VFA investigators have visited every demobilization site in the United States and overseas, where they have monitored the quality of treatment, family support, rehabilitation, and other services that should enable a wounded servicemember to readjust to civilian life.
VFA has found that medical care for mental health and TBI is often inadequate or poorly delivered, and when a servicemember is discharged, decisions are often made by the military that negatively affect veterans for the rest of their lives.
VFA has also found that little consideration is given to TBI or PTSD in the military justice system despite the fact that these wounds are known to cause improper behavior. Lack of capabilities to treat these injuries, inadequate adherence to the Congressional inquiry process, and the inability or unwillingness to treat PTSD and TBI as wounds of equal legitimacy as physical injuries are some problems that require improved military leadership.
This report incorporates VFA investigative findings with open-source DoD and other reports and articles to provide a comprehensive picture of the state of care for America’s wounded warriors.
Friday, November 30, 2007
Thursday, November 29, 2007
While not PTSD-related, quite interesting information on how combat is changing the physical body of troops. From the St. Paul-Minneapolis Pioneer Press:
After 16 months in Iraq, Minnesota National Guard members who came home this summer expected aches and pains. They did not expect to shrink.
Brian Hesse figures he lost an inch or so - a consequence of the heavy body armor and the gear he toted on convoy and security missions. The armor alone weighed more than 30 pounds. And then there was the 4-pound helmet, the 7.5-pound loaded M-4 rifle, the 10 pounds of extra ammunition and other necessities.
"I shrunk," the 25-year-old from Minnetonka said, "and got a bit wider. It's like my body said, 'OK, I need a wider base.' "
It's no myth. Some returnees and their doctors agree they did get shorter - if at least temporarily. The 60 to 90 pounds of gear around their torsos, shoulders and heads likely caused their spinal discs to compress, making the soldiers shorter and causing back pain.
Guard officials expected the 2,600 members of the state's returning 1st Brigade Combat Team to suffer from a host of physical ailments. While less dramatic than gunshot wounds or brain injuries caused by blast exposures, musculoskeletal injuries are easily the most common health problems for Iraq returnees.
"A good chunk of what we're seeing is actually overuse that we would really anticipate would get better in a short period of time," said Dr. Michael Koopmeiners, who directs community clinics for the Minneapolis VA Medical Center.
The key question , now that returnees have been home for three months, is how many are in fact developing chronic problems and how many are getting better.
Mental health experts say that a correlation -- a comorbidity -- exists between PTSD and drug abuse. In that vein, tomorrow night on ABC News, 20/20 covers the issue of some of today's soldiers turning to drugs, as some had in the Vietnam, to ease the experience of war. Throughout the week, the network's chief investigative correspondent, Brian Ross, and his counterparts have begun sharing some of the data and stories they collected over the past few months:
In the third year of a joint project with the nonprofit Carnegie Corporation, six leading graduate school journalism students were again selected to spend the summer working with the ABC News investigative unit.
This year's project involved an examination of whether, as happened in the wake of the Vietnam War, Iraqi war veterans were turning to drugs as a result of the trauma and pain of war. The U.S. military maintains the percentage of soldiers abusing drugs is extremely small and has not increased as a result of Iraq.
The students' assignment was to get the unofficial side of the story from soldiers, young men of their own generation.
Kathie Costos has created another series of bracing and poignant videos along with a new PTSD group on YouTube for anyone wishing to share related multimedia clips. These videos are heartfelt tributes that reflect the real burdens and costs of war borne by the individuals who fight and the military families who support their warriors.
As such, please bear in mind that they may be difficult for some especially close to the situation to view.
Wednesday, November 28, 2007
Passing along word of an important hearing to be held by the House Committee on Veterans' Affairs at 10 a.m. on December 12, 2007.
I have been asked to testify before Congress to discuss Stopping Suicide and Ending Homelessness: Mental Health Challenges Within the Department of Veterans Affairs, and have accepted the invitation.
Will pass along further details as I have them on related Washington, D.C. events we are planning.
From the Committee's press release:
Chairman Bob Filner (D-CA) announced that the House Committee on Veterans’ Affairs will hold a hearing to examine current mental health care available to our nation’s veterans by the Department of Veterans Affairs (VA). The hearing will focus on two recent reports: a National Alliance to End Homelessness study which showed that one out of four homeless are veterans and a CBS News report that found the rate of suicide among veterans is double that of the general population.
“These two reports only highlight what we do not know about our veterans,” said Chairman Filner. “I think the report on homeless veterans underestimates the reality of the number of America’s heroes that are on the street tonight. The tragedy of homeless veterans is that we know what we need to do to prevent it, but neither the military nor the VA bureaucracy is ready to do this. What is worse is that we know the repercussions of not acting.”
The hearing will focus on recent statistical data from private sources as a platform to discuss comparative data from the VA on these issues. Witnesses invited will include members of the media, scholars from the mental health care profession and representatives from the VA. The hearing will take place in December.
A really informative 6-part Christian Science Monitor series is soon coming to a close, and well worth a read. For those who grew up in the era of M*A*S*H, who can forget the soothing salve of the unit's beloved Father Mulcahy?
