Medical Intervention in Veteran PTSD

By: Kirsten Moran 

Introduction to PTSD | Veterans and Criminal Activity | Medical Intervention | Medical Prevention | Closing Introduction 

As the United Kingdom and the United States approach Post Traumatic Stress Disorder Awareness Month in June, it is essential for the public to understand what the disorder is and its consequences on veterans' lives. PTSD develops after a traumatic event, including combat or sexual abuse. While most people experience stress reactions to a trauma, those diagnosed with PTSD undergo persistent and interfering reactions for over a month. Those diagnosed experience a variety of symptoms characterized into four groups: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical reactions. It is also simultaneously experienced with other conditions, such as depression, substance use, and memory difficulties. In the United States, PTSD occurs in 4% of adults and 8% of adolescents aged 13 to 18. Additionally, veterans are bound to a higher 6% 

among males and 13% among females. The statistics 

continue to vary depending on the service era of the 

veteran. According to data recorded from the U.S. 

Department of Veterans Affairs, 29% of veterans who 

served in Operations Iraqi Freedom and Enduring 

Freedom experienced PTSD. Of those who served in the Persian Gulf War (Desert Storm), 21%, and <10% of veterans who served in the Vietnam War, World War II, and Korean War underwent or are undergoing the disorder. All figures exclude veterans who had passed prior to the study

and are credited to factors including screening accessibility, military sexual trauma, deployment, the politics of the war, and where the war was fought. 

The Parallels of PTSD Veterans and Criminal Activity 

Contrasting the honorable duty of a soldier, veterans with PTSD are commonly susceptible to criminal activity due to their exploited mental state. The similitude is not only forlorn, but deathly to the courageous veterans who already virtuously risked and bore their lives in warfare. In 2015, the Death Penalty Information Center’s Battle Scars report uncovered data of 300 veterans incarcerated under a sentence of death, comprising at least 10% of those on death row, along with many others who had been executed (1). To understand the events that lead veterans to this final stage, it is essential to recognize how they arrived at this point. The Preliminary Assessment of Veterans in the Criminal Justice System and released in 2022, said Justice Department data showed that about 8% of all U.S. inmates, or about 181,500, were military veterans, 98% being male, and another study showing 33% of veterans veterans surveyed with PTSD had committed at least one act of aggression or violence in their community. While most do not act violently on returning home as a war hero, many do, specifically to their loved ones. The National Domestic Violence Hotline claims in a report that the calls they received about veterans between 2006 and 2014 were 90% made by women, 73% stated physical abuse, and 14% of callers were not calling for the first 

time. However, not all crimes committed are directly violent. Common 

offenses include DUIs, possession or distribution of illegal substances, 

theft, and public disturbance. Non-specific to PTSD, veterans mentally 

suffering have been found to drug trafficking and commit child 

pornography offenses more than four times as often as citizen offenders

overall and and sex abuse offenses more than twice as often. Extremity in these issues, along with murder, has led to devastating effects such as the death penalty as described above. The once-honored men and women of the nation’s military find themselves in this unfortunate state, facing a grim fate if no intervention occurs. 

Medical Professionals in Intervention 

Implementing effective strategies in healthcare and the criminal justice system is vital and life-saving for veterans with PTSD, particularly through Veterans Treatment Courts (VTC). Many veterans who become incarcerated experience further deterioration of their condition due to the harsh realities of jail and prison. This focus on 

acknowledgement and restoration can help improve 

their mental health and support their recovery (Rousseau 

1). The Save A Warrior program, along with the 

Veterans Treatment Court in Orange County, California, 

was able to turn Jeff Henson’s life anew. Henson is an 

Air Force veteran diagnosed with PTSD in 2016 after his incident in 2013. During a dispute with his wife, he waved a firearm in her presence as well as in front of her two children. This led to him being charged with seven serious offenses, which included three counts of assault with a deadly weapon. At that moment, he was grappling with several typical symptoms of PTSD: nightmares, mood fluctuations, anxiety, depression, social withdrawal, and intrusive memories. He recounted that during the incident, he had a flashback to a traumatic event when he inadvertently witnessed a decapitation in Riyadh, Saudi Arabia, during the Gulf War in October 1990, which caused him to lose control (VA). After facing charges, Henson admitted guilt and was convicted, leading to a 45-day stay at a detention center in Orange County. He participated

