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Biomedicine

Veterans in Need

Brain-injury survivors in the U.S. military need far better care.

Traumatic brain injury (TBI) is all too common on battlefields where blasts from improvised explosive devices pose a constant danger (see “Brain Trauma in Iraq”). Today, U.S. troops do not have adequate resources for TBI prevention, diagnosis, rehabilitation, or treatment. But fortunately, things are beginning to improve.

According to an army report released in February, 11 percent of 2,994 soldiers surveyed in Iraq and Afghanistan showed signs of mild brain injury, but fewer than half of those injured were identified and evaluated in the field. The Defense and Veteran Brain Injury Center has urged that troops be screened for TBI upon discharge. As cochair of the Congressional Brain Injury Task Force, I proposed that the military prescreen all personnel before they even set foot on the battlefield and continue diagnostic analysis until the day they return to their communities. The Pentagon will soon require that troops be checked as they come home.

In 2007, Congress provided a historic $900 million to the Department of Defense and the Department of Veterans’ Affairs for research and treatment of TBI and post-traumatic stress disorder. Developing the expertise to treat TBI within the DOD/VA system is a worthy goal, but so many returning TBI victims require timely treatment and rehabilitation that we need additional resources and more-immediate expertise.

For a survivor of TBI, reintegrating into the community is difficult, especially if the injury is undiagnosed or misdiagnosed. Those with brain injuries can require lifelong care, and many patients need services and help from multiple programs. Without coördinated care, they are often placed inappropriately into nursing homes or other unsuitable living situations.

One way to better coördinate care is through military-civilian partnerships. Last year, the Congressional Brain Injury Task Force worked to build a system ensuring that returning troops receive what they need to put their lives back together. The newly created Department of Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, which opened its doors in November 2007, will serve as the nexus of military and civilian science and service for TBI.

The number of brain-injured troops returning from combat, added to the millions of Americans living with long-term disability as a result of TBI, convinced me long ago that publicizing, preventing, rehabilitating, and curing traumatic brain injury deserve urgent attention. My fight to expand the work of our task force, secure federal funding, and change federal policy will go on.

U.S. Representative Bill Pascrell Jr. is the founder and cochairman of the Congressional Brain Injury Task Force.

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