). Therefore, the child may engage in repetitive play surrounding his area of special interest, such as, lining up his model car collection on the floor. This preoccupation is abnormal in its focus and/or its intensity. In the area of interest, the individual has an incredible capability to memorize facts. Although overall conversation ability is typically poor, when discussing his area of interest, the individual may possess advanced knowledge on the topic (Treffert,1999). However, when discussing his area of interest, the conversation is usually one sided and the child may not pick-up on social cues regarding the other person’s disinterest or know when to stop speaking.

Since common features of AD include anxiety, repetitive behavior, and fixed habits, it is apparent that this disorder can mimic OCD (Yaryura-Tobias, Stevens, & Neziroglu,1998). Research studies in the psychology literature have focused on distinguishing between the restricted, repetitive, and stereotypic behavior associated with AD as compared to the compulsions found in OCD (Baron-Cohen, 1989; McDougle, Kresch, Goodman, Naylor, Volkmar, Cohen, & Price, 1995). In general, AD is typically characterized by a more severe impairment in social interactions (e.g., poor social reciprocity, poor peer relationships, and poor verbal and non-verbal skills). In addition, individuals with AD tend to have a more restricted pattern of interests and activities than those individuals with OCD. For example, a child with OCD may be obsessed and fearful of contamination and germs, whereas, a child with AD has a positive interest in a particular area. The next section will focus on some of the important differences between AD and OCD that can assist one in further differentiating between the two disorders.

As previously mentioned, a defining feature of AD is that obsessive thoughts surround involvement in an activity or area of specific interest. For example, an individual with AD may have a restricted interest in the area of trains. The high level of interest in this area may appear obsessional; however, it is important to bear in mind the definition of an obsession. By definition, obsessions are recurrent and persistent thoughts, impulses, or images that cause marked anxiety or distress. Individuals with AD typically do not experience anxiety or distress surrounding their area of interest. In fact, they derive pleasure from it. However, in OCD individuals experience a marked level of anxiety or distress. Therefore, ways to further differentiate AD and OCD is to assess whether the individual experiences anxiety or distress related to his obsessive thought patterns or compulsions. If the individual derives pleasure from the repetitive behavior and not just pleasure from anxiety reduction, then this feature is more likely linked to AD than OCD.

To minimize or neutralize the distress, an individual with OCD will engage in compulsive behavior. In AD, obsessional thoughts do not have specific compulsions attached to them.
Researchers have hypothesized that individuals with Pervasive Developmental Disorders may be unable to monitor their internal states and report anxiety related to obsessive thoughts (McDougle et al., 1995). Therefore, it is important to also examine the content of the behavior that occurs. It has also been found that some of the more common compulsions in OCD patients, such as checking and hand washing, are rarely found in AD (McDougle et al., 1995). Although, restrictive and repetitive behavior may mimic a compulsion, it is not completed with the intent to minimize anxiety or distress, nor is it specifically associated to intrusive thoughts.

Distinguishing between AD and OCD is potentially easier when each disorder is occurring on its own. However, as we have seen in our clinical experience, patients present with co-morbid AD and OCD. Co-morbidity is defined as the co-occurrence of two separate disorders at the same time. In these instances, it can be very difficult for clinicians to distinguish between what may be repetitive behaviors related to AD and what may be an OCD compulsion. Exposure and response prevention (ERP) to minimize rituals and restrictive interests in an individual with AD is not very effective because the child does not experience anxiety and therefore there is nothing to “habituate” to (habituation is the process by which anxiety is extinguished). It is through habituation that compulsions are reduced in OCD (there is neuronal fatigue occurring in the brainstem reticular formation). Rituals related to AD provide comfort to the individual and are not anxiety provoking. There is no negative situation to expose the individual to, however, one can limit some of the repetitive activity. If we attempt to strip the individual of this activity entirely, we potentially risk removing one’s positive coping strategy. On the other hand, if a clinician can distinguish between behaviors related to OCD and those that belong to AD, then one can attempt to successfully treat the OCD related symptoms with ERP. If an individual with co-morbid Asperger’s and OCD presents with an overwhelming amount of compulsions and ritualized behavior, by treating the OCD with ERP the amount of compulsive behavior that the person engages in can be reduced. After the OCD symptoms are treated, then one can proceed with other treatments to address the AD related behavior. Treatment of AD typically involves social skills training, parent training, and behavior therapy to decrease unacceptable behavior, while increasing more adaptive skills. For example, if a parent wants to increase desirable homework performance in his or her child, then the parent can make activities related to the specific area of interest (i.e., reading history books) contingent upon homework completion. One should note, that targeting undesirable behavior in AD children does not mean changing those behaviors that are considered “odd,” rather interventions should target behaviors such as repetitive questioning, inappropriate homework behavior, or increasing appropriate social skills.

