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Friday, November 16, 2007

NPR: Army Personality Disorder Discharges Rocket 40% in Iraq War Era

Yesterday, an unsettling update on personality discharges by ace reporter Daniel Zwerdling on NPR's All Things Considered:

New Pentagon figures released to NPR show that since the United States invaded Iraq, officers have kicked out far more troops for having behavior issues that are potentially linked to post-traumatic stress disorder than they did before the war. ...

NPR asked the U.S. Army and the U.S. Marine Corps to disclose how many troops have been discharged by their commanders in recent years and why. The Marine Corps has not provided statistics. But an Army chart, which NPR recently received, shows that since the United States invaded Iraq:

— Commanders have discharged almost 20 percent more soldiers for "misconduct" than they did in the same period before the war;

— Commanders have discharged more than twice as many soldiers for "drug abuse" (a subset of the "misconduct" category);

— Commanders have discharged almost 40 percent more soldiers for "personality disorder."

In all, the Army has kicked out more than 28,000 soldiers since the war in Iraq began on the grounds of personality disorder and misconduct.

In educational interest, article(s) quoted from extensively.

In the interest of education, article quoted from extensively.


Some mental-health specialists are especially worried that commanders and military medical staff are abusing the diagnosis of "personality disorder," which commanders have used to discharge some soldiers who were also diagnosed with PTSD.

Psychiatrist Jonathan Shay, who has been studying combat veterans for more than 20 years at the Department of Veterans Affairs and other institutions, criticizes the use of personality disorder partly because it's a "deeply stigmatizing diagnosis," he says. Shay says that when the military diagnoses soldiers with personality disorder, it is saying, in effect, that fighting in the war didn't cause their mental health problems.

"It's saying, in essence, you're rotten and have been rotten since childhood," he says.

If true, Shay wonders, why didn't Army doctors diagnose such a serious and deep-rooted psychological ailment when they were recruiting the prospective soldier?

Shay says the Army's statistics, showing that discharges for "personality disorder" have increased in recent years by almost 40 percent, suggest that the military may be abusing the diagnosis because doing so is convenient.

Under the Army's rules, it takes a commander months to expel soldiers on the grounds that they can't function due to PTSD — and the military has to pay the soldier disability benefits. But if a psychiatrist diagnoses a solider with a "personality disorder," the base can discharge him or her in less than two weeks without paying any disability.

"It troubles me that it appears that sometimes, mental-health professionals are ready to be the willing servants of the command," Shay says. He worries that military doctors are telling commanders, in effect, "'If you want me to get this kid out quickly, I'll do it. It doesn't matter how much I have to bend my own conscience or bend the facts to do it.'"

NPR submitted requests to five spokesmen at the Pentagon and U.S. Army to interview a top official about these issues. These requests were not granted.

Listen to the full report via NPR.

A few days ago, Illinois Congressman Phil Hare chimed in on the personality disorder discharge issue:

Congressman Phil Hare calls it a disgrace and apologizes about the lack of benefits some recent war veterans are getting. ... Since it's pre-existing, the government is off the hook in paying for medical treatment for mental illnesses.

This happened to 23-year-old Louie Schmidt of Chillicothe. He served two tours of duty in Iraq, seeing some of the most gruesome acts of violence. He was honorably discharged last October for a pre-existing personality disorder, something that never popped up on any of his previous evaluations. Congressman Hare first heard about these cases in a Veterans Affairs Committee meeting.

The 17th District Democrat said, "I sat there almost in disbelief that this could be happening to people we put in harm's way. I can't think of anything more disrespectful to our troops than to do this." Congressman Hare wants to place a temporary moratorium on personality disorder discharges and get an outside agency to investigate.

"It's all part of the defense appropriation bill which could go before the President in as early as a week."

Congressman Hare estimates this diagnosis can save the Department of Defense $12.5 billion.

More background and examples in an October St. Louis Post-Dispatch article:

After two combat tours in Iraq on a "quick reaction team" that picked up body parts after suicide bombings, Donald Schmidt began suffering from nightmares and paranoia. Then he had a nervous breakdown. The military discharged Schmidt last Oct. 31 for problems they said resulted not from post-traumatic stress disorder but rather from a personality disorder that pre-dated his military service.

