Official Urged Fewer Diagnoses of PTSD
A psychologist who helps lead the post-traumatic stress disorder program at a medical facility for veterans in Texas told staff members to refrain from diagnosing PTSD because so many veterans were seeking government disability payments for the condition.
“Given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out,” Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs’ Olin E. Teague Veterans’ Center in Temple, Tex. Instead, she recommended that they “consider a diagnosis of Adjustment Disorder.”
VA staff members “really don’t . . . have time to do the extensive testing that should be done to determine PTSD,” Perez wrote.
Adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months, said Anthony T. Ng, a psychiatrist and member of Mental Health America, a nonprofit professional association.
Veterans diagnosed with PTSD can be eligible for disability compensation of up to $2,527 a month, depending on the severity of the condition, said Alison Aikele, a VA spokeswoman. Those found to have adjustment disorder generally are not offered such payments, though veterans can receive medical treatment for either condition.
Perez’s e-mail was obtained and released publicly yesterday by VoteVets.org, a veterans group that has been critical of the Bush administration’s policies in Iraq and Afghanistan, and Citizens for Responsibility and Ethics in Washington (CREW), a nonprofit government watchdog group.
“Many veterans believe that the government just doesn’t want to pay out the disability that comes along with a PTSD diagnosis, and this revelation will not allay their concerns,” John Soltz, chairman of VoteVets.org and an Iraq war veteran, said in a statement.
Melanie Sloan, executive director of CREW, said in a statement: “It is outrageous that the VA is calling on its employees to deliberately misdiagnose returning veterans in an effort to cut costs. Those who have risked their lives serving our country deserve far better.”
Veterans Affairs Secretary James B. Peake said in a statement that Perez’s e-mail was “inappropriate” and does not reflect VA policy. It has been “repudiated at the highest level of our health care organization,” he said.
“VA’s leadership will strongly remind all medical staff that trust, accuracy and transparency is paramount to maintaining our relationships with our veteran patients,” Peake said.
Peake said Perez has been “counseled” and is “extremely apologetic.” Aikele said Perez remains in her job.
A Rand Corp. report released in April found that repeated exposure to combat stress in Iraq and Afghanistan is causing a disproportionately high psychological toll compared with physical injuries. About 300,000 U.S. military personnel who have served in Iraq or Afghanistan are suffering from PTSD or major depression, the study found. The economic cost to the United States — including medical care, forgone productivity and lost lives through suicide — is expected to reach $4 billion to $6 billion over two years.
Ng said diagnosing PTSD often requires observing a patient for weeks or months because the condition implies a long, lingering effect of stress.
“Most people exposed to trauma, in general, can get better,” Ng said. “You don’t want to over-diagnose people with PTSD. Whether it’s adjustment disorder is one thing. It’s usually a temporary disorder with severity that is not as bad as someone with full-blown PTSD.”
© 2008 The Washington Post
!!! SUPPORt the tro..oops????
Its the same up here. we only chear for the ones that come home in a box.
for those counting:
Iraq
At least 30,004 U.S. troops have been wounded in action, according to the Pentagon
There have been 4,390 coalition deaths — 4,078 Americans, two Australians, 176 Britons, 13 Bulgarians, one Czech, seven Danes, two Dutch, two Estonians, one Fijian, four Georgians, one Hungarian, 33 Italians, one Kazakh, one Korean, three Latvian, 22 Poles, three Romanians, five Salvadoran, four Slovaks, 11 Spaniards, two Thai and 18 Ukrainians — in the war in Iraq as of May 16, 2008, according to a CNN count.
http://www.cnn.com/SPECIALS/2003/iraq/forces/casualties/
Afganistan:
At least 1,944 U.S. personnel have been wounded in action, according to the Pentagon
There have been 801 coalition deaths — 497 Americans, five Australians, 95 Britons, 82 Canadians, three Czech, 14 Danes, 16 Dutch, two Estonians, one Finn, 12 French, 22 Germans, 11 Italians, three Norwegians, three Poles, two Portuguese, six Romanians, one South Korean, 23 Spaniards, two Swedes — in the war on terror as of May 16, 2008, according to a CNN count.
http://www.cnn.com/SPECIALS/2004/oef.casualties/
Threepenny Opera, Army Song
“Johnny got shot and Jimmy is dead
And George went crazy shooting
But blood is blood and red is red
And the army is still recruiting.
