Complementary and Alternative Medicine (CAM) Used at Forts Hood and Bliss, Brain Scan Imaging Detects PTSD Sooner, Migraines and PTSD
More PTSD Combat Diigo links.
Monday, April 06, 2009
Wednesday, March 18, 2009
Gulf War Vet Dies on Road to Honor the Fallen, Are Doctors Over-Diagnosing PTSD?, Colbert Nation to Invade the Middle East, VFA News, MTV's Real World
More PTSD Combat Diigo links.
Monday, March 16, 2009
Congressman Hall's COMBAT PTSD Act Deserves Our Support
Last Monday, Rep. John Hall [D-NY], the chairman of the House Veterans’ Affairs subcommittee on disability assistance and memorial affairs, introduced important legislation that would give vets coping with PTSD easier access to their disability benefits and the treatment they need. Press release:
After visiting with veterans at the U.S. Veterans Hospitals at both Montrose and Castle Point, Congressman Hall announced legislation he has written called the COMBAT PTSD Act: Compensation Owed for Mental Health Based on Activities in Theater. The legislation will remove the onus from any veteran diagnosed with PTSD to have to prove that a specific incident during combat caused his or her PTSD. Hall's COMBAT PTSD Act will make it so that any veteran diagnosed with PTSD who served in combat will automatically have the ability to get treatment and benefits for the service injury of PTSD. ...
The VA's current policy forces veterans to "prove" that a specific stressor during a war triggered their PTSD, even if they have already been diagnosed and been receiving treatment for the condition. Veterans must track down incident reports, buddy statements, present medals, and leap other hurdles to validate to the VA that their PTSD was a result from their war service.
"The current policy violates common sense," stated Hall. "A soldier who does not have PTSD before entering a war, who returns home from war with PTSD, should not have to prove that his PTSD is a result of a specific experience during war. Simply serving in combat can induce PTSD. The wars America is fighting right now have no front or rear lines. Danger can strike in any place, anywhere. It is clear that the current regulations are in need of change."
People are beginning to chime in on the issue.
Tuesday, July 22, 2008
Army's RESPECT-MIL Program Aims to Reduce Stigma by Screening All Care-Seeking Soldiers for PTSD
From Army News Service:
According to Army medical officials, the new Re-Engineering Systems for the Primary Care and Treatment of Depression and PTSD in the Military program is designed to help providers recognize warning signs and treat those disorders early while eliminating Soldiers' fears about the stigma of psychological illnesses and their treatment.
Program officials say RESPECT-MIL takes advantage of any visit Soldiers make to their assigned primary care physicians for any reason, turning those visits into opportunities to detect symptoms that could indicate that the Soldier is struggling with PTSD.
"The Army is doing a lot more as far as trying to reach out and find Soldiers who are having issues but are reluctant to seek mental health care due to the historical mental health stigma within the military," said Dr. (Maj.) David Johnson, a Schweinfurt Health Clinic psychiatrist.
Monday, June 30, 2008
Study: Lack of Consistency, Flaws in PTSD Research Methodology Hamper Prediction-Making Ability
News of an interesting Australian study, from PR Inside:
While a number of risk factors such as injury severity, demographic factors and compensation-related factors have been identified, none is strong enough to reliably predict which patient will develop the disorder. PTSD is characterized by flashbacks of the event, anxiety, and social withdrawal. Victims of major trauma are at significant risk of developing PTSD, with about 15% developing the disorder within a year of the injury.
A study in the July issue of ANZ Journal of Surgery titled 'Predictors of Post-Traumatic Stress Disorder following Major Trauma' by Professor Ian Harris et al. argues that the lack of consistency of previous PTSD studies is a result of methodological flaws such as selection bias, and poorly defined diagnostic criteria.
The authors investigated the association between injury severity, demographic and compensation-related factors with the development of PTSD and found that the disorder was also independently associated with having an unsettled compensation claim, their use of lawyer services and the placement of blame on others for the injury.
