The Enduring Legacy: Counting Afghanistan's Veteran Survivors

The war in Afghanistan, which lasted nearly 20 years, was America's longest war. Between 1.9 and 3 million US service members were deployed to Afghanistan at least once, with over half of them deployed more than once. The number of Afghanistan veterans is estimated to be about 775,000, many with multiple tours of duty. The war has taken a heavy toll on the veterans, with many facing physical and psychological injuries, high rates of suicide, mental illness, drug and alcohol dependence, homelessness, and family issues. The withdrawal from Afghanistan has left many veterans with feelings of anger, betrayal, and humiliation.

The mental health of Afghanistan veterans

Afghanistan veterans number about 775,000, many with multiple tours of duty. The mental health of these veterans is a pressing issue, with high rates of post-traumatic stress disorder (PTSD), depression, substance use disorder (SUD), and interpersonal violence.

PTSD and Depression

PTSD and depression are the most widely publicized mental health challenges faced by Afghanistan veterans. Research indicates that approximately 14% to 16% of US service members deployed to Afghanistan have been affected by PTSD or depression. Women veterans are more likely than men to meet the criteria for major depression, but a smaller proportion of women screen positive for alcohol misuse.

Substance Use Disorder

SUD, including alcohol use, is prevalent among Afghanistan veterans and is often used for stress relief and socializing. A study conducted on military personnel revealed that approximately 30% of completed suicides and around 20% of deaths resulting from high-risk behavior were attributed to alcohol or drug use.

Interpersonal Violence

Afghanistan veterans and their families experience higher rates of divorce as well as homicide, child abuse, and child neglect.

Accessing Mental Health Services

Many Afghanistan veterans face barriers to accessing mental health services, such as stigma, beliefs that they should handle their problems themselves, and practical issues like not knowing where to get help or not being able to get time off work. Only about half of veterans with PTSD or depression seek care.

Impact on Families

The mental health challenges faced by Afghanistan veterans also take a toll on their families, who often provide care for their loved ones. This can lead to increased stress and burden on spouses, partners, and children.

Recommendations for Improvement

To improve the mental health of Afghanistan veterans, it is crucial to address the barriers to accessing care and encourage more veterans to seek help. This can include increasing awareness of gender differences in mental health issues, integrating mental health and pastoral services, and recognizing that alcohol misuse may reduce utilization of treatment services. Additionally, training more mental health providers in the US health care system on delivering evidence-based treatments specifically for veterans can help ensure they receive the care they need.

The physical health of Afghanistan veterans

Afghanistan veterans face a plethora of physical health issues. The physical health of veterans is a complex issue, with many suffering from service-related injuries and long-term health problems.

Firstly, it is important to acknowledge the high number of veterans with physical disabilities. Over 1.8 million veterans have some degree of officially recognised disability, with veterans of the Afghanistan war accounting for more than half of the severely disabled veteran population. These disabilities can include loss of limbs, chronic pain, and impaired physical functioning.

In addition to disabilities, veterans also face an increased risk of developing chronic illnesses. These illnesses can include chronic multisymptom illnesses (CMI), such as chronic fatigue syndrome, functional gastrointestinal disorders, and medically unexplained chronic multisymptom illnesses. Veterans are also at risk of developing respiratory problems, with studies finding higher rates of respiratory issues during and after deployment compared to non-deployed veterans.

Furthermore, the extreme environmental conditions in Afghanistan, such as sand, dust, extreme cold, and heat, can lead to health issues such as skin cancer, frostbite, heat stroke, and respiratory problems. Veterans are also at risk of contracting infectious diseases such as malaria, brucellosis, and tuberculosis.

Another concern is the impact of toxic chemicals and hazardous materials on the physical health of veterans. Burn pit smoke, depleted uranium, and toxic embedded fragments can cause a range of health issues, including respiratory problems, cancer, and injury at the site of the fragment.

Lastly, the physical toll of combat cannot be overlooked. Explosions and concussive events can lead to traumatic brain injuries (TBIs), which can have long-term effects on brain function. Veterans are also at risk of hearing loss and tinnitus due to exposure to loud noises from weapons, explosives, and aircraft.

