Tuesday, July 10, 2007

Fort Bliss PTSD Recovery Center Aims to Return Troops Quickly to Battle

Editor's Note: Please scroll down to the 'Related Posts' section below for more in-depth coverage of this issue. -- Ilona Meagher

From the El Paso Times:

On Wednesday, officials will dedicate the Fort Bliss Restoration and Resilience Center, which will employ a holistic treatment approach including everything from meditation to medication. The center's first-year goal is to bring approximately 200 soldiers with PTSD back to "battle-readiness."

"We have every hope we will help these soldiers get back to fighting strength," said John Fortunato, head of the R&R center. "The soldiers who become disabled to the point they can't function are few."

However, there is an intensive screening process to try to make sure the soldiers chosen for the program are not just going to be reopening old wounds if they are sent back. "If they were going to come back from a tour in even worse shape, we wouldn't do it," Fortunato said

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

Continuing:

Recent research has shown that maintaining the alertness required to survive a tour in Iraq for months at a time creates physical changes in the brain, Fortunato said. The "fight-or-flight" center enlarges and the more contemplative, decision-making part of the brain shrinks. ...

The center -- which required a $549,000 renovation of a World War II-era building and $150,000 in equipment -- will use a nine-month program starting with a 35-hour-a-week routine that includes individual and group psychotherapy, movement therapy, a nutrition program and more, Fortunato said. Also included will be a spiritual component. "War raises all the questions about life and death," he said. "Like, 'Who is God and who would allow all this carnage?'"

Other elements include drug and alcohol treatment, massage, acupuncture, chiropractic, yoga, tai chi, biofeedback that trains a person to calm themselves, and more. Of the meditation room, he said, "I don't think you will find another one of these in the Department of Defense."

El Paso veterans advocate Ron Holmes said the center is "long overdue." "Why aren't they implementing it everywhere?" he asked. "Circumstances are a lot different than they used to be and we need to do everything we can to help these guys out." Innovations that prove effective eventually will be used throughout the Army, Powell said. "All of these services are being offered under a research program," Fortunato said. "A lot of this is going to evolve."

Although money is not the prime concern, Fortunato said, the program is cost effective. He said the nation loses nearly $1 million in training, future disability payments and other costs when a soldier is medically discharged. And he added that much of the stigma of PTSD -- once called "shell shock" and ignored for the most part -- has diminished as soldiers are reporting symptoms in greater numbers.

Quick Stats on Types of VA Services Being Drawn by Returning Troops

From the [Maryland] Herald-Mail:

Military members serving in Iraq and Afghanistan have more exposure to improvised explosive devices, or IEDs, than veterans of past wars, so doctors are seeing more blast and blunt trauma injuries, according to officials at the Martinsburg Veterans Affairs Medical Center. Other medical conditions these veterans are dealing with upon returning home include traumatic brain injuries and post-traumatic stress disorder.

Of approximately 686,000 troops who had returned from Iraq and Afghanistan and left the military, about 229,000 had gone to Veterans Affairs facilities as of April for health care, whether it was a veteran getting a flu shot or a quadriplegic receiving perpetual care, said VA spokesman Phil Budahn in Washington, D.C.

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

Some info on traumatic brain injuries:

Budahn said he didn't have specific statistics for injuries caused by IEDs, but the VA was treating about 400 people for traumatic brain injuries. Such injuries could range from subtle symptoms such as loss of concentration all the way up to extreme personality changes and short-term memory loss. In the past, everyone thought they understood the risks of traumatic brain injury to be obvious physical injury such as shrapnel, so traumatic brain injury wasn't always properly diagnosed, Budahn said.

But in 2003, a study out of the Tampa, Fla., VA hospital pointed out that people could experience a closed head trauma, or concussion, with no visible wounds, just from being close to a bomb going off, said Dr. John Sentell, chief of Mental Health Service at the Martinsburg VA Medical Center. The brain can get injured from an IED blast without visible blood; even from the brain being jostled in the skull from the blast, Sentell said. These less obvious traumatic brain injuries are more common in today's wars and often make diagnosis difficult.

More injury stats in a recent USA Today piece:

More than 800 of them have lost an arm, a leg, fingers or toes. More than 100 are blind. Dozens need tubes and machines to keep them alive. Hundreds are disfigured by burns, and thousands have brain injuries and mangled minds.

