The Phoenix, Arizona, Veterans Affairs office is still improperly canceling veterans’ appointments, has built up a new backlog of cases — and at least one veteran is likely dead because of it. That’s according to a new inspector general’s report that was released on Tuesday.

The inspector general said in a statement that two years after it first sounded the alarm about secret waiting lists leaving veterans struggling for care at the Phoenix VA, “some services have improved.” But confusion and bureaucratic bungling are still prevalent. Some veterans are waiting half a year or longer for treatment and staff are still canceling appointments for questionable reasons.

An estimated 50 to 60 percent of people will experience a traumatic event at some point in their lives.

As this latest case gets all the attention it deserves, what is true is that we still don’t know why some veterans develop post-traumatic stress disorder and others do not.

The question has been examined at length since the 1970s. One study from the Columbia School of Public Health showed that pre-combat psychological vulnerabilities contributed to the onset and persistence of PTSD symptoms. “Combat exposure alone was not sufficient to cause the PTSD syndrome,” according to a statement about the study.

Other studies have shown that specific genetic variants influence an individual’s odds of developing PTSD. Neuropeptide Y (NPY), a hormone released in the brain during stress, is one of the most well-known biological markers of resilience. Investigators have also been looking at how the body and brain change during the recovery process and why psychological interventions do not always work.

“The hope is that this research might lead to therapies that enhance resilience,” the journal Nature reported in 2012.

Related: Veterans Need Lifesaving Companions

An estimated 50 to 60 percent of people will experience a traumatic event at some point in their lives, whether through military combat, assault, a serious car accident, or a natural disaster, the report also stated. If the association lasts more than a month, as it does for about 8 percent of trauma victims, it is considered PTSD.

There are many factors that increase a soldier’s risk for developing PTSD. If a soldier enters the Army before age 25, he or she has an increased risk. Pre-war trauma such as sexual, physical, or verbal abuse also puts soldiers at risk. Finally, chances of developing symptoms are much higher among soldiers who inflict harm on civilians or prisoners of war.

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In his Monday remarks in Herndon, Virginia, to a group of veterans, Republican candidate Donald Trump spoke sensitively and off-the-cuff about veterans and this issue. He acknowledged that some soldiers develop PTSD and some do not.

“When you talk about the mental health problems, when people come back from war and combat and they see things that maybe a lot of the folks in this room have seen many times over and you’re strong and you can handle it. But a lot of people can’t handle it. And they see horror stories. They see events that you couldn’t see in a movie — nobody would believe it,” Trump said during the question and answer session.

“Now we need a mental health help and medical. And it’s one of the things that I think is least addressed and is one of the things that — like your question — one of the things that I hear the most about when I go around and talk to the veterans. So we’re going to have a very, very robust, level of performance having to do with mental health. We are losing so many great people that can be taken care of if they have proper care.”

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The left-wing media, naturally, pounced on Trump for implying that veterans with post-traumatic stress disorder were weak-minded. But that is not what he said and not what he meant.

“I think it’s sickening that anyone would twist Mr. Trump’s comments to me in order to pursue a political agenda,” Chad Robichaux, the veteran who asked Trump this question, told The Washington Times. “I took his comments to be thoughtful and understanding of the struggles many veterans have, and I believe he is committed to helping them.”

Robichaux survived PTSD himself and heads the Mighty Oaks Warrior Programs for veterans in Temecula, California. He felt that the candidate addressed his concerns — and expressed disgust over the media fracas.

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“I interpreted his answer to affirm that the system is broken and he would take the necessary steps to address it.”

Related: Veterans Still Need Far Better Treatment

In his comments, Trump acknowledged some fundamental truths about PTSD. He’s not a mental health expert or a doctor, of course. But he’s also not the type to tiptoe around a conversation.

He has acknowledged the terrible and difficult truth that more than two dozen soldiers commit suicide each day — and that better mental health services and treatment procedures at the VA could help save lives.