GAO report on VA and what needs to be done

Department of Veterans Affairs
The Department of Veterans Affairs' (VA) mission reflects the nation's commitment to care for veterans, their families, and their survivors.

About a quarter of the nation's population, approximately 74.5 million people, are potentially eligible for VA benefits and services because they are veterans, family members, or survivors of veterans.

VA is responsible for providing federal benefits to eligible veterans and their families and operates nationwide programs for health care, financial assistance, and burial benefits.

The health care delivery system operated by VA is the largest in the nation and provides a broad range of services, including services uniquely related to veterans' health or special needs.

VA also provides disability compensation to veterans who are disabled by injury or disease incurred or aggravated during military service as well as pensions for certain wartime veterans with disabilities.
VA faces a range of key management challenges in the areas of disability benefits, health care delivery, property management, and information technology.

VA's eligibility criteria for disability compensation do not fully incorporate a modern understanding of how technology and the labor market affect disabled veterans' ability to work. In addition, VA continues to face long-standing problems with large pending disability claims inventories, lengthy processing times, concerns about decision accuracy and consistency, and replacing an aging benefits processing system it relies on to accurately process benefits to more than 3.5 million veterans. Further, both VA and the Department of Defense (DOD) face challenges in meeting the health care and disability evaluation needs of servicemembers returning from military operations in Iraq and Afghanistan, as well as veterans of those military operations.

VA has faced difficulties in managing its resources to be consistent with a substantial increase in its patient workload, has allowed internal control weaknesses and inadequate oversight to limit its ability to maximize revenue from third-party insurers, and has challenges recruiting and retaining health care professionals to provide care to its veteran population. In addition, VA lacks policies and procedures designed to provide adequate controls over funds used for the procurement of goods and services.

Compounding VA's challenge to manage its resources is its vast inventory of underutilized and vacant space.

VA faces challenges in controlling its IT equipment and managing its IT resources.
http://www.gao.gov/transition_2009/agency/vad/

linked from Veterans For Common Sense

VA doctors tell Mullen that vets need mental health screenings

VA doctors tell Mullen that vets need mental health screenings
Too many troops are returning from war zones with undiagnosed psychological problems, the physicians tell the chairman of the Joint Chiefs of Staff during his visit to the VA hospital in West L.A.
By Peter Spiegel, Los Angeles Times Staff Writer
September 21, 2008
Senior physicians with the veterans health system in Los Angeles told the top U.S. military officer Saturday that the Pentagon needs to overhaul the way it discharges troops because hundreds are leaving the armed forces with undiagnosed combat-related mental health problems.

Several of the physicians, including the system's chief of staff and its top psychiatrist, advocated mandatory mental health screenings for all service members who retire after serving in war zones.


The doctors said that because of the stigma attached to combat stress disorders, few troops acknowledge or seek help for psychological problems while in the military, meaning most remain undiagnosed until they run into family or work problems in the civilian world. Combat stress disorders become more difficult to treat the longer they remain undiagnosed.

"We need to make it a gradual discharge process with milestones, whether it's six months or a year, whatever it takes," said Dr. Robert Rubin, chief of mental health at the Veterans Administration healthcare system for Greater Los Angeles. "The stigma goes away if they have no choice but to go for the exams."
click post title for more

Iraq vet, Marine says "I have no problem telling people I have PTSD"

"I have no problem telling someone I have PTSD. It's not a bad word. I went through something that was traumatic. It may take me time to get over it,'' Seitz said. "The veteran has to want to get the treatment. You have to be proactive in your own recovery from what you went through. You just have to tell somebody you need help, and they'll help you."

Let those words sink in.
Iraq War vet celebrates progress over PTSD
By Mary Delach Leonard, Beacon staff
Last Updated ( Friday, 15 August 2008 )




For Iraq War veteran Brad Seitz, the color purple symbolizes five years of life after near-death.

Purple balloons will direct guests to a party this weekend noting the fifth anniversary of the day he earned a Purple Heart in service to his country. He will hang out with family and friends at the bowling alley in the recreation center of the Jefferson Barracks VA Medical Center. Refreshments will include a Purple Heart cake, compliments of the VA.

Seitz, 31, has a fondness for the place. On Thursday nights, the pool, weight room and other facilities are open to all area veterans of the wars in Iraq and Afghanistan. It's a place to find people who understand what he's been through, he said.

Here, too, Seitz has found help to cope with symptoms of post-traumatic stress disorder.

"I just like getting my story out there. I guess I would be considered a good story for the VA. All of my treatment has been excellent,'' Seitz said. "I think I've gotten the top-notch care that the VA offers. People should know that it's not all bad stories. There are good things that happen.''

Five years ago – on the night of Aug. 13, 2003 – Seitz's convoy of Humvees was ambushed by insurgents. Shrapnel from a rocket-propelled grenade peppered his right arm, the explosion knocking him unconscious. He was also shot in the foot during the attack.

Lucas Senescall's suicide raises questions about PTSD care

When will they get the message that the suicide hot line is great but they need to have the rest of the VA up to speed or all it does is prolong the suffering?

Army Vet's Suicide Raises Questions About VA's Treatment of PTSD Cases
Written by Jason Leopold
Thursday, 14 August 2008
by Jason Leopold

The tragic death earlier this month of a 26-year-old Navy veteran who hung himself with an electrical cord while under the care of a Spokane, Washington Veterans Administration hospital depression underscores what veterans advocacy groups say is evidence of an epidemic of suicides due failures by the VA to identify and treat war veterans afflicted with severe mental health problems.

Lucas Senescall, who suffered from severe depression, was the sixth veteran who committed suicide this year after seeking treatment at the Spokane VA, according to a report published last weekend in the Spokesman Review.

Senescall’s father said his son was “begging for help and [the VA] kicked him to the curb,” according to the July 20 report in the Spokesman Review.

On Tuesday, Sen. Patty Murray, D-Wa, addressed the increasing number of war veterans who are committing suicide, specifically pointing out the death of Lucas Senescall, during a speech on the Senate floor.


