Thursday, March 08, 2012

Suicides and PTSD

Carrie Gann (ABC News) reports on the military suicide rate increasing by 80% since the start of the Iraq War. Dr. Michelle Chervak co-authored the study and cautions, "This study does not show that U.S. military operations in Iraq and Afghanistan cause suicide. This study does suggest that an Army engaged in prolonged combat operations is a population under stress, and that mental health conditions and suicide can be expected to increase under these circumstances." But, as AFP quotes the study, "This increase, unprecedented in over 30 years of US Army records, suggests that 30 percent of suicides that occurred in 2008 may be associated with post-2003 events following the major commitment of troops to Iraq, in addition to the ongoing operations in Afghanistan." And Stephanie Armour (Bloomberg News) notes the Health Command's Injury Prevention Program in Aberdeen Proving Groudn, Kathleen Bachymaki, declaring, "The recent increase in suicide rates may be viewed as the tip of the ‘mental health iceberg,' signaling more prevalent underlying mental health problems." Press TV adds:

According to three different studies published in the American Journal of Public Health in January, many US military personnel and veterans are struggling with post-traumatic stress disorder (PTSD), depression or other consequences of deployment to war zones.
A study of almost 600 US veterans returning from Iraq or Afghanistan showed that nearly 14 percent of them were suffering from PTSD and 39 percent from probable alcohol abuse.

In other news, there's an ongoing investigation into a medical center in Washington (state). At issue is whether or not some of those who received a medical diagnosis of PTSD later had their conditions re-classified in order to cut costs. February 28th, Secretary of Defense Leon Panetta appeared before the Senate Budget Committee. Senator Patty Murray, who is the Chair of the Senate Veterans Affairs Committee and also one of Washington's two US senators. She had this exchange with Panetta.

Senator Patty Murray: Secretary Panetta, you know I spent a lot of time last year on the Joint- Select Committee on Defecit Reduction working with Democrats and Republicans to tackle some of the issues that you're talking about today. All of us went into the Committee knowing that sequestration would be a terrible outcome and we understood that, across the board, cuts to these programs middle class families and most Americans depend on would be bad policy. That was really the point of the bi-partisan triggers that Senator [Harry] Reid and Speaker [of the House John] Boehner agreed to -- they were supposed to be painful to push us towards a compromise. So I was really disappointed that despite the fact that we put a lot on our side, some pretty painful cuts out, we couldn't get to an agreement because we couldn't come to that shared sacrfice moment. I'm still willing to make those compromises needed to get to that. I hope everyone on both sides are because I think we're all really concerned about where that's going to go. But I -- I didn't want to focus on that today on my time, I wanted to ask you a question about an issue that has become very important and recently come to light at Madigan Army Medical Center in my home state of Washington. A number of soldiers had their behavioral health diagnoses changed from PTSD to other behavioral health disorders that didn't come with the same level of benefits. However, following, as you may know, an independent review at Walter Reed, a number of those diagnoses was changed back to PTSD. Obviously, this is really troubling. But what's even more troubling to me and to many service members and their family members in my home state and to a lot of people I've been talking to allegation that the decision to strip those soldiers of a PTSD diagnoses came from a unit at Madigan that seems to be taking the cost of a PTSD diagnosis into account when they were making their decision. Now there's an investigation going on into this but really, to me, one of the things that's clear is that oversight within the army and at the departmental level allowed this break from standard diagnoses process to go unchecked. So I'm really concerned about how the services handle non-PTSD behavioral health conditions like adjustment disorder where service members are administratively separated instead of going through the physical disablity process and I wanted to ask you given that an adjustment disorder is compensable, VA and DoD is required to use the VA's rating schedule, what is the reason for DoD treating adjustment disorder differently?

