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National Guard Association of the United States

One Mind for Research

National Alliance on Mental Illness

Brain Injury Association of America

Iraq and Afghanistan Veterans of America

Tragedy Assistance Program for Survivors

Comfort for America's Uniformed Service

Code of Support Foundation

Army Wife Network

Yellow Ribbon Fund

United Children of Veterans

Operation Never Forgotten

National Center for Victims of Crime

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More than 30 centuries ago, long before even the written word Homer talked about combat stress in his epic poems on the Trojan War. 

During the Civil War soldiers were removed from the front and considered for disability and pensions for Soldiers Heart or “nostalgia”, but in reality combat stress during that time was considered a form of insanity.

By 1914, at the outbreak of World War I, combat stress and its civilian counterpart, “railway spine” had actually risen to the position of being considered physical ailments that deserved medical treatment. 

By the summer of 1916, the brutal trench warfare on the Western Front had produced an epidemic of shell shock among French and British troops, and “nervenshock” among Germans troops which was draining the treasuries and manpower pools on both sides. To address this crisis, Kaiser Wilhelm directed the German Association of Psychiatry to convene a special War Congress.

 After briefly discussing the evidence, these leading psychiatrists of their day settled the debate by declaring –“Persistent distress or functional impairment following exposure to a traumatic stressor could only occur in individuals already afflicted with the pre-existing personality weakness that they termed hysteria”.

Subsequently, the German government was relieved of its responsibility to pay disability pensions to veterans sufferingfrom combat stress, while commanders in the field were no longer obligated to evacuate stress casualties from the front.

The term “hysteria” was never intended to be a neutral label. It was chosen to be intentionally stigmatizing, especially when applied to male service members who understood it to be a feminizing term. 

The French and English and later the Americans also adopted the doctrine. The term shell shock was dropped and there was a drastic reduction in the evacuation of stress casualties along with the responsibilities of paying compensation fees.  

As a result of these new tenets the rates of wartime psychiatric evacuations during the 20th century fell to approximately 10% in WWII, 3.7% in the Korean War and barely 1.2% in Vietnam.

47 States and both Houses of Congress drop the “D”

    A WOUND NOT A WEAKNESS         

The diagnostic term Post-traumatic Stress Disorder (PTSD) was crafted in 1980 by the American Psychiatric Association to commonly describe and categorize the psychological aftermath of experiencing traumatic events. Since, as the result of intensive electromagnetic imaging research, it has been shown that severe post-traumatic stress, combat induced or otherwise, causes physical changes within the brain which more accurately describe an injury than a disorder – a treatable wound calling for definitive and timely treatment.

The stigma advanced by the term “Post-traumatic Stress Disorder” presents a needless liability to the health and welfare of those already overwhelmed by this basic natural response to an extraordinary event. To label them “disordered” only serves to add to their struggle, discouraging some of the afflicted from seeking care while keeping others, particularly those who do not know them, from truly caring.

In 2012, the American Psychiatric Association held an open hearing to debate the name change of post-traumatic stress disorder (PTSD) to, or include post-traumatic stress injury (PTSI). Regrettably, the APA’s decision was to not change or add to the name for DSM 5.

Beyond this obvious obstruction to the healing process, the use of the word “disorder” here negates the sense of honor owed the brave men and women who have received these wounds while risking their lives to protect ours, be it on the field of battle, the emergency rooms of our hospitals, or the streets of our communities. On a personal level it disparages the character of victims of crime and abuse, as well as survivors of life-threatening accidents, natural disasters, and more.

In 2013 Honor for ALL began a grassroots campaign to rebrand the term as Post-traumatic Stress Injury on a cultural level by petitioning federal, state and local officials to declare June 27 as Post-traumatic Stress Injury Day Awareness Day (the date June 27 was first chosen by the United States Senate as National PTSD Awareness Day in 2010). Our objective was, and remains, to gather enough support among governing bodies, the press, and the electorate, to positively influence succeeding actions of the APA’s DSM Scientific Review Committee in favor of name change.

Our first state resolution for came from our home state of Michigan in 2014. We have now, as of the Spring of 2022, received participation from 47 states by way of bill, resolution and/or proclamation designating June 27 Post-traumatic Stress Injury Awareness Day. The US House of Representatives signed on in 2017 and the Senate has designated June 27 as PTS Awareness Day beginning in 2016.

HFA Medical Advisor, Dr. Frank Ochberg, former Associate Director of the National Institute of Mental Health (NIMH) and member and chair of APA councils, committees and task forces in the late 1970s and early 1980s materially responsible for advancing the creation and modification of the original diagnosis known as PTSD agrees, “As far as I am concerned, the name PTSD, was never important.  The concept was important.  We knew before 1980 that research would help us adjust the diagnostic criteria through time.  We knew that later versions would reflect evolving scientific knowledge.  And now, evolving knowledge leads us to a modification in the name as well as modifications in criteria.  The basic concept remains. Some details have c   hanged.  The fact that profound trauma creates injuries to brain function, brain physiology and brain anatomy is well established.  The fact that calling this phenomenon an injury, not a disorder, confers honor rather than stigma is now established.”

Initially a veterans focused organization, Honor for ALL’s concern has grown to include all who suffer from the psychological and moral injuries now grouped together under the term post-traumatic stress disorder (PTSD). Removing the “D” can reduce the stigma and that is good. Adding the “I” for injury introduces honor and that is better.

Identifying Post-traumatic Stress as an Injury by officially and publicly declaring a Day of Awareness cannot unwring the bell sounded by the APA in DSM III some forty years ago when they coined their original descriptor, but it can serve to redirect public sentiment. Officially and publicly declaring a Day for Post-traumatic Stress Injury Awareness says we are committed to excluding shame, adding honor, and in the end – saving lives.