Monday, June 02, 2008
2007 Another Record-Breaker for OEF/OIF Troops Identified with PTSD
From Voice of America:
The U.S. military says newly diagnosed cases of post-traumatic stress disorder [ptsd] among American troops sent to Iraq and Afghanistan climbed nearly 50 percent last year, bringing a five-year total to nearly 40,000.
Officials Tuesday released figures that showed Marines and Army soldiers were most affected. These are the forces bearing the brunt of combat in Iraq and Afghanistan. ...
Army Surgeon General Lieutenant General Eric Schoomaker says the larger number of diagnoses in recent years partly reflects greater awareness and tracking of the disorder by the U.S. military. But he says increased exposure of troops to combat is a factor. Experts have said symptoms increase as soldiers return to combat for multiple tours of duty.
Sunday, May 18, 2008
Combat PTSD or Adjustment Disorder? Saving Money, Not Lives, Floated at One VAMC
Last year, a firestorm erupted when it was found that 24,000+ OEF/OIF veterans had been booted out of the military with Personality Disorder discharges. PD (once labeled "Section 8") discharges are a quicker and more cost-efficient way of dealing with service members who are exhibiting problematic behavior.
The problem, of course, was that some of the discharged were combat-injured Purple Heart recipients who may have instead been coping with PTSD, a fact that would allow them access to VA health care benefits to treat their condition.
This week, we've moved from the military's diagnoses of Personality Disorder over PTSD to a Texas VAMC PTSD program coordinator advising that Adjustment Disorder diagnoses should be handed out over that of PTSD. The reason given? Saving money.
Friday, February 22, 2008
War-Related Mental Health Problems of Today's Veterans: New Clinical Awareness
Appearing in the July 2005 issue of the Journal of Psychological Nursing, this 11-page article is a good all-purpose clinical guide that can help us all better understand the diagnosis and treatment of combat PTSD. Download your own pdf copy to learn more about the following issues and more:
- War-related Emotional Responses
- Screening Questions for PTSD
- Stressors Faced by Today's Soldiers
- Medications Used to Treat PTSD
Tuesday, February 19, 2008
Military PTSD Diagnosis Now Proof Enough for VA -- For Some
Kelly Kennedy, Air Force Times:
The Department of Veterans Affairs has scrapped a policy requiring combat veterans to verify in writing that they have witnessed or experienced a traumatic event before they can file a claim for post-traumatic stress disorder — but only if the military has already diagnosed them with PTSD.
“This change provides a fairer process for veterans with service-connected PTSD,” Sen. Daniel Akaka, D-Hawaii, said in a written statement. “[It] leaves claim adjudicators more time to devote to reducing the staggering backlog of veterans’ claims.”
In the past, a veteran has needed written verification — a statement from a commander or doctor, or testimony from co-workers — that he or she was involved in a traumatic situation to receive disability compensation from VA if they had not already been diagnosed by the military during a disability retirement process. But PTSD is the only condition that a veteran must “reprove” to receive disability benefits from VA.
“They don’t have to reprove their diabetes,” said Mary Ellen McCarthy, special projects counsel for the Senate Veterans’ Affairs Committee. “They don’t have to reprove a leg injury. I have never seen any other condition diagnosed in service [for which] people had to reprove their injury.”
Sunday, February 17, 2008
Action: Full Faith in Veterans Act
Editorial from the Bangor Daily News:
The phrase "War is hell," attributed to Union Gen. William Tecumseh Sherman during the Civil War, is perhaps the most succinct and eloquent description of armed conflict. Yet it falls far short of bridging the gulf between those who have experienced war and those who have not, and it fails to impart the indelible impression this particular hell leaves on young hearts and minds.
Almost no one survives war unscathed; whether the scars are physical or psychological, they are there, and remain for decades. The terms used to describe troops who struggle to heal from those wounds have changed, from "shell shocked" in the World War II era, to "flashbacks" from the Vietnam years, to the clinical Post Traumatic Stress Disorder now in vogue. But the condition is the same. After witnessing unspeakable horrors, or having to kill, or simply from the crushing weight of constant fear, our young men and women succumb. It is a reaction that is more normal than not.
