What motive does the Army have to misdiagnose PTSD?

So asks the two Salon writers, Mark Benjamin and Michael de Yoanna, following their recent series starting with the incriminating evidence, an audio recording by a Veteran suffering from PTS. Recording his visit because his wife couldn't be there so he needed a way to remember what took place in his session with his army psychologist.

A reluctance to diagnose post-traumatic stress disorder could be about the money, and about the need for troops in Iraq and Afghanistan.

The subject title and the blockquote above are what they use in their forth of four reports from last week. That all started with this audio from a session with Sgt. X and his army psychologist:

April 10, 2009 | In two stories published this week, Salon has described how a soldier secretly taped a psychologist saying that the Army was exerting pressure not to diagnose soldiers with post-traumatic stress disorder. Psychologist Douglas McNinch of Fort Carson, Colo., twice states on the recording that the Army discourages PTSD diagnoses.

If what McNinch says on the tape is true, why is it happening? Why would the Army purposely diagnose soldiers suffering from post-traumatic stress disorder with something other than PTSD? Combat stress is as real as your big toe. Why would the Army want to deny, or at least minimize, a known consequence of combat? The truth might rest in math.

This is their first report:

"I am under a lot of pressure to not diagnose PTSD"

A secret recording reveals the Army may be pushing its medical staff not to diagnose post-traumatic stress disorder. The Army and Senate have ignored the implications.

Editor's note: Last June, during a medical appointment, a patient named "Sgt. X" recorded an Army psychologist at Fort Carson, Colo., saying that he was under pressure not to diagnose combat veterans with post-traumatic stress disorder.

April 8, 2009 | FORT CARSON, Colo. -- "Sgt. X" is built like the Bradley Fighting Vehicle he rode in while in Iraq. He's as bulky, brawny and seemingly impervious as a tank.

In an interview in the high-rise offices of his Denver attorneys, however, symptoms of the damaged brain inside that tough exterior begin to appear. Sgt. X's eyes go suddenly blank, shifting to refocus oddly on a wall. He pauses mid-sentence, struggling for simple words. His hands occasionally tremble and spasm.

The Audio with above initial report is the one above or at that site page.

The next day Mark Benjamin and Michael de Yoanna wrote a follow up article:

Tale of the secret Army tape

After a soldier taped a psychologist saying he'd been pressured not to diagnose PTSD, the Army launched an investigation. Read the details of how the Army declared itself innocent.

Editor's note: Read about Sgt. X's tape -- and listen to a segment of it -- in the first story in this series, "I Am Under a Lot of Pressure to Not Diagnose PTSD." Read a summary of the Army's internal investigation, in which it determined that it was not exerting such pressure, here

"This report does not find pressure to change clinical diagnoses"
A summary of an Army investigation says some soldiers with PTSD may not get the diagnoses they deserve -- but nobody in the Army did anything wrong.

April 9, 2009 | In a story published yesterday, Salon reported on a surreptitious tape recording of an Army psychologist telling a patient last June that he had been pressured not to diagnose soldiers as having post-traumatic stress disorder. The soldier, whom Salon dubbed Sgt. X to protect his identity, recorded the Fort Carson, Colo., psychologist, Douglas McNinch, twice describing pressure to label soldiers with "anxiety disorder" instead of PTSD. The diagnosis of anxiety disorder could result in improper treatment and lower disability payments if the Army discharges a soldier from the military. "It's not fair," McNinch said on the tape. "I think it's a horrible way to treat soldiers."

That night, the 9th, on MSNBC HardBall they had this discussion:



Now to just break in, on the Salon reports, here this was known about, or at least suspected, from reports many of us Veterans or Advocates of had been hearing about or in talking to the returning soldiers from these two theaters. But on May 15th 2008 VoteVets and CREW {Citizens for Responsibility and Ethics in Washington} broke it open with a press release:

15 May 2008 // Washington, DC – Today, Citizens for Responsibility and Ethics in Washington (CREW) and VoteVets.org released an e-mail obtained from a Veterans Affairs (VA) employee directing VA staff to refrain from diagnosing soldiers and veterans with Post Traumatic Stress Disorder (PTSD).

