Monday, June 20, 2011

VA Spends Millions on useless PTSD research

Chaplain Kathie

The numbers don't lie. The suffering does not end. Millions are spent on programs that do not work yet congress keeps funding more in a series of failures. Congress holds hearings, listening to family members share their heartache after it is too late to save a veteran's life but they never seem to want to hear about what has been working. Why? There is not much money required to do it. So this is what we're left with.

Suicide Prevention. Years after it began it is still being called by more and more veterans reaching the point of wanting to die, yet no one seems to wonder why.

VA crisis hotline takes record number of calls, no one asks why?
Will anyone else ever ask why so many reach the point they have to call in the first place? With all the programs and money invested in helping them when they come home, the numbers go up instead of down. What is going on here? More calls to the suicide prevention hotline and more deaths. Any reporters bothering to check into why this is all happening?

VA crisis hotline takes record number of calls
By Rick Maze - Staff writer
Posted : Wednesday May 25, 2011 12:01:23 EDT
The Veterans Affairs Department’s Veterans Crisis Line received 14,000 calls in April, the highest monthly volume ever recorded for the four-year-old suicide prevention program.

“Every day last month, more than 400 calls were received,” said Sen. Patty Murray, D-Wash., the Senate Veterans Affairs Committee chairwoman who disclosed the call volume during a Wednesday hearing. “While it is heartening to know that these calls for help are being answered, it is a sad sign of desperation and difficulties our veterans face that there are so many in need of a lifeline.”

How do they go from wanting to survive in the midst of combat but once back home, they lose it? With the Suicide Prevention Hotline, topped off with all the money the DOD has been spending on PTSD and suicides, why are these numbers still happening?

Two Marine suicides in May
The number of attempted suicides reported in May was 14, raising that figure for the year to 83.

Army 16 "potential" suicides for April with 9 "potential" more in Reserves
May 13, 2011

Army Released April Suicide Data
The Army released suicide data today for the month of April. Among active-duty soldiers, there were 16 potential suicides: none have been confirmed as suicide, and 16 remain under investigation. For March 2011, the Army reported seven potential suicides among active-duty soldiers. Since the release of that report, no cases have been confirmed as suicide, and seven cases remain under investigation.

This is a report from the GAO on the amount of money spent but we should all be asking why we are still funding research that has been done to "death" over the last 40 years. Humans still have the same basic structure and combat is still combat. With so little new coming out, it is a waste of time, money and especially lives to keep repeating the same mistakes already made.

VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services
GAO-11-32 January 24, 2011
Highlights Page (PDF) Full Report (PDF, 47 pages) Accessible Text

In addition to providing health care to veterans, the Department of Veterans Affairs (VA) funds research that focuses on health conditions veterans may experience. According to VA, experts estimate that up to 20 percent of Operation Enduring Freedom and Operation Iraqi Freedom veterans have experienced post-traumatic stress disorder (PTSD) and demand for PTSD treatment is increasing.

Because of the importance of research in improving the services that veterans receive, GAO was asked to report on VA's funding of PTSD research, and its processes for funding PTSD research proposals, reviewing and incorporating research outcomes into clinical practice guidelines (CPG)--tools that offer clinicians recommendations for clinical services but do not require clinicians to provide one service over another--and determining which PTSD services are required to be made available at VA facilities.

To do this work, GAO obtained and summarized VA data on the funding of PTSD research from its medical and prosthetic research appropriation through its intramural research program. GAO also reviewed relevant VA documents, such as those for developing CPGs and those related to VA's 2008 Uniform Mental Health Services in VA Medical Centers and Clinics handbook (Handbook), which defines certain mental health services that must be made available at VA facilities. GAO also interviewed VA officials.

Based on VA data GAO obtained and summarized, GAO found that the amount of funding VA provided for intramural PTSD research increased from $9.9 million in fiscal year 2005 to $24.5 million in fiscal year 2009. From fiscal year 2005 through fiscal year 2009, intramural PTSD research funding ranged from 2.5 percent to 4.8 percent of VA's medical and prosthetic research appropriation. In addition, the number of PTSD research studies VA funded through the Merit Review Program and the Cooperative Studies Program (CSP)--VA's two primary funding mechanisms in its intramural research program--increased from 47 in fiscal year 2005 to 96 in fiscal year 2009. According to VA officials, intramural research proposals, including those on PTSD, are funded primarily according to scientific merit in both the Merit Review Program and CSP.

