The psychological toll of America's wars in Iraq and Afghanistan has touched one in five servicemen and its consequences will be long-lasting, a study suggested yesterday.

The Rand Corporation, a leading research operation, said that 320,000 soldiers suffered brain injuries on the battlefield, while more than 300,000 suffered mental disorders on returning home.

The report said that US veterans are incurring "invisible wounds" of war, most notably traumatic brain injury. A survey of 1,926 soldiers represented a statistically significant sample of the 1.6 million troops sent to Iraq and Afghanistan since 2001, Rand said.
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Roadside bombs were responsible for a vast number of injuries never fully diagnosed or treated in modern warfare, according to the report's authors.

It found that 19.5 per cent of the returning soldiers were reported to have experienced a "probable brain injury" during deployment but only 57 per cent of those had seen a doctor about the incident.

The report added there was a similar picture of mental health problems: "Among those who met diagnostic criteria for post traumatic stress disorder or major depression, only 53 percent had seen a physician or mental health provider to seek help for a mental health problem in the past 12 months."

Rand called for stronger support for veterans from the military's medical hierarchy. "There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, the lead researcher.

"Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need.

Researchers predicted that 300,000 servicemen, or 18.5 per cent of those sent to fight, would suffer long-term depression or other mental health conditions.

A national class action lawsuit brought by Iraq and Afghanistan war veterans went to trial on April 21. The suit, known as Veterans for Common Sense vs. Peake was brought by two veterans organizations who argue the Department of Veterans Affairs is systematically denying hundreds of thousands of wounded veterans needed medical treatment, while forcing them to wait months or even years for the disability benefits they've earned.

"We're dealing with people who are almost totally disabled; people who have lost arms, lost legs in these wars, people who have come home with Post Traumatic Stress Disorder or physical brain injury," explained Gordan Erspamer, an attorney with the law firm Morrison and Forrester who is handling the case pro bono. "We can't have these people waiting for months and years for the treatment they need."

According to a study released last week by the Rand Corporation, an estimated 300,000 veterans among the nearly 1.7 million who have served in Iraq and Afghanistan are battling depression or post-traumatic stress disorder. Another 320,000 veterans suffer from Traumatic Brain Injury, physical brain damage which is often caused by roadside bombs.

However, the VA reports only about 300,000 Iraq and Afghanistan war veterans have received health care from the VA system - about 120,000 for mental injuries. That means more than half the American service personnel wounded in Iraq and Afghanistan have slipped through the cracks.

"The VA needs aggressive, pro-veteran leaders, for more additional funding for staff, office space and for screening and treatment equipment," said Paul Sullivan of Veterans for Common Sense. "The VA needs more streamlined policies so that veterans don't need to fill out a 20 page form in order to get care."

Sullivan said his organization decided to file suit when it became clear the agency wouldn't take action on its own. Before helping to found Veterans for Common Sense, Sullivan monitored disability claims for the VA. In 2006, he resigned in protest.

"In 2005, while working at VA, I briefed senior VA political leaders that VA was in a crisis of a surge of disability claims of Iraq and Afghanistan war veterans," he said. "I recommended in writing that the VA hire more claims processors to make sure the veterans get their benefits faster instead of facing six month delays or even longer."

"The VA didn't do anything to help the veterans. What the VA actually did was several things to lock the doors and block veterans from getting mental health assistance from VA," Sullivan added.

Starting Phased Redeployment within Hillary's First Days in Office: The most important part of Hillary's plan is the first: to end our military engagement in Iraq's civil war and immediately start bringing our troops home. As president, one of Hillary's first official actions would be to convene the Joint Chiefs of Staff, her Secretary of Defense, and her National Security Council. She would direct them to draw up a clear, viable plan to bring our troops home starting with the first 60 days of her Administration. She would also direct the Department of Defense and the Department of Veterans Affairs to prepare a comprehensive plan to provide the highest quality health care and benefits to every service member -- including every member of the National Guard and Reserves -- and their families.

