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(US) Army Launches Sweeping Review of PTSD Diagnoses


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I don't really want to start another topic, so if the mods can find a place for this .......


(US) Army Launches Sweeping Review of PTSD Diagnoses

Associated Press- 17 May 12 - Lolita C. Baldor

WASHINGTON - Army leaders are launching a sweeping, independent review of how the service evaluates soldiers with possible post-traumatic stress disorder following recent complaints that some PTSD diagnoses were improperly overturned.

The Army said Wednesday it will review the diagnoses at all of its medical facilities going back to October 2001. And top Army leaders said they will develop a plan to correct any decisions or policies necessary to make sure that soldiers are receiving the care and treatment they deserve.

The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of providing care and benefits to members of the military.

Over the past several years, the U.S. military has seen a dramatic spike in the number of PTSD and traumatic brain injury cases as the long and deadly wars in Iraq and Afghanistan dragged on. The services have struggled to find better ways to monitor their troops, identify the often invisible wounds and beef up treatment both at the battlefront and when they return home.

"We owe it to every soldier to ensure that he or she receives the care they need and deserve," said Army Secretary John McHugh, adding that the Army "must ensure that our processes and procedures are thorough, fair and conducted in accordance with appropriate, consistent medical standards."

The Army review will also scrutinize how well soldiers can participate in the system that assesses their ability to receive medical retirements, including whether the appeal process is adequate and whether any nonmedical factors may affect the diagnosis.

There is also a system-wide review being done by the Army inspector general to determine if psychiatrists overturn PTSD diagnoses to save money. The evaluations are the key first step in determining soldiers' disability benefits.

Sen. Patty Murray, D-Wash., who heads the Senate Veterans Affairs Committee, said this is the Army's opportunity to correct the mistakes of the past and ensure that veterans and their families don't need to "wade through an unending bureaucratic process to get proper access to care."

"The bottom line is that the Army needs to fix the inconsistencies we have seen in diagnosing the invisible wounds of war," Murray said. "Out of this review, the Army needs to provide a uniform mental health policy so that service members are given the care they need."

According to Murray, more than 40 percent of the cases since 2007 that involved candidates for retirement had been overturned. During a recent Senate hearing, she said that of the 1,680 patients screened at Madigan, more than 690 had been diagnosed with post-traumatic stress disorder. The psychiatric team there reversed more than 290 of those diagnoses.

On Wednesday, she said that so far, based on the review at Madigan, more than 100 service members have had their PTSD diagnosis returned.

The new Army review will be led by Joseph Westphal, undersecretary of the Army, and Army Gen. Lloyd Austin, the vice chief of staff.

Army officials say soldiers sent to war may be checked up to five times, including before being deployed, during combat, once they return home and six months and a year later. Every soldier returning from deployment completes what the Army calls a post-deployment health assessment and a face-to-face interview with a mental health professional. The Army screens soldiers for depression and PTSD, asking questions to find out about any social stressors, sleep disruption and other problems. Those who are detected as having problems go on to a second phase of screening.

Officials say, however, that no test is considered diagnostically definitive for mental illness in general or PTSD in particular.

More than 134,900 Army personnel were diagnosed with traumatic brain injuries between 2000 and 2011. Of those, 75 percent, or more than 100,000, were diagnosed as having a mild or regular concussion. Army policy calls for every service member involved in a blast, vehicle crash or a blow to the head to be medically evaluated.

This is interesting in the article:

The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of providing care and benefits to members of the military.

I would say this is a result of the investigation of this "troubled" base.


Suspect in Afghan shooting from U.S. base with troubled past

AP - 12 Mar 12 - Ted S. Warren

JOINT BASE LEWIS-McCHORD, Wash. (AP) – Joint Base Lewis-McChord is one of the largest military installations in the U.S., and one that has seen its share of controversies and violence in the past few years.

Still, the news hit hard that a soldier from the base about 45 miles south of Seattle is suspected of killing 16 Afghan villagers in an overnight assault on Sunday.

"It's another blow to this community," said Spc. Jared Richardson, an engineer, as he stood outside a barbershop near the base. "This is definitely something we don't need."