These important caregivers are much-need, but unfortunately severely-strained (each deployed chaplain has a client base of about 1,000 troops to minister to). These professional souls do some of the most exigent work providing comfort and support in and out of the field to our warriors. Wonderful to see this work appreciated and recorded by CSM:
They carry no guns, yet US military chaplains are considered a force multiplier in the war theater. Today, in Iraq and Afghanistan, the military expects chaplains to meet the spiritual needs of troops. But it also recognizes their importance in everything from counseling the young soldier crying in his bunk over a Dear John letter to being a leveling moral presence among troops trained to fight and kill. Reporter Lee Lawrence spent three months with dozens of military chaplains in Iraq and Afghanistan. She profiles six of them in a weekly series.
From McClatchy News Service:
The Department of Veterans Affairs fell further behind this year in its attempts to give veterans timely decisions on their disability claims, new records show.
The latest numbers are in an annual report the VA prepares for Congress detailing a range of short- and long-term goals for its disability, health and other benefit programs. Overall, the agency either has fallen behind or has made no progress in improving its performance in more than half of what it lists as its key goals.
In the benefits measure the VA has said is "most critical to veterans" -- the speed of processing disability claims -- the agency lost ground for the third year in a row. Moreover, McClatchy has found that the VA put a positive spin on many of its numbers and in two instances provided Congress with incorrect or incomplete figures.
The agency said it took an average of 183 days to process a claim in fiscal 2007, longer than in any of the five years tracked in the report. Processing exceeded its 2007 goal of 160 days and its long-term goal of eventually reducing processing time to 125 days.
From the Fort Worth Star-Telegram:
Joel Chaverri has seen combat, having participated in the 2004 attack on Fallujah, Iraq, the scene of some of the most bitter street fighting involving U.S. forces since Hue in Vietnam. He knows the readjustment that a young man must go through when he leaves behind that kind of carnage.
So when Chaverri left the Marines and returned to North Texas, he accepted a job with the Department of Veterans Affairs. His mission: to go out and tell young combat veterans that it's OK to ask for counseling.
"I tell guys, 'You don't have to have a PTSD diagnosis or have a disability rating,'" Chaverri, 25, said. "'You don't have to have a disorder.' Our brochures never use the word PTSD. We offer readjustment counseling."
Tuesday, November 27, 2007
This is another issue that's been floating around for a bit, but I'm only now getting to posting on it: PTSD researchers are now testing the efficacy of the hallucinogenic drug MDMA, or ecstacy, to treat post-traumatic stress. The Washington Post Magazine ran an article ("The Peace Drug") on the issue this past weekend:
PTSD is usually triggered by combat, rape, childhood abuse, a serious accident or natural disaster -- any situation in which someone believes death is imminent, or in which a significant threat of serious injury is accompanied by an intense sense of helplessness or horror. Not all or even most trauma victims develop PTSD, but enough do so that nearly 24 million Americans, or 8 percent of the population, have suffered from it at some point in their lifetime. It is estimated that in any given year, more than 5 million Americans have active PTSD -- a costly problem in humanitarian and economic terms. Drug and alcohol abuse are all-too-frequent consequences of PTSD, as is loss of productivity and the need for expensive, long-lasting medical treatment.
The ever-lengthening Iraq war will count among its other costs a legacy of thousands of veterans in need of psychiatric treatment. The government estimates that already more than 50,000 soldiers -- about 4 percent of those who have been deployed to Iraq and Afghanistan -- have been treated for symptoms of PTSD. Many more might actually have it: Military studies put the number at 12 to 20 percent of those returning from Iraq and 6 to 11 percent of those returning from Afghanistan. And the news gets worse.
"Vets with PTSD are particularly costly to the [Veterans Affairs] system," says Linda Bilmes, a lecturer in public policy at Harvard's Kennedy School of Government. "They constitute 8 percent of the claims, but 20 percent of the payments." Bilmes, who has studied the ongoing costs of the wars, estimates that treating Iraq vets with PTSD over the next 50 years will cost taxpayers $100 billion. This is based on findings that one-third of vets with PTSD will remain unemployable, and all suffering with PTSD will have a much higher than normal likelihood of needing treatment for physical ailments. And that's just the direct costs to the budget. "Assuming that the war continues, though with lower deployments, through 2017," she says, and assuming the rate of PTSD isn't being underreported, the cost of lost economic productivity to the U.S. economy will be in excess of $65 billion.
Monday, November 26, 2007
It may be long in coming, slow in arriving, but Americans are finally beginning to realize that our defenders can use some defending, too.
And so, many are rising to the challenge and spreading the news, asking for others to join with us to care about our veterans. Gives me great hope. Though these are only videos, the sentiment behind them should shore up our courage to continue advocating for what's right.
These clips are varied, but the message is the same: America cares about you, and we're ready to cover your back dear soldier, sailor, airman and Marine.
Several New York veterans have been asked to repay part of their signing bonuses after war injuries prevented them from completing their tours of duty in Iraq and Afghanistan, Sen. Charles Schumer said.
