Thursday, June 29, 2006

"...I'm Away From My Desk"

Well, the old grandfather clock is back out, meaning only one thing: I'll be away from the computer for a few days. I'm heading out to be a panelist at Media Giraffe Project's Democracy & Independence: Sharing News and Politics in a Connected World conference at UMass-Amherst this weekend. The gathering brings together traditional media and citizen journalists (yikes! :o).

I'll be on the Why Citizen Journalism? panel:

This panel is a discussion and debate of the recent phenomenon of citizens as journalists. How and why did citizen journalism come about? Can citizens be journalists? What is the role of advocacy journalism? How does citizen journalism relate to professional media? What are the effects of citizen journalism on the civic arena? Can a lost dog be news ... and much more. Moderator: Tish Grier, editor, Corante Media Hub. Panel: Eesha Williams, author, Grassroots Journalism; Ilona Meagher, ePluribus media; Lisa Williams, H2OTown; Lise LePage, iBrattleboro; Paul Thomas, ePluribus Media

I've also been asked to sub on the Can old media be part of the new ecology? panel at the last minute. So, it will be a busy and informative time. I'll be back to reporting on combat PTSD in the early part of next week. Be safe, be well.

Wednesday, June 28, 2006

An Interview with Doonesbury's Garry Trudeau

I haven't written a Doonesbury update in months -- I last posted on B.D.'s progress coping with his combat PTSD back in February (here and here), although every week I tell myself I'll get another update in. While I struggle to find some time to do that, the Army Times offers a wonderful interview with creator Garry Trudeau that's highly recommended reading.

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PTSD Combat News Roundup: June 15-28, 2006

There's been a lot of news coverage on the combat PTSD issue of late; so much so, that it's been hard to keep on top of it all, passing it along as soon as I'd like. Behind the scenes here, I've begun working on an incredibly important project: writing the upcoming book Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops.

The next couple of months are going to focus primarily on the writing, with publication coming in April of 2007. As you can imagine, I'm going to be swamped; and so, I've decided to start a new feature, the News Roundup, that will give you a list of some of the more important articles out there with a descriptive graf or two. So, grab your morning cup of coffee and please join me for the first installment.

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PTSD Combat News Roundup: June 15-28, 2006

6/15/06 - AP New York:

Clinton measure would boost mental health efforts for vets

Sen. Hillary Rodham Clinton on Thursday sought to boost community efforts to treat the mental wounds of U.S. soldiers returning from Iraq and Afghanistan. Clinton, D-N.Y., is pushing an amendment that would expand community services to military men and women suffering from post-traumatic stress disorder, called PTSD, or traumatic brain injuries, known as TBI.

The legislation would create a training program to help family members care for a veteran who suffered a serious brain injury, a common medical problem among Iraq soldiers struck by improvised explosive devices. Such injuries are estimated to effect one out of every four survivors of bomb blasts in Iraq. "Lessons from past wars have taught us that identifying and dealing with problems like PTSD and TBI right away is vital for overcoming them," Clinton said. More >>

6/16/06 - Asheville Citizen-Times:

Soldiers’ mental health a priority

Dr. William Winkenwerder, assistant secretary of defense for health affairs and Asheville native, talked with the Asheville Citizen-Times recently about mental health services available to military personnel returning from Iraq and Afghanistan.

He also responded to media reports on a study by the federal government’s General Accountability Office that found only 22 percent of service members identified as at-risk for post-traumatic stress disorder on a post-deployment questionnaire were referred for a mental health examination.

Winkenwerder, who in April was named the third most powerful physician executive by Modern Healthcare Magazine, said one of the most exciting advancements in military health care is the Armed Forces Health Longitudinal Technology Application, a database with medical information for more than 8 million personnel. He said medics in the field now have the ability to access and transmit medical information on hand-held devices. More >>

6/20/06 - Kansas City Star:

PTSD cases leap far beyond VA’s estimate

The Department of Veterans Affairs is on a pace to see nearly 20,000 new cases of post-combat stress this fiscal year among troops who have served in Iraq and Afghanistan. The latest VA report on usage of the agency’s services shows that nearly 5,000 troops were initially diagnosed with post-traumatic stress disorder in the second quarter of this fiscal year. That’s on top of 5,000 PTSD diagnoses made in the first three months.

The Kansas City Star reported last month that the VA had dramatically underestimated the number of troops that would return from the war with the disorder. The new numbers further underscore just how far off the department was. It had estimated 2,900 new PTSD cases in all of fiscal 2006. ...

The lowball estimate was in response to a series of questions sent to the department in February before a budget hearing by Rep. Lane Evans of Illinois, the ranking Democrat on the House VA Committee.

But The Star found that the VA’s own reports contained numbers that, when added up, showed more cases in the first quarter of fiscal 2006 than the estimate it gave Evans for the entire year. VA spokesman Jim Benson subsequently explained that VA officials were aware of the higher estimate before the hearing, but the report was still being drafted, so they stuck with the lower estimate because it might be less “confusing,” he said.

A statement from the Democratic members of the House VA Committee said that even as the number of cases increases, the VA has cut back on the number of therapy sessions for veterans by 25 percent in the last 10 years. More >>

6/24/06 - Uniontown [PA] Herald Standard:

Fighting war only part of soldiers' battles

Local soldiers serving in Iraq and Afghanistan want to come home, but many will return with feelings of sorrow and mistrust that developed during their tours of duty, and those feelings make it difficult for them to reconnect to their families and society, a veteran said.

Maj. Glenn McQuown, a chaplain in the New York Air National Guard and an Iraq war veteran, spoke from a soldier's point of view at a Fayette County Mental Health/Mental Retardation program on post- traumatic stress disorder (PTSD) on Friday at the Uniontown Holiday Inn. He was one of several speakers who talked to about 30 local mental health professionals, veterans and family members about dealing with PTSD.

The life of a soldier in a war zone is a complicated one, McQuown said. Many soldiers live with some denial about the dangers of combat until they experience fighting or see a comrade injured or killed, he said. Certain feelings a soldier develops stem from their pre-deployment training. Some of those who conduct training never served in the area where they are preparing soldiers to go, he said.

After a soldier arrives in a combat zone, they discover that their training was out of touch with the situations they are actually faced with, he said. "Soldiers come back and we have some distrust of others' competence," McQuown said. "You come back with a lack of trust in others."

Combat also creates feelings of "arousal" and fear, he said. "They carry that home with them. It affects all soldiers," McQuown said. "You and I have to get past those barriers." More >>

6/26/06 - AP:

'Marlboro Man' Marine files for divorce

A Marine who was dubbed the "Marlboro Man" after appearing in an iconic photograph from the Iraq War has filed for divorce less than a month after dozens of Americans contributed to a dream wedding for him and his bride.

Millions became intrigued with James Blake Miller, 21, after seeing a 2004 Los Angeles Times photo in which the grubby, exhausted Marine lance corporal is pictured taking a break from combat in Fallujah with a cigarette dangling from his lips.

Miller and his wife, Jessica Holbrook, were initially married at a county building in June 2005, but Miller had said in a Jan. 29 story in the San Francisco Chronicle that he wished he could give his wife the wedding she had always wanted. Readers responded by contributing toward a $15,000 wedding June 3 at a golf course clubhouse near his hometown of Pikeville.

But by June 12, Miller and his bride were living apart, according to court papers. Miller filed for divorce on June 20, saying the marriage was "irretrievably broken." More >>

This last bit of news is especially painful, and I almost hesitate to include it; I'm hoping that Blake and Jessica are all right in all of this din. My heart goes out to them both...

