Army Reports Flaws in Treatment of Post-Traumatic Stress Disorder

Anyone who experiences something traumatic, such as abuse, sexual assault, the death of a loved one, is susceptible to the devastating mental disorder called post-traumatic stress disorder, or PTSD. It is particularly prevalent among veterans who have been overseas. Many of the things they see, do, and experience are traumatic, leaving them vulnerable to the disorder. A recent report from the Army has indicated that veterans may not be getting adequate treatment for PTSD.

PTSD is characterized by flashbacks, nightmares, or strongly unpleasant recurring memories of the traumatizing event; avoidance of anything related to the trauma or of feelings and emotions attached to it; and feeling startled, more aware of the environment, or the need to respond in an exaggerated way to stimuli. Mental health professionals can diagnose PTSD by observing symptoms or hearing a description of symptoms that have lasted for 30 days or more.

Treatment for PTSD is available and includes cognitive behavioral therapy, desensitization, medications, support groups, and other techniques. People with PTSD are more susceptible to having other issues, such as depression, addiction to alcohol or drugs, or even physical medical conditions. Because veterans are particularly vulnerable to PTSD, early diagnosis and treatment for this subset of the population are crucial.

The Controversy

The report from the Army came on the heels of pressure from Senator Patty Murray, a Democrat from Washington. She had learned of hundreds of soldiers whose diagnoses of PTSD had been reversed by a psychiatry team at Madigan Army Medical Center near Seattle. With their diagnoses reversed, these soldiers lost funding for important treatments. Sen. Murray suspected that the move was designed to trim the budget rather than for any interest in the mental well-being of soldiers.

In 2012, the Army, as well as all other branches of the military, saw a record number of suicides. The Secretary of Defense at the time, Leon Panetta, declared the situation an epidemic. In the Army in 2012, 183 active-duty soldiers committed suicide, compared with 167 in 2011. The military as a whole saw 350 in 2012 and 301 in 2011.

The Report

Spurred by the Senator’s outrage and pressure from others, the Army commissioned a task force to conduct a review of evaluations of all mental health disorders across all of its facilities. The resulting report found numerous problems with the way soldiers are diagnosed, treated, and cared for in terms of mental health. Among these problems are inconsistent training, incompatible data and records systems, and confusing and overwhelming paperwork.

The task force conducted its review by interviewing 750 people stationed in different locations around the world, engaged in listening sessions with another 6,400 people, and reviewed nearly 150,000 Army medical records. They also reviewed all diagnoses made for soldiers with behavioral health problems from 2001 to spring of 2012.

The Results

The results of the review indicated that 4.1 percent of all deployed soldiers ended up with some type of behavioral health disorder diagnosis. This includes PTSD and traumatic brain injuries. Additionally, over 6,000 of those diagnosed had some kind of adjustment made by a medical evaluation board. Two locations made more adjustments than the average across the Army and, although not named, they are being investigated further.

Among other reasons for inadequate treatment for mentally ill soldiers was the fact that every base does not have a mental health professional on staff. The Army Secretary, John H. McHugh, released a statement promising to provide behavioral health experts at all bases to provide better support, diagnoses, and treatment for soldiers who need it.

Coordination of services and bureaucracy were found to be other problems in the Army as a whole. Of the soldiers surveyed, over one-third stated that they had never been given information about the system for disability evaluation. Many stated that the system is confusing and inefficient and that the coordination between the Army and the Veterans Administration is poor.

Although it took too long in the eyes of many, the report is an important step in providing better services for both active-duty soldiers and veterans. In addition to providing a dedicated mental health professional at every base, the Army also hopes to instate a universal electronic health record, have better services in rural areas, and standardize the way diagnoses are made.