These are America's war wounded, a toll that has received less attention than the 3,500 troops killed in Iraq. Depending on how you count them, they number between 35,000 and 53,000. More of them are coming home, with injuries of a scope and magnitude the government did not predict and is now struggling to treat. ...

Survival rates today are even higher than the record levels set early in the war, thanks to body armor and better care. For every American soldier or Marine killed in Iraq, 15 others have survived illness or injury there. Unlike previous wars, few of them have been shot. The signature weapon of this war — the improvised explosive device, or IED — has left a signature wound: traumatic brain injury.

Soldiers hit in the head or knocked out by blasts — "getting your bell rung" is the military euphemism — sometimes have no visible wounds but a fog of war in their minds. They can be addled, irritable, depressed and unaware they are impaired.

VIDEO: Troop injuries overwhelm government

Only an estimated 2,000 cases of brain injury have been treated, but doctors think many less obvious cases have gone undetected. One small study found that more than half of one group of wounded troops arriving at Walter Reed Army Medical Center had brain injuries. Around the nation, a new effort is underway to check every returning man and woman for this possibility.

Some of those on active duty may have subtle brain damage that was missed when they were treated for more visible wounds. Half of those wounded in action returned to duty within 72 hours — before some brain injuries may have been apparent. The military just adopted new procedures to spot these cases, too.

Back home, concerns grow about care. The Walter Reed hospital scandal and problems with some VA nursing homes have led Republicans and Democrats to call for better care for this new crop of veterans. A lucky few get Cadillac care at one of the VA's four polytrauma centers, where the most complex wounds are treated with state-of-the-art techniques and whiz-bang devices like "power knee" or "smart ankle" prosthetics. Others battle bureaucracy to see doctors or get basic benefits in less ideal settings.

Returning to the Herald-Mail:

The VA Hospital in Martinsburg has the largest post-traumatic stress disorder program among VA hospitals in the nation, hospital officials said. Typically the 50-bed residential treatment unit is full with one-fourth of those patients having served in Operation Iraqi Freedom or Operation Enduring Freedom. ...

The Martinsburg VA Medical Center added outpatient treatment within the last six months, Sentell said. Many veterans with post-traumatic stress disorder are reservists with spouses and jobs, so they don't want to take the time to enter a residential program. They get individual and group counseling after hours.

While some Operation Iraqi Freedom and Operation Enduring Freedom veterans are more likely than veterans of past wars to show up for help with their spouses or parents, there are still some veterans who hesitate to seek counseling because of the perception of a social stigma, VA officials said.

VA Medical Center officials said their hope is that veterans will seek out assistance through the VA if they need it. Some of the programs set up to help veterans include counseling not just with the veterans, but also with their families because they also are affected, officials said.

Read the rest, find VA services near you or graze through many more OEF/OIF stats.

Study: War Effects Mental Health of One-Third of Military-Separated OEF/OIF Veterans

Buzzflash Review of 'Moving a Nation to Care'

Yeah! Buzzflash reviews Moving a Nation to Care:

Ilona Meagher is a product of the new citizen journalism. Coming upon the plight of GIs with PTSD returning from Iraq, she decided to start an online account of the plight of troops with PTSD. In turn, this drew the attention of other blogs and websites.

Eventually, she developed enough material for a compelling...wake-up call to the nation to help those who served our country. ...Beyond the compelling subject matter of "Moving a Nation to Care," Meagher's book is evidence that citizen journalists are creating a new media that is more relevant, in many ways, than the mainstream media.

Additional reviews. Click on 'Article Link' below tags for much more...

ePluribus Media spoke on this whole citizen journalism thing Buzzflash mentions. Last week, Cho wrote about her recent Wisconsin Associated Press Editors Annual Meeting keynote address, "Bridging the Gap Between Traditional Media and the Citizen Journalists."

A year ago, as a participant in the UMass MediaGiraffe project in Amherst, I was struck by how, even in a symposium dedicated to sticking our necks out and sharing ideas across boundaries, the attendees, myself included, seemed to cling to our own tribes. Print media over here; broadcasters over there; citizen journalists and bloggers in that corner, activists in yet another.

Much of this self-segregation may have been caused by the venue itself, an underground concrete space with dark large cavernous rooms. It wasn’t until the last day that real sharing began, and by that time, most of the representatives from the traditional media had gone home.

But much has changed in a year.

Cho continues (or rather begins):

Steve Outing in his June 2005 PoynterOnline article identifies 11 phases of citizen journalism, moving from the “one to many” to the “many to many” model of news. The 11 phases go from a simple dabble one’s toes in the water to a full scale, powered-by-the-people journalism effort. His article seeks to give advice to the traditional media trying to understand and harness the energy and dynamism of online citizen- produced news.

