I am always moved by the many stories of sacrifice and courage shared in the media leading up to Yom HaZikaron and Yom Ha’atzmaut. But this year, one passage that I read about Itzik Saidyan, the Israeli combat veteran who self-immolated earlier in the week, has lingered in my mind:
“He was recognized by the Defense Ministry as having 25 percent disability from his post-traumatic stress disorder, but had requested 50% recognition. The ministry had refused, saying at least a portion of his condition was due to childhood trauma, not his military service.”
To be clear, I do not know Mr. Saidyan, nor am I familiar with his particular symptoms.
But something about these lines struck a chord.
This paragraph reflects the cruel reality when real-life suffering meets bureaucratic detachment. Posttraumatic stress disorder, or PTSD, is a sanitized term that describes an excruciating existence: night terrors and sleeplessness multiple times a week, often waking up in a pool of sweat; mood swings that interfere with friendships and intimate relationships; inability to hold down a job, leading to hopelessness and despair; crippling survivor’s guilt; alarming expressions of anger that result from a brain that constantly sees the environment as threatening; substance abuse as a way of managing with the mental pressure; and any number of other debilitating effects that we casually refer to as “PTSD.”
And here you have a man, struggling to cope with witnessing the violent death of his brothers in arms, who is told that he does not really understand the source of his nightmares, his guilt, his pain. Doesn’t he realize that it is really this childhood trauma that is causing an equal portion of his distress? As a spectator, it is hard to blindly accept that the effects of this childhood trauma, whatever it was, apparently was not sufficient for the army to disqualify him from serving in combat, but when it comes to receiving support for debilitating PTSD, it became a factor of equal importance. Indeed, it seems that the military has been willing to spend substantial money to contest claims of disability, but not invest the same resources to determining fitness for combat in the first place, or to find veterans who have fallen off the radar and are in dire need of support.
As another line in the story points out, the enigmatic compensation structure is just a fraction of the larger issue:
“The network reported that 15% of Protective Edge veterans were suffering from post-traumatic stress disorder, but only around 200 have been officially designated as having the condition.”
In other words, the vast majority of soldiers who are experiencing significant disability due to PTSD are not receiving any support or compensation from the government. Anecdotally, I have had many conversations with Israelis who, as I describe my background in PTSD clinical work and research, tell me about a family member who was never quite the same after their military service. Some recall uncles who fought in the Yom Kippur War or Second Lebanon War, others think of friends or family members of more recent conflicts. They say things like “he doesn’t really sleep well, doesn’t go out much — the family doesn’t see him at all. It’s really sad.” Despite some evidence that PTSD rates among Israeli combat veterans may be lower than combat veterans from other countries, there are generations of Israelis whose lives have been permanently impaired and who have received virtually no support from the system that sent them into war in the first place.
Before solutions can be offered, it is worth considering why some gaps in support may exist.
Any system necessarily has rules and guidelines, and as a result, some people will end up on the unwanted side of a bureaucratic threshold, engendering resentment and bitterness. The question is how are these categorical decisions made and by whom? Are they fair? Do they account for the particular experience of the petitioners, and are there clear pathways for appeals and adjustment? And what other resources can be available to soldiers whose support from the government is insufficient?
Veterans also may have difficulty submitting a claim to begin with. The government would likely say that any veteran can submit a claim, and the army is not at fault if veterans fall through the cracks. But the reality is not so simple. A common result of surviving a traumatic combat event is a sense of distrust of the army who put the soldier and his team in harm’s way. And now, this veteran is being told that the system that sent him into battle is the same one determining whether the effects of that battle warrant compensation; at the very least, there can be a perceived conflict of interest which can deter soldiers from trusting the army’s disability assessment team.
An additional challenge is that the psychological and mental health effects of combat may not emerge immediately, at least not in severe forms, and it may only be months or years later that the intrusive impairment and distress of PTSD comes out. Upon leaving the army, many soldiers may report no psychological distress because they want to just be done with the military, even if there are some mental health concerns brewing. The army may be skeptical of such claims, and veterans may assume that their claims will not be accepted.
Finally, for many soldiers, it can take a long time to work through the stigma of seeking mental health support. After all, when in combat, they receive training to push through any psychological hardship, to overcome fear, to focus on completing the task at hand no matter the obstacle. It is no wonder that many soldiers may view even submitting a claim for PTSD as a violation of their training and identity as a combat warrior. Placing the burden to come forward with mental health challenges entirely on the combat veterans suggests that supporting those who are suffering is not a top priority.
Of course, solutions are complicated, and they require the cooperation of many systems within the government and the private sector. But as the recent tragic story of Itzik Saidyan painfully reminds us, if we expect our young men and women to fight our wars, it is our responsibility to make sure we are here to support them when they return home.