The Army and PTSD: Keeping Soldiers' Best Interests At Heart, Unless It Costs Money, In Which Case We Don't Want To Tell You About It

Abby Zimet

denied foia requests fr several media

after review madigan results lots more diagnoses

he results of a months-long investigation into the reversal of post-traumatic stress disorder diagnoses at Madigan Army Medical Center are being kept confidential.

Earlier this month, Army Secretary John McHugh told reporters at Joint Base Lewis-McChord in Washington state that the Madigan findings would not be disclosed.

Days later, the Army denied Freedom of Information Act requests for documents related to the controversy made by three Seattle-area news organizations.

a lecture to colleagues, a Madigan Army Medical Center psychiatrist said a soldier who retires with a post-traumatic-stress-disorder diagnosis could eventually receive $1.5 million in government payments, according to a memo by an Army Medical Command ombudsman who attended the September presentation.

The psychiatrist went on to claim the rate of such diagnoses eventually could cause the Army and Department of Veterans Affairs to go broke.

accuse malingering, enefits treatment denied sometimes after as little as 10 min interview, soldiers already stressed out who feel their honor at stake, would rather be nin comabt

"He (the psychiatrist) stated that we have to be good stewards of the tax payers dollars, and we have to ensure that we are just not 'rubber stamping' a soldier with the diagnoses of PTSD," stated the ombudsman's memo.

That memo has helped spark what the Army Medical Command calls a "top-to-bottom" review of a Madigan forensic psychiatric team charged with screening soldiers under consideration for medical retirement.

aid that doctors should not be taking financial considerations into account as they make a mental-health diagnosis.

"This is the opposite of everything that we are working for," Murray said of the statements detailed in the memorandum. "It is very disheartening to see this in writing."

The Army Surgeon General's office also has asked psychiatrists from Walter Reed Army Medical Center to evaluate the mental health of more than a dozen soldiers who complained that the Madigan team had unfairly dropped their PTSD diagnoses as they prepared for medical retirement.

George Wright, an Army spokesman at the Pentagon, told NBC News that “concerns brought up in the Madigan matter will be addressed” in a separate forthcoming report by the Army's Task Force on Behavioral Health.

Wright said he had not viewed that document, which is an Army-wide review of mental health diagnoses as far back as 2001, and could not comment on what information it would include about the Madigan inquiry.

The Madigan investigation, completed last fall, sought to determine whether or not a team of forensic psychiatrists inappropriately changed soldiers’ PTSD diagnoses, perhaps to save the federal government money.

In a memo obtained last year by the Seattle Times, a Madigan Army Medical Center psychiatrist gave a presentation to colleagues in September 2011 in which he noted that a soldier medically retired with a PTSD diagnosis would collect $1.5 million in disability payments over his or her lifetime. The psychiatrist warned his colleagues against “rubber stamping” a PTSD diagnosis.

Around the same time, several soldiers screened at Madigan complained that their PTSD diagnoses had been switched to conditions like anxiety disorder, which could have affected their medical retirement rating and the amount of their disability payments. 

A subsequent review of 431 Madigan cases — some of which had been overturned — led to PTSD diagnoses for 150 soldiers by last October, according to the office of Sen. Patty Murray, D-Wash.

Murray pushed for the investigation into the PTSD diagnoses at Madigan — an Army hospital in Tacoma, Wash., that serves soldiers stationed at Joint Base Lewis-McChord — but has yet to see its findings.

Multiple public information requests for the results of an extensive inquiry into the treatment of soldiers with post-traumatic stress disorder (PTSD) have been denied according to NBC News, but the Army says the results will be made public sooner or later.

Patricia Murphy, a reporter at KUOW Puget Sound Public Radio, said the Army denied the station’s attempts to obtain information and subsequently denied an appeal. The Army described the Madigan documents as “pre-decisional,” a legal privilege extended to documents that influence new rules and regulations. In a letter to the station, the Army said this designation is meant to “protect the quality of agency decisions by encouraging frank and open discussions of agency policy.”

Murphy said she understood that the documents might contain sensitive government and patient information, but was hopeful the Army could strike a balance for transparency. “We don’t care about the names,” Murphy told NBC News. “We care about the reasons they were doing this and whether or not this was a cultural issue at Madigan.”

The Army has said that Madigan was the only Army hospital to employ a team of forensic psychiatrists who vetted PTSD diagnoses and said it had stopped that practice.

Last February, it announced that the hospital’s commander, Col. Dallas Homas, was reassigned during the inquiry. The Army reinstated Homas several months later after finding that he did not "exert any undue influence on PTSD diagnoses." The Army provided that document to KUOW in response to a FOIA request. 

The Army also issued new guidelines for PTSD screening last April, discouraging staff from using testing to identify patients who might be "malingering" or faking their symptoms, an approach some soldiers claimed was utilized at Madigan. 

Despite these corrective actions, critics of the decision to withhold the Madigan findings say that transparency is key to restoring trust in the Army’s ability to accurately diagnosis and treat PTSD.

Tom Tarantino, chief policy director of the advocacy organization Iraq and Afghanistan Veterans of America and a former Army captain, said that keeping the report confidential reflected a “shocking amount of tone deafness.”

The probe centers on Madigan Army Medical Center in Tacoma, Washington, where some soldiers claim their PTSD diagnoses have been wrongly changed to save the government money. The review was launched after an Army psychiatrist at Madigan gave a lecture citing a memo that claims veterans suffering from PTSD could get up to $1.5 million in health benefits over their lifetimes.

That memo was obtained by The Seattle Times in February 2012, resulting in the suspension of Madigan’s top official. But now that the probe into how Madigan treats PTSD patients is complete, the Army is mum on its results.

A Pentagon spokesperson told NBC that the probe covers every single mental health diagnosis issued going back to 2001, but cautioned that the files contain sensitive medical information. Nevertheless, the spokesperson said that work to filter out sensitive information would be “completed shortly,” after which “we will be able to share not only the findings, but the way ahead.”

Roughly one soldier committed suicide every 25 hours in 2012, the Army said, for a combined total death toll of 349: an all-time high that outpaced even combat deaths. Veterans who’ve experienced traumatic brain injuries and have suicidal thoughts as a result are urged to call the National Suicide Prevention Lifeline at 1-800-273-8255.

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