in the local Veterans Treatment Court, a collaborative effort between the VA Long Beach Healthcare System and the Orange County Sheriff’s Department, which enables veterans like Henson to serve their sentences while also receiving treatment. Through this intervention opportunity, he learned meditation techniques and engaged in cognitive behavioral therapy, specifically prolonged exposure (PE) therapy. PE is 

one of the evidence-based approaches offered by the 

VA to assist veterans dealing with PTSD, helping them 

to gradually confront and process traumatic memories 

and address situations healthily. Henson is now a 

volunteer at Save A Warrior, passionately supporting the providing of counseling in mental health, wellness, and suicide prevention to Veterans, active-duty military, and first responders. However, not all in need have access to a VTC in their community, so the U.S. The Department of Veterans Affairs has developed the Veterans Justice Outreach initiative (VJO). Under the VJO program, every VA Medical Center has a dedicated justice outreach specialist. These specialists serve as a bridge between the VA, Veterans, and the local criminal justice system. They collaborate with the courts to provide eligible Veterans with mental health assessments, treatment plans, and referrals to VA services. Additionally, specialists keep the courts informed about Veterans' adherence to VA treatment programs and may also assist in training law enforcement personnel on topics like PTSD and traumatic brain injury. According to the VA fact sheet on the topic, as of December 2024, VJO Specialists report serving in 731 Veterans Treatment Courts (VTCs) and other Veteran-focused court programs across the United States. This implementation is a great step towards protecting Veterans from the criminal pipeline and offering much-deserved mental treatment regardless of their trauma-caused record.

The Role of Health Professionals in Prevention 

“Most of the veterans get themselves engaged in criminal activities due to PTSD that is undiagnosed. Most of the time, veterans who get convicted and incarcerated without being assessed for post-traumatic stress disorder end up worsening their condition due to the situation and circumstances they are exposed to while in jails and prisons.” (Rousseau 1). While intervention will continue to be depended on, it is 

even more important to address and dismantle the 

systemic issue that causes the output of crime. Nurses, 

physicians, family health providers, court officials, and 

many more all carry a heavy weight in the veterans’ path 

to rehabilitation before and unfortunately after destruction. Re-routing can look like providing accessible support through free mobile apps, including VetChange by the National Center for PTSD, VA Boston Healthcare System, and Boston University, as well as PTSD Coach, created by the VA's National Center for PTSD and the Department of Defense's National Center for Telehealth & Technology. Services provided include managing alcohol use, goal setting, and guidance to professional treatment. These apps are also available to those in active duty, ensuring that members have access to vital resources for managing PTSD and enhancing their well-being. Additionally, a more reliably effective method is SSRI and SNRI medications for PTSD. Common choices include Sertraline (Zoloft), Paroxetine (Paxil), and Venlafaxine (Effexor). Treatments like these are effective because individuals with PTSD have varying levels of neurotransmitters in their brains compared to those without the condition. SSRIs and SNRIs are thought to help restore balance to these brain chemicals, thereby alleviating PTSD symptoms. To receive the mentioned solutions, a meeting with a provider authorized to prescribe medications is

necessary. Veterans can choose from various types of providers, including family physicians, nurses, and physician assistants, who can prescribe antidepressants for PTSD. Collaboration with the chosen provider helps determine the most suitable antidepressant medication. Taking these impactful steps allows for a healthier, safer, and happier future for those who risked their lives for their country. 

Closing 

In conclusion, as we approach PTSD Awareness Month, Kirsten Moran from Teen Health Journals urges readers to engage with June in a spirit of compassion and awareness for those grappling with post-traumatic stress disorder, particularly veterans who are valiantly navigating their secondary battles alongside their honorable service. She encourages the sharing of valuable knowledge about available treatments and support resources while also approaching those in the criminal justice system with empathy and understanding. By fostering a culture of awareness and proactive assistance, a contribution can be made to the well-being of Veterans in need and promote healing in our communities.