“More than five years [after the start of the Iraq war], we should have the resources in place to treat the psychological wounds of war as well as we do the physical ones. But we don’t,” Murray said. “When someone with a history of depression, PTSD, or other psychological wounds walks into the VA and says they are suicidal, it should set off alarm bells We can’t convince veterans or service members to get care if they think they will be met with lectures and closed doors. That is unacceptable. At the very least, we must ensure that staff at military and VA medical centers have the training to recognize and treat someone who is in real distress.

“Time and again, it has taken leaks and scandals to get the Administration to own up to major problems at the VA – from inadequate budgets to rising suicide rates. And its response to rising costs has been to underfund research and cut off services to some veterans. Service members and veterans need more than an 800 number to call,” Murray said.

Paul Sullivan, the executive director of the advocacy group Veterans for Common Sense, agreed.

“The facts show VA lacks consistent and complete policies and oversight on the subject of suicide, as VA leaders confirmed during the trial in the lawsuit veterans brought against VA.”
click post title for more

PTSD:"Daddy, why don't you play with us anymore?"

This article says that most veterans will seek help after the family insists on it. It is something too many families avoid. They see the signs of distress but do nothing. They complain about how their husband, wife, son or daughter return home changed, but do nothing about it. They do not make themselves aware of any of this. While someone is deployed, a wife will say, "I have enough to worry about and don't want to think about them coming home changed" believing they can just avoid it. The problem is they don't understand that while their family member is deployed they have a job to do. It's not just about taking care of the family and taking on the chores the soldier used to do, especially with the citizen soldiers deployments. It's about getting prepared with knowledge for when their war becomes a battle to fight at home.

Iraq vets here seek help while psychic wounds are still fresh
By Carol Ann Alaimo
Arizona Daily Star
Tucson, Arizona Published: 08.03.2008
"Daddy, why don't you play with us anymore?"
Iraq war veteran Rigo Morales was cut to the core by the question from his 4-year-old twin girls.

His wife had been asking questions, too, wondering what had become of the doting husband who used to leave her roses on the windshield and love notes on the fridge.

"I knew right away when he got back from the war that something was wrong with him," Angelica Morales, 30, said of her 34-year-old mate.

"He used to be so loving and attentive. After he got back, he was always tense. He looked scared.

"If we tried to go anywhere, the people and the noise would bother him so much that we'd have to leave. So we stopped going places."

A trip to Tucson's veterans hospital confirmed her fear: Her husband had severe post-traumatic stress disorder — a combat-induced condition that had taken their whole family hostage.

Such cases are on the rise in Tucson and around the country. The Pentagon and the Southern Arizona VA Health Care System are reporting major spikes in stress illness among veterans who have returned from Iraq and Afghanistan.

The PTSD clinic at the local veterans hospital has seen its caseload soar by more than 100 percent. Last fiscal year, an average of 32 Iraq and Afghanistan war veterans visited the clinic each month, compared with 73 a month so far this year.
Nationally, about 40,000 troops have been diagnosed with the disorder since 2003, The Associated Press has reported.

Unlike veterans of past U.S. wars, who often buried their pain for decades, some young veterans are seeking help while psychic wounds are still fresh, often at the insistence of loved ones.
go here for more
http://www.azstarnet.com/metro/251035

House Passes Increases for Veterans Mental Illness Treatment

House Passes Increases for Veterans Mental Illness Treatment
August 1, 2008
By a vote of 409-4 the House today passed legislation funding the Department of Veterans Affairs for FY 2009. The bill (HR 6599) includes $3.8 billion for mental illness treatment and $584 million for substance abuse treatment in the VA, significant increases over current year funding. Overall, the Veterans Health Administration budget is set at $40.8 billion for FY 2009 -- $1.6 billion more than the President requested and $3.9 billion more than current levels. It is projected that the VA will serve 5.8 million veterans in 2009.

For homeless veterans, HR 6599 allocates $130 million for the homeless grants and per diem program, rejecting a proposal from the Bush Administration to cut the program by $8 million. This allocation also includes $32 million to hire additional personnel as part of the joint HUD-VA "VASH" program for veterans supportive housing. A separate bill funding the Department of Housing and Urban Development (HUD) appropriates an additional $75 million at HUD for rent subsidies, i.e. the housing side of this joint program.

The bill also includes $500 million for medical research at the VA, $38 million more than the President requested and $20 million more than was allocated in FY 2008. A full summary of HR 6599 can be found here.

Next Steps for the VA Budget
With House action on the VA spending bill, Congress has now adjourned for its summer recess and will not return to Washington until the week of September 8. In September, these will be efforts to complete action on HR 6599 before FY 2009 begins on October 1. However, the other FY 2009 discretionary spending bills - including those covering mental illness research, services and housing programs are unlikely to be passed before October 1. As a result these other programs are expected to be funded after October 1 at current FY 2008 levels - perhaps through March of 2009.

Senator Patty Murray to make speech on veterans mental health care

From Paul Sullivan, Veterans for Common Sense
FYI – This should be a very interesting press conference given the recent incident in Washington State where VA appears to have improperly denied emergency medical care to a suicidal veteran, leading the reporter’s discovery of six recent suicides of veterans receiving care at the same VA facility, including recent Iraq War veterans: http://www.veteransforcommonsense.org/articleid/10703.

Or go here for the article and read my comment.


http://woundedtimes.blogspot.com/2008/07/va-refused-medical-care-to-suicidal.html

Senator Patty Murray

FOR PLANNING PURPOSES CONTACT: Alex Glass

Tuesday, July 22, 2008 (202) 224-2834



Senator Murray to Deliver Speech on Veterans Mental Health and Suicides



(Washington D.C.) – Today, U.S. Senator Patty Murray (D-WA) will deliver a speech to raise awareness of the continuing problem of veterans struggling to get the mental health care they need and the epidemic of veterans suicides.



Senator Murray will use the examples of recent veterans suicides in Spokane, Washington and the highly publicized tragic death of Joseph Dwyer – an Army medic made famous in a photo taken during the first week of the U.S. invasion of Iraq – to illustrate the need to take action.



Although, Senator Murray will acknowledge that the VA is taking some helpful steps to address suicides including running advertisements highlighting their 24-hour suicide prevention hotline, Murray will call for more to be done. In her speech, Senator Murray will call for an increase in resources to boost outreach, breakdown barriers to care, and ensure that veterans are not turned away when they seek mental health care at VA facilities.