Let’s all go barmy, live off the Army
See the world we never saw
If we get feeling down we wander into town
And if the population
Should greet us with indignation
We chop them to bits
Because we like our hamburgers raw”
Last Act (to be written)
Jimmy will never be mentioned.
Johnny will wait for treatment at the VA.
George will drink and become homeless.
.
I’m not sure that Dr. Perez is not on to something here.
The rush to certify a diagnose of PTSD, because its what the patient, the family, their lawyers, and their politicians desire…may indeed be misdiagnosis.
The issues here are severly under staffed, and under funded Mental Health Programs; both in the active Military Services and in the Veterans Administration Health Programs. They are NOT EQUIPTED or STAFFED to deal with the massive mental health problems of returning military personnel.
Mental Health Services need to be rethought and restructured…..the present system is a broken Korean War Era model.
However, a professional diagnosis of PTSD may take 6 months to a year………in a section or department staffed by MH Proffessionals, who treat and progressively evaluate the patient. To bend to political pressures to lie with an inaccurate misdiagnosis in a few sessions is both unprofessional, and can in the long run do serious harm to the patients.
The VA should demand the major funding needed to create a “MH state of the arts” Program across the country.
This an urgent need of giant proportions…this a national Mental Health emerengency.
Dr. Perez may deserve a metal for drawing attention to it.
.
jmadison4 May 16th, 2008 8:17 pm
However, a professional diagnosis of PTSD may take 6 months to a year………in a section or department staffed by MH Proffessionals, who treat and progressively evaluate the patient. To bend to political pressures to lie with an inaccurate misdiagnosis in a few sessions is both unprofessional, and can in the long run do serious harm to the patients.
The VA should demand the major funding needed to create a “MH state of the arts” Program across the country
*************************************************************************
Untrue. PTSD in returning troops is showing up within 2-4 weeks becuase of STOP-LOSS. they sre redeployed 2 and upwards of 7 times before the VA sees them. Vietnam Vets when returning, 12 month tours more if you would volunteer to go back, and PTSD wasn’t even identified yet.
The VA could give a S##T about the Veterans they see. They wouldn’t demand anything, unless it was a raise. They are government Zombies.
Mental parity does not exist yet when it comes to health ?care? in hell holes like Walter Reed.
And why is this news, it has been known forever the VA does this crap.
The last time a state showed such contempt for the rank-and-file who fought its’ wars, it was the Roman Republic during its’ turbulent last 150 years before the change-over to the Empire. During that age, the patricians and their hired thugs would dispossess from their farms the families of small farmers (the backbone of the army), often while the men were on campaign. Then they would buy favorable judgement from the courts, if the case was brought before a magistrate at all. While the USA has a particularly disgraceful history of treating its’ veterans shabbily: from Revolutionary War regulars land grants being sold to speculators to the Bonus March of 1932, this episode is shameful and a great disincentive for military service. It is also a warning from history that bodes ill if the elite are allowed to do what they’ve been doing during the Bush crime family’s reign.
Sounds like Dr. Perez is relying on an updated Catch 22.
From the book (by way of Wikipedia:)
‘There was only one catch and that was Catch-22, which specified that a concern for one’s safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn’t, but if he was sane he had to fly them. If he flew them he was crazy and didn’t have to; but if he didn’t want to he was sane and had to. Yossarian was moved very deeply by the absolute simplicity of this clause of Catch-22 and let out a respectful whistle.
“That’s some catch, that Catch-22,” Yossarian observed.
“It’s the best there is,” Doc Daneeka agreed.’
WmC: Yeah, that about covers it. Crazy people don’t know their crazy so if you ask for help because you think you’ve got a mental illness then you don’t have a mental illness because if you did you wouldn’t ask for help because crazy people don’t know they’re crazy so if you ask for . . .
20,000 or so troops have died by their own hand, after coming home from Iraq, since the war began. Suffering from PTSD and unable to get treatment, they killed themselves.
This is evil.
Yo Common Dreams,
I did 3 full tours in South Viet-nam.
So know a little about combat. This big increase in
PTDS is really a way to get MONEY. Simple, sure there
may be a few PTDS folks but most of the rest is just
money. Keep in mind the military has to scrape under
rocks just to get people in. Theres guys & gals had
major problems BEFORE military service or combat so
sure their “illness?” will show up. Take away the
money for life and just work to “cure” the person, then
you will see most of these bums go away. Sort like the
“lay hands - talk in tounges BS”. Not true just self.