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Monday, June 26, 2006

Iraq War's Effects on Former Veterans Goes Nationwide

In April, I wrote about a Lafayette, LA Daily Advertiser article exploring how some Vietnam veterans are affected by the past years' wars. Well, last week, the national media finally went wide with the issue, too. Let's see what the players and veterans have to say about this -- even well-known vets like former Senator Max Cleland.

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Last week, from a front page Washington Post piece:

More than 30 years after their war ended, thousands of Vietnam veterans are seeking help for post-traumatic stress disorder, and experts say one reason appears to be harrowing images of combat in Iraq. Figures from the Department of Veterans Affairs show that PTSD disability-compensation cases have nearly doubled since 2000, to an all-time high of more than 260,000. The biggest bulge has come since 2003, when war started in Iraq.

Experts say that, although several factors may be at work in the burgeoning caseload, many veterans of past wars reexperience their own trauma as they watch televised images of U.S. troops in combat and read each new accounting of the dead.

"It so directly parallels what happened to Vietnam veterans," said Raymond M. Scurfield of the University of Southern Mississippi's Gulf Coast campus, who worked with the disorder at VA for more than 20 years and has written two books on the subject. "The war has to be triggering their issues. They're almost the same issues."

The VA hasn't done any formal studies, but they do agree that the Iraq War is likely a "contributing factor" to the caseload increases they've seen. Meanwhile, others have studied the connection:

PTSD researcher John P. Wilson, who oversaw a small recent survey of 70 veterans -- nearly all from Vietnam -- at Cleveland State University, said 57 percent reported flashbacks after watching reports about the war on television, and almost 46 percent said their sleep was disrupted. Nearly 44 percent said they had fallen into a depression since the war began, and nearly 30 percent said they had sought counseling since combat started in Iraq.

"Clearly the current Iraq war, and their exposure to it, created significantly increased distress for them," said Wilson, who has done extensive research on Vietnam veterans since the 1970s. "We found very high levels of intensification of their symptoms. . . . It's like a fever that has gone from 99 to 104."

Vietnam veterans are the vast majority of VA's PTSD disability cases -- more than 73 percent. Veterans of more recent wars -- Iraq, Afghanistan and the 1991 Persian Gulf War -- together made up less than 8 percent in 2005.

The easing (relatively) of the stigma surrounding PTSD is also considered a factor in the rise of reported cases. Veterans groups generally agree.

PTSD is better understood than it once was, said Paul Sullivan, director of programs for the group Veterans for America. "The veterans are more willing to accept a diagnosis of PTSD," he said, "and the VA is more willing to make it."

In addition, as Vietnam veterans near retirement age, "they have more time to think, instead of focusing on making a living all the time, and for some this is not necessarily a good thing," said Rick Weidman, executive director for policy and government affairs at Vietnam Veterans of America.

Max Cleland, a former U.S. senator from Georgia and onetime head of the VA who was left a triple amputee by the Vietnam War, said the convergence of age and the Iraq war has created problems for many of his fellow veterans -- as well as for himself. "As we Vietnam veterans get older, we are more vulnerable," he said. When the war started in 2003, he said, "it was like going back in time -- it was like 1968 again."

Now he goes for therapy at Walter Reed Army Medical Center and is wary of news from Iraq. "I don't read a newspaper," he said. "I don't watch television. It's all a trigger. . . . This war has triggered me, and it has triggered Vietnam veterans all over America."

Of course, as with anything that costs money for the government, the issue is highly politically charged -- some even saying the caseload increase is driven by overdiagnosis or money. Sally Satel, MD perenially leads this charge, leaving her few friends in the veterans community (some refer to her as Silly Satel):

"I'm skeptical that it accounts for a broad swath of this phenomenon," said psychiatrist Sally Satel, a resident scholar at the American Enterprise Institute. "These men have had deaths in their families, they had all kinds of tragedies over 30 years that surely affected them emotionally but they coped with."

Although a small percentage of veterans might be deeply affected, she said, she doubts "they have become chronically disabled because of it."

A recent VA study, however, seems to counter her opinion:

A study published in February by VA experts showed that veterans under VA care experienced notable mental distress after the war started and as it intensified. While younger veterans, ages 18 to 44, showed the greatest reactions to the war, "Vietnam era VA patients reported particularly high levels" of distress consistently, the study reported.

Powerful images of war have revived combat trauma in the past. "Traumatized people overreact to things that remind them of their original trauma," said Scurfield, the PTSD expert in Mississippi. When the movie "Saving Private Ryan" was released, World War II veterans sought mental health help in great numbers, said Wilson of Cleveland State. "It rekindled it all," he said.

Consider emailing the Washington Post to thank them for their front page coverage of this issue. It's good to see the topic presented and debated, front and center.

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Youth Radio: 'Reflection on Return' Collects Veteran Interviews

Youth Radio, whose mission is to "promote young people's intellectual, creative and professional growth" through hands-on broadcasting opportunities, has been busily growing a collection of some of the most interesting, provocative, and heart-rending interviews with recently-returned troops. Their Reflection on Return page offers 20+ interviews covering a broad range of war issues, including Living with PTSD and Depression after Combat.

Friday, June 23, 2006

Growing Military Family Movement Helps Returning Troops

There's a movement underfoot these days. Can you feel it? Families who've lost loved ones in the new century's wars are beginning to find creative solutions to problems that the underfunded VA (as professionally-manned as it may be) isn't able to solve for our returning troops. I reported on Sarah Farmer's Lehner Foundation earlier in the month; now there's news of another woman, Nadia McCaffrey, using her personal pain to find a way of giving returning troops a sanctuary from the din.

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First an editorial appearing in today's Tracy [CA] Press:

Sanctuary idea good for troops

Although it may have a fancy sounding name and acronym as post-traumatic stress disorder and PTSD, our troops are returning from war still shell-shocked.

It was that way during Vietnam, Korea and World War I and World War II. Even today, the wars in Iraq and Afghanistan are flaring up the PTSD in aging Vietnam veterans. The Department of Veteran Affairs says PTSD disability-compensation cases have nearly doubled since 2003 to more than 260,000. What may be happening is that many Vietnam veterans are reliving their own war trauma while watching or reading about the combat in Iraq and Afghanistan.

What we do know is that these flashbacks are striking America’s most recent war heroes, where the estimated risk of PTSD is 18 percent from Iraq and 11 percent from Afghanistan. Thirty percent of the 260,000 PTSD cases are Iraqi war veterans.

Our troops are reliving the nightmare of a war where there are no borders or uniforms worn by the enemy. The person standing next to you, whether a friend or a foe, might kill you, and sometimes himself or herself, too. No wonder our returning troops are edgy and many times unable to trust their families, friends and neighbors.

The mother of one of Tracy’s fallen soldiers, Nadia McCaffrey, wants to have sanctuaries for the returning members of our military. Her idea of civilian-run retreats across the country has merit. Our soldiers must have some vehicle to readjust so the symptoms of post-war stress can be controlled before becoming a psychological illness that further burdens VA medical care. We agree with McCaffrey that our war heroes need a place to heal their war wounds.