     In summary, individuals with AD or OCD may evidence similar symptoms, including, shifting, incompleteness, anxiety, compulsions, and adherence to rituals. In general, individuals with AD are more socially impaired and demonstrate difficulty forming reciprocal relationships. In AD, individuals may have obsessive thoughts surrounding a restricted area of interest, but these thoughts do not likely cause a marked level of anxiety or distress as they do in OCD. Lastly, compulsive behavior in OCD is completed with the intent to minimize anxiety. In AD, individuals derive pleasure from engaging in these activities.

* To protect confidentiality, case descriptions in this article are based on composite or fictionalized clients.

Fugen Neziroglu, Ph.D., is a board certified Behavior and Cognitive psychologist involved in the research and treatment of OCD for 25 years.  She is the Clinical Director of the Bio-Behavioral Institute in Great Neck, NY and Professor at Hofstra University.  Jill Henirksen, MS, is a school psychologist who works with children and adolescents and interned with Dr. Neziroglu at the Bio-Behavioral Institute.

New Veterans Report Record Rate Of Disabilities


Taken from  St. Louis Today   which is located   HERE.

America’s newest veterans are filing for disability benefits at a historic rate, claiming to be the most medically and mentally troubled generation of former troops the nation has ever seen.

A staggering 45 percent of the 1.6 million veterans from the wars in Iraq and Afghanistan are now seeking compensation for injuries they say are service-related. That is more than double the estimate of 21 percent who filed such claims after the Persian Gulf War in the early 1990s, top government officials said.

What’s more, these new veterans are claiming eight to nine ailments on average, and the most recent ones over the last year are claiming 11 to 14. By comparison, Vietnam veterans are currently receiving compensation for fewer than four, on average, and those from World War II and Korea, just two.

It’s unclear how much worse off these new veterans are than their predecessors. Many factors are driving the dramatic increase in claims — the weak economy, more troops surviving wounds, and more awareness of problems such as concussions and post-traumatic stress disorder. Almost one-third have been granted disability so far.

Government officials and some veterans advocates say that veterans who might have been able to work with certain disabilities may be more inclined to seek benefits now because they lost jobs or can’t find any. Aggressive outreach and advocacy efforts also have brought more veterans into the system, which must evaluate each claim to see whether it is war-related. Payments range from $127 a month for a 10 percent disability to $2,769 for a full one.

As the nation commemorates the more than 6,400 troops who died in post-9/11 wars, the problems of those who have survived also draw attention. These new veterans are seeking a level of help the government did not anticipate and for which there is no special fund set aside to pay.

The Department of Veterans Affairs is mired in backlogged claims, but “our mission is to take care of whatever the population is,” said Allison Hickey, the VA’s undersecretary for benefits. “We want them to have what their entitlement is.”

The 21 percent who filed claims in previous wars is Hickey’s estimate of an average for Operation Desert Storm and Desert Shield. The VA has details on only the current disability claims being paid to veterans of each war.


The AP spent three months reviewing records and talking with doctors, government officials and former troops to take stock of the new veterans. They are different in many ways from those who fought before them.