And in searching out a bit of information I came across this CNN Video from a month before:

Post traumatic stress stigma Sun, March 8, 2009
Army generals hope to remove the stigma that keeps many soldiers from getting help for stress. CNN's Barbara Starr reports.

These two Generals had recently come out about their own PTS and the counciling and help they received, and their want to help their fellow soldiers to seek out the help needed themselves.

On the day of the second Salon report there was another discussion at CNN:

Veterans and PTSD Thurs. April 9 2009
Veterans groups talk about post-traumatic stress disorder to CNN's Kyra Phillips
.

Now in the CNN discussion, in the beginning, Kyra makes the point that they've been contact the new Veterans Administration Director General Shinseki and that he hadn't returned their contacts for this report. I'm not going to fault Kyra for whatever point she wanted to make, as she clears that up later in the discussion by pointing out this all happened under the previous administration in 2008. But will say that the General has only been in the lead a very short time, and would not want to speak about all that is coming out finally until he has all the facts, so Kyra think before speaking please!

Salon followed up the first two reports with the following:

"I believe that I did have PTSD"

Matthew Marino was sent back to Afghanistan for a second tour of duty after the Army diagnosed him with "anxiety disorder" instead of post-traumatic stress disorder.

April 10, 2009 | Matthew Marino served five years in the Army and was deployed to fight in Afghanistan twice. He began to suffer from symptoms typical of post-traumatic stress disorder following his first tour. After returning to Fort Drum, N.Y. in late 2004, he couldn't lose the hyper-alertness he'd developed in Afghanistan. He had thoughts of suicide, was nervous, had nightmares, couldn't sleep, and stayed away from family and friends.

Despite his symptoms, however, the Army diagnosed the first lieutenant with anxiety disorder instead of PTSD. He was also diagnosed with depression and given antidepressants. The Army then "stop-lossed" Marino, to prevent him from leaving the Army although his time was up. He was shipped back to Afghanistan for a second tour in 2006. A diagnosis of PTSD might have kept him from being redeployed and sent back into combat; a diagnosis of anxiety disorder did not.

While searching I found a few more reports, following the Salon report, like this one:

Wartime Mental Health, Scandal and Stigma

Posted on April 9th, 2009 by Kelley Vlahos

Nearly a year ago, Secretary of Defense Robert Gates announced that eliminating the stigma of mental health from the military culture would be a Pentagon priority. Seeing that some one-third of soldiers returning from the wars in Afghanistan and Iraq are reporting mental health symptoms, particularly those associated with Post-Traumatic Stress Disorder (PTSD), hearing him say, “We have no higher priority in the Department of Defense, apart from the war itself, than taking care of our men and women in uniform who have been wounded — who have both visible and unseen wounds,” was at the very least, an institutional acknowledgment of the problem.

Good intentions and politically correct language aside, like most of what we see and hear in Washington, his words papered over and have yet to affect a cruel reality, one with which only a small percentage of Americans have any real familiarity. Perhaps with the help of investigative reporters Mark Benjamin and Michael de Yoanna, who have been producing some amazing work for Salon.com, we can all get up to speed.

I would like to make a couple of points to Kelley on an otherwise needed article. First: when Gates made his call he was relatively new in an administration that, while starting two long running occupations, all that is coming out now happened under their watch and with a congress of the same political ideology. Second: we could have all "gotten up to speed" if many had been listening to those of us, in the previous administration labeled "focus groups", had been saying all along, not to mention all of us Veterans who have been saying for years, but welcome to the reality now!!

WWP Concerned by Stigma of PTSD and Mental Illness in Military

In response to recently released information, http://www.woundedwarriorproject.org/Wounded Warrior Project again cited their grave concerns with the manner in which mental health and PTSD are perceived and dealt with within the military. One specific article on Salon.com highlighted concerns that military doctors are being pressured to not diagnose PTSD in returning military personnel and specifically brought to light such a situation in Fort Carson, Colorado.

"Post traumatic stress disorder is very serious," said Nardizzi. "We call on the military to prioritize the reduction of this stigma against seeking care and to foster unfettered access to mental health services, regardless of cost."

