47 States and both Houses of Congress drop the “D”



The diagnostic term Post-traumatic Stress Disorder (PTSD) was crafted in 1980 by the American Psychiatric Association (APA) to commonly describe and categorize the psychological aftermath of experiencing traumatic events. Since, as the result of intensive electromagnetic imaging research, it has been shown that severe post-traumatic stress, combat-induced or otherwise, causes physical changes within the brain which more accurately describe an injury than a disorder – a treatable wound calling for definitive and timely treatment.

The stigma advanced by the term “Post-traumatic Stress Disorder” presents a needless liability to the health and welfare of those already overwhelmed by this basic natural response to an extraordinary event. To label them “disordered” only serves to add to their struggle, discouraging some of the afflicted from seeking care while keeping others, particularly those who do not know them, from truly caring.

In 2012, the American Psychiatric Association held an open hearing to debate the name change of post-traumatic stress disorder (PTSD) to include post-traumatic stress injury (PTSI). Regrettably, the APA’s decision was not to change or add to the name in DSM 5.

Beyond this obvious obstruction to the healing process, the use of the word “disorder” here negates the sense of honor owed the brave men and women who have received these wounds while risking their lives to protect ours, be it on the field of battle, the emergency rooms of our hospitals, or the streets of our communities. On a personal level, it disparages the character of victims of crime and abuse, as well as survivors of life-threatening accidents, natural disasters, and more. 

In 2013, Honor for ALL began a grassroots campaign to rebrand the term as Post-traumatic Stress Injury on a cultural level by petitioning federal, state, and local officials to declare June 27 as Post-traumatic Stress Injury Day Awareness Day (the date June 27 was first chosen by the United States Senate as National PTSD Awareness Day in 2010). Our objective was, and remains, to gather enough support among governing bodies, the press, and the electorate to positively influence succeeding actions of the APA’s DSM Scientific Review Committee in favor of name change.

Our first state resolution for Post-traumatic Stress Injury Awareness Day came from our home state of Michigan in 2014. As of the Spring of 2022, 47 states have participated by way of bill, resolution, and/or proclamation designating June 27 as PTS Awareness Day. The US House of Representatives signed on in 2017, and the Senate designated June 27 as PTS Awareness Day beginning in 2016.

HFA Medical Advisor, Dr. Frank Ochberg, former Associate Director of the National Institute of Mental Health (NIMH) and member and chair of APA councils, committees, and task forces in the late 1970s and early 1980s materially responsible for advancing the creation and modification of the original diagnosis known as PTSD agrees, “As far as I am concerned, the name PTSD, was never important.  The concept was important.  We knew before 1980 that research would help us adjust the diagnostic criteria over time.  We knew that later versions would reflect evolving scientific knowledge.  And now, evolving knowledge leads us to a modification in the name as well as modifications in criteria.  The basic concept remains. Some details have changed.  The fact that profound trauma creates injuries to brain function, brain physiology, and brain anatomy is well established.  Removing the “D” can reduce the stigma, and that is good. Adding the “I” for injury introduces honor, and that is better.”

Although our original intent was to advocate for service members and veterans, we have come to realize that the impact of this trauma, whether it stems from personal tragedy, societal upheaval, or the horrors of war, is a pervasive and insidious threat to the well-being of all our fellow citizens.

Without pressure from the public sector, the APA will most certainly continue to use this harmful term, which acts as a barrier to getting adequate and timely care. The first critical decision that a victim of severe post-traumatic stress is forced to deal with is the one of ownership. The stigma created by the word ‘disorder’ interferes with that ownership, which in turn interferes with access to treatment, which in turn, too often leads to depression, despair, and ultimately self-destruction.

Identifying Post-traumatic Stress as an Injury by officially and publicly declaring a Day of Awareness cannot unwring the bell sounded by the APA in DSM III some forty years ago when they coined their original descriptor, but it can serve to redirect public sentiment. Officially and publicly declaring a Day for Post-traumatic Stress Injury Awareness says we are committed to excluding shame, adding honor, and in the end – saving lives.

Honor for ALL specifically encourages the use of the full term “Post-traumatic Stress Injury” rather than simply “Post-traumatic Stress” in resolutions and bills. The primary reason is as follows: for medical and or legal reference, PTS only has to comply with Criteria A; PTSI (née PTSD) must comply with Criteria A through H of Section 309.81. Both of these diagnoses come under the umbrella of Traumatic Stress, for which the DSM does not provide a specific definition but is clearly an increasingly common mental health issue in present-day life. A lot of the pushback from the existing opposition stems from the belief that changing the name will present confusion and complexity in obtaining compensation and healthcare qualifications. For this reason, we encourage all bills and resolutions to include a clause stating, “any injury exhibiting compliance with criteria A through H, §309.81 in the Diagnostic Statistical Manual deserves consideration and compensation strictly matching legal entitlements provided for disabilities that have been or are currently, classified as post-traumatic stress disorder”. 

For individual Bills, Resolutions, and Proclamations to date, go to *Supporters*.