This has been a great week of discussion here at TPM Café. I wish the conversation in the mainstream media had been as robust as this one.

For my final post of the exchange, I want to shift away from the media a bit, and focus on the human side of this war. This is an area of the wars in Iraq and Afghanistan that Greg Mitchel has been especially diligent about covering. He has consistently documented the alarming number of suicides that have occurred involving military personnel--both on and off active duty. Each suicide is a canary in the coalmine. The mental health toll of the wars in Iraq and Afghanistan will be tremendous.

The story of Keri Christensen (featured here on CNN.com) should upset all Americans. She is a patriot. She is also one of an estimated 180,000 women who have courageously served in combat in Iraq and Afghanistan since 9/11.

Women make up 11 percent of Iraq and Afghanistan veterans, and 15 percent of the military as a whole. Despite DoD and Army policies that prohibit women in combat, there are more female service members serving in Iraq and Afghanistan than in previous conflicts, and a greater portion are situated in combat roles.

But, like so many others, Keri is now facing another fight. Today, she is back at home in Denver struggling to overcome mental health injuries. And five years after the start of the Iraq war, Keri is not alone…

By now, many Americans know that mental health problems can be crippling for veterans, increasing the risk of divorce, unemployment, even homelessness and suicide. A recent news report offers a dire warning:

“Veterans aged 20 through 24, those who have served during the war on terror… [have] the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age.”

This shocking data only highlights the tremendous need for quick action to treat troops’ mental health problems. PTSD is treatable, especially if it’s caught early. We can (and must) help hundreds of thousands of veterans just like Keri.

Unfortunately, the Department of Defense’s system for screening troops — a bunch of paperwork followed by a phone call — doesn’t catch most of the people who will need treatment. We vets have known this for years. A recent study in the Journal of the American Medical Association agreed.

The study looks at the paperwork forms on 88,000 soldiers to see who needed treatment and who actually got care, and came to some disturbing conclusions.

Asking a troop just back from Iraq to fill out another form is not the same as screening them for PTSD. The report concludes: “Surveys taken immediately on return from deployment substantially underestimate the mental health burden.” That’s why it’s crucial that troops get mandatory, in-person interviews with a mental health professional. And not just when they come home, but months later, when the long-term effects of combat have had time to become visible.

Mental health issues are family issues. In the six months after getting home, there was a four-fold increase in troops’ concerns about “interpersonal conflicts” with family and friends. The military needs to do a better job of reaching out to troops’ families, so they can help get their loved ones into treatment.

National Guardsmen and Reservists are facing a special set of issues, and their concerns need to get heard. 42.4 percent of National Guardsmen and Reservists were identified as needing mental health treatment, compared to 20.3 percent of the active duty. These troops are more likely to have family and financial problems result from their deployment, and when they get home, they go straight back to work in a civilian job. No wonder they have higher rates of stress. We need to get them the care they need, starting with stronger job protections and better family support for deploying reserve troops.

Troops need more time to access care. Far more troops admitted a mental health problem when interviewed after six months than when they just got home. Of those who received a referral for mental health treatment, 39 percent still had not seen a mental health professional 90 days after their second interview. That’s nine months after their return. The military and the VA need to prepare for the time-lag between troops coming home and their entry into the mental health care system.

As the authors of the JAMA study conclude, there is an “enormous opportunity” for the military to “intervene early before soldiers leave active duty.” That includes thousands of women who have bravely fought and suffered wounds right alongside their male counterparts–and sometimes also face the incredibly stress of a sexual assault and/or trauma.

60,000 veterans were diagnosed by the VA with Post-Traumatic Stress Disorder. ³Of those, 22 percent of women suffered from military sexual trauma,¹ which includes sexual harassment or assault, compared with just 1 percent of men.²

In 2007, there were 2,688 sexual assaults reported. This followed a 24 percent jump in 2006, and a 40 percent increase in 2005. The overwhelming majority of service members who report sexual trauma are women. The VA has clearly seen a connection between mental health injuries and sexual assault.

But more research is necessary to understand the connection. Although the number of female veterans is rising, there is still a knowledge gap when it comes to the unique needs of female veterans. In IAVA’s 2008 Legislative Agenda, we call for a more comprehensive approach to treating female service members¹ psychological injuries, including funding for an independent research study of the scope of sexual harassment and assault in the military, and an analysis of the effectiveness of the military¹s response to the problem.

We know the consequences if we fail to act. The only question is whether we have the political will to help these heroes like Keri before it’s too late.