WHO: U.S. Senator Patty Murray (D-WA)



WHAT: Floor Speech on Veterans Suicide



WHEN: Tuesday, July 22, 2008

Not before 5:00 PM ET/ 3:00 PM PT

*E-mail notification on timing will go out closer to speech time.



WHERE: Senate Floor

C-SPAN 2 in Washington State



AUDIO: Following speech a transcript and mp3 audio file will be released.

Post-traumatic stress disorder draws vets to Roseburg VA

"I served in Vietnam 40 years ago," a 60-year-old said quietly. "And I am trying to come home. I went to sea 33 years as a merchant seaman. That took care of the need to be a part of society -- I just stayed gone. Then, three years ago, I was forced to retire because of medical stuff, and I've had a tough time readjusting to civilian life."

Post-traumatic stress disorder draws vets to Roseburg VA
The sole in-patient unit in the Western U.S. focuses on disengaging combat veterans from their experiences
Sunday, July 20, 2008

JULIE SULLIVAN

The Oregonian Staff

Red brick buildings with stately white columns rise above the green campus like a Civil War postcard come to life. Visitors pass a rose garden, a gazebo and then a dark carved stone.

"To care for him," it reads, "who shall have borne the battle" -- Abraham Lincoln

The only in-patient ward west of Topeka, Kan., specifically for combat-related post-traumatic stress disorder is tucked inside the Veterans Affairs Roseburg Healthcare System just off Interstate 5.

When a fledgling federal agency rebuilt the old Oregon State Soldier's Home 75 years ago, half the veterans cared for nationally were neuropsychiatric patients.

Today, old soldiers still arrive, often terribly troubled.

New ones, too.

They appear alone, sometimes in uniform, taking the elevator to the third floor of Building 2, as though reporting for duty.

That changes quickly, staff say. The 28-day stay is not a deployment. Admission is voluntary. Military clothing is discouraged. The double doors are open, as in most hospital wings. Patients can go into town and go home on weekend passes.

This unit specifically treats combat-related post-traumatic stress disorder. But the demand for in-patient care is rising so fast that the Roseburg VA has already boosted capacity this year from 10 to 15 beds and has applied for the money and staff to go to 21.

The VA has about 200 special programs for PTSD nationwide, including 36 intensive in-patient programs aimed at treating symptoms. People in an acute crisis can go to Seattle. Those needing longer stays head to Palo Alto, Calif. But Roseburg is one of only five that allow veterans to step out of their lives and specifically focus on combat-related trauma. Here they work with staff to learn skills and receive psychotherapy for complex and difficult problems. Among them: memory and sleep problems from traumatic brain injuries, as well as physical problems such as back and skin disorders.

"Step out of the black hole into the light," one ribbon reads.

"That was then, this is now," says another.

And:

"Finally Home."

Julie Sullivan: 503-221-8068; juliesullivan@news.oregonian.com

click post title for more

VA Refused Medical Care to Suicidal Veterans

Why is this still going on? Why are they being turned away when they finally seek help? When they want to live, why are they not helped to stay alive?

July 20, Another Tragic Suicide: VA Refused Medical Care to Suicidal Veteran in Spokane, Washington

Kevin Graman


Spokesman-Review (Washington)

Jul 20, 2008

Lucas Senencall "was begging for help, and they kicked him to the curb," said Senescall's father, Steve Senescall, of Spokane, who drove his son to the hospital and was with him during a brief consultation with [VA psychiatrist William] Brown. . . . Sullivan said the problem could get worse, that the VA is unprepared to absorb 1.7 million returning Iraqi and Afghanistan war veterans if they need care. The health care system currently is treating 325,000 of them; of those, nearly 134,000 are being treated for mental health conditions.

LIVES LOST AT HOME

July 20, 2008, Spokane, Washington - A distraught 26-year-old Navy veteran who had a history of mental illness hanged himself within three hours of seeking help at Spokane Veterans Affairs Medical Center. The July 7 death of Lucas Senescall was the sixth suicide this year of a veteran who had contact with the Spokane VA, a marked increase in such deaths.

Last year, there were two suicides among veterans treated at the local VA.

Senescall's death comes amid heightened concern nationwide over the suicide rate among veterans.

VA officials said the medical center continues to take steps to identify veterans at risk of harming themselves, and it is training all employees in suicide prevention. Citing confidentiality rules, officials would not identify the recent fatalities.

But the identity of one other veteran who killed himself this year became public when his family wrote U.S. Sen. Patty Murray in April about concerns with VA mental health care. Spc. Timothy Juneman, 25, a National Guardsman and former Stryker Brigade soldier who was injured in a roadside explosion in Iraq, died March 5.

The same VA psychiatrist, Dr. William L. Brown, attended Senescall on the day he died and Juneman in early January when he was released from inpatient suicide watch at the Spokane VA. Brown had prescribed Juneman several medications, including potent antidepressant, anti-anxiety and antipsychotic drugs.

Parents of both dead veterans have independently raised concerns that the Spokane VA could have done more to save their sons.

"He was begging for help, and they kicked him to the curb," said Senescall's father, Steve Senescall, of Spokane, who drove his son to the hospital and was with him during a brief consultation with Brown.

Said Juneman's mother, Jacqueline Hergert, of Toledo, Wash.: "This thing should never have happened with my son."

Juneman was a combat veteran diagnosed by the Spokane VA with traumatic brain injury and post-traumatic stress disorder. He was attending Washington State University. "As soon as those diagnoses were made, somebody should have been standing on a soapbox for him, and nothing was done," Hergert said.

Juneman's body was found in his Pullman home March 25, nearly three weeks after he had hanged himself. He had missed several appointments at the Spokane VA. In records obtained by Juneman before his death, Brown wrote that imminent redeployment to Iraq with the National Guard was a "major stressor" contributing to Juneman's condition, his mother said.

The Spokane VA couldn't contact the 161st Infantry of the Washington Army National Guard to advise officials there of Juneman's diagnosis. Without a patient's consent, the VA cannot inform the Department of Defense about the medical condition of "active veterans" such as Guard and Reserve members.

The week before he died, Juneman received final notification that the National Guard had rescinded a promise not to send him back to Iraq for two years.