Some rebound with rest and connection with family and friends back home. Others need help. Just as the federal government is obligated to treat the physical wounds, so must it treat the psychological wounds. A bill proposed by Reps. Tom Allen and Mike Michaud, the Full Faith in Veterans Act [pdf], goes a long way toward ensuring that PTSD victims get help and compensation.
The bill would change the standard of proof for veterans who don’t have full military records to verify the cause of their PTSD. Under current law, veterans must have a diagnosis of the condition and military documentation or two "buddy statements" to show the stressor event occurred during duty.
Friday, November 16, 2007
NPR: Army Personality Disorder Discharges Rocket 40% in Iraq War Era
Yesterday, an unsettling update on personality discharges by ace reporter Daniel Zwerdling on NPR's All Things Considered:
New Pentagon figures released to NPR show that since the United States invaded Iraq, officers have kicked out far more troops for having behavior issues that are potentially linked to post-traumatic stress disorder than they did before the war. ...
NPR asked the U.S. Army and the U.S. Marine Corps to disclose how many troops have been discharged by their commanders in recent years and why. The Marine Corps has not provided statistics. But an Army chart, which NPR recently received, shows that since the United States invaded Iraq:
— Commanders have discharged almost 20 percent more soldiers for "misconduct" than they did in the same period before the war;
— Commanders have discharged more than twice as many soldiers for "drug abuse" (a subset of the "misconduct" category);
— Commanders have discharged almost 40 percent more soldiers for "personality disorder."
In all, the Army has kicked out more than 28,000 soldiers since the war in Iraq began on the grounds of personality disorder and misconduct.
Wednesday, November 07, 2007
Center for Deployment Psychology Offers 2-Week Mental Health Provider Course
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
Details:
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.
Sunday, June 17, 2007
For Father's Day: Blue Star Mothers' "Guide to Post Traumatic Stress Disorder"
For those of who have loved ones deployed or blessedly welcomed back curious to learn more about combat PTSD, I have a good resource for you: The Blue Star Mothers has just published a free 17-page guide to help answer some of your questions.
From the American Forces Press Service:
After watching her own son return home from combat with post-traumatic stress disorder, an Army mom wants to share the lessons she learned -- and resources she found -- with others who find themselves faced with the same challenges.
Emily Afuola said she'll never forget the emotions that tugged at her and her family when they learned that Pvt. Matthew Afuola had been diagnosed with PTSD during his deployment to Afghanistan with the 10th Mountain Division. "When families find out about this, they're scared and worried. They're in a state of shock and a state of panic," she said. Afuola sought out every resource she could find to get answers and allay her and her families' concerns. "Initially, it was very, very hard," she said. "But I found that people were out there who wanted to help."
Afuola recognized that other families are confronting the same circumstances and wanted to share what she learned. She joined together with several other members of Blue Star Mothers of America, Inc., to produce a 17-page "Guide to Post Traumatic Stress Disorder" to help them [link to guide in MS Word doc format]. "We knew that other families are going through the same thing we did, and we're hoping that through this, they won't have to walk the same path," she said.
The guide offers basic, easy-to-understand information about what causes PTSD and symptoms to look for, as well as advice for getting treatment. It recognizes the effect a servicemember's PTSD has on family members, and the role they can play in helping their loved one deal with the affliction. One of the guide's most valuable resources is an extensive list of places to turn to for help.
Click on 'Article Link' below tags for a sample of the guide...
TREATMENT TIMELINE
As the survivor starts showing signs of post traumatic stress, time is of the essence to receive proper treatment that will benefit them the most. The following is a condensed timeline that will help walk you through what to do and what will take place.
1. A loved one or yourself starts to recognize there maybe a problem.
2. If still in the military speak to a first sergeant, or someone above you in rank. You may also speak to a chaplain, as they will listen to what is happening or what you feel is happening.
3. If the symptoms last longer than a couple weeks start recording the symptoms so you will have a record. If it dissipates within the couple weeks it may be traumatic stress and not go any further, if it continues you maybe on a path that you will need treatment for PTSD.
4. Seek help with a professional
5. At this point, depending on the severity, medication may be prescribed
6. Start treatment, this may include: education on PTSD, training for relaxation, coping suggestions, discussions, assessments, and counseling sessions.