Nadia McCaffrey is back in the news two years after her son, National Guard Army Specialist Patrick McCaffrey, was killed while serving in Iraq. Only now, 9 months following the close of their investigation, is the DoD reporting to her (with no further explanation) that her son was actually killed by one of the Iraqi soldiers he was training. Senator Barbara Boxer today released papers to prove the charge, saying:

"The family was not told the truth," Boxer, D-Calif., told reporters during a conference call. "It's troubling that the Pentagon would withhold this information from the family. It's troubling that Specialist McCaffrey told his family that he had been attacked twice before by Iraqi soldiers. It's troubling that it took the involvement of a Senate office to get the autopsy and a written report about his death."

As painful as this time must be for McCaffrey, she's determined to do what she can to help other returning troops who are experiencing difficult readjustments to civilian life. Judging by the editorial board of the Tracy Press, she's on to something. McCaffrey's been inspired to act by one of her late son's Iraq battle buddies.

From the San Francisco Chronicle:

There were three television satellite trucks parked Wednesday outside Nadia McCaffrey's house in Tracy. News organizations from around the world wanted to talk to her about the tragic story of her son, Patrick, who was killed by "friendly" Iraqi forces.

But that's not the only story she wanted to tell.

McCaffrey, while devastated by the news about her son, is also deeply concerned about the returning troops. When she met and spoke with National Guard veteran Steve Edward Jr., a friend of her son's in Iraq, and realized the terrible psychological trauma he's been having, McCaffrey came up with an idea.

"We would like to get an old farm, a place they could go to get help when they come back," McCaffrey said Wednesday. "We'd like to give them a paintbrush, a shovel, let them ride a horse if they wanted to. The machine does not function the way it did. We need to put it back in gear."

She got the idea from an experience Edward had after an 11-month tour as a combat engineer in Iraq in February. As Edward says, his counseling when he returned consisted of a week of debriefing and then, "Thanks, good luck, and have a great life. I just wanted to get into my blue jeans and a T-shirt and be home," he says. "But it hasn't worked out."

Edward, 40, who lives in San Jose, says he would lie in bed in the morning, literally afraid to open his eyes because he feared he would still be in Iraq. Once, when he tried to go shopping, a supermarket employee found him "huddled in a corner, behind my shopping cart, rocking back and forth."

Edward had PTSD, and his buddy's mother helped to set up a visit for him to the Zaltho Foundation in Oregon which offers a unique 4-day retreat for returning veterans (the next one scheduled to take place on November 16-19, 2006; email or call 503-636-8635 for more details).

Edward was sent on a four-day retreat in Oregon.

There, he and other vets met in groups, wrote out their experiences and practiced meditation. The experience was such a success that he called McCaffrey from the airport on the way back to rave about the program. "When I'm having a really bad day," he says, "I will just sit down and do 10 or 15 minutes of meditation. It helps me control my breathing and I feel 10 or 15 times better."

The important thing to remember about post-traumatic stress disorder, or PTSD, is not only are we just now beginning to find treatments, we have only now begun to recognize the condition. As Dr. Tasha Souter, a psychiatrist who directs the men's PTSD program at the Palo Alto Veterans Affairs Hospital, says, the condition was not even identified until well after the Vietnam War.

"Part of the issue now is really getting people into treatment and agreeing to treatment," Souter says. "Members of the National Guard tend to slip back into their communities. A study in the New England Journal of Medicine in July 2004 said that 30 percent to 40 percent of those who need treatment are not getting it."

Although Guard members like Edward can feel lost and abandoned, officials at the Palo Alto facility stress that their programs are available. If McCaffrey is able to get her idea of a retreat up and working, that would be fine, but if not, the VA is not ignoring them. Most people seem to agree that the problem is, as Edward says, that "they don't always tell you what you are eligible for."

Kerri Childress, the spokeswoman for the Palo Alto facility, says she "would be the first to admit that it is extremely difficult to reach the Reserve and Guard soldiers. The first thing they want to do is go home, and then they tend to dissipate into the community."

Though Edward benefited from the program, he's still not interested in leaving his house. When he does, his anxiety and hyperarousal get the better of him.

"The minute I go outside, I am on edge," he says. "I get out of the car and I am looking at roofs and windows. My wife says, 'There are no snipers here. Stop that!'" But he can't. "I am not the Steve who left for Iraq," he says, "but I have to accept that. I am OK."

There are moments. The retreat gave him a glimpse of how he could manage his condition. And there are surprising moments of hope. His 10-year-old daughter Lauren read a pamphlet the VA provides called "Why is Daddy Like This?" and now sometimes actually steps in and explains the situation to others. "I am like, 'Who the hell are you and what did you do with my 10-year-old daughter,'" Edward jokes.

We need more moments like that. Edward is a part of a badly damaged generation of men and women who are going to need a safe place to try to recover as much of their lives as possible. Maybe that will be a retreat, like what McCaffrey has in mind, or a program with VA. But it is going to be with us for a long, long time. "Let's just say, I am not looking forward to the Fourth of July," Edward says.

I'll look into Nadia McCaffrey's plans for that farm retreat program, and see what more I can dig up. But, I want to commend people like her and Sarah Farmer for using their pain to ease that of those returning home and in need of our help.

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NPR's On Point: Troops in Combat Zone on Anti-Depressants

This one's a must-listen-to program. NPR's On Point had an important hour-long discussion of an issue gaining a lot of attention for those concerned with the mental health of our troops.

Matthew Kauffman, staff writer for the Hartford Courant and co-writer of an investigative series called Mentally Unfit, Forced To Fight opened the program. Steven Robinson, Gulf War veteran and Director of Government Relations at Veterans for America in Washington D.C. followed, along with Ret. Command Sergeant Major Mike Lopez and Scott Peterson, Reporter for the Christian Science Monitor. Troops and military family members also called into the show to share their stories.

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Thursday, June 22, 2006

ePluribus Media Book Review: The Corroding Effect

As many of you know, I'm a citizen journalist with the very fine outfit ePluribus Media. Independent writers and researchers like myself have one disadvantage over our peers connected with major media outlets. Support, resources, leads, access to fact-checking, copy editing, and a wide variety of opportunities for growth are often hard to come by.

Fortunately, ePluribus Media comes to the rescue and offers people like me all of that and more. One of the latest opportunities includes having the chance to work with ePMedia writer, editor, and board member Cho on a review of an important book.

Please read The Corroding Effect, consider purchasing author Penny Coleman's masterwork Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War, and if you like the work that ePMedia allows citizen journalists such as myself to complete, please consider donating a few nickels to their bucket...they receive no funds from advertisers, and rely on supporters just like you to keep the work moving in the right direction.

OEF/OIF Cases of PTSD Doubled Over Past Year

The Bangor Daily News (via reports on the crush of new post-traumatic stress disorder cases turning up at the Veterans Administration over the past year, far surpassing predictions. Rep. Michael Michaud [D-Maine] is alarmed, saying, "If the trend keeps up, by [Sept. 30] more than 30,000 servicemembers and veterans returning from Iraq and Afghanistan will seek mental health services at the VA due to an initial diagnosis of PTSD. Frankly, I don't think the VA's budget planned for this number of new veterans with mental health concerns."

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Thousands of veterans are returning from combat duty in Iraq and Afghanistan in need of mental health services, and concern is growing about the ability of the U.S. Department of Veterans Affairs to meet the demand.

Over the past year, the number of veterans from Operation Iraqi Freedom and Operation Enduring Freedom diagnosed with post-traumatic stress disorder has more than doubled, increasing from a cumulative 9,688 by May 2005 to 25,317 by last month, according to a recent VA report. "VA therapists and counselors are dedicated, but VA's leadership is spreading them too thin. How can this increase in demand, coupled with the decrease in the frequency of care, not affect access and the quality of care VA gives veterans?"