Hundreds of veterans nationwide may have been affected by what the Army characterizes as a mistake, said Schumer (D-N.Y.), who along with lawmakers including Sen. Hillary Rodham Clinton (D-N.Y.) has called for legislation to guarantee that signing bonuses won't be reduced. ...
The issue surfaced earlier this month when a soldier who was partially blinded by a roadside bomb in Iraq told media outlets that the Army asked him to repay $2,800 of his $7,500 enlistment bonus because he had only completed about a year of his three-year service.
Former Pfc. Jordan Fox, 21, of Pittsburgh, received the bill in late October and a week later received a notice that he could be charged interest if he didn't make a payment within 30 days.
Sunday, November 25, 2007
I recently had the chance to sit down for a 30-minute interview with a local team of great hearts and minds, the hosts of The Suicide Prevention Show. The show airs this morning at 9:30 a.m. on WLBK-1360 AM [DeKalb County, IL]. It's also already available online, so everyone can listen in at their own leisure.
A big thanks to Citizen Mike, Chuck Siebrasse, and Tamara Sutton for making me feel welcome and for producing such an important community show for their listeners. They've had other informative guests on, so head over to their show archives if you can.
Saturday, November 24, 2007
Military Spouses for Change is a "non-profit, non-partisan organization created to promote the rights, interests, and needs of service members, veterans, wounded warriors, and military families by educating the public and empowering military spouses."
They are laying down a compelling challenge:
As much as individual presidential candidates talk about health care plans or personal values, the fact remains that we are electing a war president. We are electing a president who will probably spend the bulk of his or her first term managing military conflicts and performing extensive foreign policy damage control. In 2008, the next President will inherit at least two wars and the costs of those wars, internally as well as internationally, will continue to grow long after the last service member comes home.
Consequently, Military Spouses for Change is inviting the presidential candidates from both parties to Fort Hood, Texas (Killeen), on February 1st, to talk about foreign policy, our military, our veterans, our wounded warriors, and our military families. ...
This kind of event has never been done before and it needs to be done now. Not only because Americans on both side of the aisle need to be reminded (before Super Tuesday) that we are electing the next Commander-in-Chief, but also because our service members and their families deserve to be addressed and heard by the people who wish to be elected in that position.
In early January of this year, as the time for final editing of Moving a Nation to Care was quickly coming to a close, I was doing one last quick scan of my galley copy. Opening it to the Preface's first page, first paragraph, out jumped what was at the time a glaring typo: a sentence stating that 20,000 of returning Afghanistan and Iraq veterans had been diagnosed with traumatic brain injury.
The publicly available figure at the time was around 2,000, and you can imagine how quickly I got on the horn to my publisher to ask that we make sure to correct the error. What a difference a year makes. From USA Today:
At least 20,000 U.S. troops who were not classified as wounded during combat in Iraq and Afghanistan have been found with signs of brain injuries, according to military and veterans records compiled by USA TODAY.
The data, provided by the Army, Navy and Department of Veterans Affairs, show that about five times as many troops sustained brain trauma as the 4,471 officially listed by the Pentagon through Sept. 30. These cases also are not reflected in the Pentagon's official tally of wounded, which stands at 30,327.
A detailed piece from the Dayton Daily News:
For two years Elizabeth Bowen watched her husband, Ryan, endure more than 40 surgeries, frequent nightmares and the devastating effects of Post Traumatic Stress Disorder. ...
It was Oct. 26 and Ryan already had been in Georgia for six weeks, much of it spent waiting for word from the Army medical board that would determine his level of disability for injuries he received when a roadside bomb exploded under his tank in Baghdad during his second tour.
The 24-year-old Army specialist had just said goodbye to friends heading to Iraq for a third tour. "Some of these guys I've known since the first time," he said. Back in his hotel room, his mind began racing. He started pacing, hyperventilating.
Then he began to cry.
Friday, November 23, 2007
[UPDATE December 1, 2007]: The female Oregon soldier, Sgt. Julie Stendahl, mentioned below has turned herself in to military authorities; she was, in fact, planning to stage her own disappearance. Additionally, another soldier, Raymond Roussel of Augusta, Maine has gone missing as well since this post was published. Details in extended.
It's Thanksgiving weekend, and at least one military family marks another year since their recently-returning Iraq veteran loved one has gone missing without a trace. Jason Roark, who I wrote about last year, is still missing following his November 9, 2006, disappearance.
Meanwhile, in Georgia again, another veteran, Gary Chronister, has gone missing. And in Oregon, a female soldier who was to deploy to Iraq at the end of October has gone missing, although one local newsroom has apparently gotten a reply to an inquiry they made to her MySpace page believe to have been made by her.
Please take a moment to pass along the details I've added in extended (compiled from press accounts as linked) to others in online and offline communities you frequent; perhaps something can be turned up to help these families during a time of what must be much anxiety.
From Stars and Stripes:
Veterans service organizations are thrilled with a $43.1 billion appropriations bill that Congress is set to pass next month for the Department of Veterans Affairs.