Secretary Leon Panetta: Well I was, uh, I was very concerned when I got the report about what happened at Madigan. And I think, uh, it-it reflects the fact that frankly we have not learned how to effectively deal with that and we have to. We-we-we need to make sure that, uh, that we have the psychiatrists, the psychologists and the medical people who can make these evaluations because these are real problems. I've met with men and women who have suffered this problem. Just met with a couple last night and they had to go through hell in order to be able to get the diagnosis that was required here. And that should not happen. So we are investigating obviously what took place but I've directed our Personnel Undersecretary to look at this issue and to correct it because it's unacceptable now to have the process we have in place.

Senator Patty Murray: Well I appreciate the attention given to this. It's going to take a lot of work. And I'm deeply concerned when someone comes home from war that they have to go through a diagnosis like this. It's hard enough after you've been told to "man up" during your time of service to then face the fact that you have PTSD -- and then to have that reversed and changed back and told there's nothing wrong with you is just devastating to these men and women and their families. So this is something I'm going to be following very closely. I want your personal attention on it. And I think that the issue raised at Madigan really shows us that we need to have a more clear, consistent guideline for clinical practices for diagnosing and treating PTSD.

Secretary Leon Panetta: I agree with that. I agree with that. Abosluetly. You're absolutely right.

Senator Patty Murray: I never want to hear anybody in any service say we're not going to give you a diagnosis of PTSD because we have a budget problem.

Secretary Leon Panetta: That's for sure.

Hal Bernton (Seattle Times) reports the disturbing news that, "The Army Medical Command has identified some 285 Madigan Army Medical Center patients whose diagnoses of post-traumatic stress disorder were reversed as they went through a screening process for possible medical retirements, according to U.S. Sen. Patty Murray." Of the 285, 14 have been retested at Walter Reed and six -- nearly half, roughly 43% -- received a diagnoses of PTSD. If all 285 were re-tested and the rate held, you'd have at least 122 being rediagnosed with PTSD. Repeating, they were originally diagnosed with PTSD. After remarks were made by those in administration at Madigan about the costs of PTSD, 285 were stripped of their PTSD diagnoses.

The following community sites -- plus On The Wilder Side, Adam Kokesh, CSPAN and the Los Angeles Times -- updated last night and this morning:

We'll close with this from the National Lawyers Guild -- they issued it last week, I missed it until a friend called (to ask why I hadn't noted it):

The National Lawyers Guild (NLG) continues to stand behind longtime member, civil and human rights defender Lynne Stewart, as the Second Circuit appeal of her sentence is argued before a three-judge panel today.

“It is a rare honor for us in the Guild to be among Lynne’s friends and colleagues,” said NLG President David Gespass. “And government repression and overreaching only reinforces that.”

The prosecution and utterly unjustified sentence leveled against Ms. Stewart carries the larger aim of intimidating any lawyer in the post-9/11 era who would represent controversial clients. Ms. Stewart devoted her life to defending poor people, political activists and others with unpopular viewpoints, and her 2002 arrest directly targeted her for that vigorous representation.

“Even as she serves out a harsh and unjust sentence, Lynne’s dedication to her community, her clients, and her principles continues to be an inspiration,” said NLG Executive Vice President Ian Head. “Guild members will pack the courtroom today to show our support.”

The NLG has helped launch a broad-based, national education campaign about the impact that her indictment and harsh sentencing have had on the Sixth Amendment right to an attorney and on the First Amendment right to free expression.

Lynne Stewart is imprisoned in a federal facility in Texas, and will not appear at the oral argument. She was re-sentenced in 2010 to 10 years in a federal medical prison facility. Supporters can write to her at: Lynne Stewart #53504-054, Federal Medical Center, Carswell, PO Box 27137, Ft. Worth, TX 76127. For more information on the case visit

The National Lawyers Guild, founded in 1937, is headquartered in New York and has chapters in nearly every state. The Guild has a long history of representing individuals whom the government has deemed a threat to national security. The organization also helped expose illegal FBI and CIA surveillance, infiltration, and disruption tactics, leading to enactment of the Freedom of Information Act and other limitations on federal investigative power.

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