Michaud's alarm is shared by veterans organizations, according to Ron Brodeur, a spokesman for the Maine office of Disabled American Veterans. "We're very concerned," he said Tuesday. Not only are many returning veterans and service members seeking treatment for PTSD and other mental health conditions after their tours, but at the same time a presidential commission is reviewing all VA health benefits to see where efficiencies may be implemented, he said.

"We're very concerned they're going to be second-guessing veterans' problems, including PTSD," Brodeur said. "It's taken us 30 years to get it out of the cellar and onto the table," he said, referring to the long battle to get the debilitating disorder recognized as a combat-related diagnosis.

Brodeur, a U.S. Air Force veteran who saw combat in Vietnam and the Persian Gulf, said veterans from all U.S. wars since World War II have been diagnosed with - and many continue to be treated for - PTSD, which is characterized by overwhelming flashbacks, panic attacks and paranoia. Untreated, the condition can last indefinitely and worsen over time.

While recent reports confirm that so far about 10 percent of service members returning from the Middle East have sought treatment for PTSD, Brodeur said, he would not be surprised to see the percentage rise to 30 percent or 35 percent. "We should be thinking about it now," he said. "We're going to see it, and we should be ready for it."

At the Togus VA Medical Center, director Jack Sims said Tuesday that although there is "widespread concern" across the country that demand for mental health services may outstrip availability, Maine veterans from all conflicts can expect speedy access to the care they need. Sims said 3,242 Maine veterans have an active diagnosis of PTSD. Maine recently had a "slight" increase in cases, he said, but even if there is a significant increase, existing services will be able to meet the demand.

As the news comes in fast and furious on this issue this week, we're reminded that our advocacy for our veterans is all that much more important with every such report.

Part II: Iraq Vet Zack Bazzi on War -- and The War Tapes

Paul Rieckhoff, Zack Bazzi, Abbie Pickett, and Perry Jeffries

My coverage of the 2006 YearlyKos Convention continues with a focus on Staff Sgt. Zack Bazzi, one of the four panelists who took part in the tremendous View from the Ground: Iraq Veterans on the War and Returning Home discussion. He's also one of the three soldiers/cameramen who made the new film The War Tapes.

Although viewing may not be suitable if you're coping with PTSD, the film is important from an educational standpoint for the American public. The movie, currently set to open in select theaters across the country following a strong opening in New York City, has already snagged a Tribeca Film Festival award for best international documentary.

Give a listen to an exclusive interview I completed with Zack this past Monday night. And take a look back at Part I to learn about Abbie Pickett and the other panelists (who will have their own posts in the coming days) before jumping into Part II.

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

Zack Bazzi is a professional soldier, a great American, and now a movie star.

All right. That last one there is a bit of an exaggeration, but he's headed in that direction -- fast. (Watch out George Clooney!) Besides everything already listed, Zack's also super nice and gracious as can be. On Monday, he agreed to answer a few questions on the movie, on war, on the troops who are fighting in it.

Tonight I'm excited to share my second interview with him -- the first one that I thought we'd recorded hadn't, in fact, recorded. Ouch. I guess he's been through more trying circumstances lately than having to redo an interview (thanks, Zack); he handled it with ease and grace. And, although I really grieve for some of the lost musings that made it on the first run-through but didn't find their way onto the second, I hope you agree that this soldier is the best of the best in every way.

Listen to my interview with Zack Bazzi, June 19, 2006 (turn up the volume)

While you're listening to the podcast, I thought I'd tell you a little more about the excellent documentary he stars in: The War Tapes. The film was shown for us at YearlyKos, and I have to say I've never experienced anything quite like it before. Not a difficult thing to say, because there's never been a war movie like this before. (That's Zack Bazzi, Executive Producer Chuck Lacy and Supreme Promo Guy Alex Urevick-Ackelsberg in the picture to the right.)

Just out from AP:

The movie was the brainchild of director Deborah Scranton of Goshen, who got an offer to embed with a Manchester-based company of the 172nd Mountain Infantry Regiment, thanks to a previous documentary she had made about World War II veterans from New Hampshire.

Instead, she persuaded 10 guardsmen in Charlie Company of the 3rd Battalion to take cameras to Iraq, then guided and encouraged them via e-mail and instant messaging. Five stuck with the project from March 2004 to February 2005, and three are featured prominently: Moriarty and Sgts. Zack Bazzi and Stephen Pink.

Scranton and her crew also filmed the three and their families during the men's training, their deployment and for 10 months after their return. She says she had no political agenda: She simply wanted Americans to see the soldiers' experiences, whether good, bad, ugly or heroic. "I believe in the power of empathy," she said. "So often, people see a soldier and they see an armed cipher."

Documentary filmmaker Ken Burns, director of "Baseball" and "The Civil War," gave Scranton the award for best international documentary at the Tribeca Film Festival in New York last month. He calls the movie a "remarkably clear-eyed view of what's going on there."

"She's just dropped us right onto the front lines," he said. "It's not overtly political, so it gathers everybody in. It allows you to have thoughts and conversations across what is an ever-increasing political divide in our country."

But the movie is political as far as showing us what KBR has been up to in Iraq, for example, and letting us into some of the more private thoughts of our soldiers fighting overseas. Head on over to see the power of the film by spending some time with the dozen clips available online.

Clips I'd highly recommend: the movie trailor, Man Down, and Night Vision.

Back to the AP piece, Zack shows us how important the voices of our returning veterans are:
Bazzi, a Lebanese immigrant who speaks fluent Arabic, is a "proud and happy soldier" who had no qualms about following orders, but thinks the war is probably not in the United States' best interests. "There's nothing un-American, unpatriotic or wimpy about being against the war. There's nothing patriotic about blind conformity," he said in an interview.

He added: "I've earned my opinion: I spent a year in a combat zone."

Now a staff sergeant, he was the only one of the three to re-enlist following the Iraq deployment. Before joining the Guard, he served in the Army, which he sees as an honorable institution. "The Army is a tool: It can be used for bad wars and good wars. ... You can only hope your leaders send you to the right war, if there is such a thing," he said.

Bazzi, 27, is finishing a degree in international affairs and psychology at the University of New Hampshire, which he said he could not have done without service-related financial help.

Zack is definitely a take-charge kind of guy. But, that doesn't mean he's all serious and no fun. To make my point, don't miss the chance to get a glimpse of Zack's wisecracking side (and one of the funnier moments in the movie), by viewing the Asscrack clip.

Thanks, again, Zack for your service to our country in and out of uniform.

And I hope everyone gets an opportunity this summer to see this important film. Shows are being added as the buzz picks up. Here's the current schedule:


Cinema Village
22 East 12 Street


AMC Empire 25
234 West 42 Street

06/22 - CONCORD, NH (Capitol Center for the Arts)
Special Concord Event: On opening night, June 22nd, at the 7:00 pm screening, come meet the soldiers of the New Hampshire National Guard from C Company, 3rd of the 172nd Mountain Infantry plus the New Hampshire based director, Deborah Scranton, Vermonter Exec Producer Chuck Lacy, and Major Greg Heilshorn the Public Affairs Officer of the New Hampshire National Guard. They'll be there to talk about the making of the movie and the soldiers' deployment in Iraq.

