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Trump’s implication that PTSD is a sign of weakness is dangerous

Stigma is a huge reason why people don’t get the help they need.

CREDIT: iStock
CREDIT: iStock

At an event in Virginia for the newly formed Retired American Warriors PAC on Monday, GOP presidential candidate Donald Trump said that “strong” veterans don’t suffer from mental health problems as a result of what they’ve experienced in combat — and implied that those who do are “weak.”

The event was a town-hall style event, and Trump was asked by a member of the audience what he would do about the “tragic suicide epidemic among our veterans,” and whether he would support “faith-based” interventions.

Trump’s reply, to a room full of veterans, reiterated an inaccurate but persistent stigma that mental health problems are a sign of weakness.

“When you talk about the mental health problems, when people come back from war and combat and they see things that maybe a lot of the folks in the room have seen many times over, and you’re strong and you can handle it, but a lot of people can’t handle it.”

You can watch the exchange here:

Trump then went on to say that veterans who did need help should be able to get it: “We’re going to have a very very robust, very very robust level of performance having to do with mental health. We are losing so many great people who could be taken care of if they had proper care.”

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Although the full context of Trump’s quote — which includes him emphasizing the necessity of mental care and expressing sympathy for veterans — is a bit less damning, Trump’s comments about “strength” immediately set off a firestorm on social media.

Regardless of what came after the problematic part of the quote, implying a link between mental illness and weakness like Trump does here ultimately prevents people from getting help that they need.

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According to data from RAND, 18.5 percent of service members returning from Afghanistan and Iraq suffer from PTSD or depression, and 19.5 percent report experiencing a traumatic brain injury (TBI) while deployed. While TBIs are still poorly understood, depression and changes in thought and mood are common effects of the injury.

Research from RAND also finds that only about half of veterans who need mental health treatment actually seek it.

That’s partly because, as Trump mentioned, veterans often face long waits at the VA before they can access care. Investigations into VA clinics across the country have shown the system to be plagued with appointment delays. But in addition to logistical problems, data from USGAO also names stigma as a primary cause forcing people into the shadows.

“At the end of the day, there is still stigma and fear of being labeled ‘a broken, damaged veteran.”

The National Veteran’s Foundation parses this stigma as: “embarrassment about service-related mental disabilities; shame over needing to seek mental health treatment; stigma associated with mental health issues,” and, “fear of being weak.”

It’s a sense echoed by experts and public health professionals. In January, Paul Rieckoff, founder and head of the IAVA, told Fox news that stigma was still a large part of the reason veterans don’t access care.

“I think we have made some headway, but there is a long way to go and at the end of the day, there is still stigma and fear of being labeled ‘a broken, damaged veteran,’” he told FoxNews.com.

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Nor is this stigma confined to veterans — for all Americans suffering from mental illness, the lingering shame and association with weakness poses a huge barrier to seeking help. It also promotes substance abuse: those who are afraid to seek professional help are more likely to turn to addictive substances for self-medication.

So while Trump — who received five deferments from the draft, attacked war hero and former POW Sen. John McCain for being captured, and once said that avoiding STDs was his own “personal Vietnam” — may have been phrasing his answer as a solution, he was also contributing to the problem. His urge to reassure the room of veterans he was speaking to that he didn’t think any of them were weak enough to suffer from PTSD also speaks to a his assumption that the disorder is shameful, meant to be hidden, and not something that strong or successful veterans deal with.

Trump — who bragged that he has “tremendous veteran support” — also repeated an outdated statistic about veteran suicide. The official rate from the Department of Veteran’s Affairs, as of July, puts the number of suicides per day at 20, not 22 as Trump said today and has inaccurately said in the past (to a veteran who had the correct statistic).

Trump also implied that, once veterans do get connected with appointments at the VA, the care they receive there is substandard — an assertion not borne up by the data. The annual Independent Budget, published by four leading veteran organizations, has consistently found that the VA serves as “a model health-care provider,” and a 2013 survey released by the U.S. Department of Veterans Affairs found that 93 percent of veterans using the VA health system have a favorable impression of it, a sense echoed by data from the Iraq and Afghanistan Veterans of America (IAVA).