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Thursday, October 29, 2009

"Moving a Nation to Care" Subject of Extensive Book Review Essay in VA's Premiere "Veterans Law Review" Journal

A book review any author would be bowled over by (this one being no exception) appears in the premiere issue of the VA's Veterans Law Review journal.

It's much more than a mere review, however.

Written by Holly Seesel, Mary Sorisio, and Paul Sorisio -- Associate Counsel with the Board of Veterans’ Appeals at the Department of Veterans Affairs -- the 24-page (!) 'book review essay' provides an in-depth look at my book (Moving a Nation to Care) and another by Stanley Krippner, Ph.D., and Daryl S. Paulson (Haunted by Combat). "Consequences of Combat" [pdf] begins:

Almost every week there is a different news report concerning the recovery and treatment of veterans returning from the Persian Gulf. Given this focus, we have examined two recently published books on the topic: Haunted by Combat: Understanding PTSD in War Veterans Including Women, Reservists, and Those Coming Back from Iraq as well as Moving a Nation to Care: Post-Traumatic Stress Disorder and America’s Returning Troops. While the intended audiences and the themes of the two books are different, both offer insights into understanding the disorder, include suggestions for improving treatment, and identify areas where more research is required. We will examine two topics discussed in each book: the changing face of PTSD and treatment options for PTSD. We will then offer suggestions for treatment of PTSD and highlight areas where further research is most needed.

In extended, I've included VLR's welcome by Secretary James B. Peake, its table of contents and another clip from the review. A lot of good info -- and all available freely online from the VA.


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

The Secretary’s Forum welcomes readers, explaining the purpose of the Veterans Law Review:

I am pleased to introduce the seminal issue of THE VETERANS LAW REVIEW. As part of the Department’s (VA) outreach to all veterans and their families, this volume highlights legal issues and legal-policy concerns that are currently faced by the Office of General Counsel, the Veterans Benefits Administration, the Board of Veterans’ Appeals and the Court of Appeals for Veterans Claims (Court) in their service to our men and women who have served this nation in uniform.

Topics addressed in this issue include VA’s duty to provide medical examinations, our duty to assist under the Veterans Claims Assistance Act of 2000, the effects of representation by attorneys in cases before VA, and the causes and effects of remands emanating from the Court. As additional foci, the REVIEW examines both the role of the new media in the delivery of veterans’ benefits and how the Department is addressing undiagnosed illnesses from the first Gulf War with Iraq.

During the past year, the Department’s service to our veterans in the provision of medical care, the dispensing of disability benefits, and the adjudication of claims has never been higher. Nearly 5.8 million veterans have been treated, more than $30 billion in benefits have been dispensed, more than 800 thousand claims have been adjudicated, and more than 43 thousand appeals have been reviewed and adjudicated. In each case, the quality of service and the quality of care are a matter of pre-eminent concern to my office and to each of our Administrations and Offices.

As we move into a new Administration in 2009, the Department recommits itself to providing the very best service to each of our veterans, wherever residing and/or hospitalized. We believe this volume of the REVIEW reflects that commitment, and its carefully written articles, essays and notes will provide an exemplar of the commitment shared by every VA attorney, Veterans Law Judge and employee on behalf of this nation’s veterans.

James B. Peake, M.D.

Secretary Peake mentioned a number of the topics covered in the journal's 277 pages. The full table of contents:

SECRETARY’S FORUM

ARTICLES
  • EFFECTS OF REPRESENTATION BY ATTORNEYS IN CASES BEFORE VA: THE “NEW PATERNALISM” - Steven Reiss & Matthew Tenner
  • VA’S DUTY TO ASSIST IN THE CONTEXT OF PTSD STRESSOR VERIFICATION: WHAT MUST VA DO TO FULFILL THE VETERANS CLAIMS ASSISTANCE ACT OF 2000? - Shera Finn, Thomas Jones, & Barbara C. Morton
  • FEDERAL JURISPRUDENCE REGARDING VA’S DUTY TO PROVIDE A MEDICAL EXAMINATION: PRESERVING THE UNIQUELY PRO–CLAIMANT NATURE OF VA’S ADJUDICATORY SYSTEM WHILE PROVIDING TIMELY DECISIONS - Daniel Brook, Motrya Mac, & Nathaniel Doan
  • WHY SO MANY REMANDS?: A COMPARATIVE ANALYSIS OF APPELLATE REVIEW BY THE UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS - James D. Ridgway
  • GULF WAR SYNDROME: ADDRESSING UNDIAGNOSED ILLNESSES FROM THE FIRST WAR WITH IRAQ - James P. Terry
  • THE ROLE OF NEW MEDIA IN THE VETERANS BENEFITS ARENA - Emily Woodward Deutsch, & Michael Donohue
NOTES & COMMENTS
  • TWO PERSPECTIVES ON LEGAL AUTHORITY WITHIN THE DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION - Jeffrey Parker
  • REFORMING VA’S MEDICATION COPAYMENT STATUTE - Timothy J. McDonald
  • VA’S DUTY TO ASSIST INCARCERATED VETERANS - Jonathan Hager
  • VA DISABILITY APPEALS & 38 U.S.C. § 7105: IS THE ONE YEAR TIMEFRAME FOR THE FILING OF A NOTICE OF DISAGREEMENT EXCESSIVE? - Phyllis L. Childers
BOOK REVIEWS
  • BLOOD BROTHERS: AMONG THE SOLDIERS OF WARD 57 BY MICHAEL WEISSKOPF - Alice A. Booher
  • HONOR BOUND: AMERICAN PRISONERS OF WAR IN SOUTHEAST ASIA, 1961–1973 BY DRS. STUART I. ROCHESTER & FREDERICK KILEY - Alice A. Booher
BOOK REVIEW ESSAY
  • CONSEQUENCES OF COMBAT: A REVIEW OF HAUNTED BY COMBAT: UNDERSTANDING PTSD IN WAR VETERANS INCLUDING WOMEN, RESERVISTS AND THOSE COMING BACK FROM IRAQ BY DARYL S. PAULSON & STANLEY KRIPPNER; AND MOVING A NATION TO CARE: PTSD AND AMERICA’S RETURNING TROOPS BY ILONA MEAGHER - Holly Seesel, Mary Sorisio, & Paul Sorisio

Finally, one last "Consequences of Combat" clip:

Important and similar lessons can be learned from both books to help medical practitioners, veterans, veterans’ families, and the general public address the rising tide of PTSD victims. The authors of both books raise many areas where more research is needed before certain groups can be effectively addressed and treated.

One of these groups is composed of National Guard and Reserve troops, who are serving in combat roles at the highest rate ever. A recent study by The Journal of the American Medical Association found that while reservists had similar battlefield experiences to active duty troops, they suffered substantially higher rates of psychological problems, including PTSD, depression, and suicidal thoughts. This study of 88,235 active duty and reserve troops162 found that 24.5 percent of reservists had symptoms of PTSD, thirteen percent had symptoms of depression, and 35.5 percent reported an overall risk of developing mental health problems. Comparatively, 16.7 percent of active duty troops reported PTSD symptoms, 10.3 percent reported depression symptoms, and 27.1 percent reported an overall mental health risk. The study attributes this difference to the stresses of civilian work, worries about losing military health benefits for them and their families, and separation from their units. Notably, these are also points that Meagher, Paulson, and Krippner identify as potential factors affecting this group of troops. Meagher notes that active duty troops have many more support options available to them and their families than reserve troops have.

More than in any previous war, women are being placed in combat support roles and seeing violence firsthand. As previously noted, fifteen percent of active duty troops and almost twenty-five percent of reservists are women. These new roles for women have been shown to have had a profound effect on their mental health—a 2007 VA study found that women were reporting symptoms of mental illness “at a higher rate than their male counterparts.” Additionally, of 60,000 veterans diagnosed with PTSD, twenty-two percent of women claimed to have suffered from sexual harassment or assault, while only one percent of men had. Due to the lack of current research on the mental toll of combat and military service on women, neither book provides any insight into what methods or policies could most help this group. However, the books note that early studies seem to show that a disproportionate number of female veterans are being affected by PTSD, indicating they are an important group on which to focus treatment and research efforts. ...

In conclusion, Meagher’s book is a great resource for anyone who wants to learn more about PTSD and wants to figure out how he or she can help our returning veterans. It is also very useful for veterans returning from Iraq and their families to aid them in recognizing that other veterans are dealing with the same problems. While Paulson and Krippner’s book is targeted more towards medical practitioners seeking alternative ways to treat their mental health patients, they also purport to provide advice to veterans to help them through the therapeutic process. Both books provide important lessons that can be learned by all parties involved in treating and addressing the needs of our returning military soldiers. The different areas each book identifies where more research is needed are useful for Congress and government agencies to consider when making policy decisions and determining where budgetary resources can most effectively be utilized.

Please read "Consequences of Combat" [pdf], available online as is the journal of the VA's Board of Veterans' Appeals: the Veterans Law Review - Vol. 1 (2009). On a personal note, my thanks go to the essay's authors, Holly Seesel, Mary Sorisio, and Paul Sorisio.

It's an honor to have my work reviewed in such a significant way.


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