More are from the Reserves and National Guard — 28 percent of those filing disability claims — rather than career military. Reserves and National Guard made up a greater percentage of troops in these wars than they did in previous ones. About 31 percent of Guard/Reserve new veterans have filed claims compared with 56 percent of career military ones.

More of the new veterans are women, accounting for 12 percent of those who have sought care through the VA. Women also served in greater numbers in these wars than in the past. Some female veterans are claiming PTSD due to military sexual trauma — a new challenge from a disability rating standpoint, Hickey said.

The new veterans have different types of injuries than did previous veterans. That’s partly because improvised bombs have been the main weapon and because body armor and improved battlefield care allowed many of them to survive wounds that in past wars proved fatal.

“They’re being kept alive at unprecedented rates,” said Dr. David Cifu, the VA’s medical rehabilitation chief. More than 95 percent of troops wounded in Iraq and Afghanistan have survived.

Larry Bailey II is an example. After tripping a rooftop bomb in Afghanistan last June, the 26-year-old Marine remembers flying into the air, then fellow troops attending to him.

“I pretty much knew that my legs were gone. My left hand, from what I remember, I still had three fingers on it,” although they didn’t seem right, Bailey said. “I looked a few times, but then they told me to stop looking.” Bailey, who is from Zion, Ill., north of Chicago, ended up a triple amputee and expects to get a hand transplant this summer.

He is still transitioning from active duty and is not yet a veteran. Just over half of Iraq and Afghanistan veterans eligible for VA care have used it so far.

Of those who have sought VA care:

• More than 1,600 of them lost a limb; many others lost fingers or toes.

• At least 156 are blind, and thousands of others have impaired vision.

• More than 177,000 have hearing loss, and more than 350,000 report tinnitus — noise or ringing in the ears.

• Thousands are disfigured, as many as 200 of them so badly that they may need face transplants. One-quarter of battlefield injuries requiring evacuation included wounds to the face or jaw, one study found.

“The numbers are pretty staggering,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston who has done four face transplants on nonmilitary patients and expects to start doing them soon on veterans.

Others have invisible wounds. More than 400,000 of these new veterans have been treated by the VA for a mental health problem, most commonly, PTSD.

Tens of thousands of veterans suffered traumatic brain injury, or TBI — mostly mild concussions from bomb blasts — and doctors don’t know what’s in store for them long-term. Cifu, of the VA, said that roughly 20 percent of active duty troops suffered concussions, but only one-third of them have symptoms lasting beyond a few months.

That’s still a big number, and “it’s very rare that someone has just a single concussion,” said David Hovda, director of the UCLA Brain Injury Research Center. Suffering multiple concussions, or one soon after another, raises the risk of long-term problems. A brain injury also makes the brain more susceptible to PTSD, he said.

On a more mundane level, many new veterans have back, shoulder and knee problems, aggravated by carrying heavy packs and wearing the body armor that helped keep them alive. One recent study found that 19 percent required orthopedic surgery consultations and 4 percent needed surgery after returning from combat.


All of this adds up to more disability claims, which for years have been coming in faster than the government can handle them. The average wait to get a new one processed grows longer each month and is now about eight months — time that a frustrated, injured veteran may spend with no income.

More than 560,000 veterans from all wars currently have claims that are backlogged — older than 125 days.

The VA’s benefits chief, Hickey, gave these reasons:

• Sheer volume. Disability claims from all veterans soared from 888,000 in 2008 to 1.3 million in 2011. Last year’s included more than 230,000 new claims from Vietnam veterans and their survivors because of a change in what conditions can be considered related to Agent Orange exposure. Those complex, 50-year-old cases took more than a third of available staff, she said.

• High number of ailments per claim. When a veteran claims 11 to 14 problems, each one requires “due diligence” — a medical evaluation and proof that it is service-related, Hickey said.

• A new mandate to handle the oldest cases first. Because these tend to be the most complex, they have monopolized staff and pushed up average processing time on new claims, she said.

