Iraq War Clinician Guide 46 Medical Casualty Evacuees V. Treatment of Medical Casualty Evacuees

Men and women evacuated from the war zone due to physical injury are at higher-risk than other soldiers for development of PTSD and other trauma-related problems. If the VA serves as a care facility for Iraq War medical casualties, it will be important that clinical attention be given not just to their physical recovery and health, but to their mental health needs. Failure to do so may be to lose a significant and unique opportunity for early intervention to prevent development of more chronic emotional and behavioral problems. In this section of the Iraq War Clinician Guide we outline some considerations related to the integration of mental health care with physical care of recently evacuated Iraq War veterans. (See also Chapter IV for general treatment considerations). This kind of activity represents a challenge for VA mental health professionals. While VA PTSD, behavioral medicine, and other mental health practitioners are familiar with delivery of traumatic stress assessment and treatment to help-seeking veterans with chronic PTSD or general health problems, they are less likely to have delivered such services to individuals who have been injured during very recent exposure to traumas of war. More generally, focus on treatment of physical problems is often accompanied by a strong desire on the part of both patient and provider to avoid discussing emotional issues (Scurfield & Tice, 1991)