As the debate over the war in Iraq grows more intense and the presidential race heats up, it is more important than ever to maintain a sharp focus on the needs and concerns of those who are fighting overseas, especially when their time in combat leads to mental-health concerns.

As these brave men and women continue their dedication and service to our country in the wars in Iraq and Afghanistan, we unfortunately must continue to fight on the home front to meet their needs when they return.

Today, many veterans who served in Iraq and Afghanistan, and in earlier conflicts, are suffering from invisible wounds. Service members return home, but the war often follows them in their hearts and minds. As chairman of the Senate Committee on Veterans' Affairs, I have made meeting the mental-health needs of returning service members one of the committee's highest priorities.

In Hawai'i, the U.S. Department of Veterans Affairs is currently treating over 11,000 wounded warriors for mental-health disorders, including 1,138 with full-blown post-traumatic stress disorder, or PTSD.

The numbers nationwide are equally disturbing. According to a RAND study released in April, nearly one in five Iraq and Afghanistan veterans report symptoms of PTSD or major depression. The study emphasized the high risks of PTSD and depression, especially among service members sent on multiple deployments, and among National Guard and reservists.

Further, the RAND study found that the stigma associated with mental healthcare, and concerns that admitting a problem will harm one's career, continues to prevent many service members and veterans from seeking care.

With thousands of Hawai'i National Guardsmen and Hawai'i-based active-duty troops rotating in and out of the Middle East, joining 130,000 from across the United States, we must take action immediately.

Last year, Congress passed wounded-warrior legislation I authored that extended the time a new veteran can come to the VA for needed mental healthcare from two to five years, because PTSD often take time to surface.

And earlier this month, the Senate passed my mental-health bill, named for yet another young veteran who died tragically after returning home from service. If passed by the House and signed by President Bush, this bill would improve mental healthcare, suicide prevention, care for substance-use disorders and prevention of homelessness.

For all these improvements, there are still serious system-wide problems within the VA's mental healthcare system.

Last month, we learned of a "suggestion" made by a VA psychologist in Texas that her colleagues not diagnose veterans with PTSD in order to save time and resources. This disturbing incident reinforced fears among many veterans that VA's mental-health system is not meeting their needs.

This e-mail followed an earlier publicized e-mail from the VA's top mental-health official who sought to suppress data on veteran suicides. Together, these incidents suggest a possible trend or more widespread indifference to the invisible wounds of war.

Veterans deserve a mental healthcare system worthy of their trust.

For my part, I have asked the VA to review and revise its PTSD treatment and compensation guidelines, and requested that the VA provide the Veterans' Affairs Committee with complete data on veteran suicides. I have also asked for an inspector general investigation of the situation at the Temple, Texas, VA Medical Center.

There must be a sharply focused, national effort to identify returning service members and veterans at risk for more severe mental-health problems, and to reach out to them in an effective way.

I resisted President Bush's push for war in Iraq. I argued for diplomacy on the Senate floor and was one of only 23 senators who voted against authorizing the invasion. However, the moment the decision was made to send our troops into harm's way, I vowed to do everything in my power to make sure they are trained and equipped before deploying, and properly cared for when they return.

As chairman of the Veterans' Affairs Committee and chairman of the Armed Services subcommittee on readiness and management support, I will continue to work hard to ensure that the brave heroes who have fought or are currently fighting for this nation receive the training and tools they need when they go, and the care and services that they deserve when they return.

Unfortunately, we will be paying for these wars for many years into the future. Caring for our veterans is a cost of war.

As President Abraham Lincoln stated in his second inaugural address, "With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan ... "

It is our duty to care for our veterans and their families who have sacrificed for our country.

We must act swiftly. No expense can be spared in this effort.

U.S. Sen. Daniel K. Akaka, D-Hawai'i, wrote this commentary for The Advertiser.