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Sarah Christine
Professor McGriff
July 21, 2014
ENC 1102


Veterans with Post-Traumatic Stress Disorder in the Criminal Justice System


On July 18, 2014, personal interviews of three United States Veterans representing both the
Marine Corps and Army met at the St. Johns County Florida Courthouse roundtable style to discuss
the impact of combat trauma on the returning veteran.
"You go into the military as a very young man, go to Boot Camp and get torn
down and rebuilt in their image. You get indoctrinated into the military way of
life. You learn to eat, live and breathe the military. The way you think and even
the way you talk is military. You learn to kill and be killed. If you get into
trouble, its handled internally through military channels. You are disciplined
internally but get no criminal record. Then you go to war. You see, hear and
smell death, pick up body parts and hear and smell burning human beings. Some
are your buddies. At night your group leader brings out a bottle of liquor and
you drink heavily and make jokes about the destruction youve seen and the
danger youve survived. You have done two combat tours. You can get out
now, but your unit has gotten orders for a third and you cant abandon your
buddies. They are your family now, long ago replacing the broken family you
grew up in and left. You make it back home, frequently waking up in the
middle of the night in a cold sweat, smelling those smells, hearing those sounds.
In 30 days youre discharged. Youre out on the street, lost. Nobodys heard of
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PTSD much less treated you for it. Youre abandoned. Any loud noises,
fireworks, take you apart. That restaurant is too loud, way too crowded. Youve
got to get to the back of the room, your back to the wall so you can constantly
survey the dangers around you. You drink your 'medication' - a bottle of Ouzo,
'til youre numb. Then mount your powerful motorcycle and escape. Fast, really
fast. No helmet, no gloves no protection because youre bulletproof, invulnerable
You wake up in the hospital. You have survived again. The crash didnt take
your life, but this time it may take your freedom." (B. David, C. Ralph, W. John)

The Iraq and Afghanistan veterans are returning home with combat related trauma that
has a far-reaching impact on the veteran and society, as candidly and bluntly shared above by the
water-eyed veterans themselves. Todays all volunteer military results in radically fewer soldiers
shouldering the combat role that has historically been spread over many more military draftees.
Combat deployment for the soldier has dramatically increased in both their number and length.
Consequently, the incidence of post-traumatic stress disorder, a combat related trauma rises
significantly with each additional combat tour. Returning home, the veteran faces the lack of
available mental health care and support needed for combat related trauma. The warrior mindset
of the military culture, which has historically ostracized the psychologically injured soldier,
causes the veteran to shun treatment. Post-traumatic stress disorder left untreated in veterans will
inevitably lead a large amount of them having legal problems because of the aggressive and
unregulated anger behavior, illegal substance abuse and the hazardous use of alcohol PTSD can
cause. Thus, their ultimate encounter with the criminal justice system. Unprecedented levels of
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post-traumatic stress disorder among Iraq and Afghanistan war veterans will ultimately result in
higher demands on the criminal justice system that must prepare and adapt itself accordingly.
Post-traumatic stress disorder, also known as PTSD, defined by the Mayo Clinic is a
mental health condition that is triggered by a trauma, or terrifying event by either experiencing it
or witnessing it. Symptoms include flashbacks, hallucinations, repeatedly reliving the trauma
through thoughts and nightmares, avoidance of reminders of the trauma, emotional numbness,
loss of interest, severe anxiety and irritability, hyper arousal, strong startle response, increased
aggressiveness, and even violence. Dr. Elbogen and colleagues at the UNC School of Medicine
found through a study, Post-deployment anger and hostility were associated with PTSD hyper
arousal symptoms: sleep problems, being on guard', jumpiness, irritability, and difficulty
concentrating." Further, they identified features associated with anger and hostility, which can
result in increased risk of post-deployment adjustment problems as veterans transition to civilian
life. Studies found that these symptoms can become critical and can prevent a veteran from
living a normal healthy lifestyle. David Wood, a writer for the Huffington post explains, The
finding that a combination of PTSD and high irritability can lead to criminal misbehavior is
important because the treatment for PTSD provided to veterans by the Veterans Health
Administration and others often doesnt include therapy designed specifically to reduce
irritability. Without mental health care and specific treatments needed for veterans with PTSD
the risk for involvement in the criminal justice system only increases.
Returning Iraq and Afghanistan veterans with psychological and neurological in need of
mental health care are continuing to grow in numbers. The most common of the injuries
experienced by veterans are post-traumatic stress disorder and depression. One of the leading
studies to date, Invisible Wounds of War, conducted in 2008 by The Rand Corporation and The
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Center for Military Health Policy Research, contributing authors Vanessa Williamson and E.
