The military is currently experiencing a mental health crisis, with suicide now the second leading cause of death for service members. Brain injuries suffered by service members are a big part of this crisis, and new information has revealed the risk that service members face even if they don’t deploy.

A recent New York Timesinvestigation into artillery crews serving in Iraq and Syria found that those service members suffered from brain injuries caused by the firing of their own weapons. These injuries are also coming from shoulder mounted weapons and may have also played a role in the mental state of the Maine mass shooter.

I served with many of the men in The New York Times article on the artillery crews in Iraq and Syria and know them well. I have seen what effects these injuries have had on their lives and have experienced it myself. What happened to us doesn’t have to happen to other service members, if the Department of Defense and Congress acts.

It’s hard to explain how it feels to be behind an artillery piece when it fires: the force from the explosion that threw a hundred-pound shell for miles, knocking the breath out of you and causing a shudder in your bones. When the dust clouds began to form from the sand blown off the walls and ground, filling our noses with soot, and staining our uniforms to the point they sometimes looked white, I also often had a dull pain in my head like I had just gotten hit in the face.

It’s worse if you’re inside or under something; one day I was asleep under a truck when an M777 howitzer suddenly fired a few feet away, the shock wave forcefully ejected me from my slumber and threw me in a state best described as being between consciousness — the world spinning as I tried to remember where I was.

Now imagine experiencing that feeling over 6,000 times, in the span of less than nine months, like the artillery unit I was with. Or tens of thousands of times, like some of the Marine artillery crews who supported operations in Syria. The high amount of rounds my other units fired during the war on the Islamic State is something that U.S. military wasn’t prepared for, acknowledging as much in a report published in 2019 on the amount of injuries being suffered due to this heavy rate of firing.

I didn’t realize that Iraq was just the beginning of hellish experience I would have as I was forced to navigate a care system that told me that these explosions somehow hadn’t caused me lasting damage, which included headaches and effects on my mental state. The insidious thing about these types of wounds is that service members often have to attempt to convince the military doctors that they need help. To this day I still suffer from difficulties.

Traumatic brain inju­ries (TBIs) caused by explosions and other hazards during military service have been linked to mental health issues, including suicide; research published just this August analyzing a cohort of almost 900,000 Service Members found that individuals with a history of military-identified TBI had significantly higher rates of new-onset mental health conditions than those without. Additional research has shown that among service members who have suffered moderate traumatic brain injuries (MTBIs) in the military, they have a suicide rate that is almost three times the national average.

I remember the night my head started to ring like a doorbell in northern Iraq. It was a dull throbbing pain and I sat there rubbing the sore spot as I tried to go sleep, wondering what was going on. When I got home, I could literally feel something in my head before my mood shifted. It is a horrifying feeling to know that something may be wrong with you and worse, there’s nothing you can do about it as your life is affected in a multitude of ways. These blast injuries can occur not only in combat, but also during training.

The first step toward any attempt to tackle this problem starts with the DOD. Congress in 2020 asked the that the DOD measure blast pressure troops were exposed to and track blast exposure history routinely, but that still hasn’t been done almost four years later.

The thing about military health care is that if there’s no record of an event occurring, then you’re not going to get treatment on active duty or as a veteran. The DOD also needs to ensure the best practices to protect against TBI are being undertaken, service members are being properly tested for TBI symptoms, and that TBI exposure is properly tracked in service member medical records. This is not currently happening. The scale of this problem is not even fully understood — and for artillery personnel, there’s no way to avoid exposure to these types of injury unless current practices change. Thousands may be at risk.

The issue of these injuries won’t just end with us. Outside of artillery units, service members continue to suffer TBIs from attacks in Syria and Iraq even as the DOD has still not properly enacted its own protocols. Just like us, they’re going to eventually come back home as they suffer from an illness that has no clear answer. They don’t have to, though.

If the DOD takes the right steps, or at least enforces the measures it already has in place, hundreds if not thousands of service members can be saved.

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