For individual Bills, Resolutions and Proclamations to date go to *Supporters*.

 

 

Tom Mahany started a hunger strike on Veterans Day 2009 lasting 29 days to draw attention to the issue of combat stress and related suicide. He fasted again in August of 2012, this time for 17 days, when he learned that the number of suicides among active duty service members had doubled from June to July.

Now Mahany heads up the veterans’ advocacy group Honor for ALL, which organizes an annual event, Visible Honor for Invisible Wounds, to raise awareness of posttraumatic stress injury.

This year’s event recognized the passing of legislation introduced by U.S. Senator Heidi Heitkamp designating June 2014 as National Posttraumatic Stress Disorder Awareness Month. JB Moore, NAMI Manager for Military and Veterans Policy and Support, represented NAMI at the event.

Though usually held in Washington, D.C., Visible Honor for Invisible Wounds took place in New York City on Saturday, June 28, 2014 and was co-hosted by the Mental Health Association of New York City. The scope of the program was expanded to include first responders and victims of abuse.

The keynote speaker Staff Sergeant Ty Carter, who has struggled with PTSD, was the 2013 recipient of the Congressional Medal of Honor. When awarding the Medal of Honor, President Obama described SSgt. Carter this way, “He’s as tough as they come. And if he can find the courage and the strength to not only seek help, but also to speak out about it, to take care of himself and to stay strong, then so can you.”

In addition to SSgt. Carter, officials included commissioners from the New York City police and fire departments, representatives from the Chiefs of Staff of the Army and Navy; the Wounded Warrior Project; Iraq Afghanistan Veterans of America (IAVA); Service Women’s Action Network.

“It is reprehensible that an estimated 22 veterans take their lives each day”, declared JB in her remarks.  “Posttraumatic stress is treatable. Let’s eradicate stigma!”

According to Mahany, “There was an unmistakable message from the event. Posttraumatic stress is an injury that needs to be accepted and honored as such. If we don’t attend to it, it will be allowed to progress into a disorder.”

Earlier this year, the Senate Armed Services Committee passed the Jacob Sexton Military Suicide Prevention Act of 2014 – introduced by U.S. Senator Joe Donnelly (D-Ind.), as part of this year’s National Defense Authorization (NDAA) bill.  If passed, this legislation will: (1) Require annual mental health assessments for all service members-Active, Reserve, and Guard; (2) Establish a working group between the Department of Defense and Department of Health and Human Services; and (3) Require an interagency report to evaluate existing military mental health practices and provide recommendations for improvement.

According to Mary Giliberti, NAMI’s Executive Director, “The National Alliance on Mental Illness strongly supports the Jacob Sexton Military Suicide Prevention Act of 2014 and applauds Senator Donnelly for his recognition that suicide rates among active duty service members, National Guardsmen and Reservists are unacceptably high and in dire need of attention.  This important piece of legislation advances NAMI’s goals of parity, accountability, collaboration and action.”

Honor for ALL is already at work organizing next year’s National Posttraumatic Stress Awareness activities. Events will be held in New York, Michigan, San Diego, and Indianapolis, all on Saturday June 27, 2015.

Tom Mahany believes the sure sign of true awareness about posttraumatic stress will be when Major League Baseball plays with purple bats for the month of June

Honor for ALL is responsible for initiating the first governmental resolution of its kind designating Post-traumatic Stress Injury Awareness Day

Adopted concurrently by the House and Senate of the State of Michigan, June 23, 2014:

June 27, 2014, is designated ‘‘Michigan Post-traumatic Stress Injury Awareness Day’’

Whereas the brave men and women of the United States Armed Forces, who proudly serve the United States, risk their lives to protect the freedom of the United States and deserve the investment of every possible resource to ensure their lasting physical, mental, and emotional well-being;

Whereas more than 2,000,000 United States service members have deployed as part of overseas contingency operations since the events of September 11, 2001;

Whereas the military has sustained an operational tempo for a period of time unprecedented in the history of the United States, with many service members deploying multiple times to combat zones, placing them at high risk of post-traumatic stress injury (referred to in this preamble as “PTSI”);

Whereas it is expected that ten thousand veterans will return to the State of Michigan every year for the next three to five years after spending a significant amount of time in combat environments, exposing thousands of soldiers to traumatic life threatening events;

Whereas the Department of Veterans Affairs reports that in fiscal year 2012, more than 500,000 veterans from all wars sought care at a Department of Veterans Affairs medical center received treatment for PTSI;

Whereas PTSI significantly increases the risk of depression, suicide, and drug and alcohol related disorders and deaths;

Whereas the Department of Defense and the United States Department of Veterans Affairs have made significant advances in the prevention, diagnosis, and treatment of PTSI and the symptoms of PTSI, many challenges remain; and

Whereas the establishment of a Michigan Post-Traumatic Stress Injury Awareness Day will raise public awareness about issues related to PTSI:

Now, therefore, be it Resolved, that the (Senate/House) —

(1) designates June 27, 2014, as ‘‘Michigan Post-Traumatic Stress Injury Awareness Day’’;

2) urges the Michigan Veterans Affairs Agency and The Adjutant General to continue working to educate servicemembers, veterans, the families of servicemembers and veterans, and the public about the causes, symptoms, and treatment of post-traumatic stress injury; and

(3) respectfully requests that the –(Sec of the Senate/Clerk of the House)– transmit a copy of this resolution to the governor of the State of Michigan.

Tom Mahany and others talk about suicides among Vietnam Veterans