Wednesday, December 28, 2005

Govt. denying PTSD

December 27, 2005


The Bush administration is twisting itself into a pretzel trying to find
ways not to diagnose soldiers returning from Iraq and Afghanistan with
Post-Traumatic Stress Disorder (PTSD), including altering the diagnostic
criteria established by the American Psychiatric Association-- that's
the essence of a first-rate piece of reporting in today's Washington
article, by staffer Shankar Vedantam, relates the attempt to have
politics dictate medicine. "Larry Scott, who runs the clearinghouse , said conservative groups are trying to cut
VA disability programs by unfairly comparing them to welfare.
"Compensating people for disabilities is a cost of war, he said:
"Veterans benefits are like workmen's comp. You went to war. You were
injured. Either your body or your mind was injured, and that prevents
you from doing certain duties and you are compensated for that." Not
cited by the WashPost was a New England Journal of Medicine study
showing that 1 in 6 Iraq vets are suffering from PTSD -- and less than
half of them seek treatment..

"Scott said Veterans Affairs' objectives were made clear in the
department's request to the Institute of Medicine for a $1.3 million
study to review how PTSD is diagnosed and treated," the WashPost
continued. "Among other things, the department asked the institute -- a
branch of the National Academies chartered by Congress to advise the
government on science policy -- to review the American Psychiatric
Association's criteria for diagnosing PTSD. Effectively, Scott said,
Veterans Affairs was trying to get one scientific organization to
second-guess another.

"PTSD experts summoned to Philadelphia for the two-day internal "expert
panel" meeting were asked to discuss "evidence regarding validity,
reliability, and feasibility" of the department's PTSD assessment and
treatment practices, according to an e-mail invitation obtained by The
Washington Post. The goal, the e-mail added, is "to improve clinical
exams used to help determine benefit payments for veterans with Post
Traumatic Stress Disorder."

"What they are trying to do is figure out a way not to diagnose vets
with Natl_gulf_resource_center_logo
PTSD," said Steve Robinson, executive director of the National Gulf War
Resource Center <>, a veterans advocacy group.
"It's like telling a patient with cancer, 'if we tell you, you don't
have cancer, then you won't suffer from cancer.' ..." The article makes
the politics of this administration effort clear: "The growing national
debate over the Iraq war has changed the nature of the discussion over
PTSD, some participants said. "It has become a pro-war-versus-antiwar
issue," said one VA official who spoke on the condition of anonymity
because politics is not supposed to enter the debate. "If we show that
PTSD is prevalent and severe, that becomes one more little reason we
should stop waging war. If, on the other hand, PTSD rates are low . . .
that is convenient for the Bush administration."

Earlier this year, USA Today reported in a lengthy article on PTSD
that, "Of the 244,054 veterans of Iraq and Afghanistan already
discharged from service, 12,422 have been in VA counseling centers for
readjustment problems and symptoms associated with PTSD." And that's an
obvious undercount, for, as USA Today added, "Many of the most common
wounds aren't seen until soldiers return home. Post-traumatic stress
disorder, or PTSD, is an often-debilitating mental condition that can
produce a range of unwanted emotional responses to the trauma of combat.
It can emerge weeks, months or years later. If left untreated, it can
severely affect the lives not only of veterans, but their families as
well." And the WashPost article underscored that many Iraq-Afghanistan
vets suffering from PTSD are afraid to seek treatment, both because of
the stigma attached to a mental disorder, and because the Bush
administration's humiliating toughening of the criteria for diagnosing
PTSD means the vets have to relive the very horrifying episodes that
provoked the profound mental troubles. Moreover, "A study published in
the New England Journal of Medicine found that one out of six soldiers
surveyed may be struggling with PTSD," ABC News reported
<>two weeks ago.
You can read the New England Journal of Medicine study by clicking here.

PTSD has also become a budget issue:"In the past five years, the number
of veterans receiving compensation for the disorder commonly called PTSD
has grown nearly seven times as fast as the number receiving benefits
for disabilities in general, according to a report this year by the
inspector general of the Department of Veterans Affairs. A total of
215,871 veterans received PTSD benefit payments last year at a cost of
$4.3 billion, up from $1.7 billion in 1999 -- a jump of more than 150
percent." And those numbers don't even reflect the full impact that will
be felt when the boys currently occupying Iraq and fighting in
Afghanistan return. So many soldiers are being driven 'round the bend by
their service in an illegal war and occupation that now the Bushies are
trying to exercise cost control by refusing to diagnose them! You can --
and should -- read the entire fascinating WashPost article by clicking
And for more information on the PTSD issue, visit the National Gulf War
Resources Center webpage
<> devoted to it, and
the VA Watch site <>, both of which have lots
of links. The National Center for PTSD
<> also has a lot of relevant
material, including an Iraq Clinician's Guide


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