• VA recognizes the great sacrifices made by Service members and Veterans of all eras and that nobody returns from combat unchanged. Some Veterans develop PTSD and may have significant challenges for several years as they live with PTSD and other related problems, and we believe that this film has poignantly and powerfully depicted the experience of some of those who have been the most significantly impacted by their military service.


• Post Traumatic Stress Disorder (PTSD) is a condition resulting from exposure to direct or indirect threat of death, serious injury or a physical threat.

Symptoms of PTSD can include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, emotional numbing, hyper-alertness, anxiety and irritability.

• There is no single solution for PTSD, but it is treatable and there are multiple effective treatments offered at VA. Mental health is central to treatment of PTSD but VA can also provide assistance with education, employment, and housing counseling.

• Recent changes to VA regulations have made it easier for Veterans to establish service connection for PTSD by eliminating the requirement for corroboration of the stressor in certain circumstances.

• We note two particularly important things about PTSD:

1) The primary response to stressful events is resilience. Most individuals who return from a combat deployment do not meet criteria for PTSD or another major mental health condition, although they may experience normal problems readjusting back home after deployment. a. But they may experience Post Traumatic Stress – that is, some symptoms and emotional difficulties triggered by stress, but without a full diagnosis of PTSD.

b. Our military Veterans have great strengths and often grow in ways that they never could have imagined before a deployment. This is known as posttraumatic growth, and we believe this is as important to talk about as posttraumatic stress.

2) While PTSD is treatable, it is important to encourage returning OEF/OIF Veterans to seek an evaluation and treatment as soon as it is identified that they may be having problems with PTSD, in order to prevent those problems from getting worse. a. However, these evidence-based treatments for PTSD are also effective for Veterans with PTSD from all eras of service.

b. PTSD is NOT a hopeless condition. Further, treatment can be effective for those with PTS, in helping with resilience, relieving symptoms, and preventing development of PTSD over time.

• VA has a commitment to provide the most effective, evidence-based care for PTSD. VA has implemented significant training initiatives to ensure that VA clinicians receive training in state-of-the-art treatments for PTSD. VA has trained over 2,900 VA clinicians in the use of Cognitive Processing Therapy or Prolonged Exposure, which are evidence-based therapies cited by the Institute of Medicine Committee on Treatment of PTSD as proven to be effective treatments for PTSD.

• Other approaches also are available which can help with particular symptoms or help Veterans seeking a different approach. The choice of which treatment approach to use is a decision made by the Veteran in collaboration with his or her mental health treatment provider.

• With innovations led by VA’s National Center for PTSD, VA operates an internationally recognized network of more than 200 specialized programs for the treatment of PTSD through its medical centers and clinics. Every VA medical center has outpatient PTSD specialty capability and all of these programs have an addictions specialist associated with the program to address the commonly co-occurring problem of substance use disorder.

• VA has focused efforts on the early identification and management of stress related disorders in order to decrease the long term burden of these problems on returning troops. OEF/OIF Veterans coming to VA for the first time are screened for the presence of symptoms of PTSD, depression, and alcohol misuse and for any history of military sexual trauma. They also are screened for TBI, a physical health problem (not a mental health disorder). 1. The same screening for PTSD, depression, and alcohol misuse is repeated on a regular basis for new or existing Veterans of any service era.

2. Should the Veteran screen positive for any of these conditions, further evaluation and appropriate treatment are provided, often right there in the primary care clinic.


• Women Veterans, like male Veterans, receive treatment for conditions associated with military sexual trauma (MST), mental health treatment based on psychosocial rehabilitation and recovery, and homeless services.

VA’s Suicide Prevention Hotline 1-800-273-TALK (8255) and Chat Service The program saves lives (11,300 rescues to date) and links Veterans into effective ongoing mental health services. 1. We hope that the dialog about this film will encourage more Veterans in distress to contact our Suicide Prevention Hotline and Chat Service, so that we can help link them in to care immediately.

2. Family members also can access these services to express concern about a Veteran, and they will receive guidance and support. The VA Hotline is also available to Active Duty Servicemembers.

VA Vet Centers provides a broad range of counseling, outreach, and referral services to eligible veterans and their families to help them make a satisfying post-war readjustment to civilian life. Vet Centers also furnish bereavement counseling services to surviving parents, spouses, children and siblings of service members who die of any cause while on active duty.

• VA has programs for Veterans whose mental health problems result in interactions with the Justice system. Justice Outreach efforts include: § Collaboration with Veterans Treatment Courts

• Collaboration with police departments to train officers to deal effectively with individuals in crisis situations who have mental health problems

• A program to work with Veterans nearing release from prison to ensure that all needed health care services are in place at the point of release

• VA continues extensive work together with DoD to increase the consistency, quality, and access to mental health services across the two Departments

• We hope that interested Veterans, family members, clinicians and members of the public will visit the website for VA’s National Center for PTSD (, which provides

reliable, expert information about PTSD and can provide hope for recovering from PTSD with effective treatments.

• VA’s leadership and mental health clinicians emphasize the importance of Service members and Veterans taking the initiative to seek help for stress related issues.


• If you or a loved one are in crisis: Suicide Prevention Hotline: 1-800-273-TALK (8255)

• Link to Suicide Prevention Online Chat (See “Live Chat” Icon

National Center for PTSD:

PTSD Program Locator Online:

Veteran Combat Call Center – Staffed by combat Veterans 24 hours/day: 1-877-WAR VETS (1-877-927-8387)

Transitioning to civilian life after combat:; 1-800-905-4675 (Eastern time); 1-866-496-8838 (Pacific)

• Find your local VA Medical Center: (click on “Locations”): 1-877-222-8387

VA Health Benefits: 1-877-222-8387 (VETS)

Benefits Information & Assistance: 1-800-827-1000

Education & Training: 1-888-442-4551

National Call Center for Homeless Veterans: 1-877-4AID VET (424-3838)

Military Sexual Trauma (MST): 1-800-827-1000 or ask at your local facility. Please feel free to request a provider of the gender – male or female – with whom you would feel the most comfortable.


• A little goes a long way- “Thank You” and “Welcome Home” are always appropriate.

• Let the Veteran lead the conversation.

• It is best to talk with a Veteran in a quiet place, one on one, perhaps over a meal.

• Do not ask a Veteran if he or she killed anyone.

• Do not ask about the experience of watching friends die.

• Remember to also thank our Veteran and Military families – they also serve

October 28, 2010 (end)