ANATOMY OF A RESOLUTION

National Post-traumatic Stress Injury Awareness originated with the adoption of Senate Resolution 541 of the 111th Congress, introduced in 2010 by Senator Kent Conrad of North Dakota. The date of June 27 was inspired by the birthday of North Dakota National Guard Staff Sergeant Joe Biel, who suffered from PTSD and, tragically, took his own life in April 2007.

Michigan became the first legislative body nationally to designate June 27 as Post-traumatic Stress Injury Awareness Day in House Resolution 375. To date, 47 states have participated at least once through bills, resolutions, and/or proclamations in designating PTSI Awareness Day. Of these states, 22 have adopted perennial resolutions, and another 12 have provided annual resolutions for six or more years.

In his address to the Senate on May 26, Senator Conrad referred to post-traumatic stress as a disease, a disorder, and an illness. Since the prolegomenous day, it has been confirmed with the aid of electromagnetic imaging that severe traumatic stress causes physical changes within the brain, which are most accurately described as an injury. In 2013, Senate Resolution 169 changed the designated date to include the entire month of June. In 2016, the word “disorder” was removed from the designation in Senate Resolution 512. In 2017, the designation was further changed to add the word “Injury” in House Resolution 391.

SR 541 had eight preambular clauses and three operative clauses. In 2023, SR 264 had eighteen preambular and seven operative clauses; House Resolution 572 had nineteen preambular and seven operative clauses.

Five preambular clauses and all three operative clauses from the Senate Resolution of 2010 have survived to be included in SR 264 and HR 572 of 2023:

*** Words, terms, and phrases underscored and highlighted were considered for inclusion with the encouragement and approval of Honor for ALL

2010 – SR 541

• The lead clause survives virtually without change except for punctuation and remains the lead clause of SR 264 and HR 572 in 2023
  • Whereas the brave men and women of the United States Armed Forces, who proudly serve the United States, risk their lives to protect the freedom of the United States and deserve the investment of every possible resource to ensure their lasting physical, mental, and emotional wellbeing;
• Clause 2 evolved into Clause 8 of SR 264 and Clause 6 of HR 572 in 2023
  • Whereas the Secretary of Veterans Affairs reports that—
    • approximately 20 percent of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom have post-traumatic stress in a given year;
    • approximately 12 percent of veterans who served in the Persian Gulf War have post-traumatic stress in a given year; and
    • approximately 30 percent of veterans who served in the Vietnam era have had post-traumatic stress in their lifetimes;
  • Clause 6 of SR 541 evolved into Clause 7 of SR 264 and Clause 11 of HR 572 in 2023
    • Whereas post-traumatic stress significantly increases the risk of post-traumatic stress responses, including anxiety, depression, homelessness, substance abuse, and suicide, especially if left untreated;
      • The term “post-traumatic stress responses” first appears in Clause 4 of SR 618 in 2020.
    • Clause 7 of SR 541 evolved into Clause 10 of SR 264 and Clause 11 of HR 572 in 2023
      • Whereas the Department of Defense, the Department of Veterans Affairs, veterans service organizations, and the private and public medical community have made significant advances in the identification, prevention, diagnosis, and treatment of post-traumatic stress and the symptoms of post-traumatic stress, but many challenges remain;
        • The language “veterans service organizations and the private and public medical community have made significant advances in the identification,” first appears in Clause 10 of SR 481 in 2014
      • Clause 8, the last of the SR 541 preamble, evolved and remains last as Clause 18 of SR 264. and Clause 19 of HR 572 in 2023
        • Whereas the designation of a National Post-Traumatic Stress Awareness Month and a National Post-Traumatic Stress Awareness Day raises public awareness about issues relating to post-traumatic stress, reduces the stigma associated with post-traumatic stress, and helps ensure that individuals suffering from the invisible wounds of war receive proper treatment
          • The term “invisible wounds of war” was added to this clause in SR 202, 2011
          • The language “reduce the stigma” was added in SR 481, 2014
        • Operative Clause 1 evolved and remains Operative Clause 1 of SR 264 and HR 572 in 2023
          • designates—
            • June 2023 as “National Post-Traumatic Stress Awareness Month”; and
            • June 27, 2023, as “National Post-Traumatic Stress Awareness Day”;
              • clause was changed to designate the entire month of June in SR 169, 2013

*** The word “disorder” was removed from the titles of SR 512 in 2016.

*** Operative Clause #1 was further changed to add the word “Injury” to the designation titles in HR 391 in 2017  

• Operative Clause 2 evolved and remains Operative Clause 2 of SR 264 and HR 573 in 2023
  • urges the Secretary of Veterans Affairs and the Secretary of Defense to continue working to educate servicemembers, veterans, the families of servicemembers and veterans, and the public about the causes, symptoms, and treatment of post-traumatic stress disorder
    • The entities “entire medical community” and “the public” were added in SR 481 in 2014
  • Operative Clause 3 survives as Operative Clause 7 of SR 264 and HR 572 in 2023
    • respectfully requests that the Secretary of the Senate transmit a copy of this resolution to—
      • the Secretary of Veterans Affairs; and
      • the Secretary of Defense.