Mulhall write, "nearly twenty percent of Iraq and Afghanistan veterans (studied) screen
positive for Post-Traumatic Stress Disorder or depression . Also found is that "early
intervention on the battlefield could significantly reduce the rate of veterans returning with
PTSD". Additionally, "veterans who receive testing immediately upon returning home have a
better chance of cure than the veterans who wait a year or more to get treated. We know that
effective treatments are available for them, particularly for PTSD and depression. However,
these evidence-based treatments are not yet available in all treatment settings." The Veterans
Health Administration offers medical and psychiatric care programs to veterans but
unfortunately, it takes an average of 568 days to process the veterans' disability claims prior to
them receiving these benefits (Wolfe). Gathered from the findings of these studies, out of
289,328 returning veterans resulted in a 36.9% diagnosis rate for PTSD. With the increasing
number of veterans with PTSD and without these treatments and mental health care discussed,
these abandoned veterans must try to fight the bad effects of their PTSD alone.
Of these abandoned veterans suffering from PTSD not every veteran reacts or copes the
same way to traumatic events. Dohwrenwend and colleagues at the Association for
Psychological Science found, traumatic experiences during combat predicted the onset of the
full complement of symptoms, known as the PTSD syndrome, in Vietnam Veterans. But other
factors, such as pre-war psychological vulnerabilities, were equally important for predicting
whether the syndrome persisted Certain groups are at higher risk for receiving Post-Traumatic
Stress Disorder. From examining several studies, Dr. Seal provides, veterans younger than 25
were at nearly twice the risk for PTSD diagnosis, over twice the risk for alcohol use, and at
nearly a 5 fold risk for drug use diagnosis. The highest of these risks are among young men in
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the military who serve in combat. Of around 3,000 soldiers aged under 30, more than 20
percent had a conviction for violent offenses, compared with only 6.7 percent of civilian men in
the same age group (Kelland ). Another risk factor that plays a big role is the area of service and
duty of a veteran. Those in combat roles are 50 percent more likely than those in non-combat
roles to commit assaults or threaten violence after returning. One study shows, other factors
not related to military service, including growing up in a violent home and a prior history of
substance abuse, also raised the risk that veterans will commit crimes (Wood). These risk
factors coupled with multiple deployments prove to increase the risk of veterans now home with
PTSD with over half more likely to commit assaults or threaten violence
The widespread impacts of PTSD include the development of secondary PTSD among
the veterans family members. The emergent need for mental health care for veterans has now
spread to their family members. (McClelland). Since the U.S. government demonstrates limited
resources to support these veterans, the expense of outside treatment for them and their families
is very high. This is causing the veterans and their families to go into severe debt resulting in a
higher number of divorces, bankruptcies, loss of jobs and homelessness. Almost 2,000 Iraq and
Afghanistan veterans have already been seen in the Department of Veterans Affairs homeless
outreach program (Williamson). The homeless population is disproportionately made up of
veterans. For example, 24% of Minnesotas male homeless population are veterans and
more than half of homeless veterans have serious mental illness (Hunter). Much of this
untreated mental illness results in suicide. Army records show that 65% of active duty soldiers
commit suicide, outpacing combat deaths. A veteran dies by suicide every 80 minutes. Children
of veterans are also greatly affected. Among other things, children and teenagers of a parent
who has committed suicide are three times more likely to kill themselves (McClelland).
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If a veteran does not receive mental health care, the combat trauma can eventually lead to
criminal behavior. This will inevitably lead veterans into the criminal justice system because of
PTSD associated legal problems arising from illegal substance abuse, aggressive and unregulated
anger behavior, and the hazardous use of alcohol. The leading cause of criminal behavior from
returning veterans is anger and aggression, substance abuse and alcohol. Literature shows that
the single greatest predictive factor for the incarceration for veterans is substance abuse
(Swords). However, crimes much more serious are kept well documented. After a series of
violent crimes including homicides, the U.S. Army commissioned a study called
Epidemiological Consultation, or EPICON, for short. A team of 24 physicians, looking for
common factors, studied soldiers at Fort Carson, Colorado. The murder rate for Ft. Carson had
doubled since the start of the Iraq war. Rape arrests had tripled and stood at nearly twice the rate
of other army posts (Hunter).