VA psychiatrist orchestrates services for increased PTSD patients

Some veterans got proper treatment 20 or 30 years after the issue should have been recognized, he said.

Many returning Vietnam veterans sought refuge from PTSD with addictive behaviors. They were frequently misdiagnosed with schizophrenia and other psychological abnormalities, Otero said. In reality, they were driven to those addictions to mask the increasing severity of flashbacks to horrific combat experiences.

"One of the differences between the current war and the Vietnam conflict is that current vets are receiving counseling and education (about PTSD) before they go and immediately after they return, he said.

"We are trying to catch PTSD early - undiagnosed, it becomes a much more disabling condition," he said.

While the VA mental health community is much more in tune to the workings of PTSD for the new group of veterans, these veterans face some stress issues the Vietnam era combatants did not.

As many Vietnam-era veterans were drafted, they served in the combat zone for a year and were discharged back to civilian life, Otero said.

Now this is for the Veterans and residents of Maryland but others may want to study what they're doing and submit to their state legislators to follow the example, if you don't have similar in your states.

Veterans Network Of Care Portal
Lt. Governor Brown Launches Maryland Veterans Network Of Care Portal

Maryland Department of Health and Mental Hygiene
Press Release:

ANNAPOLIS, MD (March 31, 2009) - Maryland Lt. Governor Anthony G. Brown today joined representatives of the public mental health industry and veterans affairs as Maryland became the first state in the nation to launch a "Network of Care" Website devoted to the state's veterans. The Maryland Veterans Network of Care portal is an on-line resource that provides simple and fast access to information on local, state and national behavioral health services available to veterans. The portal is part of Network of Care online community.>>>>>Rest Here

And those who may be seeking a new profession, have kids looking for a rewarding profession, or are returning Veterans of these conflicts seeking to continue your service to country and citizens of, you may find this worthy to research further.

VA Announces New Nursing Academy Sites
April 9, 2009

To provide compassionate, highly-trained nurses to serve the health care needs of the nation’s Veterans, the Department of Veterans Affairs (VA) is establishing new partnerships with five of the country’s finest nursing schools. With these new partnerships, the VA Nursing Academy will expand the number of collaborations between the department and nursing schools from 10 to 15.

“The expanded role of the Department of Veterans Affairs in the education of nurses will ensure the department has the nurses needed to continue our world-class health care for Veterans,” said Dr. Linda D. Johnson, director of VA Nursing Academy. “The VA Nursing Academy expands the teaching faculty, improves recruitment and retention, and creates new educational and research opportunities.”

The VA Nursing Academy is a virtual five-year pilot program with central administration in Washington. It expands learning opportunities for nursing students at VA facilities, funds faculty development of VA staff for additional faculty positions to competitively selected school partners. The five-year, $59 million program began in 2007.

The names of the newly added schools, as well as those participating already in the program, can be found at the site link.

"That young man never should have come into the Army" 4th in Series "Coming Home"

The above subject title is the forth addition in a week long series at Salon.com by Mark Benjamin and Michael de Yoanna on the returned Soldiers from Iraq and Afghanistan called "Coming Home". It's the open window into what happens to some after serving in man's hell on earth, Wars and Occupations of Choice!

This is the fourth installment in a weeklong investigative series called "Coming Home." You can look at Kenneth Eastridge's MySpace page here, and read the story of Robert Marko here. Marko was sent to Iraq despite psychological problems and is now awaiting trial for murder in Colorado. You can also read the introduction to the series, and the first, second and third installments, which appeared Monday, Tuesday and Thursday.

This installment in this important series begins with this:

Kenneth Eastridge is being held at Kit Carson Correctional Facility in Burlington, Colo.

Feb. 13, 2009 | FORT CARSON, Colo. -- Late on the night of March 11, 2006, Kenneth Eastridge got in a fight with his girlfriend. It ended with his arrest for a felony.

The Kentucky native, an Army soldier stationed at Fort Carson, between deployments in Iraq, had fallen asleep after drinking when his girlfriend began to pound on his apartment door. She wanted inside, and she wanted to talk.

