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PTSD/SUBSTANCE ABUSE COMMITTEE REPORT
BY TOM BERGER, CHAIR
In late July, House Veterans’ Affairs Chair Bob Filner
(D-Calif.) held a hearing to examine how the Department of
Veterans Affairs addresses the military diagnosis of Personality
Disorder. In the last six years, the military has discharged
more than 22,500 service members due to Personality Disorders.
The Committee found that once service members are diagnosed
with a Personality Disorder, they have a much more difficult
time receiving benefits and treatment from the VA.
Service
members discharged due to a Personality Disorder—rather
than PTSD or some other mental health condition—generally
are not provided military disability benefits because the
military classifies Personality Disorders as existing prior
to entry into military service. The service member must show
that his or her prior existing condition was aggravated or
worsened by military service, which is difficult to do. Service
members may seek veterans’ disability benefits, but,
again, they must show that their condition was aggravated
by military service.
In related matters, the Government Accountability
Office (GAO) announced in late July that it will study whether
the Departments of Defense and Veterans Affairs are providing
proper mental health care for veterans returning from Iraq
and Afghanistan. In May, nine members of Congress asked the
GAO to conduct such a study; this was followed by letters
from Colorado Sens. Wayne Allard (R) and Ken Salazar (D),
which broadened the scope of the study and asked the GAO
to provide recommendations for legislation to improve mental
health care and to capitalize on best practices in the military.
The GAO said it would assess the VA’s treatment of
veterans with mild traumatic brain injury; the Department
of Defense’s pre- and post-deployment screenings for
mental health conditions and mild traumatic brain injury;
and whether policies pertaining to Personality Disorder discharges
have been followed.
The studies are to be completed by the
end of the year. Note that prior to the National Convention
in July, VVA President John Rowan sent a letter to Secretary
of Defense Gates calling for a moratorium on the issuance
of Personality Disorder discharges until such an investigation
can be conducted.
Figures
released in August by the Army’s Office of
the Surgeon General show that a total of 23,788 soldiers,
most of them deployed to Iraq or Afghanistan, have been diagnosed
by the military with PTSD in the past four years. Only about
3 percent of soldiers who have served in combat since 2003
have been diagnosed by the Army with Post-traumatic Stress
Disorder—far fewer than the numbers of those who have
screened positive for PTSD symptoms in recent Army studies,
suggesting that the disorder is being under-reported and
under-diagnosed. The Army figures do not account for all
cases of PTSD among soldiers who have served in Iraq and
Afghanistan, but instead represent only diagnoses made while
soldiers were on active duty. Other diagnoses are made by
the VA, after soldiers are discharged.
But even the combined
total of Army and VA diagnoses of PTSD—about
76,000 to date—represents only about 5 percent of the
more than 1.5 million troops who have served in Iraq or Afghanistan.
The Army figures show active-duty diagnoses of PTSD have
nearly doubled in the last two years, from 3,867 in the 2004
fiscal year, to 7,352 in the fiscal year that ended last
September. In the first half of this year 4,477 new cases
were diagnosed. Army spokespersons attribute the relatively
low numbers to the stigma surrounding mental health issues.
On the other hand, in May the Pentagon’s Mental Health
Task Force found that 49 percent of National Guard members,
38 percent of soldiers, and 31 percent of Marines have experienced
mental health issues after serving in Iraq or Afghanistan.
The
VA has treated about 52,000 Iraq and Afghanistan veterans
for PTSD, according to the report by the President’s
Commission on Care for America’s Returning Wounded
Warriors. That figure represents about 7 percent of the more
than 720,000 troops—including Marines, sailors, and
airmen—who have separated from the armed forces since
returning from Iraq or Afghanistan. The VA numbers do not
include veterans who might seek mental health care from private
doctors or other sources.
SUICIDE PREVENTION
According to an internal May 2007 VA report, veteran suicides
account for almost one in five of suicide attempts in the
entire country. Five thousand veterans commit suicide every
year and more than 50,000 have been diagnosed with Post-traumatic
Stress Disorder.
Another finding is that too many veterans
are being turned away from treatment because patients are
required to demonstrate “sustained
sobriety” before they receive any type of treatment.
The report also made a number of recommendations for helping
these at-risk veterans, such as more qualified staff, extra
mental-health screening, as well as tracking patients more
accurately by storing a list of suicidal patients in a database
accessible to all VA clinics and hospitals. The report cited
a lack of funding to help suicidal veterans and was released
days after VA Secretary Jim Nicholson reported that he and
other VA officials had received almost $4 million in bonuses
last year.
But in a sudden turnaround, the Department of Veterans
Affairs announced plans in June to hire suicide-prevention
counselors at each of its 153 medical centers across the
country. This announcement came after national media reports
of the death of Marine Pvt. Jonathan Schulze, a combat veteran
who killed himself after his parents said he repeatedly sought
help at the VA Medical Center in Minneapolis, but was put
on a waiting list.
In addition, on August 1 the Department of Veterans
Affairs began operating a national suicide prevention hotline
for veterans. The toll-free hot-line number is 800-273-TALK
(8255). According to the press release, VA’s hot line
will be staffed by mental health professionals in Canandaigua,
N.Y. They will take calls from across the country and work
closely with local VA mental health providers to help callers.
To operate the national hot line, VA is working with the
Substance Abuse and Mental Health Services Administration
of the Department of Health and Human Services. The Vet Centers
also will be part of the referral network.
Speaking of the
Vet Centers, VVA was very pleased to learn that in 2007 the
VA plans to open new Vet Center facilities in Grand Junction,
Colo.; Orlando, Fla.; Cape Cod, Mass.; Iron Mountain, Mich.;
Berlin, N.H.; and Watertown, N.Y. (with others located in
Montgomery, Ala.; Fayetteville, Ark.; Modesto, Calif.; Fort
Myers and Gainesville, Fla.; Macon, Ga.; Manhattan, Kans.;
Baton Rouge, La.; Saginaw, Mich.; Las Cruces, N.M.; Binghamton,
Middletown, and Nassau County, N.Y.; Toledo, Ohio; Du Bois,
Pa.; Killeen, Tex.; and Everett, Wash. scheduled for opening
in 2008).
While VVA is grateful that new centers
will offer access to veterans, it is not just the new centers
that require staff. VVA has called on the VA to increase
staff at existing centers for the past three years. VVA would
like to see more family services, including bereavement counseling
and counseling for military sexual trauma, available at every
Vet Center. Ideally, each Vet Center would be able to provide
round-the-clock crisis-intervention services.
Congratulations to VVA’s
newly elected Board members, re-elected officers, and Board
members. Thanks also to the National Convention Planning
Committee, the Illinois State Council, and VVA staff for
making the 2007 Convention a great success.
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