Brown has declined through VA officials to comment on either Juneman's or Senescall's case. His superiors at the Spokane VA said they were unable to speak about specific cases because of laws protecting patients' confidentiality.

However, Sharon Helman, the medical center's director, and Dr. Gregory Winter, chief of behavioral health, said each of the six suicides this year was being investigated. As of this year, they said, every hospital employee is undergoing suicide prevention training.

"We have dedicated mental health staff who are very passionate about treating veterans, whatever their diagnosis is, to ensure they receive the quality, safe care that they deserve," Helman said. "When there is even just one suicide we are going to do everything we can to look at our process to determine (whether there is) anything we can do to improve that process and that care."

Winter said that when he came to the Spokane VA medical center seven years ago, his staff numbered about 30. Today, largely as a result of increased attention to the mental health of returning veterans, that number has grown to 52 behavioral health workers, who see about 4,500 patients.

"We save lives every day in the mental health service and all the other services as well, but we are not 100 percent," Winter said. "It is a tragedy when we lose a veteran and we ask ourselves many, many questions when that happens."
go here for more
http://www.veteransforcommonsense.org/articleid/10703

When my husband's darkest days were claiming more and more of his life with each passing day, he finally reached the point when he said "Drive me to the hospital." We headed to the VA hospital in Bedford MA. Driving on Route 128 for the half hour drive, I was afraid for him. The color of his skin had drained. The twitches I was used to seeing were out of control. I prayed all the way to the hospital.

I thanked God that all the years of trying to get him to go to the VA for help had come to that point. When we got there, we waited for hours for someone to see him. We were told there were no beds in the Rehab for him. I feared having to take him home. Being turned away from the hospital would have been too much for him and I knew that if this chance, this glimmer of hope of him being helped, was not fulfilled, it may have been his last chance. I cried. I begged. I talked to a doctor and pleaded for his life. We waited most of the day and they finally admitted him. I knew we got lucky with the doctor having compassion for us.

It was 1993. It had taken me 11 years to get him to those doors. Back then when I contacted the media, The Lynn Item, the Salem News, Boston Globe and Boston Herald, I was told our story was nothing more than "sour grapes" and if he was being turned away, there had to be a reason for it. No reporter wanted to listen, hear our story, or take the time to even investigate what was happening to our veterans back then. All the talk of appreciation for the troops after the Gulf War had come and gone. Vietnam veterans were still paying the price and no one cared. The only time their stories showed up in the newspapers, was when they had committed crimes. Reports of their early deaths were limited to the simple words of "Vietnam Veteran" when most of their lives were ended by suicide. They were suffering in silence and dying in obscurity. Families were falling apart but no one seemed to care.

What is the excuse for all of this now? Do they have any excuses left to use? The reports of this began to be reported in 2004. Only a few were released in 2003 regarding the new veterans and the newly wounded. Because of the media attention, congress has passed Bills to prevent more like Timothy Bowman, Jonathan Schultz and Joshua Omvig from being turned away but here we have two more stories all these years later.

While reports come out on steps being taken and some VA facilities moving mountains to treat the wounded, PTSD is still claiming lives. Veterans are still being turned away when they finally reach out for help begging to stay alive. There is no excuse worthy of them or their families.
The numbers we saw after Vietnam were staggering. What we saw back then, will be multiplied with Iraq and Afghanistan simply because of the nature of this new attitude that redeployments are acceptable even though each redeployment causes a 50% increase risk of being wounded by PTSD. They go back for a 3rd, 4th, 5th deployment. If we were unprepared to care for the wounded 20 years after Vietnam, how long will it take us to get there with Iraq and Afghanistan veterans lives on the line now? Will we ever be? How many more wives, husbands and parents will have to face what I did in 1993, thanking God they reached out for help only to be turned away from the help they need to live?


Senior Chaplain Kathie Costos
Namguardianangel@aol.com
www.Namguardianangel.org
www.Woundedtimes.blogspot.com"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." - George Washington

Gary Sinise in Public Service Ad for VA Suicide Prevention

VA To Test Suicide Public Service Ads
The VA Is Stepping Up It's Suicide Prevention Outreach With A Public Service Announcement Featuring Actor Gary Sinise.

July 14, 2008
CBS) CBS News Investigative producer Pia Malbran wrote this story for CBSNews.com.

--------------------------------------------------------------------------------

July 15 Update: During a Congressional hearing today on Capitol Hill, the Department of Veterans Affairs unveiled a new suicide prevention PSA. CBS News has obtained a copy of the clip. Click on the video box to the left to watch it. Rep. Harry Mitchell said that the VA’s “self-imposed ban against television advertising” that has been in place until recently was “outdated and out of touch.”

The Department of Veterans Affairs (VA) is expected to launch a suicide prevention public service campaign in Washington, DC next week as part of a three-month pilot program.

CBS News has learned that the VA will roll out the campaign on July 21 which will include a series of bus advertisements as well as more than 300 ads inside DC commuter trains and at metro train stations.

The agency has also produced a television public service announcement featuring actor Gary Sinise who portrayed a disabled veteran in the 1994 movie “Forrest Gump”. A spokesperson for Sinise confirmed his participation.

The pilot program is intended to raise awareness of suicide prevention and spread the word about the VA’s 24-hour suicide prevention hotline. CBS News has learned the ads will show a silhouette of a soldier kneeling in front of an American flag with the message: “it takes the courage and strength of a warrior to ask for help. If you or someone you know is in an emotional crisis call 1-800-273-TALK.”
click post title for more
linked from VAWatchdog.org

Gary Sinise has done a lot for veterans. It's great to see him doing this. The ad is short but gets right to the point. Pray it works to help the wounded reach out for help and pray they are there to answer the phone.

Veteran Healthcare Advocates Want VA to Focus More on Prevention

Veteran Healthcare Advocates Want VA to Focus More on Prevention


WASHINGTON, July 1, 2008--A first-ever leadership summit for veterans' healthcare advocates ended here Thursday in general agreement that the Department of Veterans Affairs must focus more time and resources on prevention and preventive medicine practices.

The objective of the Patient Advocacy Leaders Summit, sponsored by the Veterans of Foreign Wars of the U.S., was to expand awareness about critical health issues that impact the lives of veterans and those currently serving in uniform. Almost 100 attendees from more than three dozen organizations from the veteran and medical communities were present to hear and interact with prominent physicians and researchers in the fields of Traumatic Brain Injuries (TBI), Post-Traumatic Stress Disorders (PTSD), Diabetes, and Chronic Obstructive Pulmonary Disease (COPD).