06/23 - MANCHESTER, NH (Regal Cinemas 9)
06/30 - WASHINGTON, DC (E Street Cinema)
06/30 - BOSTON, MA (Kendall Square Cinema)
06/30 - SAN FRANCISCO, CA (The Castro Theatre)
06/30 - BERKLEY, CA (Landmark Shattuck Cinemas)
07/07 - CHICAGO, IL (The Music Box Theatre)
07/07 - SAN RAFAEL, CA (Rafael Film Center)
07/14 - SAN JOSE, CA (Camera 12)
07/14 - WILTON, NH (Town Hall Cinema)
07/14 - WILKES-BARRE, PA (R/C Wilkes-Barre Movies 14)
07/17 - KEENE, NH (Colonial Theatre)
07/21 - BALTIMORE, MD (The Charles Theatre)
07/28 - SACRAMENTO, CA (The Crest Theatre)
08/04 - NASHVILLE, TN (Belcourt Theatre)
08/04 - LINCOLN, NE (Mary Riepma Ross Media Arts Center)
08/11 - TUSCON, AZ (The Loft Cinema)
08/11 - STAMFORD, CT (Avon Theatre)
08/18 - HARTFORD, CT (Real Art Ways)
08/27 - OJAI, CA (Playhouse Theatre)
08/30 - PORTLAND, ME (The Movies on Exchange)
09/01 - DENVER, CO (Starz FilmCenter)
09/08 - AUSTIN, TX (Landmark Dobie Cinemas)
09/15 - MINNEAPOLIS, MN (Landmark Lagoon Cinemas)
09/22 - DETROIT, MI (Detroit Institute of Art)
09/22 - FLINT, MI (National Amusements Cinema 10)

More dates and cities to be added soon- please check back for updates! If your city isn't listed, and you want to see The War Tapes in a theatre near you, sign up on our Frappr map and we'll try and make it happen!

If you don't see your city listed, why not work to bring it to your city? Tell friends and family about it. Ask your local indie theater if they'll show it. Help these independent filmmakers get their work out there so that others can have an opportunity to see what's really going on in Iraq.

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Wednesday, June 21, 2006

First Peek: Interview with Author Penny Coleman

The folks over at ePluribus Media are preparing to end the week on a strong note. ePMedia writer/editor Cho and I (and others behind the scenes) have been working together on a review of the massively readable, incredibly researched book Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War.

PTSD researcher and author Penny Coleman (whose husband committed suicide after returning home from another generation's combat zone: Vietnam) agreed to give me an interview a few weeks ago. I'm giving you guys the scoop here before it goes wide at ePluribus Media later this week.

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

Ilona Meagher: In your book, you write that the story of the Vietnam war widow is invisible -- and one reason for this is the way "women's history and family history are commonly erased in the 'official' versions of events." Could you explain this in a little more detail?

Penny Coleman: The phrase "the personal is political" came out of the Women's Movement in the '70's and reflected a growing awareness that the circumstances of individual women were not necessarily of their own making. They were instead to be found in systemic, politically constructed institutions of power that delimited and limited available life choices and probable life experiences.

When I used the term, I meant to indicate that the individual experiences of the women whose stories are included in the book, and their families', were not necessarily due to our personal inadequacies, but were, in considerable part, politically determined and widely shared. The details may have varied, but the suicides we survived were neither unique nor an indication of our failure to adequately love or notice or intervene.

Unfortunately, there is a stigma attached to suicide in our culture that places the blame for such a death on the survivors. On top of that, there is an age-old belief that only weak or cowardly men fall apart in combat. Both assumptions are cruel as well as inaccurate. Flashback is an attempt to push back against those prejudices.

If we had known then that there were others out there whose lives had been similarly devastated, perhaps we would have been empowered to advocate for our veterans and for those yet to come. But we didn't. Our guilt and shame both isolated and silenced us. The government exploited our silence.

And so, more than thirty years after our troops withdrew from Vietnam, as veterans of that war continue to take their own lives, and as the suicides of soldiers in and recently returned from Iraq and Afghanistan relentlessly appear in the media, the relationship between combat, PTSD and suicide still has not been acknowledged.

IM: How do these emotions you mention -- guilt and shame, along with isolation -- affect those left behind following the suicide of a loved one? How do they get in the way of the usual grieving process?

PC: We were communities of one and we believed that we had failed. We had as well to deal with an inexpressibly conflicted anger, because the one we were angry with was the one we needed to mourn.  And on top of that, the fear that what had happened once might happen again continued to infect our lives and our relationships.

IM: In your interviews with military family members, did any of them have opinions on what should have been done -- what services or programs should have been offered -- once their troop returned back home? In a perfect world, what kind of reintegration care should a returning combat veteran receive when they arrive home?

PC: Before 1980, most PTSD veterans just thought they were going crazy, and their families blamed them and themselves when they couldn't cope. When PTSD was finally included in the DSM-IIIR in 1980, that began to change-- somewhat. At least there was an awareness, however limited, that the war was responsible for the symptoms. The families I spoke with, however, consistently described the VA as an adversarial, rather than a supportive, gatekeeper. PTSD diagnoses were hard to get, treatment options over-emphasized drugs, and disability compensation was usually so limited as to be an affront.

Despite what you may have heard from the new VA director, there is still no known cure for PTSD. There are only tactics for the management of symptoms. Those seem to be of limited use if they are not immediately available, and under the best of circumstances, they only work for some people some of the time. Almost all of the women I spoke to said their husbands were under VA care when they died.

In a perfect world, a great deal more energy would be put into solving international problems other than with soldiers. The military keeps experimenting with prophylactic measures (pre-induction screenings, in-service therapies, deployment durations, unit organization, training variants, post-service questionnaires, etc.), and hoping they have finally solved the problem. They have not. But their optimism has consistently translated into a lack of preparedness, a lack of resources, and a lack of commitment to preventive rather than curative measures.

That said, all of the following would be an improvement--which is to say that the suggestions on this list are not currently being done. Deploying soldiers should be thoroughly screened for any sign of past or current mental or emotional problems. Soldiers in a combat zone who express concern about their mental state should not be shamed and ignored, but sent immediately for counseling, if not home.

Psychotropic drugs should never be used in a combat zone. Every effort should be made to protect troops from injury, either mental or physical, and that would include putting them in situations where civilians are routinely killed.  When they come home, psychiatric evaluations should be mandatory and de-stigmatized, and there should be periodic follow-ups, perhaps for the rest of their lives.

Treatment for all war injuries, physical and psychiatric, should be absolutely free and compensation should be paid to those who can no longer work. Every candidate for the military, every soldier and every veteran should be thoroughly warned about the predictable incidence of PTSD and the statistical likelihood that it will end in suicide.

That is a wholly incomplete list, but it includes some of the true costs of war that are being currently ignored. If it seems prohibitively expensive, then perhaps we can no longer afford war.

IM: How about the Veterans Administration? Are they doing better than the DoD?

PC: I am not the right person to answer that question. I can't get past the stories of trying to charge wounded soldiers at Walter Reed for their lunches; or trying to have all of the 100% psychically disabled vets go through the process of recertification; or commissioning the Institute of Medicine to come up with a new definition of PTSD that will surely be less, rather than more, inclusive. I understand that VA surgeons are impressive and I know from personal experience that many of their psychiatric health care providers are self-selected truly caring human beings who work under difficult circumstances with a constantly shrinking support staff.