The treatment may start before, during, or following the evaluation.
7. Receive an evaluation: to receive an evaluation the symptoms must persist for one month or longer (reason for keeping a record as #3 suggests) and must interfere in their functioning capability.
An evaluation may include:
a. An interview: this is a short interview to see how your life is affected
b. An assessment: this can be 8-1 hour sessions or more. It will include covering your history, your experience (stressors) that affected you, and your symptoms. The assessment is done in depth. Family members may be asked to provide additional information.
c. A Global Assessment of Functioning Scale may be completed. This is a rating from the assessment and interview to be used as a diagnosis tool.
Counseling: counseling sessions will be set up on an on going basis, as the professional so deems necessary. They may be held as an individual session, group session, or both. There are many other programs available for the survivor if they so desire or want more help and support. They may ask at the base hospital facility or the nearest VA/Vet Center.
Phone numbers: it is extremely important to request phone numbers to have on hand for any emergency situation that might rise. These numbers should consist of at least one of the following: the counselor and or doctor, emergency treatment facility (hospital, clinic if there is one on base) including for the VA or you may request contact numbers for all of these facilities. You should have a copy of these to keep for yourself and for a loved one. Do Not wait until they are needed and you don’t have them, you may never need them, but don’t take that chance.
Lots of helpful information and links, including one to PTSD Combat.
Monday, May 21, 2007
'Until We Send Robots to Fight, We'll Always Have PTSD'
From the Asheville Citizen-Times:
Soldiers returning from World War I experienced shell shock, and veterans from World War II were said to suffer from combat fatigue. But a formal diagnosis for PTSD did not exist until the early 1980s.
According to the National Center for PTSD, people with the disorder have four major types of symptoms: They re-experience the event either while awake or asleep; they stay away from people, places and things that remind them of the trauma; they experience a loss of emotions; and they feel on guard, have trouble sleeping and are irritable.
To receive a formal diagnosis of PTSD, these symptoms must last for more than one month, cause significant distress and affect the person’s ability to function normally. The combat behaviors veterans learn in the military and the return to civilian life after being in a life and death situation can exacerbate some of these symptoms. But, [Bruce Purvis, a psychologist at the Asheville VA medical center] said these are normal responses to an abnormal situation. “It’s the way we’re put together,” Purvis said. “It’s the way we’re wired.”
Dr. Alan Krueger, a former psychiatrist at the Asheville VA Medical Center, said even if military personnel don’t develop PTSD or other mental health issues, war has some effect on everyone who is involved in it. “I don’t think anybody who goes into combat comes out unscathed,” Krueger said. ...
“Until we send our robots out to fight their robots, we’ll always have PTSD,” Purvis said.
Listen to an interview with Purvis, talking about the symptoms of PTSD and how a formal diagnosis for PTSD is made.
Friday, March 30, 2007
Is PTSD Over-diagnosed?
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
Playing a bit of catch-up on this report from last week. A controversial quote in the last graf in this first dip into the Boston Globe piece:The symptoms of post-traumatic stress disorder are so common that depressed people who have never faced trauma usually qualify for the condition, according to a new study that raises questions about whether thousands of Iraq war veterans as well as civilians are getting the right diagnosis and treatment for their emotional problems. ...
Researchers found that almost 80 percent of the depressed people they interviewed showed symptoms of post-traumatic stress even if they could not name a single trauma that could have caused them.
"If you can identify a nasty event which occurred before these symptoms emerged, you can call it post-traumatic stress disorder," said Dr. J. Alexander Bodkin , lead author of the study in today's Journal of Anxiety Disorders. "I'm not saying there is no such thing as a mood or anxiety disorder caused by traumatic events, but the symptoms [used to classify the illness] are really grossly inadequate."
Bodkin said it's crucial to get the diagnosis right. Though people diagnosed with post-traumatic stress commonly are also treated for depression or anxiety, he said some treatments for post-traumatic stress, such as focusing on "facing" the trauma, could be counterproductive. "It might be worse than a waste of time. Maybe you don't need to work through what is bothering you. Maybe you need to get over what is bothering you," said Bodkin.