Eastridge responded with a string of obscenities and then flung the door open. He pointed a loaded pistol at his girlfriend. She looked at him like he was crazy, then turned and ran. Eastridge didn't fire. He stood motionless, stunned by his own reaction.

For those following this series, or any of the many that have started to surface, and the many more series or just singular reports that will be coming, long into the future, keep in mind the people you won't hear or read about. Not just the soldiers sent into these conflicts and occupations but those who live in these countries that are destroyed and occupied. Think of what they are going through, have gone through, and will be going through. The ones that choose to fight against any invaders, the ones trying to survive the invasions and than the occupations, the children growing up in the conditions created, the ones that survive! They are as human as those sent, no different, and go through the same reactions to, mentally and physically, what they knew of life is no more, they exist in a new reality not the one they were taught existed but one most don't experience!

This first page, of the forth installment leads into the second page, "They'll say, 'What makes the grass grow?' and we would say, 'Blood! Blood! Blood!'", and than on to a third, "The Army released him without assessing his mental condition"

He's also not receiving treatment for his PTSD in prison. He worries that if he sees a psychologist, it could delay his release date if ongoing problems are found: "Right now I just want to get out as fast as possible."

Can he find ways to prevent his life from spiraling out of control again? "I can't really say that I can," he says.

The following report is attached to the forth in the series, link is above as well.

"He hears sounds which seem to be voices"

The Army knew Cpl. Robert Marko might have psychological problems, but sent him to Iraq anyway. He is now awaiting trial for murder in Colorado.

Feb. 13, 2009 | When Judilianna Lawrence missed school, her mother called the police. Then she checked her daughter's MySpace account. Within hours, sheriff's deputies were asking questions of Robert Hull Marko, a Fort Carson, Colo., Army soldier who fought in Iraq.

Lawrence's mother had discovered correspondence indicating that her daughter and Marko had planned to meet, and Marko piqued investigators' interest when he initially denied he knew Lawrence. His story kept changing during a chilly weekend in October 2008. Eventually, Marko admitted he knew the 19-year-old special education student, saying he was with her in the rugged terrain somewhere around Pikes Peak, west of Colorado Springs, Colo. He said he left her there.

By Monday, Oct. 13, on Marko's 21st birthday, he finally led deputies to a wooded area. There, investigators searched for and found Lawrence's body, her throat slashed. She had also been raped, investigators say.

This is very disturbing in just what it says at the beginning, the Army knew this soldier might have psychological problems, yet they not only didn't try to help him or find out more they sent him into the occupation, another body needed!

We've all read about those who didn't have problems, were dedicated to their choice of serving the country, were trained than sent into the theaters. Some, after serving their tours, many extended with little dwell time, were sent back showing signs already of what the stress and experience of the preceding tours had caused. Sent back now with drugs issued by their military branches to coup with their trauma, instead of delving deeper and getting the treatment they needed, compounding the already suffering!

We will be living with the devastating remnants of these last years for many years to come, just from the mental stress of combat and occupation, all of those we've sent have now had their lives changed forever, as have those we've occupied. Will we as societies once again ignore that which is right in front of us, as we have before? Will we find better understanding of what extreme trauma can do to many who experience it, be it in combat and occupation or the many traumatic events many go through in their lives, that change the way our minds relate to these?

"You're a p- - -y and a scared little kid", 3rd Installment of "Coming Home"

The subject title above is the third installment of a week long series of reports being run at Salon.com.

The first two installment reports can be found in links below or with this link of what I posted previously

John Needham at home in San Clemente, Calif., in January 2007, during a two-week leave from his tour of duty in Iraq.

John Needham returned from Iraq, suffering from combat stress. If he had received proper care, would he be standing trial for murder?

This is the third installment in a weeklong investigative series called "Coming Home." Read a note written by John Needham here. You can also read the introduction to the series, and the first and second installments, which appeared Monday and Tuesday.

The third installment in this series, by Michael de Yoanna and Mark Benjamin at Salon.com, starts out thus:

Feb. 12, 2009 | FORT CARSON, Colo. -- Fellow soldiers in Iraq called John Wiley Needham "Needhammer" for his toughness. They also saw him as somehow charmed, because the tall blond Army private from Southern California always seemed to be just far enough away from danger. People died next to Needham; Needham survived.

