September 02, 2006

Caring for War's Hidden Casualties - Mental Ilnesses Triggered by War

We believe an editorial from the New Scientist magazine identifies some important points. See the following excerpt:

Society has always struggled to deal fairly with the psychiatric casualties of conflict. In the first world war, the British army shot men who refused to fight, some of whom were known to have suffered from shell shock (now called Post Traumatic Stress Disorder). The horrific conditions in the trenches left them so mentally damaged they could barely walk, let alone fight. It took until last week for the UK government to decide that an injustice had been done, and that those shot for desertion and cowardice should receive a pardon. Since 1918, systematic study has given us a better idea of how people can be affected by the trauma of war. Notions of shell shock and battle fatigue have given way to post-traumatic stress disorder (PTSD). Science is also giving new hope for treatments.

Controversy, however, is never far away. This week it resurfaced in the US following a study that estimates the rate of PTSD in Vietnam veterans at 18.7 percent, considerably lower than the previous estimate of 30.9 percent. Politicians have already clashed over spending on mental health at the US Department of Veterans Affairs, and fears are growing that this latest study will provide ammunition for those who want to see such spending cut.

That would, indeed, be a mistake at a time of large-scale conflicts in Iraq and Afghanistan. Military personnel hurt while implementing the policies of democratic governments deserve the best of care. Cutting spending on mental health services and research cannot, of course, be equated with executing men suffering from shell shock, but history may judge such a move just as harshly.

Source: New Scientist


Obviously anonymous comments should be taken with several "grains" of rock salt. However I cannot substantiate the following conversation.

Please note, I am not a clinical psychologist or psychiatrist. I do not practice any type of therapy in any form. My knowledge of mental health wellness is limited.

A close friend from graduate school works at a prominate VA hospital as a psychologist. Several months ago, perhaps six, a memo was distributed requiring that psychologists use a more stringent criteria (than that outlined in the DSM-IV) when diagnosing a returning soldier that initially screens positive for potential PTSD. As soldiers began being evaluated diagnosed and treated, the number of soldiers meeting criteria for PTSD was found to be above statistical norms. (perhaps peace time norms? sarcasm).

Obviously he was furious with this and works to help soldiers recognize their own symptoms, taking every care not to help the patient inaccurately describe his condition.

This is such a slippery slope for any practitioner to find himself.

A little critical thinking will allow almost anyone to play out the worst case scenarios - missed cases of PTSD as well as misdiagnosed cases of PTSD. Throw in inappropriate prescription / medication therapy and inappropriate "talk" or behavior therapy and there is a such a glaring potential for injured soldiers to remain injured over a duration that may be completely and unneccesarily too long.

Who oversees care for our soldiers, I thought it was the VA. Who oversees the VA?
Please pass this message along to who ever can act, insure that our soldiers are cared for appropriately,if you know the answer to this question.

Posted by: anonymous at September 9, 2006 01:29 PM

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