Click on 'Article Link' below tags for more...
Continuing:
The study joins a growing body of research that questions whether post-traumatic stress disorder is a distinct mental illness, at least as it is currently defined. Unlike other mental illnesses, the diagnosis of post-traumatic stress disorder begins not with the patient's symptoms, but with identifying a major trauma such as witnessing a murder or fighting in a war. Critics say that can lead therapists to falsely conclude that the symptoms were caused by the trauma. It could be that the trauma worsened an underlying condition such as depression or anxiety.
Yesterday, psychiatric researchers who wrote the post-traumatic stress disorder definition agreed that the definition needs to be tightened. Psychologist David Barlow of Boston University said the official definition, which he helped develop in 1994, has become outdated as advances in brain science suggest that post-traumatic stress is more closely related to other conditions than researchers recognized at the time.
"We might need to step back a level and begin looking at what these disorders have in common," said Barlow, then cochairman of the committee that wrote the post-traumatic stress disorder section for the psychiatrists' bible, the Diagnostic and Statistical Manual of Mental Disorders, or DSM.
However, Dr. Michael First , editor of the DSM, said he believes post-traumatic stress disorder is a separate disorder. "My concern is that it's overused," said First, of Columbia University. "It started out as combat neuroses for very severely traumatized soldiers, but now it's all over the place."
Here's some of the study data:
The researchers at McLean Hospital interviewed 103 depression patients using the same survey that a counselor would to diagnose post-traumatic stress. If patients hadn't suffered a serious loss, they were urged to discuss even a minor trauma that caused them recurrent distress. Researchers found that 79 percent had PTSD symptoms, including 28 patients who could not come up with one traumatic memory.
Bodkin said the results show that the definition of post-traumatic stress disorder is unreliable. "People have just been averting their eyes since 1980 from some pretty glaring scientific problems," he said.
Related Posts
Tuesday, February 13, 2007
Playboy (Un)Covers The Real Cost of War
Boal was doing research for an upcoming article on combat PTSD, and read ePluribus Media's "Blaming the Veteran: The Politics of Post Traumatic Stress Disorder" by D.E. Ford, MSW, Commander Jeff Huber, and me (Ms. Ford doing the heavy lifting on that one...).
Later, in December when making arrangements to send him a galley copy of my upcoming book on PTSD, I asked when his article would arrive. "March 2007," he said. That time has arrived.
Click on 'Article Link' below tags for more...
From Playboy Enterprises press release:March Playboy Magazine Investigation Raises Disturbing Questions Regarding Diagnosis and Treatment of Post Traumatic Stress Disorder Among American Troops
Article Finds Politics, Budget Constraints and Lack of Manpower to Blame
In an extensive, months-long investigation, "The Real Cost of War," in Playboy magazine's March issue, journalist Mark Boal discovers American troops fighting in Iraq and Iraq war veterans are not receiving the mental health care they deserve, specifically when it comes to the diagnosis and treatment of post traumatic stress disorder (PTSD). Boal spoke with numerous mental health experts, government sources and former military personnel who paint a disturbing picture about the government's handling of PTSD.
Boal found that the Department of Defense (DOD) diagnoses about 2,000 cases of PTSD a year. Yet according to a landmark study conducted by Army researchers and published in The New England Journal of Medicine, PTSD rates for soldiers in Iraq and Afghanistan are running between 10 and 15 percent. That means one would expect to see the military diagnosing 13,000 to 20,000 cases of PTSD.
Former government officials agree there is a problem. "PTSD is being underdiagnosed on a fairly wholesale level," says Dr. Robert Roswell, a former undersecretary at the U.S. Department of Veterans Affairs (VA).
Reasons for the underdiagnosis? Saving money and manpower. Politics comes into play, too.[A]ccording to the article, which reports that when the DOD submitted a war budget to Congress, the line item for mental health casualties was simply left blank. "DOD never prepared for a long war; it never prepared for an occupation," says one senior congressional staffer. "Now we're seeing the third thing it didn't anticipate: what to do with the soldiers when they come home. Now they really don't have the money."
