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DISABLED WAR VETERANS NOT GETTING PROPER TREATMENT April 25, 2007 Americans Who Support PTSD Veterans According to Department of Veterans Affairs' (VA) estimates, there are over 98,000 new PTSD Vets According to Department of Veterans Affairs' (VA) estimates, there are already over 98,000 new PTSD Veterans. If it is true about this 98,000 new PTSD Veterans then the United States Congress should investigate why this number is so high. Photo: Shawn Baldwin/The New York Times Staff Sgt Ernest Swift, left, comforts Spcl. Christopher Mossburg who became emotional while speaking about the recent deaths of fellow soldiers Sgt. Jennifer Hartman and Sgt. Brandon Asbury at their base in Baghdad, Nov. 2, 2006. About one in six of the 589,000 veterans who have served in Iraq and Afghanistan have been diagnosed with post-traumatic stress disorder, or PTSD, according to the Department of Veterans Affairs. A rate expected to climb higher, since it can take months and sometimes years for the condition to manifest." Long, Repeated Tours In Iraq, Afghanistan Taking Mental Toll On Soldiers ANNE USHER c. 2006 Cox News Service Distributed by The New York Times Syndicate Multiple and extended tours of duty in Iraq and Afghanistan are resulting in rates of post-traumatic stress disorder among soldiers that will likely match or exceed the number of Vietnam veterans diagnosed with the chronic condition, government officials and veterans groups say. The unique circumstances in Iraq, where soldiers face an insurgency and no front line, have left many particularly vulnerable to combat stress and are driving the abuse of drugs and alcohol, military health experts say. Yet many veterans and on-duty troops are not getting the treatment they need. About one in six of the 589,000 veterans who have served in Iraq and Afghanistan have been diagnosed with post-traumatic stress disorder, or PTSD, according to the Department of Veterans Affairs, a rate expected to climb higher since it can take months and sometimes years for the condition to manifest. Symptoms include anxiety, sleeplessness, flashbacks and extreme wariness, a recipe that often strains personal relationships and makes it hard for those suffering to get or keep jobs. Jesus Bocanegra, a 24-year-old former Army sergeant, says he is haunted by countless shots he fired at Iraqis while serving as an infantry scout in Tikrit in 2003-04. The McAllen, Texas-native says he lost track of how many innocent civilians he killed. "How the hell was I capable of that?" he says now. Back home and plagued with anxiety attacks, he said he tried to close himself off from the world by drinking to the point of passing out. He progressed to marijuana use and then cocaine. "The only way to sustain yourself day-to-day is to keep yourself drugged up," he said. But "it made it worse." Eventually, he stopped taking drugs. But he said it took nearly two years for him to get an appointment at the closest veterans hospital, a four-hour drive away, because it was overbooked. He was diagnosed with PTSD and given pills, but with no VA therapists in the area he sought help from a group called Vets for Vets. "It's good to have someone to talk to," he said. "It's the only thing that keeps me going." Between 15 and 29 percent of soldiers returning from Iraq and Afghanistan will suffer from PTSD, according to an estimate by Col. Charles Engel, a clinician at the Walter Reed Army Medical Center. As of August 2006, 63,767 discharged soldiers had already been diagnosed by the VA with a mental disorder and 34,380 with PTSD, data shows. Experts say the PTSD rate among Iraq veterans could well eclipse the 30 percent lifetime rate found in a 1990 national study of Vietnam veterans because soldiers still on active duty are being deployed longer and more often to Iraq and more doctors are aware of the disorder and will properly diagnose it. But a study released in May by the Government Accountability Office, the investigative arm of Congress, found that nearly four in five service members returning from Iraq and Afghanistan who may have been at risk for PTSD were not referred for further mental health evaluation. The Pentagon was unable to explain to the GAO why some were not referred for care. Medical experts say mental health and substance abuse problems are intertwined. And drugs ranging from marijuana to prescription anti-depressants are easily accessible in Iraq, according to interviews with more than a dozen soldiers who served there. Soldiers said they used banned substances as a way to mentally escape the violence around them. Others said pills were handed out by medics in the field. John Crawford, a 28-year-old former Florida National Guardsman with the Army's 101st Airborne Division, said soldiers in his unit drank alcohol, some took steroids, "pretty much everyone took Valium" and "some did all three." Crawford said he bought 200-300 pills of Valium on the street in Baghdad for $2 as a way to catch some sleep between patrols. After eight months, he built up a tolerance and was taking 7 or 8 at a time. The extent of alcohol and drug abuse among combat veterans is difficult to quantify. Announced drug tests are usually done just once a year. Army Maj. James Weeden, who directed a team of 200 specialists dealing with combat stress in Iraq until he left the country in September, says senior officers recognize the strain their troops are under and have begun assigning some specialists to remote forward operating bases. But seeking treatment in a combat environment is difficult since any travel risks exposure to enemy attacks and roadside bombs. And asking for help is still seen as a sign of weakness. Weeden and other medical specialists say they can only treat the symptoms of combat stress - with anti-depressant drugs and rest, for example - and that soldiers are sent out of Iraq only when they have clearly disabling cases of PTSD. Commanders naturally want to keep soldiers in the field, and most soldiers say that they don't want to abandon their units. "We strengthen (combat readiness) because we get them back," Weeden said. Joyce