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Tuesday, February 13, 2007

Playboy (Un)Covers The Real Cost of War

Last year I was contacted by Mark Boal, freelance journalist and writer for Playboy magazine. (His 2004 Playboy article, "Death and Dishonor," is currently in production and slated to be released as In the Valley of Elah [imbd] starring Tommy Lee Jones, Charlize Theron and Susan Sarandon.)

Boal was doing research for an upcoming article on combat PTSD, and read ePluribus Media's "Blaming the Veteran: The Politics of Post Traumatic Stress Disorder" by D.E. Ford, MSW, Commander Jeff Huber, and me (Ms. Ford doing the heavy lifting on that one...).

Later, in December when making arrangements to send him a galley copy of my upcoming book on PTSD, I asked when his article would arrive. "March 2007," he said. That time has arrived.

Click on 'Article Link' below tags for more...

From Playboy Enterprises press release:

March Playboy Magazine Investigation Raises Disturbing Questions Regarding Diagnosis and Treatment of Post Traumatic Stress Disorder Among American Troops
Article Finds Politics, Budget Constraints and Lack of Manpower to Blame

In an extensive, months-long investigation, "The Real Cost of War," in Playboy magazine's March issue, journalist Mark Boal discovers American troops fighting in Iraq and Iraq war veterans are not receiving the mental health care they deserve, specifically when it comes to the diagnosis and treatment of post traumatic stress disorder (PTSD). Boal spoke with numerous mental health experts, government sources and former military personnel who paint a disturbing picture about the government's handling of PTSD.

Boal found that the Department of Defense (DOD) diagnoses about 2,000 cases of PTSD a year. Yet according to a landmark study conducted by Army researchers and published in The New England Journal of Medicine, PTSD rates for soldiers in Iraq and Afghanistan are running between 10 and 15 percent. That means one would expect to see the military diagnosing 13,000 to 20,000 cases of PTSD.

Former government officials agree there is a problem. "PTSD is being underdiagnosed on a fairly wholesale level," says Dr. Robert Roswell, a former undersecretary at the U.S. Department of Veterans Affairs (VA).

Reasons for the underdiagnosis? Saving money and manpower. Politics comes into play, too.

[A]ccording to the article, which reports that when the DOD submitted a war budget to Congress, the line item for mental health casualties was simply left blank. "DOD never prepared for a long war; it never prepared for an occupation," says one senior congressional staffer. "Now we're seeing the third thing it didn't anticipate: what to do with the soldiers when they come home. Now they really don't have the money."

Boal discovered politics may also be a factor. "The soldier has tremendous symbolic power in American politics. Healthy, happy soldiers bespeak a just war. Like the amputees and flag-draped coffins the administration hides from public view, such soldiers are antithetical to the hawkish goal of mitigating the costs of the conflict," writes Boal. "The critical difference is that mental illness isn't always obvious and is therefore easier to sweep under the rug." As one congressional staffer puts it, "It's much easier to deny the reality of mental illness than it is to deny the spinal cord injury of some guy sitting in a wheelchair."

Another cause given of the low PTSD figure is protective:

Officials attribute the low rates of diagnosis to a reluctance on the part of military doctors to "stigmatize the person or bring harm to their careers" by labeling them with PTSD according to Lieutenant Colonel Dr. Charles Engel, the director of the deployment health clinic center at Walter Reed Medical Center. "It's out of respect for the patient that they don't make the diagnosis."

Out of respect?

Another point sure to cause a bluster:

Dr. Sally Satel, a psychiatrist and adviser to President Bush on mental health issues views PTSD this way: "I'm not saying PTSD doesn't exist, but it's gotten out of hand. I mean, if you see a lot of action and then you come home you have a hard time walking your dog by the bushes at night, maybe you just avoid the bushes."

Read the full article here.

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