Two years later, a recent google on the search string citizen journalism produced over 1,280,000 hits. Clearly, it is a term with many connotations and flavors, but the common element is the so-called non professional contributing to the news (and some say the noise) in the public sphere. My talk identified the five types most commonly known. ... [they include hyperlocal, participatory, activist, blogger, and aggregator]

Activist Journalism advocates for an issue, but is not limited to politics, though the most commonly known are. Two such examples are the work of Ilona Meagher and Susie Dow who research, document and advocate for their issues: for Meagher (another Media Giraffe alum), [PTSD] in returning veterans resulting in her recent book Moving a Nation to Care and for Susie Dow, the missing details about civilian contractors in theaters of war.

The term Bloggers is sometimes used interchangeably with that of citizen journalists – but more and more “blogger” is becoming the pejorative to refer to the pajama clad, wild-eyed rantist who, working in solitude, cuts and pastes material from traditional media publications and keyboards a screed. Despite that perception, within the ranks of the solo blogger are many outstanding experts – several of whom are far more well-informed in their area of expertise than the Washington beltway pundits.

These bloggers provide an often untapped wealth of information about their subject matter. One well-known example is Juan Cole a University of Michigan professor, who through his blog Informed Comment – is now regarded as one of the leading experts on the Middle East.

Please read the rest as the Buzzflash review propels us out:

Meagher cares deeply about how this administration crafted a war that maximized the likelihood of increasing the occurrences of PTSD -- and then didn't provide adequate funding or support for its victims. Like wounded Iraqis, GIs with PTSD are just so much collateral damage to the White House.

What makes "Moving a Nation to Care" particularly significant is that it is grounded in personal accounts of how many GIs with PTSD arrived at where they are. This is a well-researched book that combines facts, details and personal accounts into a compelling call for assisting our own victims of a fraudulent war.

Ilona Meagher truly supports our troops and cares about their well-being as they return to a country. ... Meagher identified an injustice done to our troops and has sought to do something about it with the power of the pen.

That, our friends, is a true patriot.

Cheers and thanks to Mr. Karlin and everyone at Buzzflash.

And ePluribus Media without fail, too.

Sunday, July 08, 2007

Returning Veterans and Suicide: Alaska's Perfect Storm?

An Anchorage Daily News piece from a couple of weeks ago, filled with stats worthy of noting (more war stats):

As bad as the suicide rate in Alaska already is, the situation could grow even worse once thousands of new veterans return home from combat duty in Iraq. That's the warning local public health officials are culling from a new study that finds male veterans twice as likely to die by suicide as men with no military service -- and even more so if they're physically or mentally impaired.

Such news is particularly worrisome now, veteran advocates say, with hostilities in Iraq having left 52,000 U.S. troops either wounded or hospitalized for ailments ranging from insect-borne boils to severe depression.

According to the Department of Defense, 111 active-duty U.S. troops in Iraq have committed suicide since the beginning of the war. With one of the highest concentrations of veterans in the U.S. -- and suicide rates that often lead the nation -- Alaska was already at risk for suicide, according to Portland State University public health specialist Mark Kaplan, lead author of the new study. But now Iraq adds a new factor. "That's the perfect storm," Kaplan said of the convergence of Alaska and an influx of newly disabled vets. "This (study) foreshadows some ominous trends."

Tracking the lives of more than 320,000 U.S. men -- about a third of whom were veterans -- the Oregon-based research team found that over a period of 12 years (from 1986 to 1997) more than 500 members of the study group committed suicide, including 197 veterans. Those with the highest risk for suicide were veterans who were white, college-educated and living alone in a rural area, most often in a Southern or Western state, the study found. Veterans were half again more likely than non-vets to kill themselves with guns.

Notably, those whose daily activities were limited by physical or mental impairments were 4.4 times more likely to take their lives than vets who were unimpaired. "They had problems functioning at school, at work, at home," Kaplan said. "That really stood out in our analysis."

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

In the interest of education, article quoted from extensively.

Continuing:

If the government fails to adequately care for its returning vets, expect to see skyrocketing rates of divorce, homelessness and suicide, says Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, based in New York. "Veterans will show the psychological scars of these wars for years to come."

Hoping to prevent that, the VA has conducted an extensive survey of Vietnam-era vets who committed suicide. It hasn't yet released its findings.