IM: Should the American taxpayer pay for counseling that may be needed for military family members following the return of a loved one suffering with PTSD -- or should the taxpayer only be responsible to foot the bill for the veteran?

PC: I don't understand why veterans' benefits aren't thought of in the same vein as workers' compensation. Why should a New York City police officer be treated better than a U.S. soldier?  If a soldier goes into the service in health and comes out with an injury, what conceivable argument can be made for not providing for his or her care?

Since the Revolutionary War, Americans have promised to take care of their wounded soldiers. If we decide we can't afford to do that, if we decide that the cost has simply become too high, and I would suggest that it has always been too high, then what we are saying is that we can no longer afford to use soldiers to solve our problems.

IM: How best can average, concerned citizens help our returning troops? What
should they do to get their elected officials and the media on board to ensure programs and resources are in place for our returning veterans and their families?

PC: The social safety nets that most Americans assume to be in place have been systematically attacked over the past six years. The survival needs of soldiers and citizens alike have been sacrificed to a war that has made us more isolated and less secure in the world.  That war has also been used as an excuse to undermine the civil liberties that have traditionally protected those of us who would object or protest.

Republican and Democratic politicians alike, with very few exceptions, have failed to push back against this erosion. I understand that there are many Americans who see this war as necessary and legitimate, and who would disagree with me on many points, but what I am concerned with here is something about which I believe all Americans can, or should, agree: namely that we have an obligation to those we ask to risk their lives in our name.

It is astonishing to me that anyone who speaks out against this war risks swift-boating, including the families of casualties and of deployed soldiers.  Supporting the war is a litmus test for patriotism under this administration that few politicians and few media outlets have been willing to denounce.  It is our obligation to convince them all that they are safer with us than with them.

Military Families Speak Out's website posts links to groups that are actively trying to bring public attention to the needs of soldiers and veterans.

The 2006 election campaigns also promise to be forums for debating the war and its prosecution, and specifically what it means to support the troops and veterans. In New York, for example, Jonathan Tasini recently lost his bid for the Democratic nomination for Hillary Clinton's Senate seat. Tasini, an avowedly anti-war candidate, is supported by Cindy Sheehan, who said of Clinton, "I will resist her candidacy with every bit of my power and strength...I will not make the mistake of supporting another pro-war Democrat for president again." Tasini probably stands no real chance of beating Clinton, but he is mounting a grass-roots petition drive to get his name on the primary ballot, which would allow him to rip into her in front of her supporters, family and the national media.

Nationwide, similar local and state-wide protest campaigns are being mounted, some with a real chance of unseating an incumbent; some with no chance of winning, but the possibility of influencing party platforms and priorities. This election season politicians of all stripes will be forced to talk about how the troops are being supported. It is a critical time to be involved.

Not everyone wants to knock on doors, lick envelopes or speak at rallies. But when it comes to supporting the troops, the rhetoric has been high-jacked by the same people who are cutting the healthcare budget for the VA, allowing recruiters to cut corners, re-deploying troops beyond the military's own safety guidelines, using self-reporting questionnaires in place of pre- and post-deployment mental health evaluations, and on and on. We need to reclaim what it means to support the troops. For many, myself included, there is only one meaningful way to support the troops, by bringing them home immediately. But whatever our positions are on the war, all of us can make an effort to be more visible in our lives and more vocal in our concerns and opinions, especially where the welfare of the troops is involved.

Thank you, Penny, for the great opportunity to hear your thoughts on these important issues, and for adding a fine reference to our libraries (which won't have much time to collect dust). We Americans do need to do a better job of advocating for our troops and ensuring that they have the best resources to pick up their lives once they return home to us.

Thanks for showing us the way.

Tuesday, June 20, 2006

Important Action: Contact Your Senators Today

The Senate is currently debating the National Defense Authorization Act of 2007, S. 2766, and we need to make our voices heard on two issues especially. Hat tip to Veterans for America for the following information and for setting up an easy online feedback form that allows you to quickly send your Senators a fax today. Learn more, and read the sample letter you can use to easily let your Senators know how you feel about these important issues.

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

From a Veterans for America email alert:

Your messages to your Senators are making a big difference, but there may be only a few days left before the debate in the Senate is over. If we want these amendments to pass, we must act right away.

If you have not yet written your Senator, please do so today!

Our military and our veterans need your help today to fix some very serious problems.

Veterans for America (VFA) recently posted several disturbing news articles about veterans committing suicide and other serious mental health problems among soldiers in Iraq and Afghanistan. Clearly, VA and the military are failing to respond to this growing crisis.

A phone call or faxed letter from you today sent to your U.S. Senator can help soldiers and veterans now, before the situation gets worse.

Here's how you can help right now. The U.S. Senate is debating next year's military budget. The bill is called the National Defense Authorization Act of 2007, S. 2766. During the debate, several pro-service member and pro-veteran amendments are expected to come up for separate votes. Read the statement by Bobby Muller, VFA director.

Veterans for America has learned while there are several pro-veteran amendments being considered during debate on the issue, there are two in particular that deserve our immediate attention and support:

  • First, there are growing concerns about service members redeployed from the U.S. back to Iraq for a second tour after being diagnosed with a serious mental health problem, and some have committed suicide. That is why we ask you to urge the Senate to adopt an amendment sponsored by Senators Barbara Boxer and Joe Lieberman requiring a credentialed mental health professional to sign off before a service member diagnosed as having a duty-limiting (or serious) mental health condition can be ordered into a war zone.

  • Second, we are troubled by reports of veterans who are not aware of government benefits and services. That is why we urge you to ask the Senate to adopt an amendment sponsored by Senators Russ Feingold, Patty Murray, Barack Obama, Ted Kennedy and Jack Reed requiring the military to provide comprehensive Transition Assistance Program briefings about healthcare, employment, and other benefits so veterans don't miss out on benefits with time limits, such as healthcare and educational assistance.
Please contact your Senator today, by phone or by fax, and ask them to vote YES on all veteran-friendly amendments and in particular these two amendments. Using our fax system is simple and easy, and we've prepared a sample letter for you.

Thank you,

Charles Sheehan-Miles
Associate Director
Veterans for America

Here's a sample letter they've prepared to make it easy for you to communicate your wishes to the Senate. The form letter is only a guide, and you may customize it in any way you wish at the Veterans for America action page:

I stand with our Nation's service members veterans to make sure they receive the benefits they earned while in our military. During this week's debate over the National Defense Authorization Act of 2007, S. 2766, several pro-veteran amendments are expected to come up for a vote. These amendments are very important to all veterans, especially those fighting in Iraq and Afghanistan today.

Please vote YES on all pro-veteran amendments, and in particular these two:

1. You may have read the Hartford Courant series reporting how soldiers and Marines diagnosed with Post Traumatic Stress Disorder (PTSD) or other serious mental health conditions were ordered back into combat even though they were found unfit to fight. Tragically, some committed suicide. Senators Barbara Boxer and Joe Lieberman will introduce an amendment that requires a credentialed mental health professional to sign off before a service member diagnosed as having a duty-limiting (or serious) mental health condition can be ordered into a war zone.

2. An amendment sponsored by Senators Russ Feingold, Patty Murray, Barack Obama, Ted Kennedy, and Jack Reed requires the military to provide briefings about healthcare, employment, and other benefits to all service members when they leave the military. This amendment is important so that new veterans don't miss out on benefits with time limits, such as healthcare and educational assistance.

Once again, I urge you to support our troops and our military by voting for the pro-military and pro-veteran amendments to the National Defense Authorization Act of 2007.

