Bring It On!

Supporting the Troops the Neocon Way

June 30th, 2006 | by Liberal Jarhead |

I can’t decide whether to feel bitter or to cry first . . . watchful waiting, my ass.

Study Shows Military Care Gap
Les Blumenthal

The News Tribune - Tacoma, WA
Jun 26, 2006

WASHINGTON – The military is referring barely more than 20 percent of soldiers returning from Iraq and Afghanistan who have shown signs of post-traumatic stress disorder for further evaluation, according to a report from congressional investigators. The report, from the Government Accountability Office, concluded that unless the Pentagon makes changes, it cannot “reasonably assure” returning service members are receiving the care they need.

The Defense Department responded that while it is studying the situation, it disagreed with the GAO’s finding that military personnel returning from the war zones weren’t receiving the necessary referrals for further mental health evaluations.

On Capitol Hill, Sen. Patty Murray, D-Wash., said the report underscored her concerns that the administration was not doing enough to take care of the medical and mental health problems facing those who have been deployed in Afghanistan and Iraq.

“Many of our service members have seen and experienced things that most of us can imagine only in our nightmares,” Murray said. “I am concerned the Defense Department is not doing everything it can to seek out and help members get the mental health care they deserve.”

Murray has been one of the most vocal congressional critics of the administration’s support for veterans. She recently introduced legislation that would provide $168 million for the Department of Veterans Affairs to implement a comprehensive mental health program.

“They (the administration) have put blinders on and been dishonest about the cost of the war,” the senator said in an interview. “As I see it, treating veterans is part of the cost. They don’t see it that way.”

Once labeled shell shock or combat fatigue, post-traumatic stress disorder has been officially recognized as a psychiatric condition since 1980. PTSD is triggered by exposure to a life-threatening or horrifying experience and is the most prevalent combat-related mental health disorder.

By some estimates, 19 percent of those returning from Vietnam showed signs of the disorder. Some recent studies have estimated up to 17 percent of the soldiers returning from Afghanistan and Iraq have displayed PTSD symptoms.

The symptoms can include flashbacks, hypervigilance, anxiety, nightmares, irritability, anger and insomnia. PTSD can be treated with counseling and drugs.

The Defense Department uses a questionnaire to assess the physical and mental health of soldiers as they leave Iraq and Afghanistan. Service members who respond positively to at least three PTSD questions are considered at risk and eligible for further evaluation.

All returning soldiers also meet with health care providers to discuss any medical or physical problems.

The GAO report, released last month, said these health care providers use the results from the questionnaire and their “clinical judgment” to determine if a soldier needs further evaluation or treatment.

The health care providers can include physicians, nurse practitioners, physician assistants or independent duty medical technicians.

The report found the Defense Department failed to give them sufficient guidance in determining when soldiers need additional evaluation or care.

In reviewing data from almost 180,000 service members, about 5 percent might be at risk of PTSD, the GAO found. But of those found at risk, only 22 percent were referred for further evaluations, the report said.

The Defense Department has failed to identify what factors are used by health providers in making referral decisions, the GAO said.

The Defense Department could “not provide information” on why some soldiers with three or more positive responses to the PTSD questions received referrals while others did not, the GAO said.

Referral rates differed across the military. The GAO reported the Army and Air Force recommended further referrals for 23 percent of those found at risk of PTSD, the Navy about 18 percent and the Marine Corps about 15 percent.

Dr. Stephen Jones, principal deputy assistant secretary of defense for health affairs, cautioned that “watchful waiting” also was an appropriate health care response. That is, keeping an eye on the symptoms and not rushing a solider at risk of PTSD into treatment.

“There is no reason to expose an individual to pain and suffering when medical care could remediate the problem,” Jones said. “However, it is also not prudent to assume that a medical treatment is immediately warranted. Watchful waiting may be appropriate in situations in which the clinician is not sure about the diagnoses or the severity of the symptoms.”

A false diagnosis of PTSD also can be troublesome for soldiers, Jones said. Even though mental health treatment itself is not supposed to ruin a military career, it is a “generally held perception” that it does, he said.

Jones said symptoms associated with PTSD are “not uncommon and may even be adaptive in a high-threat combat environment. To label those symptoms as denoting a disorder may not be appropriate at this time.”

The Defense Department’s evaluation of the referral program should be completed this fall, he said.

Here are the post-traumatic stress disorder-related questions the Defense Department asks on its questionnaire for soldiers returning from Iraq and Afghanistan:
• Have you ever had any experience that was so frightening, horrible or upsetting that, in the past month, you have had nightmares about it or thought about it when you did not want to?
• Tried hard not to think about it or went to out of your way to avoid situations that remind you of it?
• Were constantly on guard, watchful or easily startled?
• Felt numb or detached from others, activities or your surroundings?

  1. 2 Responses to “Supporting the Troops the Neocon Way”

  2. By windspike on Jun 30, 2006 | Reply

    I’m reminded of the Doonsbury cartoon strip and the whole story line of the wounded vet going to get “care.”  At least there, it seems like he is recieving something.  As to if the W, Rove and Co care about vets is obviated by their action (or really, lack of actions).  Indeed. I’d spit on the W, Rove and Co shoes if I wouldn’t get tossed in the slammer for doing so.

  3. By Daniel Haszard on Jul 8, 2006 | Reply

    Bravo your blog,they are risking life and limb in the defense of our country.Back in the early 1970’s i worked with a crew of Vietnam vets many who were deeply troubled with PTSD.

    It’s about time the mental health concerns of military personnel and their dependents gets priority.–Daniel Haszard

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