The TBI seminar focused on the effects blast injuries are having on servicemen and women deployed in the wars in Iraq and Afghanistan. More than 20 percent of the 1.6 million men and women who had served in the war had experienced a blast – mostly caused by improvised explosive devices, or IEDs. Better body armor combined with modern battlefield medicine and rapid transportation have reduced the war's mortality-to-casualty rate to 10 percent, compared to previous wars that had 25 percent fatality rates in Vietnam and Korea, and 30 percent during World War II. The high survivability rates, however, are resulting in multiple grievous injuries that will continue to challenge the medical community – and the wounded veterans – for years.

Symptoms, diagnostic issues and challenges were presented at the PTSD seminar, as well as who was most at risk: military reservists under the age of 25 who have had repeated deployments, as well as those who are repeatedly exposed to traumatic events. This seminar also found the results of three independent PTSD studies to be similar: a quarter to one-third of those who went to war came home with mental health problems.
go here for more
http://www.vfw.org/index.cfm?fa=news.newsDtl&did=4620

VCS Appeals Court Ruling Because No Veteran Gets Left Behind

Keep one thing in mind as you read this. If the government had lived up to the thoughts we the people have as being grateful, no one would have to take them to court to make sure they finally do it.

VCS Appeals Court Ruling Because No Veteran Gets Left Behind
On Jun 25, 2008, U.S. Federal District Court Senior Judge Samuel Conti issued a detailed 82-page ruling where he concluded that VA is mired in crisis and that he is "troubled" by lengthy delays veterans face trying to obtain healthcare and benefits from VA. Sounds like the veterans won, right?

Unfortunately, Judge Conti said the Court lacks jurisdiction. We are deeply disappointed that he wants VA and Congress to fix VA's enormous problems.

VCS plans to press forward so our veterans receive prompt and high-quality VA healthcare as well as fast, complete, and accurate VA claims decisions. Either we repair VA now, or we face another generation of hundreds of thousands of veterans with broken homes, lost jobs, drug and alcohol problems, homelessness, and suicide.

That's why VCS will appeal the Court’s decision primarily on the Constitutional grounds that if the Judicial Branch does not enforce the law, then Legislative Branch actions become meaningless in the face of massive Executive Branch failures.

VCS needs your help to launch our lengthy and time-consuming appeal. Please click here to make a contribution to VCS today and support our work to overhaul VA for our veterans and their families.

Here are three important items about the Court's ruling:
1. The Army Times provides the best newspaper coverage about the facts.
2. CBS News / KPIX TV broadcast a thorough review of the verdict.
3. You can read the Court's decision and see VCS and Veterans United for Truth did the right thing to file suit.

VCS needs your help. In the past year we gathered veterans' stories, we obtained hundreds of pages of VA documents under the Freedom of Information Act, we worked closely for hundreds of hours with our attorneys at Morrison & Foerster and Disability Rights Advocates, and we flew to San Francisco for the two week trial.

Please consider setting up a monthly or quarterly contribution to VCS today so we can fight for our veterans.

Here is a sample of e-mails showing the broad public and veteran support of our lawsuit:
• "Your efforts will make life better for . . . veterans."

• "Thanks for all the hard work."

• "It was a great effort. The fact you were able to get the VA attitude out in the public, presented as evidence in a federal court, was of critical importance…. KEEP IT UP!"

• "I think you did a terrific job of exposing the tragedy of the veterans with the law suit."

• "All of you working on this should be proud of yourselves."

• "You have accomplished a great deal and there still things to do. This is only the beginning of the fight; end of round one."

There is a lot more work ahead as the Iraq and Afghanistan wars continue. As of April 2008, VA medical centers have treated 325,000 recent combat veterans, including 133,000 with a mental health condition, 75,000 of whom are diagnosed with PTSD.

Although we have a temporary setback, our landmark lawsuit with VUFT achieved several important goals for veterans:
• VA opened a suicide hotline, received tens of thousands of calls from highly distraught veterans, and "rescued" hundreds.

• VA hired thousands of new mental health professionals, including hundreds of suicide prevention coordinators at their hospitals and clinics.

• A trove of VA e-mails confirmed the suicide epidemic of 1,000 VA patient attempts per month. In addition, death statistics reveal that younger veterans are 3 to 4 times more likely to kill themselves than non-veterans of the same age group.

Read more of the facts uncovered by our lawsuit - facts Judge Conti agreed with.

• Congress held several oversight hearings on VA's crisis where VCS testified. Now several critical pieces of legislation inspired by our lawsuit should become law by the end of 2008. VA was also forced to explain why they concealed the suicide epidemic and why some VA staff fought against proper healthcare and disability benefits for PTSD.

• Several major media outlets now have full- or part-time journalists dedicated to investigating the human consequences of the Iraq and Afghanistan wars.

Please give to VCS today so we can win our appeal on behalf of all our veterans!
Thank You,
Paul Sullivan

Executive Director

Veterans for Common Sense
VCS provides advocacy and publicity for issues related to veterans, national security, and civil liberties. VCS is registered with the IRS as a non-profit 501(c)(3) charity, and donations are tax deductible.

Committee votes to protect vet gun ownership

Committee votes to protect vet gun ownership

By Rick Maze - Staff writer
Posted : Friday Jun 27, 2008 6:27:14 EDT

Lists of veterans who have been assigned fiduciaries to handle financial matters on their behalf could not be used to prevent gun ownership under an amendment approved by the Senate Veterans’ Affairs Committee on Thursday.

By voice vote, the committee attached to a veterans’ health care bill an amendment prohibiting the Department of Veterans Affairs from sharing lists of so-called “incompetent” veterans with the FBI. Only if there has been specific ruling that a veteran poses a risk to himself or others could the VA pass a name on to the FBI for inclusion in records used to make instant background checks before gun purchases, under the amendment to S 2969, the Veterans’ Health Care Authorization Act of 2008.