But "Needhammer" was not indestructible after all. He struggled with the aftereffects of the explosions he'd dodged. He survived a suicide attempt while in Iraq, and, after being shipped out of the country in 2007, was diagnosed with post-traumatic stress disorder and a brain injury. He took so many prescription meds he could barely hold his head up. According to Needham's father, Mike, the Army's response to the soldier's problems was punishment rather than treatment.

Last year, just weeks after his discharge, he allegedly beat 19-year-old aspiring model Jacqwelyn Villagomez to death in his California condo.

It continues with this clip:

A Salon investigation has identified several trends involving Fort Carson soldiers who became homicidal. There are failures by healthcare workers and commanders to provide proper care to soldiers struggling with hidden wounds such as PTSD and brain injuries. There is a tendency to overmedicate soldiers struggling with stress or other injuries. Behind it all is an Army culture that punishes problematic soldiers instead of aiding them.

But it can't be misunderstood that Fort Carson, nor just the Army, is the only Military Base where soldiers, returning from In-Theater tours in Iraq and Afghanistan, is the only base where these soldiers, especially after serving multiple tours, many on extended tours of more than a year, are experiencing the problems of reintegration and suffering from the effects of war and occupation of others, especially within the culture of the military. Those of us who are 'Nam vets, and others before and after that, were there with our brothers who went through the same, and back than the tour in country was normally only a twelve month one for the greater majority. Longer tours, less down time between tours, strain of these tours on the soldier and their families, and so much more of the personal and military stress can break down even the strongest minds of many, war and occupations are the complete opposite of the way we are raised and taught how to view the world around us.

This first page of the Salon report, third installment, leads into this "We believe what happened was he had a flashback and lost control" second page, subtitled thus at the bottom of page one.

While Wolgast declines to link soldier healthcare and violent crimes to PTSD, Sheilagh McAteer, a Colorado public defender and a member of a federal Health and Human Services task force exploring ways to divert combat veterans who resort to crime, sees compelling links.

McAteer says soldiers returning home after traumatic war experiences are struggling with violence. Some are winding up in prison and Army officials need to wake up and recognize the problem, she adds.

So far, though, the Army is "refusing to take responsibility," McAteer says. "That's a problem."

Just as happened before and for the long time after, till the next War of Choice raises it's ugly head, as we never learn the real lessons of, and fail to even learn and understand the tactical.

"The Death Dealers took my life!"

Salon.com has a series running all this week called "Coming Home", researched and written by Mark Benjamin and Michael de Yoanna.

The following is the description and lead in information on the series:

"Coming Home" is a week long investigative series on preventable deaths at Fort Carson, a U.S. Army post in Colorado, among troops who have returned from combat tours in Iraq.

Salon national correspondent Mark Benjamin and Colorado-based journalist Michael de Yoanna reviewed more than two dozen incidents of suicide, suicide attempts, prescription drug overdoses and murder involving Fort Carson troops and examined 10 of those cases painstakingly. They interviewed troops, their families and survivors of suicide attempts, studied thousands of pages of medical and Army records and conducted a prison interview with a soldier convicted of being an accessory to the murder of one of his comrades. They learned that much of the violence could have been avoided if the Army did a better job of recognizing and treating the symptoms of PTSD.

A friend sent me the first in the series, which was posted yesterday, 2.09.09, called "The Death Dealers took my life!"

Army Pvt. Adam Lieberman attempted suicide on October 30, 2008, leaving a suicide note scrawled on the wall of his Fort Carson, Colorado barracks.

Adam Lieberman tried to kill himself when he returned from Iraq. Only then did the Army take his mental health seriously.

This is the first story in a week long series called "Coming Home." Read an introduction to the series here; see photos of Heidi Lieberman painting over her son's suicide note, and a copy of the "Hurt Feelings Report," here.

The first page of this report starts out thus:

Feb. 9, 2009 | FORT CARSON, Colo. -- The day before Halloween 2008, Army Pvt. Adam Lieberman swallowed handfuls of prescription pain pills and psychotropic drugs. Then he picked up a can of black paint and smeared onto the wall of his room in the Fort Carson barracks what he thought would be his last words to the world.

