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 Post. The article, by staffer Shankar Vedantam, relates the attempt to have politics dictate medicine.
“Larry Scott, who runs the clearinghouse http://www.vawatchdog.org/, 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 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 troops 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 here. 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