2011 – SR 202

• New clause added to as #5; survives as Clause 6 of SR 264 and Clause 8 of HR 572 in 2023
  • Whereas many post-traumatic stress responses remain unreported, undiagnosed, and untreated due to a lack of awareness about post-traumatic stress and the persistent stigma associated with mental health conditions

*** First inclusion of the word “stigma” in any Senate Resolution

• Clause 8 was amended to include the term “invisible wounds”; survives as Clause 18 of SR 264. and Clause 19 of HR 572 in 2023
  • Whereas the establishment of a National Post-Traumatic Stress Disorder Awareness Day will raise public awareness about issues related to PTSD and help ensure that those suffering from the invisible wounds of war receive proper treatment:

*** First inclusion of the term “invisible wounds” in any Senate Resolution

2012 – SR 455

• New clause added as #3; survives as Clause 3 of SR 264 and HR 572 in 2023
  • Whereas the current generation of men and women in the Armed Forces has sustained a high rate of operational deployments, with many members of the Armed Forces serving overseas multiple times, placing those members at high risk of enduring traumatic combat stress

• New clause added as #8; survives as Clause 9 of SR 264 and Clause 7 of HR 572 in 2023
  • Whereas public perceptions of post-traumatic stress as a mental health disorder create unique challenges for veterans seeking employment

 2013 – SR 169

• Operative Clause 1 was changed to designate the entire month of June

2014 – SR 481

• New clause added as #11; survives as Clause 11 of SR 264 and Clause 12 of HR 572 in 2-23
  • Whereas increased understanding of post-traumatic stress can help eliminate stigma attached to the mental health issues of post-traumatic stress

2015 – SR 215

• Clause 12 was amended to include the term “common injury that is treatable”; survives as Clause 11 and 12 of SR 264 and Clauses 12 and 13 of HR 572 in 2023
  • Whereas increased understanding of PTSD can help diminish the stigma attached to this mental health issue, and additional efforts are needed to find further ways to reduce this stigma—including an examination of how PTSD is discussed in the United States and a recognition that PTSD is a common injury that is treatable and repairable
• New clause added as #12; evolved into Clause 14 of SR 264 and 15 of HR 572 in 2023
  • supports efforts by the Secretary of Veterans Affairs and the Secretary of Defense to foster—
    • cultural change around the issue of post-traumatic stress; and
    • understanding that personal interactions can save lives and advance treatment
      • the term “global pandemics” was added in SR 618, 2020
    • New operative clause added as #3; survives as Operative Clause 5 of SR 264 and HR 572
      • encourages the leadership of the Armed Forces to support appropriate treatment of men and women of the Armed Forces who suffer from post-traumatic stress

2016 – SR 512

• New clause added as #4; evolved into Clause 4 of SR 264 and HR 572 in 2023
  • Whereas, when left untreated, exposure to traumatic combat stress can lead to severe and chronic post-traumatic stress responses, which are commonly referred to as post-traumatic stress disorder or post-traumatic stress injury

*** First inclusion of the term “Post-traumatic Stress Injury” in the Senate or House Resolutions.

• New clause added as #13; evolved into Clause 12 of SR 264 and Clause 13 of HR 572 in 2023
  • Whereas additional efforts are needed to find further ways to eliminate the stigma associated with post-traumatic stress, including—
    • an examination of how post-traumatic stress is discussed in the United States;
    • a recognition that post-traumatic stress is a common injury that is treatable (wording added in clause 11 of SR 215 in 2015);
  • Operative Clause 1 amended to remove the word “disorder” from the designation titles in the Senate Resolutions; clause survives as operative #1 in SR 264 and HR 572 in 2023
  • New operative clause added as #3; survives as Operative Clause 4 of SR 264 and HR 572 in 2023
    • welcomes the efforts of local Vet Centers (as defined in section 1712A(h) of title 38, United States Code) to provide assistance to veterans who are suffering from the effects of post-traumatic stress

2017 – SR 203

• New clause added as #5; survives as Clause 5 in SR 264 and HR 572
  • Whereas many men and women of the Armed Forces and veterans who served before September 11, 2001, live with mental health needs from post-traumatic stress and remain at risk for responses to that stress
  • clause was amended to include the word “responses” to that stress in Clause 5 of SR 618 in 2020