Sen. Richard Burr of North Carolina, ranking Republican on the veterans’ committee and the chief sponsor of the amendment, said the VA makes a determination of incompetence based, primarily, on whether a veteran is capable of handling his own finances. If he cannot, a fiduciary is appointed to handle their benefits.
go here for more
http://www.armytimes.com/news/2008/06/military_veterans_gunownership_062608w/

Not sure on this one at all. A friend is in this postition. What we have to remember is that there is not always a one size fits all answer. Some of these veterans should never have been able to own a gun, just like some people in this country should never be able to own one. But what is the answer? Do we go with this but allow the local law enforcement to make their own rules given the fact they are the ones dealing with whatever happens in the long run? Murphy and Akaka want to side on common sense but Burr wants to take the side of the NRA attitude. Who is right?

When Congress was taking on gun ownership for PTSD veterans, they were very upset wondering if veterans with mild PTSD would have to give up their jobs if they had to give up their guns. some of them decided that they would not seek treatment for PTSD because of this. Would you rather see a veteran with PTSD owning a gun and not getting help or would you rather see them getting help and keeping their jobs? Again there is not a one size fits all answer when it comes to PTSD. After all, we do have thousands of them in Iraq and Afghanistan right now with weapons a lot more dangerous than a hand gun.

Mental Health.net takes on Perez email

When it's used to address the need for further testing then it's an appropriate diagnosis. But if it's used for political purposes - like to save the VA from having to pay out money to a disabled veteran - then that amounts to malpractice.

Mental Health Web Site Addresses Differences in Diagnosis of Adjustment Disorder and PTSD in Veterans Mental Health
MentalHelp.Net addresses the controversial email from Dr. Norma Perez and urges better care for soldiers at VA Hospitals.

(PRWEB) June 24, 2008 -- On March 20th Dr. Norma Perez, mental health specialist and coordinator of her hospital's Post-Traumatic Stress Disorder (PTSD) clinical team, sent a startling email to her staff.

"Given that we are having more and more compensation seeking veterans," she wrote. "I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder."

click post title for more

VA Claim is wrong on Chantix wrong

Monday, December 17, 2007 was the date I posted this.

Champix warning: Quit smoking drug should be avoided if you have depression
Anti-smoking pill linked to suicide
Natasha Wallace Health Reporter
December 17, 2007
THE first anti-smoking drug that specifically targets nicotine cravings will be launched in Sydney today, but there are concerns that it has been linked to depression and suicide.Varenicline tartrate, a prescription treatment for adults marketed as Champix, will be available on the Pharmaceutical Benefits Scheme from January 1 and will cost about $60 for a 12-week treatment and about $10 for pensioners and health care card holders. Patients will receive a subsidy for one course a year.
The drug works by blocking the effect of nicotine on the brain, reducing the pleasurable and reinforcing feelings associated with smoking. Smokers set their quit date between day eight and day 14 of taking the tablets.

Nick Zwar, professor of general practice at the University of NSW, said he was concerned about US reports of suicide and depression among users of the drug and recommended that people with mental health problems avoid it.
click post title for the rest
http://woundedtimes.blogspot.com/2007/12/champix-warning-quit-smoking-drug.html

While the spelling was different, perhaps because this was out of Sidney, it seems a lot like Chantix.


This went on to say that the US Government was looking into the research and ended with this statement

Associate Professor Matthew Peters, head of respiratory medicine at Concord Hospital, said most smokers make five to seven attempts before they finally quit.

"I think it is a very effective drug to help people quit smoking but I think the right sort of support is critical to get the benefits," he said. "I agree that we should be cautious about use in people with mental health problems."

But it looks like the FDA was already looking at this in November
FDA to review Champix/Chantix side effects
Nov 29, 2007 ... A drug which was designed to help people quit smoking is causing concern following a number of reports that it induces suicidal feelings and ...
www.news-medical.net/?id=33001

When it comes to PTSD help heal it or get out of the way!

One more case of "but"

Military Update: Treating mental combat wounds
BY TOM PHILPOTT Daily Press
June 16, 2008

Rep. Bob Filner, chairman of the House Veterans Affairs Committee, alleged on Wednesday that Bush administration officials were continuing to downplay the mental trauma and brain injuries suffered by veterans of the wars in Iraq and Afghanistan.

Filner, D-Calif., said an April RAND Corp. study — "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery" — justified a 10-fold jump in the U.S. casualty count, compared with the figure of 33,000 American dead and wounded used by the Pentagon.

RAND researchers extrapolated from a survey they conducted of 1,965 vets to conclude that nearly 300,000 service members and vets of Iraq and Afghanistan were suffering from post-traumatic stress disorder — PTSD — or major depression. Filner told the pair of researchers, who summarized their findings for his committee, that their work probably understated the problem.

"I personally think these are low estimates, just from my own studies," Filner said. "But if you take even the 300,000, (it's) 10 times the official casualty statistics from the Pentagon. Shouldn't this 300,000 be included?"

Lisa H. Jaycox, a senior behavioral scientist and clinical psychologist who co-directed the RAND study, embraced Filner's argument.

"Well, they are (suffering) an injury condition resulting from combat deployment, and so it's a different kind of casualty," Jaycox said, "but, yes, they are very important numbers."

The three-hour hearing also included testimony from retired Navy Rear Adm. Patrick W. Dunne, assistant secretary for policy and planning for the Veterans Benefits Administration.

At the same hearing, Michael L. Dominguez — principal deputy undersecretary of defense for personnel and readiness — said RAND gathered solid data from its survey but drew the wrong conclusions. The study, Dominguez said, "did not, and cannot, definitively say that there are 300,000 cases of clinically diagnosed cases" of PTSD or depression among vets who served in the two theaters.

Filner angrily interrupted him, telling Dominguez that RAND didn't say it showed 300,000 clinically diagnosed cases of PTSD or depression.

"It was an extrapolation to the possibility" of 300,000 cases, Filner said.

With more than 1.6 million U.S. service members having served in Iraq or Afghanistan, Dominguez said, a finding that 300,000 vets "have experienced some kind of mental health stress is very consistent with our data. And those people do need to be discovered (and) to get help."
go here for more
http://www.dailypress.com/news/local/military/dp-local_milupdatenew_0616jun16,0,6743686.story

Over 30 years ago, when people who got into this before I did, there was very little known about PTSD and it had just received that title because Vietnam Veterans fought for it. Five years later, I got into this because of my husband. By then a lot more was known. One of the things was that there were 500,000 with PTSD and this came from a study funded by the DAV. This study was published in 1978 before most of the people being quoted as "experts" today were even born. This is not a new illness. This is not a changing illness because humans are pretty much still made up of all the same parts of their original design.