• Outmoded systems. The VA is streamlining and going to electronic records, but for now, “we have 4.4 million case files sitting around 56 regional offices that we have to work with; that slows us down significantly,” Hickey said.

Barry Jesinoski, executive director of Disabled American Veterans, called Hickey’s efforts “commendable” but said: “The VA has a long way to go” to meet veterans’ needs. Even before the surge in Agent Orange cases, VA officials “were already at a place that was unacceptable” on backlogged claims, he said.

He and VA officials agree that the economy is motivating some claims. His group helps veterans file them, and he said that sometimes when veterans come in, “we’ll say, ‘Is your back worse?’ and they’ll say, ‘No, I just lost my job.'”

Jesinoski does believe these veterans have more mental problems, especially from multiple deployments.

“You just can’t keep sending people into war five, six or seven times and expect that they’re going to come home just fine,” he said.

For taxpayers, the ordeal is just starting. With any war, the cost of caring for veterans rises for decades and peaks 30 to 40 years later, when diseases of aging are more common, said Harvard economist Linda Bilmes. She estimates the health care and disability costs of the recent wars at $600 billion to $900 billion.

“This is a huge number, and there’s no money set aside,” she said. “Unless we take steps now into some kind of fund that will grow over time, it’s very plausible many people will feel we can’t afford these benefits we overpromised.”

How would that play to these veterans, who all volunteered and now expect the government to keep its end of the bargain?

“The deal was, if you get wounded, we’re going to supply this level of support,” Bilmes said. Right now, “there’s a lot of sympathy and a lot of people want to help. But memories are short and times change.”

Charles Spurgeon: Morning And Evening, May 26th, 2012

“Cast thy burden upon the Lord, and He shall sustain thee.”—Psalm 55:22.

ARE, even though exercised upon legitimate objects, if carried to excess, has in it the nature of sin. The precept to avoid anxious care is earnestly inculcated by our Saviour, again and again; it is reiterated by the apostles; and it is one which cannot be neglected without involving transgression: for the very essence of anxious care is the imagining that we are wiser than God, and the thrusting ourselves into His place to do for Him that which He has undertaken to do for us. We attempt to think of that which we fancy He will forget; we labour to take upon ourselves our weary burden, as if He were unable or unwilling to take it for us. Now this disobedience to His plain precept, this unbelief in His Word, this presumption in intruding upon His province, is all sinful. Yet more than this, anxious care often leads to acts of sin. He who cannot calmly leave his affairs in God’s hand, but will carry his own burden, is very likely to be tempted to use wrong means to help himself. This sin leads to a forsaking of God as our counsellor, and resorting instead to human wisdom. This is going to the “broken cistern” instead of to the “fountain;” a sin which was laid against Israel of old. Anxiety makes us doubt God’s lovingkindness, and thus our love to Him grows cold; we feel mistrust, and thus grieve the Spirit of God, so that our prayers become hindered, our consistent example marred, and our life one of self-seeking. Thus want of confidence in God leads us to wander far from Him; but if through simple faith in His promise, we cast each burden as it comes upon Him, and are “careful for nothing” because He undertakes to care for us, it will keep us close to Him, and strengthen us against much temptation. “Thou wilt keep him in perfect peace whose mind is stayed on Thee, because he trusteth in Thee.”

Praise & Worship: May 25th, 2012

Song List

1.  Open Our Eyes- Maranatha Singers

2.  The Light Of That City-  Brooklyn Tabernacle Choir

3.  Gone Gonna Rise Again-  The Gordons

4.  Glory Bound-  The Wailin Jennys

5.  Hallelujah-  Krystal Meyers

6.  The Anthem/Hallelujah-  Planetshakers

7.  All To You-  Kathleen Carnali

8.  The Hurt And The Healer-  MercyMe

9.  Broken Hallelujah-  Mandisa

10.  Your Love (Psalm 139)-  Oslo Gospel Choir

11.  Better Than A Hallelujah-  Amy Grant