There is a strong and demonstrable correlation between combat trauma and criminal
behavior. Each major American war results in a disproportionate number of veterans in the
criminal justice system. Studies showed a few years after WWII, one third of imprisoned men
were veterans and almost one half of all Vietnam combat veterans with PTSD had been arrested
one or more times. Post-Traumatic Stress Disorder symptoms can incidentally lead to criminal
behavior. Iraq and Afghanistan veterans have developed psychological injuries, which have had
a big impact on the criminal justice system. "The veterans offenses can be directly connected to
the specific trauma and symptoms experienced; aggression/assault, self-medication/substance
abuse, hyper vigilance /violent responses, and unresolved conflict/ reckless behavior" (Hunter).
The criminal courts must prepare and adapt to deal with the dramatic increases in the
criminally involved veteran. They can do this with specialized courts such as 'Veterans Court'.
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Chief Prosecuting Attorney for the 7
th
Judicial Circuit of Florida State Attorney, R.J. Larizza
states, Historically we have not tracked those particular types of numbers but there is a growing
consensus that these are a type of criminal cases and defendants that have a peculiar set of issues
should be addressed and considered by the criminal justice system. Veterans Court can more
effectively deal with the psychologically injured combat veteran by capturing large numbers of
veterans resistant to treatment. For example, if the criminally involved veteran does not contest
the charge they can be diverted from going to jail and placed into treatment instead. The veteran
will receive close supervision, appearing in court monthly, usually receiving monitoring, and
mentorship by a volunteer veteran. These efforts greatly increase the chances of successful
rehabilitation. A Veterans Treatment Court is also more familiar with the Veterans Health
Administration, Veterans Benefit Administration, State Department of Veterans Affairs,
Veterans Service Organizations, and volunteer Veteran Mentors and how they all can assist
veteran defendants (Justice).
In Veterans Court, as Volusia County Veterans Court Judge David Beck explains, the
prosecutor, public defenders and other court room personnel including myself have specialized
training in veterans' issues such as post-traumatic stress disorder, traumatic brain injury, and
other battle field injuries. Additionally, there is a veterans' affairs case manager at every court
session and most of the other court personnel are volunteers from veterans' organizations
throughout the county. A designated Veteran Justice Outreach (VJO) specialist who resides at
each medical center provides direct outreach assessment and case management for justice-
involved veterans in local courts and jail. The VJO acts as a coordinator or liaison with other
local justice system partners. Veterans Court personnel are trained in the application of new
federal and state legislation designed to accommodate the veteran defendants service related
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mental injuries. In having Veterans Court specialized personnel, veterans are sure to start
receiving mental health care and much needed to support they so desperately need.
State and federal mitigation statutes allow for less incarceration and more probationary
treatment alternatives in light of a veterans service and its related disabilities. In one particular
example State Attorney R.J. Larizza had recalled a case that came, immediately to mind, a
road rage case where an honorably discharged combat veteran fired a firearm over another
vehicle occupied by a gentleman and his son. The circumstance of this particular veterans
service was that of a combat soldier. The effects of his combat service had manifested itself in a
stress disorder common among such veterans. In this case, his hyper vigilance to certain stressors
proved directly related to the offence and our office considered his particular circumstance in
fashioning a lowered charging decision. This had the effect of removing the mandatory minimum
prison sentence normally associated with a criminal case involving firearms and substituted one
which permitted the judge to order a strictly monitored probationary sentence involving
significant treatment alternatives."
There are other circumstances where traditional defenses to crimes of aggression can fit
the situation of the criminally involved combat veteran. For example, special PTSD self-defense
theories in the law that can be applied similar to the traditional battered womens syndrome
defenses have been applied (Hunter). In many jurisdictions, the legislature has carved out special
exceptions to the criminal law by treating the offender differently, though the circumstances are
similar, based upon consideration of significant disadvantages or mitigating circumstances
(Swords). "Veterans courts are now attempting to strike a balance between accountability and
rehabilitation in the interest of honoring the often traumatic service of our nations veterans
(Justice). The veteran criminal defendant represents a classic subject for these efforts. Even
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critics of veterans' courts generally support the idea that veterans who have served the nation
honorably and have suffered combat trauma related mental illnesses, which contributed to their
conduct, should be allowed extra considerations within the justice system.
