Pentagon: PTSD does not warrant Purple Heart - Army News | News from Afghanistan & Iraq - Army Times

Pentagon: PTSD does not warrant Purple Heart

The Pentagon has decided it will not award the Purple Heart to troops suffering from post-traumatic stress disorder.

The decision, reached Nov. 3 but not made public until now, followed months of review by military and outside officials that was spurred when Defense Secretary Robert Gates was asked at a May news conference whether he would support awarding the Purple Heart to PTSD victims.

Gates said the idea was “clearly something that needs to be looked at.” But after conferring with the Awards Advisory Group, which includes experts from the Pentagon, Center for Military History and Institute of Heraldry, Gates’ personnel chief, David S.C. Chu, decided against such awards, Pentagon spokeswoman Eileen Lainez said Jan. 5.

Gates concurred, Lainez said. The decision was first reported by Stars and Stripes newspaper.

The Purple Heart “recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Lainez said.

PTSD “is not a wound intentionally caused by the enemy from an outside force or agent, but a secondary effect caused by witnessing or experiencing a traumatic event.”

PTSD is an anxiety disorder that can develop “after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened,” according to the National Institute of Mental Health. The affliction is one of several reported in high numbers among veterans returning from duty in the Iraq and Afghanistan wars, both marked by long tours and high exposure to combat trauma.

The Pentagon says its data suggests that up to 20 percent of returning Iraq war veterans meet the screening criteria for PTSD.

According to the Department of Veterans Affairs, nearly 76,000 veterans of the current wars received a provisional diagnosis of PTSD between 2002 and mid-2008. In another measure, the military diagnosed a total of 39,366 soldiers with PTSD between 2003 and 2007.

The Pentagon’s decision drew praise from veterans and others. Many acknowledged the need to improve and expand treatment and to reduce the stigma still perceived to be widely attached to the disorder.

“We’re very happy,” said Phil Riley, national security director for The American Legion. “We felt that the dividing line was whether it’s an illness or actual injury, and we stuck with that.”

Riley said the Legion surveyed the veteran community before passing a resolution opposing a Purple Heart award for PTSD.

John Fortunato, chief of a Fort Bliss, Texas, PTSD treatment center, had openly lobbied for a Purple Heart award to victims following Gates’ May visit, saying that “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.”

But he accepts the Pentagon’s decision. “I’m pleased that the Department of Defense gave the matter serious attention,” he said. “They’ve given it a fair hearing, and they’ve come to a decision. That’s the most anybody could ask for.”

“There’s no blood test” for PTSD, explained Charles Figley, professor of disaster mental health at Tulane University, and co-author of a 2007 book on combat stress. “There’s no neurological map that clearly identifies it.”

While it’s classified as a mental disorder, Figley said it is also “an anxiety disorder, and all anxiety disorders are extraordinarily subjective. They’re difficult to treat through medication for precisely that reason.”

But some theorize a correlation between diagnoses of PTSD and neurological damage, and ongoing research could someday lead to a blood test not only for the disorder but also to identify those most at risk, Figley said.

The Pentagon left open the possibility of a reassessment at some point.

Knowledge of “predictable and quantifiable physiologic injuries associated with specific psychological injuries is less robust now than it may be in the future,” Lainez said.

She stressed that the Pentagon encourages service members and their families “to seek care for PTSD, by reducing the stigma and urging them to seek professional care.”

Troops with PTSD “still warrant appropriate medical care and disability compensation,” she said.