Schmidt's mother, Patrice Semtner-Myers, says her son was told that if he agreed to leave the Army he'd get full benefits. Earlier this month, however, they got a bill in the mail from a collection agency working for the government, demanding that he repay his re-enlistment bonus, plus interest — $14,597.72.

Schmidt, 23, who lives near Peoria, Ill., is one of more than 22,000 service members the military has discharged in recent years for "pre-existing personality disorders" it says were missed when they signed up.

"They used these guys up, and now they're done with them and they're throwing them away," Semtner-Myers said. Her frustration extends to Capitol Hill, where the stage is being set for a confrontation between Congress and the Pentagon.

Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, calls the treatment of these troops "disgraceful."

"If they have personality disorders, how did they get in the military in the first place?" Filner asks. "You either have taken a kid below the standards, in which case you've got obligations after you send him to war, or you're putting these kids' futures in danger with false diagnoses. Either way it's criminal." ...

"These young people are being lied to and manipulated," he said. "We deny them proper classification so they can't get benefits, then they get this bill for a prorated signing bonus."

In the Senate, Missouri Republican Christopher "Kit" Bond, along with Sen. Barack Obama, D-Ill., is leading an effort to force the Pentagon to change its practice. Bond says it appears worse than the scandal earlier this year over poor conditions at Walter Reed hospital.

"This is a very sad story," Bond says. "We are fortunate enough to bring many severely wounded soldiers and Marines home, but we're not dealing with their mental health problems. They need help, not a discharge because some phony pre-existing condition is brought up."

William Wooldridge, 37, of Blytheville, Ark., re-enlisted shortly after the Sept. 11 terrorist attacks. He says he made the grade by losing 44 pounds in eight weeks by a combination of running and dieting. But intense fighting combined with family problems — his wife left him while he was in Iraq — sent him into a mental tailspin.

"We're doing 20-24 hour days, sleeping underneath our trucks, people trying to kill us and blow us up," Wooldridge said. "Then I got a letter saying I didn't have a reason to come home — and I just cracked."

Back in the United States, he continued to have blackouts, hear voices and have nighttime hallucinations of terrorism and children dying. The Army discharged him, citing a pre-existing personality disorder, even though several doctors diagnosed him as having post-traumatic stress.

"They told me the best way to handle it was to go along with a personality disorder discharge, that the (Veterans Administration) would take care of me. So I signed it and went to the VA, and the VA said, 'You were discharged with a personality disorder; you don't get any benefits.'

"I was no longer of any use to them."

Wooldridge says the military recently decided it had overpaid him for a period of time and is deducting $137.85 a month from his Social Security payments. He says he's unable mentally to hold a job.

"This is not the way I want to be," he says, "but it's the way I am."

Wooldridge appealed to the discharge review board in St. Louis, arguing that soldiers with conditions brought on or aggravated by service are supposed to be eligible for service-related assistance. He eventually got $2,635 in monthly benefits restored — but not his self-pride.

"If there's really that many people who were dysfunctional going into the military, this country is one dysfunctional mess," he said.

Col. Bob Ireland, an Air Force psychiatrist and flight surgeon, is the Pentagon's program director for mental health policy. He says as many as 100,000 service members have been diagnosed with personality disorders in the past six years. Discharges take place only where the disorders "are genuinely interfering with the ability of the unit to function," he said. ...

Patty Harvey's son, Nick Harvey, 26, of Costa Mesa, Calif., was discharged from the Army after fighting in Iraq and has spent time in a variety of hospitals and now at home, often in what his mother describes as "almost a catatonic state."

Military doctors said he had a pre-existing personality disorder, meaning reduced benefits, but his mother disagrees.

"It's obvious what happened — he gets into a war zone, the bombs are flipping him out, and all of a sudden he's an entirely different person. Before, he partied with his friends, was a surfer, played guitar like you couldn't believe. Now he has fears about everything, he has fears about the food he eats, he has fears about people poisoning him.

"He stays home every day. ... If this kid doesn't have PTSD, I don't know who does. But they won't give him the diagnosis unless I continue to fight, and I'm running out of fight."

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