Veterans Courts can save both the offender and the local and state taxpayer substantial
funds. The Veterans Court defendant has treatment administered and funded by the Veterans
Administration. Judge Beck answers, The offender benefits because he is shepherded through
services by a veteran affairs representative who can guide the veteran through the treatment
maze. The veteran will receive most treatment at no charge because of their veteran status and
where they are being directed. Additionally, the judge has much more leeway in substituting
community service work for mandatory court and supervision costs, which in many veterans
cases can make the difference between becoming homeless or not. Almost without exception,
the Veterans Court defendant spends less time in costly state funded jails and prison systems. As
Judge Beck puts it, Incarceration is primarily used to coerce the offender into compliance into
treatment programs rather than a punishment for the offense itself. As the state saves money
from the reduction of the number of offenders incarcerated, likewise placing a veteran in a
supervision or diversion program allows him or her to continue receiving Veterans Health
Administration benefits. This is because the veteran's benefits are cut off if a veteran has been
incarcerated 60 days or more. Furthermore, the literature overwhelmingly indicated that
incarcerated veterans are extraordinarily vulnerable to death by overdose or suicide (Swords).
Just as the criminally involved veteran can benefit from prosecution, the criminal justice
system can seize the opportunity of the increasing numbers of combat veterans to achieve greater
healing and rehabilitation among its criminal population. The criminal court can bring the weight
of its power to coerce treatment of the psychologically injured veteran, replacing traditional
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imprisonment with healing and reintegration of the veteran citizen into what will ultimately
result in a safer and healthier society.






















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Works Cited
American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders,
(5th ed.). Washington, DC: Author. 3 Jan. 2014. Web. 7 July 2014.
B., David, Retired United States Army. Personal Interview. 14 July 2014
Beck, David, Judge. Personal Interview. 14 July 2014.
C., Ralph, United States Marine Corps. Personal Interview. 18 July 2014.
Dohwrenwend, Bruce P. "Why Some Soldiers Develop PTSD While Others Don't." Association
for Psychological Science RSS. N.p., 21 Feb. 2013. Web. 10 July 2014.
Elbogen, Eric. "Study: Specific PTSD Symptoms Related to Anger and Aggressiveness Among
Iraq/Afghanistan Veterans." - UNC School of Medicine. N.p., June 2010. Web. 10 July
2014.
Hunter, Brockton D. Echoes of War: The Combat Veteran in Criminal Court. Brockton
Hunter & Ryan Else, eds., New York, NY: Penguin Group. 2014.
Justice for Vets. "What is a Veterans Treatment Court?" 18 July 2014. Web. 09 July 2014.
Larizza, R.J., State Attorney. Personal Interview. 13 July 2014.
McClelland, Mac. Hearts and minds: PTSD is already at epidemic levels among returning vets.
And now its spreading to their families. Mother Jones Jan.-Feb. 2013: 16+. Opposing
Viewpoints In Context. Web. 09 July 2014.
"PTSD: National Center for PTSD." PTSD Basics -. N.p., 25 June 2014. Web. 09 July 2014.
Purdy, James, Public Defender. Personal Interview. 15 July 2014.

Reno, Jamie. "Nearly 30% of Vets Treated by V.A. Have PTSD." The Daily Beast.
Newsweek/Daily Beast, 21 Oct. 2012. Web. 11 July 2014.
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Shafer, Dan, Public Defender. Personal Interview. 15 July 2014.
Seal, Karen, Md. "Trends and Risk Factors for Mental Health Diagnoses Among Iraq and
Afghanistan Veterans Using Department of Veterans Affairs Health Care." US National
Library of Medicine. NIH, 1 Sept. 2009. Web. 09 July 2014.
Segal, Jeanne, Ph.D., and Melinda Smith, M.A. "Post-Traumatic Stress Disorder (PTSD)":
Symptoms, Treatment and Self-Help. N.p., Mar. 2014. Web. 09 July 2014.
Tull, Matthew, PhD. "PTSD in Iraq War Veterans - Rates of PTSD in Iraq War Veterans."
About.com Post Traumatic Stress (PTSD). N.p., 29 Jan. 2012. Web. 11 July 2014.
W., John, Retired United States Marine Corps. Personal Interview. 18 July 2014.
Williamson, V., and E. Mulhall. Invisible Wounds: Psychological and Neurological Injuries
Confront a New Generation of Veterans. Washington, DC: Iraq and Afghanistan
Veterans of America, 2009. http://iava.org/files/IAVA_invisible_wounds_0.pdf Web. 10
July 2014.
Wood, David. Combat Veterans with PTSD, Anger Issues More Likely to Commit Crimes:
New Report. Huffington Post, 10/10/12. http://www.huffingtonpost.com/2012/10/10/
veterans-ptsd-crime-report n 1951338.html. Web. 12 July 2014.
Wolfe, Matthew. "From PTSD to Prison: Why Veterans Become Criminals." The Daily Beast.
Newsweek/Daily Beast, 28 July 2013. Web. 13 July 2014.