The wars in Afghanistan and Iraq have produced more diagnosed cases of PTSD and debilitating injuries per capita than any other war in the nation's history, health care experts say. And veterans who encounter homecoming trouble are becoming homeless more quickly than ever, street counselors say.
It's something most people don't consider when they think of sending more soldiers overseas, said Blecker, head of San Francisco's Swords to Plowshares veterans aid agency. But they should, he said - especially now, as Obama prepares to make a speech to the nation Tuesday.
In his address, the president will announce plans for Afghanistan that are almost sure to involve dispatching tens of thousands of new troops there in the cause of defeating al Qaeda and its terrorist allies.
More PTSD cases
"We have this theme in this country that we will support our troops, all work as a team, but there are so many cases when they are just released from service and left on their own," Blecker said. "We treat them as second-class citizens, but they are the ones who pay the price."
There are proportionately more vets than ever suffering from PTSD and disability upon coming home because military armor and rescue capabilities are better than ever, experts say. That means fewer soldiers die of serious wounds, and more survive with lost limbs, injured brains and the damaging memories of horror.
Estimates by organizations including Swords to Plowshares, Stanford University and the nonprofit research center Rand contend that about one-third of the 1.8 million men and women who have served in Iraq or Afghanistan have suffered from PTSD. About 17 percent have experienced brain injuries ranging from mild to severe.
In comparison, the U.S. Department of Veterans Affairs reports that 11 percent of the 8.7 million veterans of the Vietnam War suffered from PTSD. Common estimates say the numbers were lower or about the same in previous conflicts.
Redeployments - about four for most military personnel now, compared with an average of one deployment in previous wars - exacerbate the problem by exposing soldiers to more danger.
Irony of better care
"The equipment is better and the medical care is better, so they're surviving injuries that soldiers in other conflicts would have never survived," said Judi Cheary, spokeswoman for the Veterans Affairs Medical Center in San Francisco. "And we've increased staff, created a bunch of new programs and are actively doing outreach for these young vets to come to us, but unfortunately most of them don't.
"We want them to know we're here and our doors are open."
A study last year by Rand showed that 70 percent of homecoming vets who need help don't seek it from the military or Veterans Affairs.
Boosting aid efforts
As part of that push to draw young vets in and treat them faster, Cheary said, the San Francisco VA center has added 35 mental health clinicians to the 100 already on staff. Nationally, the Veterans Affairs Department held a summit in Washington earlier this month at which organizations from around the country pledged to try to house the nation's homeless veterans - estimated to number 131,000 on any given night - within five years.
One reason young vets don't seek help is the tough-it-out stance of soldier culture, Blecker said. But most will find that acting tough won't put off the inevitable need for assistance - or the troubles.
"In the past, it took Vietnam vets about 10 years to become homeless after they were discharged," Blecker said. "The trend is about half that now, for these new vets."
The VA runs several programs for homeless and struggling vets, including a one-stop integrated-care clinic at its medical center in San Francisco. Swords to Plowshares runs the most comprehensive residential counseling program for homeless veterans in the Bay Area, currently on Treasure Island - helping more than a thousand vets gain independence since 1988.
But as quickly as the warriors are healed, more take their place, said Amy Fairweather, policy director for Swords to Plowshares.
"The costs to individuals and society are going up all the time, and these costs will be with us for decades," she said. "These are young men and women."