Securing Stability in Iraq as we Bring our Troops Home. As president, Hillary would focus American aid efforts during our redeployment on stabilizing Iraq, not propping up the Iraqi government. She would direct aid to the entities -- whether governmental or non-governmental -- most likely to get it into the hands of the Iraqi people. She would also support the appointment of a high level U.N. representative -- similar to those appointed in Afghanistan, Bosnia, and Kosovo -- to help broker peace among the parties in Iraq.

A New Intensive Diplomatic Initiative in the Region. In her first days in office, Hillary would convene a regional stabilization group composed of key allies, other global powers, and all of the states bordering Iraq. The- mission of this group would be to develop and implement a strategy to create a stable Iraq.

Bringing Our Troops Home

Obama will immediately begin to remove our troops from Iraq. He will remove one to two combat brigades each month, and have all of our combat brigades out of Iraq within 16 months. Obama will make it clear that we will not build any permanent bases in Iraq. He will keep some troops in Iraq to protect our embassy and diplomats; if al Qaeda attempts to build a base within Iraq, he will keep troops in Iraq or elsewhere in the region to carry out targeted strikes on al Qaeda.
Press Iraq’s Leaders to Reconcile

The best way to press Iraq’s leaders to take responsibility for their future is to make it clear that we are leaving. As we remove our troops, Obama will engage representatives from all levels of Iraqi society – in and out of government – to seek a new accord on Iraq’s Constitution and governance. The United Nations will play a central role in this convention, which should not adjourn until a new national accord is reached addressing tough questions like federalism and oil revenue-sharing.
Regional Diplomacy

Obama will launch the most aggressive diplomatic effort in recent American history to reach a new compact on the stability of Iraq and the Middle East. This effort will include all of Iraq’s neighbors — including Iran and Syria. This compact will aim to secure Iraq’s borders; keep neighboring countries from meddling inside Iraq; isolate al Qaeda; support reconciliation among Iraq’s sectarian groups; and provide financial support for Iraq’s reconstruction.
Humanitarian Initiative

Obama believes that America has a moral and security responsibility to confront Iraq’s humanitarian crisis — two million Iraqis are refugees; two million more are displaced inside their own country. Obama will form an international working group to address this crisis. He will provide at least $2 billion to expand services to Iraqi refugees in neighboring countries, and ensure that Iraqis inside their own country can find a safe-haven.

A greater military commitment now is necessary if we are to achieve long-term success in Iraq. John McCain agrees with retired Army General Jack Keane that there are simply not enough American forces in Iraq. More troops are necessary to clear and hold insurgent strongholds; to provide security for rebuilding local institutions and economies; to halt sectarian violence in Baghdad and disarm Sunni and Shia militias; to dismantle al Qaeda; to train the Iraqi Army; and to embed American personnel in Iraqi police units. Accomplishing each of these goals will require more troops and is a crucial prerequisite for needed economic and political development in the country. America's ultimate strategy is to give Iraqis the capabilities to govern and secure their own country.

For most of the occupation, military strategy has focused on securing all of Iraq by establishing bases and conducting short operations from them. Ultimately, this secured only small areas of the country. John McCain believes the current force structure and power vacuum persisting in many areas of the country demands a more robust counterinsurgency strategy. Iraqi and American forces must not only use force to clear areas occupied by insurgents but to stay and hold these areas to deny them as a base for insurgent forces and allow economic and political development to occur in a secure environment. By emphasizing safety of the local population, this strategy will create strongholds in which insurgents find it difficult to operate.

Building a capable Iraqi army is a central requirement for ensuring Iraq's ability to govern and protect itself long after American forces have withdrawn. The U.S. must accelerate the training and equipping of Iraqi armed forces and police to enable them to play a key role in securing Iraq. Only in a secure environment will the development of Iraq's political and economic institutions have a chance to succeed. Ultimately, Iraq's future lies in the hands of its people, government, and armed forces, and strengthening them is an essential requirement for bringing U.S. troops home from Iraq. Until Iraqi forces are ready, however, a precipitous U.S. withdrawal would condemn Iraq to civil war and intervention by its neighbors and energize al Qaeda and other jihadists across the globe. This would gravely jeopardize American security.