The funding level for veterans programs and facilities is almost 20 percent higher than demoralized Republican leaders left behind a year ago. The $6.9 billion increase will allow VA to hire 1,800 more claim processors, beef up medical staffs and modernize long-neglected hospitals and clinics.
“I can’t praise the Democratic leadership enough for what they’ve done with addressing the budget that was handed to them the day they took office,” said Steve Robertson, legislative director for the American Legion.
The 109th Congress adjourned last December without passing a VA appropriations bill. It left the department operating under a “continuing resolution” with VA spending frozen at its fiscal ’06 level. In taking control of the 110th Congress, Democrats immediately raised VA funding for fiscal 2007 by $3.5 billion. They then turned to veterans groups for guidance on setting the VA budget for ’08.
Thursday, November 22, 2007
Time has been so very short on this end, and it's late (or is that early?) as it is. It's time for peaceful slumbers, something I know that half a world away many of our troops are not blessed with tonight. Many on the home front are equally sleepless, missing loved ones at every toss and turn.
Before I retire for a few hours of sleep, I'd like to take the opportunity to send out my thanks to everyone who has joined with so many of us in advocating for more attention to the plight of our returning troops, and for more action in getting resources and help where it's most needed.
It's been a great honor to work with you these past two years, though I wish the work wouldn't be necessary for any of us to do. Yet, we do it because we love our country, and we love our fellow brothers and sisters serving in uniform in our name.
What follows in extended are some of the words and reflections on Thanksgiving during wartime found in today's newspapers. May you and yours be together today in safety and peace.
And for those who are far away from home, thank you for your sacrifice today and every day.
Wednesday, November 21, 2007
Recently, I came across the following poem by a blogger who goes by the name of Universal. The lines were written after talking with a friend coping with combat PTSD, and the links are the original ones created by the author. Thank you for letting me reprint and share it here with others, Universal.
I can't sleep, can't feel
Time passes in chunks now --
A month passes for me
Like someone else's day.
Zombies don't have rhythms;
I go wherever my trance
Today I panic in a store,
Where danger doesn't lurk.
Last year, a March 2006 Journal of the American Medical Association article outlined the results of a study conducted for the Department of Defense by a team of Walter Reed Army Medical Center researchers. Last week, details of a follow-up study conducted by the same WRAMC team arrived once more in JAMA, shedding light on the health of our returning troops in the months following their combat deployments.
A full review of the study in extended.
Sunday, November 18, 2007
From Stars and Stripes:
Defense officials plan to have new counselors, charged with guiding wounded troops through the complex military and veterans health systems, in place and working with patients early next year.
Veterans support groups called the move an important first step, but said making sure the new recovery coordinators can fight on behalf of troops and families will be key in the success of the program.
“They have to be able to bust through the bureaucracy and have the authority to manage these cases,” said Jeremy Chwat, vice president for policy at the Wounded Warrior Project. “This will only be as good as the authority they are given.”
The new posts were one of the top recommendations from the President’s Commission on Care for America’s Returning Wounded Warriors, put in place after complaints arose about the quality of troops’ care at Walter Reed Army Medical Center earlier this year.
Last week, Sen. John Edwards unveiled a $400 million five-point plan to help returning troops and their families cope with post traumatic stress. While not the only presidential candidate to set his sights on this issue, the Edwards plan is the first to be prominently unveiled as the presidential race heats up. From AP:
Under Edwards' plan, veterans could seek counseling for post-traumatic stress disorder outside the Veterans Health Administration system; the number of counselors would increase; and family members would be employed to identify cases of PTSD. ...
"I strongly believe we must restore the sacred contract we have with our veterans and their families, and that we must begin by reforming our system for treating PTSD. We also must act to remove the stigma from this disorder," Edwards said in prepared remarks his campaign provided to The Associated Press. "Warriors should never be ashamed to deal with the personal consequences of war."
Let's take a deeper look at these points, as well as what fellow presidential candidates Barack Obama and Hillary Clinton are doing -- or planning to do -- on this issue.
We continue to hear of the difficulty of navigating -- much less updating -- the mammoth health care bureaucracies military families depend on both during and after deployment. There are, however, a number of online resources one can turn to for some help. Here are just a handful:
- Our Hero Handbook - A Guide for Families of Wounded Soldiers [pdf] - A 74-page guide produced by Walter Reed Army Medical Center. The booklet shares not only specifics on getting around the hospital grounds and tapping into area services, it also provides information on long-term support options and list of phone numbers and addresses anyone might find useful.
- Taking Care of America's Armed Forces Families Benefits Guide [pdf] - A 28-page guide produced by the Department of Defense for National Guard and Reserve service members. Explains TRICARE coverage along with legal, child care, and life insurance options. A whole host of other services and benefits outlined. Lots and lots of helpful website links to tap into further information.
- Federal Benefits for Veterans and Dependents Booklet [pdf]- A 170-page guide produced by the Department of Veterans Affairs. A comprehensive benefits guide.
- U.S. Veterans Healthcare Benefits [pdf] - A 32-page guide produced by MilitaryHandbooks.com. Includes general information on VA benefits and services.