Monday, June 19, 2006

WUSF 89.7 News: Report on Combat Zone Suicides

Public radio station WUSF 89.7 covered the issue of combat-zone suicides today. Audio is now available of the program; a partial transcript is as well. People who chime in on the issue include Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America (IAVA), Dr. David Tornberg, a deputy assistant secretary of defense and chief medical officer of the military's TriCare health program, and Brooksville Rep. Ginny Brown-Waite [FL-R]

Click on 'Article Link' below tags for related posts...

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Centers Offer Vets Superior Health Care and Resources

Newly returned OEF/OIF veterans interested in having a full health assessment have an incredible resource to tap into: the War-Related Illness and Injury Study Centers (WRIISC) located in New Jersey and Washington, D.C. Receive a free "1 day individualized and comprehensive medical assessment of your health, with a focus on health issues related to deployment." The comprehensive check-up is available to all OEF/OIF veterans no matter where they live. Lots of details to share with you on this.

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

Before we get to the specifics on the assessment, here's what today's Morris County/New Jersy Daily Record has to say about the WRIISC assessment program:

Mark Hechinger, a New Jersey Army National Guardsman since 1972, was 50 when he deployed to Shuaiba, Kuwait, in October 2004. For six weeks he unloaded equipment at the Seaport of Debarkation in an industrial area surrounded by fumes from oil refineries. The following January he took part in Task Force Liberty while stationed in Tikrit as part of Alpha Company, 50th Main Support Battalion, 42nd Rainbow Division.

By the time the chief warrant officer returned home to Hawthorne, he had been through a lot. Then he learned about the War-Related Illness and Injury Study Center, specifically for Iraq and Afghanistan veterans, at the East Orange campus of the VA New Jersey Health Care System. "I had a very thorough exam physically and mentally there and, when it was completed, I walked out with a binder two inches thick with general information and even more specific just to me," he said. "Everything was handled privately and professionally."

Hechinger said the staff carefully listened to his concerns about being exposed to dangerous environments while he was deployed, and that he was pleased to learn the VA is keeping a database on his experiences and those of others. When he walked out of the clinic he felt the country had learned lessons from Operations Desert Shield and Desert Storm.

While other U.S. Department of Veterans Affairs centers across the country offer healthcare and education services, what sets the WRIISCs apart is their focus on research.

What's different in New Jersey is the research component. The war center in East Orange invites, but does not pressure, veterans to participate in studies.

Its most sought-after service, though, is the specialized environmental exposure clinic, according to Dr. Ronald Teichman, associate director of clinical, education and risk communications services at the war center. Most soldiers make a beeline to this clinic, which also serves as a second-opinion referral center for veterans being treated at VA centers in other states, according to Dr. Han Kang, director of environmental epidemiology for the U.S. Department of Veterans Affairs.

"Six out of 10 veterans who come in say, 'I was near a bomb,''I was near this,''I was near that,''Do you think I should fill out an application for Depleted Uranium?'" said Michelle Stefanelli, coordinator for all New Jersey veterans returning from Iraq and Afghanistan. "You can't imagine the magnitude of concern of these veterans coming back."

Hechinger is no exception. Those six weeks he spent in Kuwait had him edgy. "There is a lot of sulfur in the air and it stinks 24/7," he explained. "If you're deployed there more than 30 days, it's considered health-significant for monitoring purposes."

Later in his deployment, at Camp Spiker in Tikrit, the garbage was burned daily in pits 20 feet wide and 100 feet long. Chemicals from the fires permeated the air. "Whenever the wind was blowing the right way," Hechinger said, "it'd take your breath away."

While 1,194 veterans have registered for this excellent health care, the New Jersey VA hasn't stop there. Female veterans also receive the benefits of a clinic specially set up to meet their own unique needs -- something increasingly necessary as more women find themselves in the line of fire these days.

After concerns over environmental toxins comes interest in the continuing emotional well-being of our returning troops.

The second most prevalent concern of returning soldiers is their mental health, and so the overall clinical evaluation at the war center screens for depression, Post-Traumatic Stress Disorder, anxiety, readjustment disorder, problems with attention span, concentration, spatial ability and memory. The war center channels those who report such problems directly into helpful programs without their having to publicly proclaim they need help with their thinking, nightmares or concentration. "There's still a huge stigma attached to raising your hand and saying, 'I've got a mental problem,'" Teichman said.

So far, records show that the 100,000 Iraq and Afghanistan veterans who have signed up for VA health care, unlike their counterparts in the Persian Gulf War, have well-recognized medical conditions, according to Kang, who also directs the war center based in Washington, D.C. "There is no mystery illness," Kang said. "They have either serious traumatic injury or mental health problems. Or they have such things as joint pain or back pain."

The Department of Defense is working with the VA to make a "seamless transition" from military to civilian life for Iraq and Afghanistan veterans. When soldiers return home they fill out a Post Deployment Health Assessment (PDHA - pdf) questionnaire, usually on the airplane that brings them stateside. Often, the questionnaire is completed at the demobilization station at Fort Dix.

Six months later, troops are asked to fill out a Post Deployment Health Reassessment (PDHRA - pdf) questionnaire, in many cases at a reserve unit weekend, to identify any problems that have arisen later. The reassessment itself is a Department of Defense initiative.

Although all of these efforts are to be applauded and continued, many agree that it's still just not enough. Many troops are falling through the cracks.

While these innovations help, they do not reach into enough aspects of veterans' lives, according to Paul Sullivan, director of programs for Veterans for America. He believes today's veterans need the kind of comprehensive help World War II veterans received immediately.

"In contrast, we waited more than 12 years to care for our Vietnam War veterans, and five years to care for our Gulf War veterans," he said. "We cannot be slow to respond again because during the waiting periods of the past, lives were lost or ruined."

WRIISC OEF/OIF Evaluation Details


  • To establish baseline health information.
  • To identify and evaluate deployment related health concerns.
  • To assist veterans with obtaining a primary care provider in the VA Health Care System.
Who is eligible?

All OEF and OIF veterans are eligible for a full day WRIISC evaluation. Since transportation must be arranged and paid by the veteran, most veterans evaluated are from the local area. Overnight accommodations may be made for veterans driving far distances.

What does the evaluation cost?

The evaluation is free.

What does the evaluation consist of?

We provide veterans with a 1 day individualized and comprehensive medical assessment of their health, with a focus on health issues related to deployment. The evaluation consists of:

  • Review of Medical Record
  • Extensive History and Physical Examination
  • Psychological Interview
  • Neuropsychological Screening
  • Exposure Assessment
  • Fitness Testing
  • Health Education
Here's a description of these medical services.

At the end of the day, team members meet with the veteran to talk together about the outcome and plan. Within three weeks, a copy of the written report is sent to the veteran and his or her primary care provider.

Free Resource Booklet and Setting Up Your Evaluation

  • Free Field Guide to Iraqi Freedom Resources: call OIF/OEF Coordinator Michelle Stefanelli at (973) 676-1000, ext. 1727 to get your complimentary copy.
  • New Jersey: For evaluation set-up or more information, reach the clinical intake coordinator at (973) 676-1000, ext. 2500 or 1-800-248-8005. [Map & Directions]
  • Washington, D.C.: This clinic accepts appointments on Tuesdays and Wednesdays and is located on 3B East, Room 3B-203. For more information, call 1-800-722-8340, e-mail or use their online feedback form.