Proposals are evaluated by a panel of reviewers and scored based on their scientific merit. Directors of VA's research and development services--offices that focus on different research areas and administer VA's intramural research program--fund proposals based on their scores, typically up to a specified percentile. The number of proposals funded may vary based on budgetary considerations and, for a small number of proposals, responsiveness to VA research priority areas. VA has a process to review and incorporate relevant research outcomes to develop CPGs for a number of topics, including PTSD. VA relies on the policies of a joint VA and Department of Defense (DOD) work group--comprised of VA and DOD officials--to ensure that systematic reviews of relevant research outcomes are conducted when issuing CPGs.

In brief, a systematic review is conducted to identify the most methodologically rigorous research studies that are applicable to each clinical question contained in the CPG. A group of subject matter experts then assesses the individual research studies in order to determine the overall quality of evidence available for each particular clinical question, considers the potential benefits and harms of a clinical intervention to determine its net effect, and, based on an assessment of the overall quality of the evidence and the net effect of an intervention, develops recommendations for the CPG. According to VA officials, the decision to require that two PTSD services--cognitive processing therapy and prolonged exposure therapy--be made available at VA facilities by including them in the Handbook was based on a review of research outcomes and the availability of existing resources. Specifically, VA officials told GAO that these two services were strongly recommended in the 2004 PTSD CPG and had greater evidence supporting their effectiveness than other PTSD services.

VA also told GAO that prior to the Handbook's 2008 issuance, VA had already begun investing resources in training programs for cognitive processing therapy in 2006 and prolonged exposure therapy in 2007. While VA provided some documentation regarding the decision-making process for PTSD services, VA officials explained that clinical decision-making processes are not typically expected to be documented in a formal manner. VA officials told GAO that they are currently clarifying language in the Handbook but do not plan to revise any requirements relating to PTSD services at this time. VA provided technical comments that GAO incorporated as appropriate.

When Vietnam veterans came home, just like their Dads and Granddads, families had nothing to work with other than love, compassion and a commitment to their veterans. The Internet did not exist. Support groups were nothing more than extended family and friends offering a shoulder to cry on and bad advice. Yet with all of this we had marriages that lasted 20, 30, 40 years, in a time when half of all "normal" marriages ended in divorce. We didn't manage to save all of them. By two separate studies the number of suicides was put between 150,000 and 200,000. Considering by 1978, contrary to published articles, PTSD was already being used and we had the startling number of 500,000 predicted to increase over the following ten year period. All of this proved true and we're at 18 suicides a day committed by veterans.

I am always asked about these numbers. While I tell reporters the numbers are bad, I remind them there are many more we'll never know about. There have been increased number of veteran/police deaths but we'll never know if they were actually suicide by cop or a flashback. Vehicle accidents, cars and motorcycles, have increased but again, we'll never really know how many were suicides or accidents. Then there is the issue of medications. We don't know for sure how many were accidental overdoses because of short term memory loss or because they just couldn't wait one more day for their emotional pain to ease up.

Just working with the numbers we already know, it should be obvious to everyone in this country, especially congress, that the money has not been well spent and people need to be held accountable for the deplorable results we've seen.

As Vietnam veterans see their children come home from combat suffering with PTSD just as they did, they wonder when this country will ever get this right. Funding research is wonderful when there is something to learn but funding research that has already been done is wrong. Using research programs and passing them off as "treatment" is deadly and the numbers prove that.

There is debate going on about changing the term PTSD to just PTS but dropping the "D" will do no good if the veterans still don't understand what it is or why they have it. The term has been changed since this nation began but still they suffer mostly in silence waiting for the day they will get over it as if some angel will pass a hand over their heads and cure them. They believe they are evil because of what they had to do so they don't feel as if they are worthy of healing. We're supporting that by not doing what they need and funding what is useless.

There is a lot of money to be made by too many people including the money made off keeping them medicated when the purpose of medication was supposed to level off the chemicals in their brains to give therapy a chance to work but therapy has not been increased for them, especially in theater.

The other issue is the backlog of claims feeding PTSD with extra stress caused by their financial loss with bills still needing to be paid but no way to pay them. They lost their military pay and left unable to work, they have nothing to support their families with.

The real disorder in this country is repeating the same mistakes while they die back home.

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