Boal discovered politics may also be a factor. "The soldier has tremendous symbolic power in American politics. Healthy, happy soldiers bespeak a just war. Like the amputees and flag-draped coffins the administration hides from public view, such soldiers are antithetical to the hawkish goal of mitigating the costs of the conflict," writes Boal. "The critical difference is that mental illness isn't always obvious and is therefore easier to sweep under the rug." As one congressional staffer puts it, "It's much easier to deny the reality of mental illness than it is to deny the spinal cord injury of some guy sitting in a wheelchair."
Another cause given of the low PTSD figure is protective:Officials attribute the low rates of diagnosis to a reluctance on the part of military doctors to "stigmatize the person or bring harm to their careers" by labeling them with PTSD according to Lieutenant Colonel Dr. Charles Engel, the director of the deployment health clinic center at Walter Reed Medical Center. "It's out of respect for the patient that they don't make the diagnosis."
Out of respect?
Another point sure to cause a bluster:Dr. Sally Satel, a psychiatrist and adviser to President Bush on mental health issues views PTSD this way: "I'm not saying PTSD doesn't exist, but it's gotten out of hand. I mean, if you see a lot of action and then you come home you have a hard time walking your dog by the bushes at night, maybe you just avoid the bushes."
Read the full article here.
Related Posts
Tuesday, January 23, 2007
The Search is On for Objective, Biological Test for PTSD
From Marine Times:
Rather than argue over whether a 15-minute survey can determine if service members suffer from post-traumatic stress disorder, researchers are trying to find biological ways to make the diagnosis. “We’re looking for an objective, independent, biological marker,” said Dr. Charles Marmar, who directs the PTSD facility for the San Francisco Office of Veterans Affairs, told the House defense appropriations subcommittee Friday.
The best bet so far is using brain imaging to look for areas of the brain with unusual activity, he said. ... A physical test could change the stigma of mental health issues. If a brain image could show PTSD, the illness is no longer invisible: The test could make the diagnosis objective because it would not depend on a service member explaining why he’s sick.
Click on 'Article Link' below tags for related posts...
Related Posts
- Study: Asthma-PTSD Link Found
- Texas A&M Researchers Set to Study Biological Components of PTSD
- Charlie Rose Explores Fear, Stress and the Brain
- Study: Specific Brain Chemical Appears to Influence Individual Resiliency and Stress Reaction
- Study: 1-in-5 Iraq Vets Diagnosed with Migraines, Suffer Higher Rates of Depression and PTSD
- Study: Brain's Hippocampus Shrinks Due to Stress in Children
- Combat and PTSD: Study Gets Underway at Waco VAMC
- Study: Military Kids Have Higher Blood Pressure, Heart Rates, and Stress Levels
- Neuroscience Study: Prefrontal Cortex Hyperactivity in Brain Associated with Learned Fear, PTSD
- A Sample of the Latest PTSD Study Results
- Combat Stress Causes Brain Changes
- Scientists Racing to Ease Painful PTSD Memories
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
Srobinson@vi.org
202-557-7593
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: gulfwarandhealth@nas.edu
Link to the study - http://www.iom.edu/?id=32410
This is the link to the NCPTSD, this is a must read - http://www.ncptsd.va.gov/facts/veterans/fs_Iraq-Afghanistan_wars.html
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.
Please see our website at www.veteransforamerica.org
Related Posts
Wednesday, April 26, 2006
Veterans Rally: Recap on State Protests
During the past two days, veterans and their supporters arrived in Washington, DC for a number of events geared to petition their government for their grievances. Those who couldn't make it to the national Capitol descended on their own state Capitols. Let's take a quick review of a few of the actions that took place.
Wednesday, April 12, 2006
Free, Anonymous Online Mental Health Screening
Screening for Mental Health, a nonprofit organization, offers military troops and family members a free, anonymous online mental health and alcohol self-assessment. Funded by the U.S. Department of Defense Office of Health Affairs, the screening lets you check yourself for depression, bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, and alcohol abuse from the comfort of your own home. This same screening is also available by calling 1-877-877-3647.
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