We mentioned that we just had a symposium, and we had veterans from both Canada and the U.S. there. I don't want to name any names, but what several people told me quietly was that as a result of this, they had extreme homicidal thoughts about killing their most intimate family members. That they were scared to sleep with their wives because of fears that they would choke their wives, dreaming of bayoneting their babies, massacring their whole families.
This was very discongruent to them. How could they be thinking of this? The people who were there had not committed suicide but they talked of others who they believed had committed suicide rather than murder their families and those whom they loved.
That is just profoundly, deeply, morally troubling. So what could we do about it? Again, I'm from a different country. I can make only a few suggestions, but a public education campaign, using your media, reaching out, not being ashamed and trying to cover it up but rather saying, “Okay, we didn't know enough; in whatever happened, whether it was legal or not, we didn't do the right thing and now we want to make it right. So come in and talk to us.”
Again, it's also a provider education piece. Make sure that the psychologists, psychiatrists, primary care.... I'm a psychiatrist in my office. Somebody comes in to me with complaints of bad dreams from the war. My first instinct is to say, “Oh, it must be post-traumatic stress disorder”. Maybe I've read up and I know a little bit about people who get their vehicle blown up and they hit their head. So I'll do some screening for TBI. But what can you do to make sure?
This is medical school curriculum, as well as for advanced practice nurses, medics and physician's assistants, just so they all have the knowledge to at least ask the question, “Did you take anti-malarial agents?” Then if the answer is yes, either weekly dose or refer them to the next level of care. You can model it depending where they are. But a mass level of education, I think, would go a very long way.