Raezer, director of government relations at the National Military Family Association, says soldiers - some now on their fourth or fifth tour - are bringing "all the baggage from the last deployment into the next." "The stress is cumulative," she said. Families are alarmed by military statistics showing that 80 percent of soldiers who have been flagged with "mild" symptoms of post-traumatic stress disorder have been sent back to Iraq and Afghanistan, many with anti-depressant pills aimed at ensuring they can still fight. When the roughly 160,000 soldiers currently serving in Iraq and Afghanistan eventually return home, the Department of Veterans Affairs has the resources to offer all of them treatment for PTSD and substance abuse, said Dr. Ira R. Katz, deputy chief patient care officer for mental health for the VA. He noted that there are 200 veterans "readjustment" centers nationwide and "telemental" health counseling available over the Internet. But many soldiers seeking treatment for combat stress when they return say they face steep hurdles getting help from the government. The Government Accountability Office said the VA has not spent millions of dollars at its disposal to treat returning soldiers, many of whom say their problems were also ignored after being flagged in post-deployment tests aimed at catching early signs of PTSD. Maj. Gen. Paul Mock, commander of the 63rd Regional Readiness Command for the Army Reserves, told an Army convention last month that he doesn't think the infrastructure is in place to treat all returning troops who need mental health care, especially in rural areas. "When they don't get the kind of mental health screening - or physical - history tells us they will turn to coping mechanisms," said Steve Robinson, director of government relations for Veterans for America, a 35,000-member veterans organization. He says many of the hundreds of soldiers he has interviewed are addicted to medications given to them in the field, such as painkillers and sleeping pills. But the soldiers are not getting the therapy that normally goes with such medications, Robinson said. Adam Reuter, a 23-year-old former Army specialist from Atlanta who was stationed near the Syrian border with the 3rd Squadron of the 3rd Armored Company, said a medic simply handed him a plastic bag filled will pills with no instructions after he was tossed out of a Humvee in an accident. The bag contained Percocet, Vicodin, Tylenol with Codeine, a muscle relaxant, Motrin and Naproxen. He said he went back for more and developed a dependency that he is still trying to shake. The military maintains a zero-tolerance policy for drug use on all but prescription medications. Some soldiers have lost their military benefits - regardless of their combat citations - after they have been found to have used banned substances. But many commanders offer leeway in such cases, choosing non-judicial punishments such as demotions in order to keep soldiers on duty, said Army Col. Bill Buckner, a public affairs officer at Fort Bragg in North Carolina. Amy Fairweather, Iraq coordinator for the San Francisco-based veterans organization Swords to Plowshares, says she helped to secure disability benefits for a veteran suffering from PTSD who went into his bedroom for five months and smoked pot during waking hours. "The impact of these repeated deployments is enormous," she said. "It contributes to all the elements for substance abuse, mental illness, and family dissolution. There's only so many times you can be uprooted from family and work. Not to mention that they're over there in hell." A study published in March in the Journal of the American Medical Association found that 35 percent of service members who returned from Iraq accessed military mental health care services in the year after coming home; 12 percent were diagnosed with a mental health problem. But fewer than 10 percent of the roughly half who got care were referred through a new post-deployment screening program. Veterans groups fear that at current funding levels the VA won't be able to adequately handle the number of soldiers being discharged if the high proportion seeking mental health care holds steady. They note that symptoms for PTSD can worsen over time if not quickly treated. A recent survey of 60 VA-run Vet Centers by the Democratic staff of House Committee on Veterans Affairs found that the number of returning veterans from Iraq and Afghanistan who have sought help for PTSD and other readjustment concerns has doubled, an increase it said has made getting quality care more difficult. About 144,000 returning soldiers have been seen at these centers for "readjustment concerns" ranging from depression and marital problems to full-blown PTSD. Forty percent of the Vet Centers surveyed have directed veterans for whom individualized therapy would be appropriate to group therapy instead. Dr. Frances Murphy, undersecretary for Health Policy Coordination at the VA told a mental health commission in March that some VA clinics do not provide mental health or substance abuse care, or if they do, "waiting lists render that care virtually inaccessible." "It's a tidal wave" of new PTSD cases, said Paul Sullivan, director of programs for Veterans for America, who served as a senior analyst at the VA until he left six months ago. "The VA needs more capacity so that vets can get treatment and don't have to wait." If they are able to see a VA doctor, hundreds of veterans with severe PTSD symptoms are being denied disability benefits because their condition is obscured by drug or alcohol abuse, which is labelled "willful misconduct," says Elinor Roberts, legal director for Swords to Plowshares. The VA is allowed to give benefits for soldiers dealing with alcohol abuse - but not illicit drugs - and only if a clinician finds that the veteran also has PTSD. VA officials say many vets with the condition have trouble making appointments to get that diagnosis in the first place. Published November 16, 2006 No wonder, Congress was trying to cut disability benefits to new and older PTSD veterans. |
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