The physical health issues faced by Afghanistan veterans are diverse and often interconnected with mental health issues. It is crucial that veterans have access to comprehensive healthcare and support to address their physical health needs.

The number of Afghanistan veterans

The Afghanistan War, which lasted from 2001 to 2021, saw the deployment of over 775,000 U.S. service members, with estimates ranging up to 3 million when including those who served in both Afghanistan and Iraq. This figure represents the total number of Afghanistan veterans, and it is important to note that many of these individuals had multiple tours of duty.

The war in Afghanistan was America's longest war, spanning nearly two decades. During this prolonged conflict, U.S. service members faced direct combat, complex counterinsurgency operations, and a constantly evolving mission. Many veterans returned home with physical and psychological injuries, leading to high rates of disability, suicide, mental illness, and other challenges.

The impact of the war on Afghanistan veterans cannot be overstated. Many struggled with anger, betrayal, and humiliation following the U.S. withdrawal in 2021, with surveys indicating that a large majority felt betrayed and humiliated. The abrupt end to the 20-year war contributed to a decline in confidence in the U.S. government and a sense of estrangement among veterans, with 76% reporting feeling "like a stranger in my own country."

In addition to the human toll, the financial cost of caring for Afghanistan veterans is significant. The U.S. government has committed to providing healthcare, disability benefits, and other support totaling more than $2 trillion over time. This cost will continue to rise as the veterans age and their needs increase.

The impact of the Afghanistan war on military families

The Afghanistan War had a profound impact on military families. The war was America's longest war, lasting nearly 20 years.cope with the absence of their loved ones, mourn their deaths, or greet the changed person who returned.

Military families faced unique challenges due to the nature of the war. There were more frequent deployments and shorter periods at home. The war in Afghanistan was more difficult for military families than past wars. Military spouses were less likely to work full-time and earned less than their civilian counterparts.

Military spouses and children experienced elevated rates of suicide, mental illness, drug and alcohol dependence, car crashes, and homelessness. They also experienced higher rates of divorce, as well as homicide, child abuse, and child neglect.

Military spouses reported high levels of stress, anxiety, and depression. They also reported feeling lonely, afraid, and overwhelmed by deployment-related challenges and responsibilities.

Military spouses often relied on primary care for mental health services.

Military children faced unique challenges, too. They had to cope with the absence of their parents, and many had to adjust to living with other relatives or caregivers. They also had to deal with the stress of having a parent in harm's way.

Military children of deployed parents experienced more difficulties at school and were more likely to have adjustment problems.

Military children of deployed parents were more likely to exhibit internalizing (e.g., sadness, depression, anxiety) and externalizing (e.g., aggressiveness, irritability) symptoms.

Military children were more likely to be diagnosed with mental health disorders, such as adjustment disorders, anxiety, and sleep disorders.

The impact of the US withdrawal from Afghanistan on veterans

The US withdrawal from Afghanistan has had a profound impact on veterans, leaving many feeling angry, betrayed, and humiliated. The end of the 20-year war has contributed to a decline in confidence in the US government and a sense of estrangement among veterans, with 76% reporting that they sometimes feel "like a stranger in my own country."

Many veterans bear physical and psychological injuries from the war and face a life of disability. They also experience elevated rates of suicide, mental illness, substance abuse, homelessness, and divorce. The war has taken a toll on their families as well, with higher rates of child abuse and neglect reported in military households.

The withdrawal itself was chaotic and left many veterans with a sense of loss and disappointment. They feel that the sacrifices made and progress achieved during their service have been undone, with the Taliban regaining control of the country. There is also concern for the Afghan allies left behind, with efforts to rescue and resettle them seen as crucial for healing and improving the mental health of veterans.

The impact of the withdrawal is not just limited to the veterans themselves but has also affected American society as a whole. Similar to the end of the Vietnam War, there is a pervasive sense of national dishonor and decline, which can have a lasting impact on politics and society.

Veterans have expressed mixed views on the decision to withdraw but are highly critical of how it was handled by the Biden administration. They believe that the US military engagement in Afghanistan had become a strategic liability and that resources would be better spent on other issues. However, they also feel that the withdrawal could have been planned and executed better, and there is a sense that more could have been done to evacuate American citizens and Afghan allies.

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