Purple Hearts for Post Traumatic Stress? Should the nation's oldest military award, the Purple Heart, be given to soldiers who suffer from Post Traumatic Stress Disorder? Army Times staff reporter Kelly Kennedy explains the debate.

Purple Hearts for Post Traumatic Stress?

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The Purple Heart, it's the nation's oldest military award. Introduced by General George Washington in the year 1782 as the badge of military merit, it was abandoned after the Revolutionary War, but then General Douglas MacArthur resurrected it in the 1930s, gave it out to Army soldiers who were wounded in combat. Today, the Purple Heart is awarded to any member of the armed forces who is killed or wounded in action.

The military currently defines wounded in a strictly physical sense, but some veterans' advocates are now suggesting the term be expanded to include troops suffering from posttraumatic stress disorder. Other veterans don't like the idea, and they argue that it will diminish the value of the Purple Heart. Kelly Kennedy has been reporting on this issue for the Army Times, and joins me now on the line. Hi, Kelly.

Ms. KELLY KENNEDY (Medical Writer, Army Times): Hi, good morning.

MARTIN: Thanks for joining us this morning. So, let's get a little background first. This debate started last month when Secretary of Defense Robert Gates was at a press conference, press availability. A reporter asked him, hey, do you think the Pentagon might consider awarding Purple Hearts to troops with combat-related PTSD? Gates actually responded that it was kind of an interesting idea, something that should be looked at. The issue then got more heat when John Fortunato, an army psychologist at Fort Bliss, put in his two cents. Tell us what he said, and where it went from there, Kelly.

Ms. KENNEDY: He basically said that if they were to make the Purple Heart something that you can have for PTSD, it could help get rid of the stigma attached to PTSD. They are having some problems with soldiers going in for treatment for posttraumatic stress disorder, just because they are worried about their careers, or the way people will see them, if they say that they've had - they have a mental-health condition.

MARTIN: And then this took off. People on both sides started chiming in, write - to your article in particular, lots of people were posting comments online. Let's go through some of those arguments. What are people saying? Those in the camp that say, yeah, PTSD needs to be incorporated into that list of injuries, what are their arguments?

Ms. KENNEDY: Well, they're saying that just like a gunshot wound, posttraumatic stress disorder is a battle wound, so it would be a way of honoring those who, for the rest of their lives, may deal with issues such as substance abuse, or are unable to have good relationship with their spouses or their children. And they are also saying that if you say that this is a battle wound, the - again, it just helps them come forward with their mental-health issues.

MARTIN: The American Legion and the VFW have both chimed in. They say they don't; support awarding the Purple Heart, because of PTSD. Is this because this is a relatively new diagnosis? I mean, the whole concept of PTSD has only emerged, you know, with this war, perhaps in the Gulf War, and these particular groups, these veterans groups, tend to have older members who fought during a time when mental illness, the stress of war, was something that people swept under the rug, didn't want to talk about. Is it generational? Are younger people more apt to support including PTSD in the Purple Heart, or are - and older people opposed?

Ms. KENNEDY: I don't know if that's it in particular. I've heard people say that it might be a good idea to have a separate award for this, for PTSD, if they are going to do it. I've heard people say that if you have PTSD, it's hard to determine when you got it, so it would be hard to say this is specific to this battle.

So, say if you've got a gunshot wound, they can say this definitely happened in battle, and PTSD is kind of hard to determine exactly when it arrived. It can show up many years after the stress there that caused it. And what I think it's just - it's difficult to show exactly where it's coming from. With a gunshot wound, you know. With PTSD, it's just difficult to determine, so...

MARTIN: And there are people out there, solders who I've talked about - with, who say that it's subjective, and they really believe this goes back to the stigma of PTSD. The whole attitude is this, pull yourself up by your bootstraps. Anything related to mental illness can be considered a weakness, or they say, oh, maybe you just weren't brought up in a good family.

Ms. KENNEDY: Yeah, it's actually kind of funny that - and people are saying that you should - this would be a good award to help get rid of the stigma, and then people are arguing against it for exactly that reason, that it's - it'd be like handing out candy, because people could say they have PTSD, when they really don't. So if you wanted a Purple Heart, you could show - you could say you had PTSD without having to really prove it. That's one version of it.

MARTIN: One commenter on your blog had this to say, quote, "I suffer from PTSD from my service in Vietnam. I do not think this disorder deserves a Purple Heart. I am a recipient of the Purple Heart for wounds sustained in combat. PTSD can be treated, although I waited until I retired in 1993 to seek treatment, so I would not have this stigma of mental-health problems hindering my career." So clearly, this fear of the stigma is a driving force. It's even people who are diagnosed with PTSD are saying, you know what? Even if you agree to give me this award, I don't even want it.

Ms. KENNEDY: Right. And I think that the military probably means to attack that stigma in other ways. One of the things they've done is this Battlemind training, where they talk about how people react to war, and how they react to the things they see there. And they've also done things like change the questionnaire for security clearance, so that if you have PTSD or if you've gone in for treatment, so that you don't have to say it on the questionnaire. And it's possible that you can't address the stigma just by handing out an award. You have to actually go in and change the way people see it, you know, and how it's treated, that sort of thing, so...

MARTIN: There also - this could open up just a whole floodgate of awards that would be handed out. The Army says nearly 40,000 service members have been diagnosed with PTSD since 2003. So, could the high number of people be one of the reasons that some veterans say, you know, as soon as you start incorporating PTSD into the criteria for a Purple Heart, you're going to be giving out a lot more wards, and it diminishes the scarcity value?

Ms. KENNEDY: They do say that. It's happened in other areas, but with the Purple Heart, they say you should have to bleed for it. You should have to have received a physical wound, and they say that PTSD isn't a physical ro - wound. And some of the arguments are kind of circular. Like, I've people say, you can't get a Purple Heart for PTSD because you can heal. Well, you can heal from a gunshot wound, too. It's just - I don't think people are thinking about the true meaning of the award, it's hard to get around that.


You know, by writing your article on the Army Times, obviously you're going to have people who feel strongly about the issue one way or the other, and it seeming like it's more one way. But do you have any idea if you polled the military, how popular or unpopular this idea would be?

Ms. KENNEDY: Every time you come up with a new award, or a new uniform, or a new weapon, or anything like that in the military, people have big opinions, but awards are probably top of the list. So, yeah, it would be a huge issue, and I think right now, because of the stigma, it would still be on the unpopular side. They're still trying to get over that.

PESCA: And is the history of the military one where they - look, it's top-down, and you can make decrees, and this is the point of being a soldier. You have to follow orders. But with things like making new awards, does the military brass look at what the rank and file thinks about it? In other words, if this is a very pop - unpopular idea, will that alone kill it?

Ms. KENNEDY: Yeah, I think so, but usually the purpose of an award is for morale, and if it's not going to help morale, then probably they're not going to go for it.

MARTIN: Kelly Kennedy is the medical reporter for the Army Times. She's been looking into this issue about whether or not to incorporate - to include PTSD, posttraumatic stress disorder, on the list of ailments that could qualify a solider for a Purple Heart award. Kelly, thanks for joining us, sharing some of your reporting on this. We appreciate it.

Ms. KENNEDY: Thanks for having me.

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