But Jonathan Shay, a psychiatrist with the U.S. Department of Veterans Affairs in Boston, estimates that more Vietnam vets have died by suicide than all of the 58,000-plus troop casualties listed on the Vietnam memorial wall -- if you define suicide broadly as death by deliberately reckless behavior. Like the previously rational soldier who decides to walk across a minefield at night. "The multitude of (vet suicide) deaths are ambiguous," Shay said in a telephone interview. "They're single-vehicle accidents. Single motorcycle accidents. They have shoot outs with police. They're bar fights, where somebody goes in, unknown, and picks a fight with the biggest, meanest looking person in the room."

One deeply depressed vet he knew didn't do drugs, Shay says -- until one night he killed himself with a heroin overdose. Says Shay: "I am morally certain that was a suicide."

VETS TOUGH TO TRACK

Across the U.S., more than 30,000 people kill themselves each year -- almost double the number of homicides -- and approximately one-fifth of those cases involve veterans, according to Kaplan. Suicide is the eighth leading cause of death among all U.S. men.

With its small population, Alaska contributes relatively few suicide cases (about 140 a year) to the national total. But the suicide rate (20.8 per 100,000 people from 2003 to 2005) is almost twice the U.S. average.

One more bit:

Alaska's death statistics don't record the veteran or military status of people who commit suicide, says Ron Perkins, executive director of the Alaska Injury Prevention Center, which conducted the follow-back study.

But according to Kaplan, lead-author of the Oregon research, the number of vets who commit suicide nationwide is much larger than reported in previous studies, since most were based on data provided by the VA. "One thing we found is that three-quarters of veterans are not served by the VA," Kaplan said. So a huge portion of the vet population was previously ignored.

Co-authored by Nathalie Huguet, Bentson H. McFarland and Jason T. Newsom, the veteran suicide report is due to be published in the July issue of "Journal of Epidemiology and Community Health."

More stats:

Suicide risks for veterans

Male veterans: 2 times more likely to kill themselves than male non-veterans.

Disabled: 4.4 times more likely than unimpaired vets.

Living alone: 3.4 times more likely than vets living with others.

White: 3.2 times more likely than non-white vets.

College-educated: 2.7 times more likely than less-educated vets.

Western state: 1.9 times more likely than Northeastern state vets.

Rural: 1.5 times more likely than urban vets.

Underweight: 2.4 times more likely than normal-weight vets.

Source: "Suicide among male veterans: a prospective population-based study."

PERFECT STORM?

U.S. veterans by state

(2002)

RANK STATE PERCENT TOTAL

1 Alaska 17.1 71,552

2 Montana 16.2 108,476

3 Nevada 16.1 238,128

4 Wyoming 16.0 57,860

5 Maine 15.9 154,590

Total U.S. veteran population: 26,403,703 (12.7 %)

Source: 2000 U.S. census

U.S. suicides by state

(2004)

RANK STATE PER 100,000 TOTAL

1 Alaska 23.6 155

2 (tie) Montana 18.9 175

2 (tie) Nevada 18.9 440

4 New Mexido 18.7 356

5 Wyoming 17.4 88

Total U.S. suicides: 32,439 (11.1 per 100,000 people)

Source: Suicide State Data Page (2004), American Association of Suicidology Suicide in Alaska

Suicide in Alaska

Interviews with relatives of 56 people who committed suicide -- out of a total of 426 cases in the past three years -- provides the following small-sample portrait of Alaskans who take their own lives:

• 54 percent had an illness or disability.

• 61 percent were born outside Alaska.

• 62 percent were taking prescription medication for mental or behavioral health problems.

• 43 percent drank alcohol daily (63 percent drank at least weekly).

• 66 percent expressed thoughts of hopelessness or a wish to die.

• 84 percent owned one or more firearms (compared to 32 percent who own firearms in the general U.S. population, according to the Centers for Disease Control).

• 87 percent had verbal fights or arguments with others.

Source: Alaska Suicide Follow-Back Study, Sept. 1-2003 to Aug. 31, 2006

Tuesday, July 10, 2007

Fort Bliss PTSD Recovery Center Aims to Return Troops Quickly to Battle

Monday, July 09, 2007

Quick Stats on Types of VA Services Being Drawn by Returning Troops

Buzzflash Review of 'Moving a Nation to Care'

Sunday, July 08, 2007

Returning Veterans and Suicide: Alaska's Perfect Storm?

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