Army Report: Civilian Psychologists Needed on OEF/OIF Battlefronts, Suicides Up, Stigma of Seeking Help Down

The Army's Mental Health Advisory Team V report arrived today chock-full of updated data on how our troops are fairing. From AP:

U.S. troops on the battlefield found it harder to get the mental health care they needed last year, when violence rose in Afghanistan and new tactics pushed soldiers in Iraq farther from their operating bases. A report the Army released Thursday recommends sending civilian psychiatrists to the warfront, supplementing members of the uniformed mental health corps.

Surveying a force strained by its seventh year of war, officials found that more than one in four soldiers on repeat tours of duty screened positive for anxiety, depression and other mental health problems. That was comparable to the previous year.

The report found more troops reported marital problems, an increased suicide rate, higher morale in Iraq, but a greater percentage of depression among soldiers in Afghanistan. "They do show the effects of a long war," said Col. Elspeth Ritchie, psychiatry consultant to Army Surgeon General Lt. Gen. Eric Schoomaker.

Added Maj. Gen. Gale S. Pollock, a deputy surgeon general: "I think the fact that they are doing as well as they are with the demands they are under speaks to a strength and resiliency of the men and women of America."

The report was drawn from the work of a team of mental health experts who traveled to the wars last fall. The experts surveyed more than 2,200 soldiers in Iraq and nearly 900 in Afghanistan.

Testimony Begins in Class Action Lawsuit Against Veterans Administration

Latest updates on this and related VA/Army lawsuits posted in "As Second Legal Attempt Fails to Force VA Hand on Disability Claims Processing, Army Sued Over Discharged Veteran PTSD Disability Ratings." -- Ilona Meagher, 12/17/08

From the San Francisco Chronicle:

The nation's foremost authority on post-traumatic stress disorder testified in federal court Monday that up to 30 percent of combat veterans of Iraq and Afghanistan are likely to be diagnosed with the ailment and that the Veteran's Health Administration is not doing enough to help them.

Dr. Arthur Blank, a psychiatrist who has worked with troops and veterans with PTSD since 1965, said the disorder is treatable, but it requires a "human connection" with a therapist, and that's something the VA is ill-prepared to support.

"With hope and with help, recovery is possible," he said.

Dr. Blank testified at a hearing in connection with a lawsuit brought by veterans advocacy groups against the VA, claiming that the federal government's health care system for troops returning from Iraq and Afghanistan illegally denies care and benefits.

The plaintiffs, Veterans for Common Sense and Veterans United for Truth, are seeking to make the case a class action on behalf of 320,000 to 800,000 veterans or their survivors. The hearing Monday concerned a request by the veterans groups that the judge issue a preliminary injunction ordering the VA to provide immediate mental health treatment for veterans who suffer from stress disorders and are at risk of suicide.

Vietnam Veterans Reach Out to Today's Returning Troops

A few recent reflections on the invaluable role Vietnam veterans play in helping those returning from Iraq and Afghanistan today. The first, from the North County Times:

In combat, the older former warrior told the young Marines, "funny things happen." Weeks, months and even years after combat, he continued, those "funny things" can re-emerge as haunting nightmares, jittery paranoia or the root of any number of abhorrent and self-destructive behaviors.

"You cannot take a normal person and put them in that environment without it affecting them," the speaker, David Pelkey, told about 25 Camp Pendleton Marines who recently returned from Iraq. Pelkey, a Mira Mesa resident and a Vietnam veteran who served in the Army's 1st Cavalry Division, is the national director of American Combat Veterans of War, a nonprofit group founded seven years ago by Carlsbad resident Bill Rider, also a Vietnam veteran.

"We try to use ourselves as an example of what not to do in terms of denying the fact that you have been impacted by the war," Rider said about the program. While theirs is not the only program about post-traumatic stress, Rider said that American Combat Veterans of War is unique in providing firsthand advice from other veterans to the troops.

"We're here because we care about you, damn it, and there's something you don't understand that we do," said retired Marine Col. Al Slater, a Navy Cross recipient who also spoke to the returning troops. "We don't want your generation to go through the hell we did."

Study: PTSD-Substance Abuse Link Hinders Positive Outcomes in Both

From Medical News Today:

* Up to one-half of those seeking help for substance-abuse disorders (SUDs) also have posttraumatic stress disorder (PTSD).

* New findings show that the frequency of a PTSD is greater among those dependent on drugs rather than alcohol, and that having a PTSD tends to predict a more severe course and worse outcome for an SUD.

From one-third to one-half of those seeking treatment for a substance-use disorder (SUD) can also have posttraumatic stress disorder (PTSD). The first multi-center study of PTSD among individuals seeking treatment for an SUD has found a greater prevalence of PTSD among those who were drug- rather than alcohol-dependent, and that having PTSD was associated with a more severe course and worse outcome for an SUD.

Results are published in the March issue of Alcoholism: Clinical & Experimental Research.

"We already knew that there is a quite relevant association between PTSD and SUDs," said Martin Driessen, professor of psychiatry at Ev. Hospital Bielefeld in Germany, and corresponding author for the study.

"More specifically, PTSD is a risk factor for the development of an SUD, particularly a drug dependence. However, it was unclear whether this is true for both abusers and dependent subjects, or only one of these groups, which is why we studied clearly dependent subjects."

"Drug dependence has frequently been observed in war veterans who also suffer from PTSD," added Andreas Heinz, director and chair of the department of psychiatry at Charité - University Medical Center Berlin. "Both men and women often increase drug abuse and develop dependence following war and other trauma."