Several of the (many) problems with giving the Purple Heart for PTSD:

-Inequality: If two Soldiers each are wounded by fragments from a grenade, both qualify for the Purple Heart. But if two Soldiers each watch a truck explode half a mile away, both unharmed, and one of them suffers PTSD as a result, only that one will qualify for a PTSD PH. How is that fair to the Soldier who had the exact same physical experience as the PTSD guy, but who had a stronger/more resilient/whatever mind?

-Veterans of past wars: WWII, Korea, and Vietnam veterans weren't systematically screened or treated for PTSD, but nonetheless, many came home with PTSD or shell-shock. Giving the PH to only current PTSD-sufferers would be a grave injustice to the many WWII, Korea, and Vietnam vets in this country. Giving the PH to all PTSD-suffering veterans is impossibly impractical--how do you verify that they had PTSD, and that it was caused by a wartime experience? What if they were never diagnosed, and just dealt with it on their own? What if the vet is deceased, and their kids want daddy's/grandad's PTSD PH? How do we know whether dad/grandad ever suffered from PTSD, or if the kids are just making it up?

-Causation: physical wounds, like those which now qualify for the Purple Heart, are directly caused by the enemy, with the intent to kill or injure American soldiers. PTSD can be triggered by such attacks, yes, but it can also be triggered by actions which were not directed at the suffering soldier, or at any soldiers.

-It doesn't help the problem: PTSD is not made better by a shiny medal and a silk ribbon. If we are going to do something significant to help those who suffer from PTSD (and we should), then we should do something that will actually help. Maybe double the VA's funding, build better care facilities, hire more and better psychologists/psychiatrists. Help vets work through their PTSD. A medal won't do that.

Excellent response!

The final point is the most important one. Medals don't stop the nightmares, the flashbacks, and the suicides. Continue pushing for identification and treatment instead of trying to fix everything in society with damn awards.

Medals WILL stop the nightmares, the flashbacks, and the suicides to the extent that they are part of normalizing the identification and treatment of PTSD. It will help the warrior accept that it is a wound, and that it can be treated just like a shrapnel wound in the leg. Part of the treatment for psychological trauma is for the victim to understand that it is a wound, that his country's men and women understand what a sacrifice it was to be injured, and that our military men and women are entitled to every treatment their country can provide.