Sunday, June 18, 2006

My Soldier Waits in Heaven

I recently received this poem from Army Captain Stefanie Pelkey. Her husband, Michael (also an Army Captain who'd served in Operation Iraqi Freedom), committed suicide in November 2004 only days following a diagnosis for PTSD. Mrs. Pelkey has been an outspoken advocate for increasing mental health awareness and care for returning veterans of this century's conflicts. She has testified before the House Veterans Affairs Committee and the President's Mental Health Commission.

Today is a good day to share her words with you, and to send out my warm thoughts of respect and support to her for her work on this issue in the face of much personal pain and tragedy.

My Soldier Waits in Heaven
By Stefanie Ellen Pelkey

You were a father, a soldier, a husband, a son
Your service and memory will live on
Your heart and mind would not forget
The war and horror would not relent
My Michael, my husband, my best friend
You could not continue to withstand the pain

We will never forget your smile and your shine
I will pass it on to the child you left behind
My Michael you made us who we are today
May your soul rest in Heaven, may we meet again someday

For Michael and Benjamin Pelkey

Father's Day Thoughts

For every father unable to be with his family because he's serving in uniform and for every child unable to give their father a hug due to that separation, I'd like to send my thoughts over to you. My hope is that by next year, you'll once again be back together happily celebrating your bond with another on this holiday.

My prayers, however, go to those children and spouses who no longer have the opportunity for such reunions. A nation bows its head, and grieves with your family today.


Saturday, June 17, 2006

Update: VA-Mandated Institute of Medicine PTSD Review

For a look at the current progress and controversy surrounding the updating of the PTSD definition for DSM-V, see "Defining PTSD: Update on Our Way to DSM-V." -- Ilona Meagher, 12/07/08

It's been a while since we've seen an update on the politically charged VA-mandated review of 'PTSD as a diagnosis' taking place at the Institute of Medicine (IOM) of the National Academies. Steve Robinson, Government Relations Director for Veterans for America (formerly Veterans for Common Sense), gives us an update on an important meeting held yesterday. Haven't found anything in Google News pop up yet; but, from the looks of the email, there's some (cautious) good news that's come out of the review so far.

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

In the interest of public education, and spreading the news, I'm going to share the entire postfound on the Veterans for America website:

Steve Robinson
Government Relations Director
Veterans for America

Today (Fri 16 Jun 06) I attended the meeting of the Institute of Medicine (IOM) Post-Traumatic Stress Disorder (PTSD) review.
At the request of the Department of Veterans Affairs, the Institute of Medicine (IOM) conducted a study to validate Post-Traumatic Stress Disorder (PTSD) as a diagnosis and to ensure the DSM-IV and other objective measures used in the diagnosis of PTSD were evidence based and scientifically sound.

The committee found that PTSD is a well characterized medical disorder and that the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for diagnosing PTSD are evidence-based, widely accepted, and widely used. This is an important finding which should end once and for all any claims that veterans were filing fraudulent claims. In fact I asked the Chairman of the committee if he believed a veteran could game the system by memorizing the DSM-IV to present false answers to a mental health care provider. He stated emphatically that it would be almost impossible because the DSM-IV has built in tools to detect deception and only a minute fraction of society had the ability to pull it off. Soldiers who serve in our wars are honorable men and women who only expect that their voices are heard and their needs are met when they come home. This study should be sent to your elected Representatives.

Additionally the committee found that only health professional with experience in diagnosing psychiatric disorders (e.g., primary care physicians, nurses, social workers) using the DSM-IV criteria are trained to make the diagnosis. The committee also stated that the diagnosis should take place in a private setting with a face-to-face interview that can last an hour or more. We all know that DoD clinicians are not spending an hour with returning veterans and they are not using the Clinical Practice Guidelines for PTSD published by the Department of Veterans Affairs. By the way, if used, the Clinical Practice Guidelines takes at least three hours to complete for one soldier.

The committee also commented on screening tools and diagnostic instruments for the assessment of PTSD. The committee commented that, “these tools cannot substitute for an evaluation by an experienced professional.” This statement is important because the way DoD screens for PTSD is the DDForm 2796 or Post Deployment Health Assessment. This form is administered by clerks, admin staff and persons who do not possess the skill to interpret the results because they are non-mental health personnel. How many soldiers are falling through the cracks because of the cost saving DDForm 2796?

Clearly this committee believes there is only one validated way to screen and diagnose PTSD. Why is the DoD allowed to make up itÂ’s own rules and screening tools?

The committee wrote that because ALL veterans deployed to a war zone are at risk for the development of PTSD, it would be prudent for health professionals to query veterans about their wartime experiences and their symptoms, when presenting at primary care and other health facilities (inpatient or outpatient) and this task must be done by trained professionals using validated screening tools.

This committee said the only validated screening tools were:

CAPS - Clinician Administered PTSD Scale
SCID - Structured Clinical Interview for DSM-IV
DIS-IV - Diagnostic Interview Schedule for DSM-IV
PSS-I - PTSD Symptom Scale - Interview Version
SIP -– Structured Interview for PTSD

Based on this report DoD is in willful violation of established and validated screening and diagnostic recommendations.

I wonder who will suffer because they donÂ’t follow the rules.

For further information on the report email:

Link to the study -

This is the link to the NCPTSD, this is a must read -

Veterans for America is all over this issue and is working diligently to inform Congress, the media and the veterans about these and other returning veterans issues.

VFA Legislative Priorities

Veterans for America (VFA) has nine immediate policy goals focusing on service members and veterans from the Global War on Terror (GWOT), Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). These policy goals represent the essential responsibilities of the Federal government to meet the needs of a new generation of war veterans.

1. Extend VA Medical Care from Two Years to Five Years: VA should extend free healthcare treatment to veterans who deployed to a war zone to five years (VHA Directive 2005-020). On May 5, 2006, Frances Murphy, M.D., Deputy Under Secretary for Health at VA, told Psychiatric News that existing lengthy waiting lists render [mental health] care virtually inaccessible.

2. Face-to-Face Medical Exams: DoD should conduct in-person physical and mental health exams with every service member 30 days before and again 30 days after deployment to war zone (PL 105-85, Sections 762 - 767). A recent GAO report (GAO-03-1041) identified serious and significant shortcomings with implementing the law.

3. Equal Outreach: VA should provide identical briefings and transition services (such as VAÂ’s Benefits Delivery at Discharge) for all deployed service members regarding VA healthcare, disability compensation, and other benefits, regardless if they are regular Active Duty, activated Reserves, or activated National Guard.

4. Electronic Records: DoD should provide each separating service member a full electronic copy of all military and medical records at the time of discharge.

5. Equal Education Benefits: VA should provide equal education benefits to veterans who are deployed to a war zone, regardless if they are regular Active Duty, activated Reserves, or activated National Guard.

6. Veteran Access to Attorneys: VA should allow veterans to hire an attorney to obtain VA healthcare, disability compensation, and other benefits (S. 2694 and H.R. 4914). This choice may be critical for some veterans (and some times families or guardians) dealing with serious traumatic brain injuries or psychological conditions.

7. GWOT Definition: VA should define GWOT in order to quickly and accurately determine healthcare and other benefit eligibility for returning war veterans.

8. GWOT Data: DoD and VA should begin collecting data on GWOT service members and veterans to monitor their health and their VA healthcare and benefit use.

9. GWOT Reports: DoD and VA should prepare reports describing the GWOT service member population so their healthcare and benefit use may be analyzed.

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