"I FACED THE ENEMY AND LIVED!" Lieberman painted on the wall in big, black letters. "IT WAS THE DEATH DEALERS THAT TOOK MY LIFE!"

With more following, about his unit, what happened, his mother and commander, leading into the second page, I am a queer; I am a little bitch; I am a cry baby; I want my mommy; All of the above. Leading to the third and final page of installment number one, "I wanted to rip her jaw off and scrape the skin off her face with her Goddamn teeth"


The second in the series comes on 2.10.09 is called "Kill yourself. Save us the paperwork":

Pfc. Ryan Alderman in Iraq in an undated photo.

Pfc. Ryan Alderman, now deceased, sought medical help from the Army. He got a fistful of powerful drugs instead.

This is part of the second installment in a week long series called "Coming Home." Read Ryan Alderman's sworn statement, written a week before his death, here, and a description of three other suicides of Fort Carson-based soldiers here. See the introduction to the series here.

The second, in this series, starts out with the following:

Feb. 10, 2009 | FORT CARSON, Colo. -- It was unseasonably warm for November in Colorado as Heidi Lieberman approached the door of the Soldiers' Memorial Chapel at Fort Carson. She walked past a few of the large evergreens that dot the chapel grounds and then entered the blockish, modern beige and brown chapel topped with a sharp, rocketlike steeple.

Inside, the chapel was hushed. Camouflage-clad, crew-cut young men packed the pews. Up in front, an empty Army helmet hung on the butt of an upright M16. A pair of brown combat boots sat below, as if they had been tucked under a bunk. A soldier handed Heidi a program for a memorial service. On the front was the image of a soldier, kneeling in prayer below an American flag and illuminated by a beacon of light from above. The inscription just below the kneeling soldier read, "Lord, grant me the strength ..."

It had been five days since Heidi's son Adam, 21, a soldier at Fort Carson, swallowed handfuls of prescription sleeping pills and psychotropic drugs in the barracks, trying to die. With a can of black paint, Adam brushed a suicide note on the wall of his room. The Army, Adam wrote, "took my life."

Adam had lived. Pfc. Timothy Ryan Alderman wasn't so lucky. Alderman had been found dead of a similar drug overdose in his room in the barracks at Fort Carson in the early-morning hours of Oct. 20, 10 days before Adam Lieberman made his suicide attempt.

Heidi, who was at Fort Carson to deal with the aftermath of her own son's suicide attempt, had decided to attend Alderman's funeral although neither she nor her son had known him. She sank into a pew and tried to reconcile two warring thoughts.

The first page leads into the second, givin this title at the bottom link to: "It looked like a slaughterhouse operation to me", which than leads to the third, "That's shitty. That breaks all the rules. He was overmedicated"

Please go over and read these two reports, than follow this extremely important series. I'll be updating this post as each days report is posted.

With the long running occupations continuing, and as the multiple tours start weighing on some of these soldiers, add on the economic problems of the country, their families sacrificing and trying to carry on a normal existence while waiting, over and over, and we're just witnessing the beginning of what may be coming!

Just as those of us who served in another long running occupation, without having to serve more than one tour, watched as our own brothers and sisters returned, never leaving behind what they had experienced nor completely returning home!

Take In A Deep Breath America

As far as suicides among active duty soldiers
and veterans of the wars in Iraq and Afghanistan
are concerned,
we in America have just seen the tip of the iceberg.
Two tours will be twice the chance of suicide.
Three tours will be triple the chance of suicide.
Four tours will be four times the chance of suicide.
These soldiers will be deleted by this country like
unwanted e-mails.
Why?
Because the American people do not support the troops.
Nobody wants to do the math.
Take in a deep breath America,
the wars are coming home to the stuffed closets of your
mind.
When you fall asleep at the wheel,
people die in your neighborhood.
Eventually,
they may die in your own home.
When I was in Vietnam toward the end of the war,
this is what I saw.
Blood on my hands,
brains in my lap.

Mike Hastie
U.S. Army Medic
Vietnam 1970-71
February 9, 2009