Post by Former NIMH Director Thomas Insel: Recognizing Those Who Have Served
It seems entirely fitting that Veterans Day this year precedes the annual Society for Neuroscience (SfN) meeting here in Washington, DC. As a nation, we pause to honor the men and women who have served the United States in uniform. As people involved in research on brain disorders, including the more than 30,000 who will attend the SfN meeting, we pause to think about the special role we play.
NIMH was founded by President Harry Truman to address the needs of soldiers returning from WWII with “combat neurosis,” the syndrome we recognize today as post-traumatic stress disorder (PTSD). Nearly 65 years later, we continue to pursue biomarkers for prediction, preventive interventions following a traumatic event, and treatments.
The NIMH/U.S.Army Study to Assess Risk and Resilience in Soldiers (Army STARRS) project enrolled over 25,000 soldiers in the past year to develop a risk calculator for PTSD, depression, and suicide, similar to what we use today for heart disease. Last week, we brought scientists together from around the country to discuss the latest evidence for predicting PTSD based on genetic profiles, psychological testing, and trauma history. New interventions, from medications like prazosin and d-cycloserine, to psychosocial interventions with virtual reality and novel cognitive therapies, are being tested, with some promising results.
The needs are great and becoming greater each year. A recent report from the Army noted,
“At 24 years of age, a Soldier, on average, has moved from home, family and friends and has resided in two other states; has traveled the world (deployed); been promoted four times; bought a car and wrecked it; married and had children; has had relationship and financial problems; seen death; is responsible for dozens of Soldiers; maintains millions of dollars worth of equipment; and gets paid less than $40,000 a year.”
Roughly 20 percent of the nearly 2 million soldiers who have served in Iraq and Afghanistan are struggling with the signature wounds of these wars, PTSD and traumatic brain injury. We know that more soldiers die from suicide than combat. And we know that veterans of these and earlier wars are at increased risk for PTSD, depression, substance abuse, and suicide. As Patrick Kennedy has said, too many soldiers return to become medical POWs. When the cause is a brain disorder, neuroscience holds the best hope of setting them free.
One of our most important partners in this effort is the Veteran’s Administration (VA), which has become a model for health care in America with its electronic medical records and integrated care system. In fact, in 2011, NIMH awarded 78 grants at a total of over $36 million for studies involving veterans or researchers at institutions affiliated with the Veterans Administration (VA).
Over the past few years, the VA stepped up its efforts for addressing psychiatric illnesses, especially PTSD. It is now a leader in mental health service, thanks to outreach, crisis lines, mobile applications, such as the award winning “PTSD Coach,” and other innovative approaches. The VA also has employed dissemination and implementation initiatives to expand the use of evidence-based practices in clinical care——which, to date, have resulted in training more than 5,000 mental health staff in the delivery of at least one evidence based psychotherapy. Later this month, they will launch a new anti-stigma campaign, “Make the Connection,” with the hope of bringing even more people into treatment. The VA has more information and resources relating mental health at www.mentalhealth.va.gov.
Along with colleagues at the VA, our focus has been on wounded warriors. This Veterans Day, 11/11/11, is a day to remember and commit to not only those who have been wounded, but to all those who have served. How many 24 year-olds have been responsible for protecting dozens of colleagues, mastering millions of dollars of equipment, and defending the values of our nation? Some current and former soldiers will be our patients, many will be our leaders, and all deserve our gratitude.