- A Survivor's Guide to Benefits: We Take Care of Our Own [pdf] - A 21-page guide by the DoD's Casualty and Mortuary Affairs Operations Center. Offers information on help provided by Casualty Assistance Officers, copies of important documents and additional resources.
This weekend, CNN's Special Investigations Unit airs another in its Broken Government series, this one on the struggles some returning troops face in receiving adequate Veterans Affairs disability compensation for severe injuries sustained in the Middle East. PTSD is also touched upon.
The program reveals flaws in the current VA disability system, many of which have been reported for years, that affect all who must navigate it.
Meet Iraq war heroes who barely escaped death, sacrificed limbs and then came home to a broken bureaucracy that let them down. Marine Sgt. Ty Ziegel, Army Maj. Tammy Duckworth, and Army Sgt. Garrett Anderson share the intimate details of their survival on the battlefield, and the war they would end up fighting on their soil. CNN's Chief Medical Correspondent Dr. Sanjay Gupta investigates the shocking reality of what happens to so many wounded warriors once they return from the battlefront in Waging War on the V.A.
Re-broadcast tonight at 8 pm and 11 pm EST, the videos are currently up at YouTube; I've included those in extended.
Friday, November 16, 2007
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.
From HealthDay News via Forbes:
A study of male twins who served in Vietnam has uncovered a strong link between asthma and post-traumatic stress disorder (PTSD). Columbia University researchers, reporting in the Nov. 15 issue of the American Journal of Respiratory and Critical Care Medicine, found that those who suffered the most from PTSD were more than twice as likely to have asthma.
"This is very good data," said Keith A. Young, co-director of the Central Texas Veterans Health Care System Neuropsychiatry Research Program. "One of the things that is very clearly delineated by this study is that there truly is an association. This association has been seen with other anxiety disorders before, and there were some hints with PTSD, but this is the best. This kind of sets it in stone."
The challenge now is to find out whether this is a cause-and-effect relationship. Previous studies have indicated a more general link between anxiety disorders and asthma, but this study focused specifically on PTSD, a disorder that involves nightmares, flashbacks and panic attacks linked to "triggers" that develop after exposure to combat or other extremely disturbing events.
Thursday, November 15, 2007
The second installment to Tuesday's groundbreaking veteran suicide investigation aired last night.
From the Associated Press:
A soldier who served two combat tours in Iraq was arrested Wednesday for leaving the Army without permission more than a year ago to seek treatment for post traumatic stress disorder.
At a news conference hours before his arrest, Sgt. Brad Gaskins said he left the base in August 2006 because the Army wasn't providing effective treatment after he was diagnosed with PTSD and severe depression. "They just don't have the resources to handle it, but that's not my fault," Gaskins said.
Tod Ensign, an attorney with Citizen Soldier, a GI rights group that is representing Gaskins, said the case is part of a "coming tsunami" of mental health problems involving Iraq and Afghanistan vets. Last month, the Veterans Administration said more than 100,000 soldiers were being treated for mental health problems, and half of those specifically for PTSD.
This is news that broke last week, which I'm only having a chance to add now for future reference. From The Times:
A study published last week shows that US military veterans make up one in four homeless people in America, even though they represent just 11 per cent of the general adult population, and younger soldiers are already trickling into shelters and soup kitchens after completing tours in Iraq and Afghanistan.
While it took roughly a decade for the lives of Vietnam veterans to unravel to the point that they started showing up among the homeless, at least 1,500 ex-servicemen from the present wars have already been identified.
The National Alliance to End Homelessness, based the findings of its report on numbers from Veterans Affairs and the Census Bureau. Data from 2005 estimated that 194,254 homeless people on any given night were veterans.
Full report [pdf], two-page OEF/OIF snapshot [pdf].
Wednesday, November 14, 2007
Many thanks to CBS News for their five-months long effort at tracking hard-to-find veteran suicide data down. While individuals (including myself in the form of the PTSD Timeline and Kathie Costos in the form of her multimedia presentations) have attempted to track and record incidents of such suicides over the years, we don't have the resources or manpower to do the need for the information justice. Only mainstream news organizations -- and government institutions -- do.
Thank you, CBS, for your attention to this matter.
The families who agreed to be interviewed for this report deserve our respect and help. They have had a most difficult road, and continue to do the heavy lifting of breaking down barriers to getting their story out. It's up to the rest of us to band around them and help to push for more change in the military culture. We must ensure troops receive proper combat stress management training from boot camp onward, along with a full reintegration support program following combat deployments for veterans and their families.
CBS Evening News First Look:
So much has been happening over the past few days on the national news front as far as combat PTSD is concerned, but offline responsibilities have taken me away from taking a look at much of it myself.
After sharing my pictures and remarks from a local event I attended last night honoring our area troops and veterans, I'll begin chipping away at the mountain of studies and reports that have come out since last week. Thanks for your patience.
I'd like to send out my deep appreciation to the members of the Dixon [IL] Elks Lodge #779 for hosting such a fine evening last night. What an honor to speak to a crowd of veterans from WWII to Iraq, and to have received such a warm wave of applause -- many even standing, which moved me greatly -- in addition to the positive comments they shared with me following my remarks.