At the NAMI convention in Orlando this weekend, we heard a lot about a lot of people suffering. A great deal of the people attending were consumers, otherwise known as patients and their families. They sat in the conference rooms right next to people who have working on helping them ranging from simple advocates like me all the way up to psychiatrists and psychologist. Why would people like us get together for 4 days of talking? Simply to provide understanding, knowledge and support to keep trying to fight for all of them. I heard a lot of heartbreak from some of the families dealing with PTSD in their own families.

Every time there was a denial of what is going on, people got up and walked out of the room. Frankly I was wondering why some of them were there are all at the head of the room instead of sitting in back and listening. No one is such an expert they have nothing to learn about this. This is why having conferences is so important for anyone living with or working in mental health needs to participate in events like this whenever and wherever possible.

Throughout the years I've come up on many articles trying to diminish the magnitude of the suffering. Whenever this happened the only question in my mind was focused on why anyone would try to do this instead of listening, learning and being quiet until they knew the answers.

While I post about medications taken totally out of the report I read, I never discuss medication when helping veterans other than to tell them they may need it, to stop self-medicating and to talk to their doctor if they feel like their medication is not working. I have very little to offer on this subject because I am not a doctor and I just don't have enough knowledge to know I am helping instead of harming with the limited knowledge I do have on this subject. In other words, a little knowledge can do a lot of harm so I keep my mouth shut on this and won't step over the line using guess work.

Why can't "experts" do the same when it comes to PTSD? If they are experts with other issues, then they should stay where they are, focus on what they know and stop pretending to be experts on what they know very little about. Why can't they except history for what it is and stop trying to stand in the way of new data drawn from history? The numbers from the Rand Study did not shock me or surprise me at all because all I had to do was pay attention in the first place to the data from Vietnam veterans to know the Rand Study is a lot closer to reality than the VA and DOD numbers are. One more thing jumping out from all of this is the fact the VA and the DAV are jumping around like their hair is on fire trying to cope with all of this. If the numbers are only about 30,000, they would be fully capable of dealing with them otherwise. They are not so inept that 30,000 would totally overwhelm them.

Just open your eyes and know what real is and what an illusion is. If you don't know what the hell you are talking about then go sit in the back of the room and open your ears as well as your mind. Otherwise, you are standing in the way of healing and that is not helping!

The following are in response to some of the things I heard during the conference which caused me to walk out of the room.

FACT: Dr. Katz did conceal the numbers of suicides and attempted suicides. The emails did not just suddenly show up on Senator Akaka's desk. The Katz emails were discovered because of the law suit brought about by Veterans for Common Sense and Veterans United for Truth. The emails were what he sent because he was trying to cover up the data CBS found with their own research work. The emails were about harmful conditions attempting to be covered up after we already saw too many suicides.

FACT: Norma Perez email about not doing a diagnosis of PTSD, was what it was. No it was not a poor choice of words because of what she followed up this with and mentioned cost cutting and how they "didn't have time" to do a thorough diagnosis. This email did not suddenly show up but was discovered because of a Freedom Of Information Act filed by CREW and VoteVets.

While we are reading horrible stories about suicides and suffering of our troops and veterans, we would not be reading them if they were not happening. This is obvious! How could any of the service organizations be taking on the VA and the DOD if there were not problems that enabled them to be taken on? The DOD and the VA heads will defend everything they are doing no matter what harm is being done as long as they can get away with it. It's all as simple as that. If they were just simply mistaken on what they did, then why were they not willing to correct the harm done and leave it at that instead of defending what they did and their right to keep doing it?

Folks, this is really simple. If there is damage being done and no one is addressing it, the damage will continue and nothing will be fixed. We will keep reading more and more stories about suffering instead of less and less. This blog alone has over 2,000 posts on it and I doubt there are two hundred good stories on it. That's really sad when you consider that PTSD has been known for over 30 years and reported in humans since King David's time.




You can read more about NAMI here.

NAMI: National Alliance on Mental Illness
The mission of the National Alliance for the Mentally Ill is "to eradicate mental illness and improve the quality of life

Perez emails shows VA care depends on where you go

Tue, 10 Jun 2008 19:25:01 GMTE
SF: JUDGE ACCEPTS CONTROVERSIAL E-MAIL AS EVIDENCE IN VETERANS CASE

SAN FRANCISCO (BCN)

A federal judge who is overseeing a case challenging mental health care for veterans accepted a controversial e-mail by government psychologist into evidence at a hearing in San Francisco today.

U.S. District Judge Samuel Conti said, "This hearing is unique" because he reopened the case after the conclusion of a two-week trial in April and May on a lawsuit filed by two veterans' groups.

Conti accepted into evidence both the e-mail written by psychologist Norma Perez and the transcript of a June 4 U.S. Senate Veterans Affairs Committee hearing on the message.

Perez is the coordinator of a post-traumatic stress disorder, or PTSD, team at a regional veterans' medical center in Texas.

Her March 22 e-mail appears instruct staff members to avoid diagnosing PTSD in returning vets because of the cost and instead to diagnose a less expensive adjustment disorder.

The e-mail says, "Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder, ruling out PTSD."

U.S. Justice Department attorney Daniel Bensing told Conti today that officials of the U.S. Department of Veterans Affairs have repudiated the e-mail. He said the "unfortunate wording" has been clarified.

Heather Moser, a lawyer for Veterans for Common Sense and Veterans United for Truth, argued that the message supports the two groups' claim that the veterans' agency isn't able to enforce its policies on the local level.

"The people who suffer at the end of the day are the veterans," she told the judge.

The veterans' groups are seeking court orders barring the agency from denying needed mental health care to veterans and requiring the agency to act in a timely way on medical claims.

Conti said he plans to rule on the case soon.
http://cbs5.com/localwire/22.0.html?type=bcn&item=VETERANS-CASE-EVIDENCE

What happened to rules that apply all over? They served one nation but it looks as if when it comes to them needing us, it all depends on where you live. What a shame this is!