The only evil is allowing this to go on & give money
for it. Help cure? them & then go on. But NO pay.
thank you,
George
“By saying that our leaders are power-drunk chimpanzees, am I in danger of wrecking the morale of our soldiers fighting and dying in the Middle East? Their morale, like so many lifeless bodies, is already shot to pieces. They are being treated, as I never was, like toys a rich kid got for Christmas.”
– Kurt Vonnegut, Jr.
I have worked with Vietnam veterans as a mental health clinician. I have also worked with trauma survivors in a disaster situation. PTSD (or PTSS as it is more commonly called nowadays, the second “S” standing for “syndrome”) is very real. I disagree with the previous post claiming that this is all about money. More likely it is about mostly young people who have been traumatized by exposure to and commitment of acts of violence, injury, and a corrupt administration seeking to continue diverting funds away from the citizenry and into corporate bank accounts.
The VA has long been known for providing inadequate and sometimes incompetent care. That is exacerbated by the current defunding of services and the magnitude of the traumatic injuries, both physical and psychological, which are part of the results of Bush’s war in Iraq.
This is just another example of the obscenity that is the Bush administration.
I am very encouraged but this PTSD epidemic will end our willingness to engage in wars of choice.
There are still Viet Vets 35 years on, sleeping under bridges in my town, but their plight is nothing compared to the onslaught on those serving 3 and 4 tours in Iraq & Afghanistan. Some seriously damaged and deranged soldiers will be coming home and when the country sees what it will cost, just financially, we will eschew these stupid wars.
This is new, and who will now sign up for this? The elite contract soldiers cost a thousand per day, or at least that is what is paid to their sponsoring corporations. What country can afford that per diem?
This is called awareness! And it’s new.
A Vet. Amen.
“Major” hutton, your compassion does you credit.
You realize, don’t you, that by stating that the military has to “scrape under rocks” to get people in, you’re implying that most of the US troops are less than admirable people. I’m willing to admit that some of them may be, just as there are less than admirable people in any profession, but to paint all the troops with as broad a brush as you just did seems to me to be more than a little unfair.
Yo baruch & Bushrod,
baruch:
American has never really taken care of her military vets, wars or not. That is to your
disgrace.
Bushrod:
Stupid wars? Easy for you to talk, you are free
due to Vets. Know not what you talk about. Sound
like a 60’s protester. Protest the draft, cause they did not want to serve - main reason in the
60″s. Been there, know that. If you lived in
the middle east under what rules there, you would
as ar most Iraq folks,thank American troops for
freeing them. Been there - done that, sure you
have NOT. You all need to go over there & just
see/live/be. Then your tune would change. Again,
thank a vet or military person each time you see
one. They pay/paid for your free easy life.
thank you,
George
your favoright neocon, retired army combat officer
& Texican
George,
No, the troops stationed on our permanent bases in Iraq do not pay for our easy life. Iraq did not attack the US, so was not a threat of any kind. WE invaded Iraq on known false intel to occupy the oil fields and send Iran a strong message.
The bad thing is the message has shown to be weak, and Iraq is pumping less oil now than pre invasion, our dollar has fallen like a rock in the ocean because of us having to borrow the money to fund the war. The falling dollar increases the cost of oil to us and Exxon, ETC are making money hand over fist while we pay more for fuel, parts, life in general.
The long term cost of this fiasco is projected to be over 3 trillion, and I honestly think it will rise even further. The cost of deaths, American and Iraq, are not even measureable in economic terms. Who knows what great mind has been blown to waste?
I would recommend watching a movie called “Why We Fight”. As a conservative older feller, vet of WestPac 71-75, I will challenge anyone with a smattering of thinking ability to look at the real reason we are involved in this.
As my father said, Vet of Korea 51-52, all wars are economic. Follow the money not the cannon fodder. A rich kid never fights but his parents expect us poor folk to do their bidding.
Thank you
And if we look at dollars in terms of human life, how much life force equals 3 trillion dollars? I am not just referring to lives lost, thousands of US soldiers and hundreds of thousands if not millions of Iraqi lives. I am talking about the daily toil of workers who pay taxes which are spent on weapons which profit a few. I saw a recent report on the Bush and Cheney families financial holdings…they continue to hold steady and increase, as most Americans are losing losing losing. Does this not say everything? The architects and executioners of these policies are doing exactly what they intended…to profit, to amass huge wealth, at the expense of everyone else. If that is not obscenity and perversion, I don’t know what is.