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National Intrepid Center of Excellence Dedication (Bethesda, MD)
As Delivered by Secretary of Defense Robert M. Gates, Bethesda, MD, Thursday, June 05, 2008

Thank you, Captain Korka.
Secretary Peake, Secretary Winter, General Cartwright, General Cody, other distinguished guests.
I’d like to start by acknowledging, as others have, the extraordinary contributions of Mr. Arnold Fisher and Ken Fisher.  The generosity of the Fisher family and the Intrepid Fallen Heroes Fund has made a profound difference in the lives of U.S. troops and their families across the country.  We are profoundly grateful to the Fishers, and to all the folks here this morning who made this day possible. There are different kinds of heroes and, in my book Arnold and Ken Fisher are heroes, especially to every man and woman in uniform, and we salute you.
This occasion represents not just the beginning of construction of this facility, but an opportunity to reflect on how far we’ve come, and how much we still have to do, to see that men and women who’ve served America in battle are properly cared for – mind, body, and spirit. 
The need for this world-class facility has never been more pressing or more important.
All wars are terrible in their destructiveness and human costs. The conflicts in Iraq and Afghanistan have presented a unique mix of injuries, stresses, and strains on the men and women of the armed forces: Repeated and extended deployments; a battlefield without front lines against an enemy that does not wear uniforms or obey any laws of war; a conflict where innocent civilians are preyed upon and bear the most frightful costs.
And as in every conflict in America’s history, many of our troops have returned bearing the scars of war – scars both seen and unseen. These invisible wounds are in many ways more pernicious, more grievous because they are not readily apparent and have not always received the attention they should.
In Iraq, improvements in armor protection and battlefield medicine mean that many troops survive or even walk away from explosions that in previous wars might well have been fatal. One of the consequences has been an increase in cases of traumatic brain injury – a condition that is still not well understood.  
More than $150 million in research has been dedicated to TBI – preventive measures as well as diagnosis, treatment, and recovery.  The military now has more thorough reporting mechanisms, requiring that any one affected by a blast or blunt trauma in theater go through an evaluation and screening. We have a single TBI registry and a single point of responsibility – the Defense and Veterans Brain Injury Center – to consolidate all TBI-related incidents and information.  We’ve learned a lot about TBI in recent years, and with this facility and the efforts underway, we are poised to learn a great deal more. 
Above all, this center represents America’s dedication to providing first-class treatment for troops who may be suffering combat-related stress and mental illness. Recently, the military, along with our partners in the VA and private sector have gone a long way towards putting programs and processes in place to deal with the psychological consequences of what has turned out to be a long war.
The OSCAR teams developed and deployed by the Marines are a terrific example of tailoring [medical] expertise to fit the needs and experiences of troops at the front. 
During my recent trip to Fort Bliss, I visited a restoration and resilience center and was impressed, and indeed awed, by what I saw.  They are doing amazing things to help soldiers who want to remain soldiers but who have been afflicted with post-traumatic stress.
And then there is the National Intrepid Center of Excellence that we are dedicating today.  This facility will provide a holistic approach featuring the latest advances to provide care for troops and their families throughout the recovery process. It will do for traumatic brain injury and psychological health what the Center for the Intrepid and the staff at Brooke Army Medical Center do so superbly for the care of amputees.
This facility will serve as the clinical research and educational arm of the Defense Centers of Excellence for psychological health and TBI – a collaborative network promoting resilience, recovery, and reintegration for troops and their loved ones.  The Defense Centers of Excellence was established at the recommendation of various task forces and committees to specialize in psychological health and TBI issues.  Already this year the DCOE has screened approximately 50,000 primary care visits for depression and PTSD and coordinated 18 TBI training events.
There is a good deal more to be done.  We know, for example, that few mental health professionals live and work in the rural areas near many military bases. More resources and people are on the way. Yesterday, the Departments of Defense and Health and Human Services announced that approximately 200 behavioral scientists and health officers from the Public Health Service will be made available to work at military treatment facilities.    
We also know that not all returning servicemen and women are getting the treatment they need for post traumatic stress. At this point, all soldiers receive training about PTSD before and after each deployment, and all are screened for mental health problems following their combat tour abroad. Despite these and a number of other proactive measures, we have further steps to go to reach all those who may need help.
In addition, we must find new ways to overcome the long standing stigma associated with mental health. That change in our culture represents our biggest challenge and we know it will not happen overnight.
For a long time, many troops believed that admitting psychological treatment was an impediment to getting a security clearance. Last month, I announced that question on the military’s security clearance form will be changed to exclude, as a general matter, counseling for combat-related stress – and in particular post traumatic stress disorder. We hope that with this change, more will be willing to come forward and seek help.
The main point is to do everything we can to ensure that the inevitable anxiety and stress from combat does not turn into something tragically worse. And time and again, we have learned that the number one factor in determining success or failure in these areas is leadership – compassionate and proactive leadership.
During my visit to Fort Bliss I spoke to the Sergeants Major Academy, where I emphasized that the senior NCO corps has a special role to play in seeing that enlisted men and women in their charge feel comfortable getting the help they need. Admiral Mullen has spoken out clearly and forcefully, as have the other service chiefs, to send the message down the line that the psychological health of the troops and their families is a command responsibility.
I would like to close with this thought.  The conflict we are in is the longest America has waged with an all-volunteer force since the Revolutionary War.
At the heart of that volunteer force is a contract between the United States of America and the men and women who serve in our military: a contract that is simultaneously legal, social, and indeed sacred. That when a young American steps forward of his own free will to serve, he or she does so with the expectation that they and their families will be properly taken care of should something happen on the battlefield.
After the wars themselves, I have no higher priority.  And this superb new center will be a living reminder that America honors that contract and keeps faith with those who have sacrificed so much for all of us.
Thank you.