Dallas Morning News explores effects of war on military families
For the paper’s series on military families, Dallas Morning News reporter Dave Tarrant has spent four months investigating what he calls the “relentless cycle of crisis and stress” that affects soldiers’ loved ones. The broad series touches on everything from the Fort Hood suicides to the Army’s preventative measures to Tarrant’s latest, “Wife faces life-or-death decision for her war-injured husband.”
Most of the content is behind the Morning News paywall, but there’s enough on the landing pages to, at the very least, help you understand where Tarrant’s investigation has taken him and just how wide-ranging the health effects of prolonged war can become.
PTSD or personality disorder? It matters to soldiers
Filed under: Government, Health journalism, Health policy, Studies
The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.
Photo by isafmedia via FlickrThe Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):
- The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
- In 2007, The Nation’s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
- Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
- Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
- At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
- Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006″ and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”
Report links Gulf War, illness; calls for more study
The Institute of Medicine has released a report, sponsored by the Department of Veterans Affairs, on certain health issues in Gulf War veterans.
The committee behind the report wrote that insufficient data from immediately before and after deployment made drawing clear conclusions difficult, but called for a commitment to monitoring and caring for what the release called “persistent, unexplained symptoms” in Gulf War veterans. It also said that interaction between genes and the environment was likely a factor in veterans’ “multisymptom illness.”
The key paragraph from the press release (emphasis mine):
Military service in the Persian Gulf War is a cause of post-traumatic stress disorder in some veterans and is also associated with multisymptom illness; gastrointestinal disorders such as irritable bowel syndrome; substance abuse, particularly alcoholism; and psychiatric problems such as anxiety disorder, says a new report from the Institute of Medicine, the latest update in a series of reports on the Gulf War and veterans’ health. There is some evidence that service during the conflict is linked to fibromyalgia and chronic widespread pain, amyotrophic lateral sclerosis, sexual difficulties, and death due to causes such as car accidents in the early years after deployment, but the data are limited, said the committee that wrote the report.
More vets come home as result of psychiatric issues
On Shots, NPR’s Health Blog, Nadja Popovich reports on a recent Johns Hopkins study that found, more troops were evacuated from Iraq and Afghanistan in 2007 for mental health problems than for combat injuries.
The increase comes despite the military’s increased focus on combating mental health problems among American soldiers. The largest number of evacuated soldiers are still those diagnosed with “noncombat-related injuries, such as muscle and joint problems that come from carrying equipment,” but psychiatric evacuations are a growing and complex problem.
American paratroopers in Afghanistan. Photo by U.S. Army Spc. William E. Henry via Flickr… those suffering from mental health issues had a remarkably low rate of returning to full duty. “Psychiatric conditions have the lowest return to duty rates among any diagnostic group aside from combat injuries,” (study leader Steven P. Cohen, an associate professor of anesthesiology at the Johns Hopkins School of Medicine and a colonel in the U.S. Army Reserve) wrote. “But the effects are much worse, because psychiatric conditions worsen the prognosis for all other conditions.”
“Patients with PTSD — as a rule — have multiple other complaints,” he continued. “Studies have shown that most people with persistent PTSD have ongoing musculoskeletal, neurological and constitutional complaints that are unlikely to respond to treatment.”
Related AHCJ articles
Interviewing ‘profoundly affected’ soldiers
Tips for interviewing service members returning from Iraq, the Middle East or Afghanistan
Resources to cover mental health and the military
AHCJ offers resources to help journalists cover the wide range of health topics, including those surrounding the military, veterans and post-traumatic stress disorder. Members and other journalists write articles and tip sheets specifically for AHCJ about how they have reported a story, issues that our members are likely to cover and other important topics.
We have compiled a selection of tip sheets, articles, Web sites and reports that we feel could be helpful as journalists cover the aftermath of the Fort Hood shootings.
Some of these resources are normally available only to AHCJ members but we are opening them up to nonmembers for one week to help journalists cover this important topic.
What happens when most of a society has PTSD?
Writing for the Dart Center for Journalism and Trauma, Judith Matloff and Robert Nickelsberg look at the effects of decades of strife upon the disputed South Asian province of Kashmir. A third of Kashmir’s residents suffer from psychological distress (in the United States, that number is around 6 percent to 8 percent) and the region’s few psychiatrists are so overwhelmed – one small clinic saw over 100,000 visitors last year – that they can do little more than rush through minutes-long consultations and hand out prescription medication as if it were “Tootsie Rolls at Halloween.”
Clouds gather over Kashmiri peaks, photo by Brian Guest via Flickr
Practically everything that can cause PTSD has coalesced in Kashmir — loss, fear, distrust, random violence, a sense of powerlessness. The unrelenting Indian occupation fuels despair. Stress affects nearly everyone: the men routinely frisked on the street, the women forced to beg when their husbands vanish and the children given up to orphanages. Kashmir illustrates what researchers have long suspected: that prolonged exposure to direct confrontation results in still greater anguish. People don’t get used to violence; they grow more vulnerable.
Suicides are up in the region – despite strong taboos among the Muslim populace – and the community’s psychological state deteriorates further with every passing year. “‘The accumulation of events results in higher levels of distress,’ (Kaz de Jong, a mental health advisor with MSF-Amsterdam) explains. ‘What you see in chronic conflict is that self-support mechanisms and resilience go down.’ Instead of getting stronger, the afflicted just get more desperate.”
DoD campaigns against stigma of depression, PTSD
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury’s new Real Warriors campaign is designed to aid soldiers with what they seem to see as the three r’s of military mental health: resilience, recovery and re-integration.
The RealWarriors.net site not only directs soldiers to additional resources, but also shares anecdotes from their peers and provides them with guidelines for good mental health, both in combat and out of it.
The effort, launched in May, even has a Twitter account.
(Hat tip to Arline Kaplan of the Psychiatric Times)
Related:
Bay Area panel on veterans’ health highlights untold stories
Report exposes failures of Army mental health care
This week on Salon.com, Mark Benjamin and Michael de Yoanna are posting the results of their investigation into climbing “preventable death” rates among American soldiers. The reporters focused on the cases of soldiers in Ft. Collins, Colo., but also included the national implications of their findings. In January, they report, the army suspects more soldiers killed themselves than died in combat in Iraq and Afghanistan combined.
Their findings are being published in a series called Coming Home:
“Salon put together a sample of 25 suicides, prescription overdoses and murders among soldiers at Colorado’s Fort Carson since 2004. Intensive study of 10 of those cases exposed a pattern of preventable deaths, meaning a suicide or murder might have been avoided if the Army had better handled the predictable, well-known symptoms of a malady rampant among combat veterans: combat-related stress and brain injuries.”
According to Benjamin and de Yoanna, many, if not all, of the deaths were preventable. They point to systemic problems with the military culture and the military standard of medical and psychological care as the root cause. The reporters said the Army’s mental health system had failed the soldiers, many of whom had returned from Iraq and suffered classic symptoms of chronic PTSD.
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