Veteran's Administration cover up of PTSD

Veteran's Administration cover up of PTSD
Tuesday, June 10, 2008 5:58 PM
By Vic Lee
SAN FRANCISCO, CA (KGO) -- There is new evidence suggesting the Veteran's Administration is covering-up sub-standard mental health care given to vets. There's evidence a federal judge in San Francisco accepted on Tuesday, even though the case has already been tried.

There was email was written in March by Norma Perez, Ph.D., a V.A. psychologist who coordinates post-traumatic stress disorder cases.

She wrote, "Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of adjustment disorder."

The email was discovered by accident through a Freedom of Information request by a veterans group.

"It is a very damning email. Cut off the money, disguise them with adjustment disorders so they don't get V.A. benefits," said Gordon Erspamer, a Veterans Groups' Lawyer.

Attorneys for Veteran's groups suing the V.A. say the email supports their case that the dept has failed to diagnose and treat PTSD and other mental health problems.

Their lawsuit asks the court to force the V.A. to treat veterans who show signs of PTSD and are at risk of suicide.

The V.A. says the email's author admits it was poorly worded and has no bearing on the lawsuit.

"I think she made it clear she had mistakes. The secretary has disciplined her and also said she doesn't reflect any V.A. policies," said Kerri Childress, a Veterans Administration spokesperson.

This is the second email that the veterans say the V.A. has tried to conceal from the public.
go here for more
http://abclocal.go.com/kgo/story?section=news/local&id=6197910

Veterans Groups Win Round In Federal Court in Lawsuit Against VA

Veterans Groups Win Round In Federal Court in Lawsuit Against VA

By Jason Leopold
The Public Record
Tuesday, June 10, 2008

Favoured : None

Published in : Law


A federal court judge sided with two veterans advocacy groups suing the Veterans Administration Tuesday, agreeing to add to evidence an explosive email written by a VA official that suggested counselors consider diagnosing war veterans who show signs of post traumatic stress disorder with a less serious condition.

Two veterans advocacy groups, Veterans for Common Sense and Veterans United for Truth, sued the VA last year for allegedly failing to provide treatment to veterans returning from Iraq and Afghanistan who are suffering from PTSD.

The groups want a judge to issue a preliminary injunction to force the VA to immediately treat veterans who show signs of PTSD and are at risk of suicide. Attorneys representing both organizations asked the judge to reopen their case and consider admitting Perez’s email into evidence after another veterans group publicly disclosed it last month.

Last week, U.S. District Court Judge Samuel Conti ordered Justice Department attorneys defending the VA to appear in court Tuesday for a hearing to explain the contents of the email and whether it should be admitted into evidence. Conti said, “The email raises potentially serious questions that may warrant further attention."


Justice Department attorney James Schwartz sent a letter to Conti last Wednesday saying the email has no bearing on the plaintiffs’ lawsuit. Schwartz said the email was an isolated incident and in no way reflected VA policy. He added that Perez had been “counseled.”

On Tuesday, Scwartz told Conti that the VA’s inspector general had launched an investigation into the matter. He added that Perez was disciplined and in no way did she intend to imply that the VA sought to cut costs by diagnosing veterans suffering with PTSD with the less serious diagnosis of “adjustment disorder.”

"It was an honest mistake by a junior staff member," Bensing told the judge. "There really is nothing more to this matter. We submit that it should have no effect on this case."

Conti was not swayed. He admitted the document into evidence, which is expected to have an impact on his ruling.

“The Court’s ruling is an important victory for veterans," Veterans for Common Sense said in a statement Tuesday. "The ruling adds critical new evidence the judge will review as part of our lawsuit against VA on behalf of all veterans. VA’s anti-PTSD e-mail is a shocking example of how serious the problems are within VA. When combined, the e-mail and the evidence presented at trial clearly demonstrate a systemic failure by VA to provide prompt and high-quality mental healthcare to our Nation's veterans suffering from PTSD.”

The March 20 email was written by Norma Perez, a VA psychologist and the coordinator of a post-traumatic stress disorder clinical team in Temple, Texas.

"Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Perez’s email says. "We really don't or have time to do the extensive testing that should be done to determine PTSD."

click post title for more

Perez says "poorly worded" email, not poor service

VA Says E-mail Was “Poorly Worded”
Veterans Affairs Psychologist Claims E-mail Appearing to Encourage VA Staff To Misdiagnose PTSD Was Out Of Context

June 4, 2008
CBS) This story was written by CBS News producer Pia Malbran for cbsnews.com.

A Veterans Affairs psychologist claims an e-mail, in which she appears to encourage VA staff to misdiagnose post traumatic stress disorder, has been taken out-of-context.

“I sent an e-mail to my staff on March 20 to stress the importance of an accurate diagnosis,” Norma J. Perez told the Senate Committee on Veterans’ Affairs Wednesday during a hearing in Washington, DC.

Perez’s internal e-mail was leaked to the media last month by two veteran watchdog groups. As the coordinator of the PTSD clinic at a VA hospital in Texas, Perez sent a message titled “Suggestion” to her mental health staff. She wrote: “given that we are having more and more compensation seeking veterans, I'd like to suggest you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder…”

Lawmakers are concerned that Perez appeared to be more interested in the cost of treatment rather than the appropriate diagnosis. A veteran diagnosed with adjustment disorder will not receive as much compensation as one diagnosed with PTSD.

“Any suggestion that we would not diagnose a condition, any condition is unacceptable,” said Dr. Michael Kussman, the VA's Under Secretary for Health, who testified alongside Perez.

Perez told the Committee that there is “no relationship whatsoever” between the VA’s disability process and the treatment clinics. As to why she mentioned “compensation” in her e-mail, Perez said she just wanted to emphasize consistent diagnoses.
go here for more
http://www.cbsnews.com/stories/2008/06/04/cbsnews_investigates/main4154924.shtml


Pure Bull!
In her e-mail, Perez cited a growing number of veterans seeking compensation when she suggested her staff "refrain from giving a diagnosis of PTSD straight out" and consider a lesser diagnosis of adjustment disorder. "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

http://woundedtimes.blogspot.com/2008/06/norma-perez-to-ptsd-veterans-no-time.html