I was taken aback and so humbled. Thank you...
Sunday, November 11, 2007
At the end of April 2006, I returned home from a few days of down time with my husband to a surprising email from a small New York publishing firm. Ig Publishing said that they were interested in putting out a book on combat PTSD. Would I write it?
The following month I set about fashioning a proposal for what would eventually become Moving a Nation to Care and began reaching out to possible interview subjects for the project.
It didn't take me long to know without any hesitation whose story I needed to open the book with: James Blake Miller, aka the Marlboro Marine. I'd begun covering the issue of combat PTSD and our returning troops in September of 2005 and Miller made a deep impression on me when he came forward only a few short months later, in January 2006, to tell the world of his struggle with PTSD.
He was so honest about his experience in the many interviews he gave, and so clearly carried no other agenda than simply wanting to help destigmatize the diagnosis he'd been given. Dr. Robert Roerich, who eventually contributed Moving's foreword, was in touch with Miller at the time that I was working on my proposal and contacted him on my behalf.
Miller agreed to an interview, writing, "I'm interested only if it's going to be a positive outlook on PTSD and it is aimed at helping our veterans, and others, who have it. I want to tell the story, not for the sake of telling it, but to try to change how things are perceived and maybe to alter the labeling."
That was at the end of May 2006.
Friday, November 09, 2007
This morning, I attended a very moving early Veterans Day ceremony held at Northern Illinois University. Usually, the yearly remembrance is slated for the 11th hour on the 11th day of the 11th month; but, due to the national holiday falling on a weekend, NIU held its ceremony today.
September and October's long Indian Summer has delayed the dropping of our leaves, many of which are brilliantly peaking at the moment. The sun shone, the weather was crisp but clear, and the fall colors combined to create a photographer's dream canvas.
Photos and transcript of the morning's reflections by NIU Veterans Club President and Iraq War veteran SSG John Galan, Naval veteran and Club Advisor Jon Lehuta, and NIU ROTC Department of Military Sciences Chairman LTC Craig Engel below the fold.
Thursday, November 08, 2007
The Labor Department faced questioning from a Senate committee on Thursday about its efforts to help reservists who have been denied their civilian jobs when they returned from active duty.
A Pentagon survey of reservists in 2005-6 found that 44 percent of returning troops said they were dissatisfied with how the Labor Department handled their complaints of employment discrimination based on their military status. That was up from 27 percent in 2004. ...
Twenty-nine percent of those choosing not to seek help to get their job back said it was because it was "not worth the fight." Another 23 percent said they were unsure of how to file a complaint. Others cited a lack of confidence that they could win (14 percent); fear of employer reprisal (13 percent), or other reasons (21 percent).
This information is very important as far as PTSD is concerned.
More on this along with survey highlights released by the Senate Health, Education, Labor and Pensions Committee showing "servicemembers are returning home only to realize that their deployment has put their healthcare, their benefits, and even their jobs at risk."
Wednesday, November 07, 2007
If you are an active duty, reserve or civilian behavioral health professional (or an intern, resident or other professional in training), you may be interested in attending one of The Center for Deployment Psychology's upcoming 2-week intensive programs.
Classes take place at the Uniformed Services University of the Health Sciences and National Naval Medical Center in Bethesda, MD, and Walter Reed Army Medical Center in Washington, DC. 2008 workshops: January 7-18, March 10-21, May 12-23
The 2-week intensive course covers topics in areas identified by military mental health professionals as particularly key to the care of service members and their families.
1. Deployment 101: examines the deployment cycle with attention to the unique culture, expectations and experience of military deployment including the reintegration with family and community upon return.
2. Trauma and Resilience: addresses issues of psychological trauma and resilience particular to the experience of combat deployment. This section also includes information pertaining to the assessment and treatment of PTSD and other problematic responses to trauma.
3. Behavioral Health Care of the Seriously Medically Injured: participants are introduced to issues that arise when providing behavioral health care to individuals suffering from serious medical injuries and traumatic brain injury.
4. Deployment and Families: explores the unique impact of military deployment on family members including children.
Limited to 30 participants, the program is free (civilians must pay for their own travel and expenses, while active duty and reserve component personnel may have their travel and per diem expenses covered). Download a registration form if interested in attending, and/or take a peek at course resources.
This has been a simmering local story since September, now widening into a system-wide review. From the Chicago Tribune:
The Department of Veterans Affairs has limited the surgical privileges of three doctors at the troubled Marion VA Medical Center in southern Illinois, and it is reviewing the credentials of 17,000 other health-care providers for veterans across the country, VA officials told a Senate committee on Tuesday.
The department also announced it is dispatching an "assessment team" to investigate hiring, personnel and management practices at Marion. It will be the third investigation launched at the facility since August, when a computer analysis showed a spike in surgical deaths at Marion and prompted officials to suspend all inpatient surgeries there.
Testifying before the Senate Veterans Affairs Committee, VA officials called their response to the Marion deaths "swift" and their credentialing process for doctors "the envy of the health-care industry." But the top official present, Dr. Gerald Cross, also expressed "some concerns" about the agency's ability to keep tabs on doctors once they've been granted privileges to treat VA patients.
