Veterans with mental-health injuries deserve Purple Hearts, too – Washington Post


Nathan Fletcher, a professor of practice in political science at the University of California at San Diego, is a combat veteran of the U.S. Marine Corps.

This Memorial Day, we honor Americans who made the ultimate sacrifice and gave their lives during service to their country. This recognition should include veterans who survived war but could not survive the peace that followed because of very real mental injuries suffered in combat. At least 20 veterans commit suicide every day in the United States. These are lives lost to war, and we must account for them today.

The epidemic of veteran suicide often elicits responses to “fix the VA.” Certainly the Department of Veterans Affairs faces structural and funding problems, but blaming VA for veteran suicide misses a critical point: Approximately 70 percent of veterans who take their lives do so without seeking help or treatment from VA. Even if VA were perfect, this problem would persist. Veterans are dying because they won’t ask for help.

We must confront and overcome the stigma of mental-health injuries. It’s time to provide equality of honor for sacrifice by awarding the Purple Heart for combat-related mental-health injuries.

We veterans brag about physical injuries; they show grit, resolve and perseverance. There is no reluctance to get “patched up.” We must likewise pay respect to the strength and resolve of transforming post-traumatic stress into “post-traumatic growth” and encourage the same cultural embrace of those injuries. I know Marines who were given the Purple Heart as a lifetime honor for injuries bearing no lasting scars or impact. But Marines who served beside them in that same combat situation suffering from devastating post-traumatic stress get no recognition and no medal and are cast into the shadows.

Lawmakers often say there’s no difference between mental and physical injuries sustained in war, but our policy creates a clear distinction, a clear stigma. Studies show that suicide among veterans is more than twice as common as among civilians. Veterans are also less likely to seek help for their mental-health injuries because of the powerful stigma associated with post-traumatic stress. We must encourage veterans with mental-health injuries to seek available treatment — and that starts with recognizing their injuries as real.

Awarding the medal is not just symbolic but also would send a strong message that we recognize and appreciate the sacrifices suffered while serving our country.

This change will not be without opposition. Stigmas are rooted in deeply held beliefs that are tough to change. You will hear that if we make this change, veterans will fake their symptoms to receive a medal. This ignores the essence of those who served. I don’t know a single Marine who would lie to get something he or she didn’t deserve. And we should never base policy on the potential for isolated abuse.

Almost a decade ago, the office of Defense Secretary Robert Gates declined to award Purple Hearts to veterans with post-traumatic stress, arguing that we needed a more scientific and medically based diagnosis. There is promising work underway to develop a medical diagnosis for post-traumatic stress. This would make it easier not only to diagnose this condition but also, more importantly, to treat it. We should fully support these efforts.

But our veterans shouldn’t have to wait to be recognized for their incredible sacrifice. We could begin honoring them immediately. President Trump could continue an established track record of amending the criteria for the Purple Heart through executive order. Congress could do the same, or the Defense Department could simply reinterpret the current criteria, which specifically do not require a physical lesion but only an injury sustained in direct or indirect combat operations that requires medical attention , to allow for this change.

Whatever the means, we need a strong and definitive statement that aligns our policies with our words. Let’s use this day to send a clear message to our brothers and sisters hurting from the unseen wounds of war: Your injuries are real, and we honor them.



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