Home to about 100,000 military and civilian personnel, the base has had a spate of suicides among soldiers back from war. The Army is investigating whether doctors at Lewis-McChord's Madigan Army Medical Center were urged to consider the cost of providing benefits when reviewing diagnoses of post-traumatic stress disorder.

Most famously, four Lewis-McChord soldiers were convicted in the deliberate thrill killings of three Afghan civilians in 2010.

The military newspaper Stars and Stripes called it "the most troubled base in the military" that year.

Catherine Caruso, a spokeswoman for Lewis-McChord, said she could not comment on reports that the soldier involved in Sunday's shooting was based there.

A U.S. official speaking on the condition of anonymity told the Associated Press that the shooter was a conventional soldier assigned to support a special operations unit of either Green Berets or Navy SEALs engaged in a village stability operation. He was a sergeant, married with two children, who had served three tours in Iraq and began his first deployment to Afghanistan in December, according to a senior U.S. official.

He deployed on Dec. 3 with the 2nd Battalion, 3rd Infantry Regiment of the 3rd Stryker Brigade, 2nd Infantry Division, based at Lewis-McChord, a congressional source told the Associated Press, speaking on the condition of anonymity because of the sensitivity of the matter.

The soldier's name has not been released.

Lewis-McChord, a sprawling complex of red brick buildings, training fields and forests, has grown quickly since the Sept. 11, 2001, terror attacks.

Officials there have said that any community the size of the base is bound to have its problems, and its reputation has been tarred by "a small number of highly visible but isolated episodes" that don't accurately reflect the remarkable accomplishments of its service members, including their work overseas and the creation of new programs to support returning soldiers.

The controversies have indeed been highly visible.

In 2010, a dozen soldiers from the base were arrested on a slew of charges that ranged from using drugs, beating up a whistleblower in their unit, and deliberately killing three Afghan civilians during patrols in Kandahar Province. Prosecutors at Lewis-McChord won convictions against four of the five who were charged in the killings.

After the first killing, the father of one of the soldiers called Lewis-McChord to report it — and to say that more killings were planned. The staff sergeant who took the call didn't report it to anyone else, saying he didn't have the authority to begin an investigation in a war zone. By the time the suspects were arrested months later, two more civilians were dead.

Army Staff Sgt. Calvin Gibbs, of Billings, Mont., the highest ranking defendant, was sentenced to life in prison. At his seven-day court martial at Lewis-McChord, Gibbs acknowledged cutting fingers off corpses and yanking out a victim's tooth to keep as war trophies, "like keeping the antlers off a deer you'd shoot."

There have been other episodes of violence involving the base's soldiers or former soldiers. A former soldier shot and injured a Salt Lake City police officer in 2010; he died when police returned fire.

On Jan. 1, a 24-year-old Iraq war veteran shot and killed a Mount Rainier National Park ranger before succumbing to the cold and drowning in a creek.

Last year, Lewis-McChord saw more suicides than ever before — 12, up from 9 in each of the prior two years. The Army has seen more suicides at bases across the country since the wars in Iraq and Afghanistan began.

The toll at Lewis-McChord rose despite new efforts to counsel soldiers when they come home from war, including the creation of a suicide-prevention office.

In the past five years, about 300 patients at Madigan Army Medical Center at the base had their PTSD diagnoses reversed by a forensic psychiatry team, The Seattle Times reported this month. The Army is reviewing whether those doctors were influenced by how much a PTSD diagnosis can cost, in terms of a pension and other benefits.

At Coffee Strong, a coffee shop near the base that doubles as a resource center for soldiers seeking to leave the Army, executive director Jorge Gonzalez said he was not surprised the shooter was from the base.

"Joint Base Lewis-McChord has been bombarded with bad stories," said Gonzales, who served in the Army in Iraq in 2006. "We're not seeing the true costs of war, we're seeing soldiers committing suicide … murder and domestic violence."

Richardson said the vast majority of the tens of thousands of soldiers at the base were professionals. Richardson, who found out about the killings during breakfast with friends who are soldiers, worried the incident would put "sisters and brothers in arms" in "harm's way."

"It's unfortunate that these things keeping ending up at Joint Base Lewis-McChord," he said. "We're not vigilantes. We're soldiers."