From the Honolulu Star Bulletin:
MANY of the veterans returning home from Iraq or Afghanistan might seem to have escaped injury, but appearances can deceive. Too often, even the veteran doesn't realize the extent of the invisible wounds, once called "shell shock" and now known as post-traumatic stress disorder. The Department of Veterans Affairs can recognize the injury but has been slow to respond.
"Even though you don't see it physically, it's just as bad," Army Sgt. Hyun Kim told the Star-Bulletin's Susan Essoyan. Overwhelmed by the aftermath of the war and oblivious to the cause, Kim cut his wrists in April, a year after leaving Iraq. Only one-third of the veterans eligible for VA care are receiving it, according to Patrick Campbell of the Iraq and Afghanistan Veterans of America.
The seriousness of the problem surfaced earlier this year when a veteran seeking treatment for the disorder was found hanging from an electrical cord at his Minnesota home after being put on a waiting list at a VA hospital. A Washington Post series soon afterward exposed flaws in the system and miserable conditions at Washington's Walter Reed Army Medical Center.
My local paper runs a feature story on my work today. A very nice piece, which includes a Q & A and a couple of recently-taken photos.
From the Rockford Register Star:
Ilona Meagher had never met anyone with post-traumatic stress disorder. She didn’t have any family members returning from Iraq, and she didn’t have military training.
In other words, there was no particular reason Meagher, a former flight attendant who lives in Caledonia, would become a passionate advocate for American soldiers struggling to adapt to life after war.
Except she saw the issue for more than its statistics. She did more than read a newspaper article and think, “Such a shame.” Rather, this 41-year-old envisioned the families torn apart by soldiers who, unable to cope with their memories of Iraq, took their own lives.
Tuesday, November 06, 2007
You've likely heard about the drug-resistant staph infection that's caused quite a stir in schools throughout the country this fall. Reacting to pressure from Medicare, this month the nation's VA Medical Centers will begin screening all patients for this and other difficult-(i.e., expensive)-to-treat conditions.
Medicare, the U.S. health plan for the elderly and disabled, will stop paying for treatment of some infections that arise in hospitals and are caused by germs such as MRSA, or methicillin-resistant Staphylococcus aureus, that are invulnerable to existing medicines. Treating resistant infections can cost as much as $300,000 for each case.
MRSA, once found primarily in hospital patients, now is surfacing among other people. Hard-to-treat infections in U.S. hospitals cost an estimated $20 billion annually nationwide. Beginning this month, about 160 Veterans Affairs Medical Centers will screen patients for the bacteria. The risk of losing Medicare payments is spurring other facilities to test for the lethal germs as well.
Monday, November 05, 2007
From the Associated Press:
President Bush signed the Joshua Omvig suicide prevention bill on Monday, providing improved screening and treatment for at-risk veterans. The law is named after a 22-year-old soldier from Grundy Center, Iowa, who committed suicide in December 2005 after he returned from Iraq. ...
The new law comes amid growing concerns over mental health issues borne by veterans who have seen combat in Iraq and Afghanistan. The VA Inspector General, in a report last May, said Veterans Health Administration officials estimate 1,000 suicides per year among veterans receiving care within VHA and as many as 5,000 per year among all living veterans.
Rep. Leonard Boswell, D-Iowa, who sponsored the bill, commended Omvig's parents for their sacrifice and support of the new law.
"While suffering this personal tragedy, they went on to help other veterans and their families and have advocated for improving all mental health services at the VA," Boswell said.
Idaho State University last week kicked off a series of TBI programs aimed at reaching those who typically have a harder time getting information and services: military families in rural areas of the country. The first telecast took place last Thursday, but there's still five more presentations on tap to choose from. [Visit their Fall 2007 Virtual Grand Round Series page to access program resources.]
From the Army News Service:
Leaders at Army installations across the country joined the Army's top brass this week in pledging to support and honor Families as Soldiers continue the fight in the war on terrorism.
Secretary of the Army Pete Geren and Chief of Staff of the Army Gen. George W. Casey Jr. signed the official Army Family Covenant Oct. 17 at Fort Knox, Ky. They added their signatures again Tuesday in West Point, N.Y., as signings took place from Fort Riley, Kan., to Fort Eustis, Va.
The covenant represents a $1.4 billion commitment to improve the quality of life for Army Families. It formally recognizes the sacrifices made on the home front while the Army is at war and pledges to standardize funding for existing Family programs and services, increase the accessibility and quality of health care, improve Soldier and Family housing, ensure excellence in schools, youth services and child care, and expand education and employment opportunities for Family members.
Sunday, November 04, 2007
Passing along news of my two upcoming radio interviews discussing combat PTSD this week. Minnesota Public Radio's Midmorning with Kerri Miller show has invited me on tomorrow morning. And on Wednesday afternoon, I'll appear on the Mary Jane PoppOff Show. Both have online streams.