*** First inclusion of the word “responses” in the Senate or House Resolutions.

• New clause added as #15; survives as Clause 16 in SR 264 and Clause 17 0f HR 572 in 2023
  • Whereas the diagnosis of post-traumatic stress disorder was first defined by the American Psychiatric Association in 1980 to commonly and more accurately understand and treat survivors of physical and psychological trauma, including veterans who had endured severe traumatic combat stress

*** First inclusion of this language in the Senate or House Resolutions.

2017 – HR 391

• Operative Clause #1 of HR 391 is written to support the designation of
  • ‘‘National Post-Traumatic Stress Injury Awareness Month’’ and “National Post-Traumatic Stress Injury Awareness Day”

*** A precursor to HR 391 was introduced as HR 930 on Nov 17, 2016

• HR 391 includes Cluse 8 with no corresponding Senate Clause; survives as Clause 8 of HR 572 in 2023:
  • Whereas exposure to trauma during service in the Armed Forces can lead to post-traumatic stress

2018 – SR 554 / HR 391

• New clause added as #16 in SR 554; survives as Clause 17 in SR 264 and Clause 18 of HR 572
  • Whereas the word “disorder” can perpetuate the stigma associated with combat stress, so the more general term “post-traumatic stress” is often preferred
    • The language “ the more general term post-traumatic stress is often preferred” was added in clause 17 of SR 618 in
  • New operative clause added #3; survives as Operative Clause 3 in SR 264 and HR 572
    • supports efforts by the Secretary of Veterans Affairs and the Secretary of Defense to foster—
      • cultural change around the issue of post-traumatic stress; and
      • understanding that personal interactions can save lives and advance treatment;

*** Senator Hoeven of North Dakota in press release:

• “In passing this resolution, we reaffirm our commitment to finding treatments to help our servicemembers, veterans, and their families as they deal with this inj
• The Senate Resolution that year had the most cosigners of any of the fifteen Senate Resolutions so far, 38:

Ms. Heitkamp, Mr. Heller, Ms. Baldwin, Mr. Grassley, Mr. Tester, Mr. Rounds, Mrs. Feinstein, Mr. Daines, Mr. Jones, Mr. Roberts, Ms. Hassan, Mr. Hoeven, Ms. Cantwell, Mr. Sullivan, Mr. Cardin, Ms. Collins, Mr. Markey, Mr. Rubio, Mr. Van Hollen, Mr. Tillis, Mr. Coons, Mr. Donnelly, Mr. Blumenthal, Mr. Casey, Mr. Merkley, Ms. Klobuchar, Ms. Stabenow, Ms. Hirono, Ms. Cortez Masto, Mr. Nelson, Mr. Bennet, Ms. Warren, Mr. Leahy, Mr. Murphy, Ms. Smith, Mr. King, Mr. Booker, and Mr. Reed

2019 – SR 220 / HR 455

• New operative clause added as #6 in SR 554 and # 6 HR 455; survives as Operative Clause 6 in both
  • recognizes the impact of post-traumatic stress on the spouses and families of members of the Armed Forces and veterans

2020 – SR 618 / HR

• New clause added as #6 in SR 618; survives as Clause 6 in SR 264 and Clause 7 in HR 572
  • Whereas many post-traumatic stress responses remain unreported, undiagnosed, and untreated due to a lack of awareness about post-traumatic stress and the persistent stigma associated with mental health conditions;

*** First inclusion of the term “post-traumatic stress responses” in the Senate or House Resolutions

• New clause added as #13 in SR 618; survives as Clause 15 in SR 264 and Clause 16 in HR 572 –
  • Whereas traumatic events such as the COVID–19 pandemic could —
    • increase the number of individuals impacted by post-traumatic stress;
    • exacerbate the responses of post-traumatic stress

2021 – SR 289

• New clause added as #12 in SR 289; survives as Clause 13 in SR 264 and Clause 14 in HR 572 –
  • Whereas timely and appropriate treatment of post-traumatic stress responses can diminish complications and avert suicides

2022 – SR 703 / HR 1206

• Clause 15 of SR 289 was removed from the Senate Resolution
• New clause added as #8 in HR 1206; survives as Clause 8 of HR 572 –
  • Whereas exposure to trauma during service in the Armed Forces can lead to post-traumatic stress
  • There is no corresponding Senate clause for Clause 8 of HR 572

2023 – SR 264 / HR 572

• Clause 15 of SR 289 was reinserted as Clause 15 in SR 264