Friday, the VA said that it believes about 6 percent of returning troops seeking care at its hospitals will be diagnosed with traumatic brain injury, or TBI. From Army Times:
A VA mandatory screening program that took effect in April has looked at 61,285 veterans of the wars. Of those, 19.2 percent were identified on the screening questionnaire as potentially suffering from traumatic brain injuries and were referred for more tests.
While evaluation continues, VA spokeswoman Alison Aikele said officials believe, based on a smaller sample, that the final result about 5.8 percent will be diagnosed with TBI.
Aikele said it is too soon to draw any conclusions from the screening because the program has been under way for only a few months. Until there is more screening and evaluation, VA officials do not want to jump to any sweeping conclusions about brain injuries, she said.
“We did not really know what to expect,” she said when asked if the number of confirmed TBI cases matched VA’s expectations.
However, the 5.8 percent figure appears low. The Defense and Veterans Brain Injury Center, a joint Pentagon-VA research effort, 14 percent to 20 percent of troops in previous conflicts have had traumatic brain injuries. The Center says there are reasons to expect a higher percentage among troops in the current conflicts because improved body armor has made them more likely to survive injuries that would have been fatal in previous wars, and because of the prevalence of roadside bombs and rocket-propelled grenades to attack U.S. forces. The blasts from such weapons can easily cause concussive brain injuries.
From HealthDay News:
Internet-based cognitive behavior therapy (CBT) treatment for post-traumatic stress disorder (PTSD) shows promise, according to a pilot study in the November issue of The American Journal of Psychiatry.
The study found that 25 percent of U.S. military personnel assigned to an Internet-based, eight-week program of self-management CBT no longer had PTSD diagnosis after treatment or at six-month follow-up, compared to 5 percent after treatment and 3 percent at six-month follow-up for those assigned to regular supportive counseling. ...
CBT helps patients process traumatic memories therapeutically, understand and manage symptoms, and correct unhealthy thoughts and behaviors. While CBT is effective, it requires substantial training and expertise to administer, according to background information in the study.
These findings suggest that rapid online delivery of effective CBT treatment for PTSD could be expanded to a large population.
"We felt that the Web-based treatment was highly innovative and particularly well-suited for groups of people who have experienced a single highly traumatic event and want to resume their normal life as quickly as possible," Robert Freedman, editor of the American Journal of Psychiatry, said in a prepared statement.
Saturday, November 03, 2007
An update on things happening at Fort Carson, the Army base which came under scrutiny last year for reportedly stigmatizing troops from seeking help for their post-deployment stress, and this year for reportedly discharging so many soldiers with personality disorder rather than PTSD.
In January, the 2nd Brigade Combat Team's 4,000 infantrymen return following a second intense deployment to Iraq, and Fort Carson is joining forces with local community resources to provide better transition help this time. This is a great, great development.
From the Colorado Springs Gazette:
Leaders at Fort Carson said Friday they’re expanding community outreach initiatives in a bid to more quickly identify war-related mental illness and family problems in the ranks. The expansion of the post’s Warrior Family Community Partnerships precedes the homecoming of nearly 4,000 soldiers who have spent the past year battling in Ramadi and Baghdad.
Fort Carson’s commander, Maj. Gen. Mark Graham, said he wants to work with police departments and schools to ensure that troops exhibiting signs of post-traumatic stress disorder or brain injury get help from the Army.
Graham said his officers are contacting experts nationwide in a bid to find better treatments for PTSD, which has been diagnosed in hundreds of Fort Carson soldiers since the Iraq war began in 2003.
“There’s not one medical solution to help our soldiers and our families get through this,” he said.
Driving the efforts is the upcoming return of the 2nd Brigade Combat Team of the 2nd Infantry Division, which is due home in January. Because the unit is on its second deployment and has seen intense combat, costing the lives of 42 of its soldiers, commanders expect a high rate of war-related mental illness that will tax the post’s staff of 37 mental health workers.
“The demand when 2nd (brigade) comes back will be really dramatic,” predicted Col. Jim Terrio, the post’s top doctor.
Friday, November 02, 2007
Some welcome news. From Stars and Stripes:
American military deaths in Iraq have hit their lowest point in 20 months, with commanders and soldiers saying the numbers show marked improvement in the security situation throughout the country.
The Pentagon has thus far reported 39 U.S. servicemember deaths for October, down from the 65 reported in September, which itself had been the lowest in 16 months. The October number is the lowest since March 2006, when 32 deaths were reported. Three more deaths were reported at press time, though a final count could not be confirmed.
The number of coalition combat deaths in Iraq dropped in October to the lowest monthly total since February 2004, officials said Thursday.
Still, 2007 is shaping up to be the deadliest year in Iraq since the war began. As of the end of October, 842 deaths have been reported by the Pentagon. With two months left in the year, the total figure is likely to surpass the 849 deaths reported in 2004, the previous yearly high.
Thursday, November 01, 2007
Tracking stateside post-deployment incidents such as domestic violence, police standoffs, and all the rest including suicide, has been something that I have been a vocal proponent of. My work on the PTSD Timeline, in fact, officially kicks off again today, and in the coming weeks you'll see (far too many) new additions.
Today, related figures from the VA's own tracking effort...