Soldier Given Stimulants in Combat Linked to PTSD Risk

Pentagon study links prescription stimulants to military PTSD risk
LA Times
Alan Zarembo
November 19, 2015

Those who had been prescribed multiple stimulants and the biggest supplies of the drugs were the most likely to have PTSD.

Stimulant medications used to treat attention deficit problems and keep service members alert during long stretches of combat might increase vulnerability to post-traumatic stress disorder, a new study suggests.

Defense Department researchers analyzing data from nearly 26,000 service members found that those with prescriptions for the stimulants were five times more likely to have PTSD.

Drugs such as Adderall and Ritalin raise concentrations of the brain chemical norepinephrine, which has been shown to result in more vivid and persistent memories of emotionally charged situations.

Traumatic memories are a hallmark of PTSD.

"When you take a stimulant, you enhance learning," said Dr. Richard Friedman, a psychiatrist at Weill Cornell Medical College in New York, who was not part of the study. "PTSD is form of learning. Traumatic experiences hijack circuits in the brain."
read more here

If you want to know what the Army knew read this and get an eye opener.

In is from March of 2009

COMBAT AND OPERATIONAL STRESS CONTROL MANUAL FOR LEADERS AND SOLDIERS

REACTIONS TO COMBAT AND OPERATIONAL STRESS STRESS BEHAVIORS IN FULL SPECTRUM OPERATIONS

1-6. Combat and operational stress behavior is the term that is used to describe the full spectrum of combat and operational stress that Soldiers are exposed to throughout their military experience.

1-7. Soldiers—especially leaders—must learn to recognize the symptoms and take steps to prevent or reduce the disruptive effects of combat and operational stress.

1-8. Combat and operational stress is a reality of all military missions. It is important to understand that combat and operational experiences affect all Soldiers and reflect all activities that Soldiers are exposed to throughout the length of their military service whether it is a complete career or a single enlistment. Combat and operational stress can occur during missions in both garrison and deployed assignments.

1-9. Combat stressors include singular incidents that have the potential to significantly impact the unit or Soldiers experiencing them. They may come from a range of possible sources while performing military missions. Operational stressors may include multiple combat stressors or prolonged exposures due to continued operations in hostile environments. Combat and operational stressors have a combined effect that results in COSRs. See Table 1-1 for examples of both combat stressors and operational stressors.

1-10. Most Soldiers are resilient and work through their COSB experiences. The resiliency displayed by these Soldiers is what we refer to as mental toughness or Battlemind.

1-11. Battlemind skills, developed in military training, provide Soldiers and leaders the inner strength to face fear, adversity, and hardship during combat with confidence and resolution and the will to persevere and win.

1-12. No amount of training can totally prepare a Soldier for the realities of combat. Sometimes even the strongest Soldiers are affected so severely that they will need additional help. Combat and operational stress behavior experiences will impact every Soldier in some way. Just because a Soldier may not be affected by a specific event, it does not mean that every Soldier in the unit is handling the stress in the same way.

1-13. Soldiers surveyed in Iraq indicated that those who experienced the most combat were the most likely to screen positive for a BH problem, including PTSD. Nearly one-third of Soldiers operating outside the wire may be experiencing severe negative symptoms related to combat and operational stress exposure. This can potentially affect the unit’s mission capability.

1-14. In fact, current research shows Soldiers continue to struggle with negative PCOS symptoms long after redeployment. Soldiers do not reset quickly after coming home and up to 17 percent of returned veterans may continue to struggle with negative PCOS effects even 12 months after coming home.

Australia Claims "First World-Study on Vietnam Veterans With PTSD"

They say it is the first study in the world? Seriously? Then I guess this didn't really happen in 2008 or any of the other studies already done and undone to be redone again.

Persisting Posttraumatic Stress Disorder Symptoms and their Relationship to Functioning in Vietnam Veterans: A 14-Year Follow-Up

The authors examined the longitudinal association between persisting posttraumatic stress disorder (PTSD) symptoms and multiple domains of life functioning in a community sample of 1,377 American Legionnaire Vietnam veterans first assessed in 1984 and followed-up 14 years later. Almost 30 years after their return from Vietnam, 10% of veterans continued to experience severe PTSD symptoms. At all levels of combat exposure, persisting severe PTSD symptoms were associated with worse family relationships, more smoking, less life satisfaction and happiness, more mental health service use, and more nonspecific health complaints at the 14-year follow-up. Further investigation is needed to determine whether the PTSD-functioning relationship is causal and if successful treatment of PTSD is associated with improvement in functioning.

In this study, we first examine whether the association between higher combat exposure and worse functioning documented in 1984 is still evident in 1998. We then test whether persisting PTSD symptoms are associated with deficits in four important areas of current functioning: family relationships, negative health behaviors, personal well-being, and nonspecific health problems, after stratifying by combat exposure.

Plus this

The association of PTSD with current smoking and nonspecific health complaints deserves further attention. A smaller proportion of veterans with persisting PTSD quit smoking between 1984 and 1998. Over 50% of veterans with PTSD in the medium and high combat groups were current smokers in 1998 compared to 30%−40% of those exposed to similar levels of combat, but who did meet criteria for severe PTSD symptoms. The significant association between combat-related PTSD and current smoking is consistent with other studies of veterans (Beckham, 1999; Eisen et al., 2004; Koenen et al., 2006; Schnurr and Spiro, 1999). Moreover, smoking has been posited as a mediator of the consistent association between PTSD and worse health and may be one reason veterans with PTSD had more nonspecific health complaints. Growing evidence suggests veterans with PTSD are at higher risk for future tobacco-related diseases including coronary heart disease and lung and other cancers (Boscarino, 2004, 2006; Kubzansky, Koenen, Spiro, Vokonas, and Sparrow, 2007). However, PTSD appears to have direct negative effects on self-reported health and coronary heart disease that are independent of the PTSD-smoking association (Kubzansky et al., 2007; Schnurr, Ford, et al., 2000; Schnurr and Spiro, 1999). In fact, path analytic studies suggest the direct effect of PTSD on health accounts for more of the variance than the indirect of PTSD through smoking (Schnurr and Spiro, 1999). Further longitudinal research aimed at clarifying the relationships among PTSD, smoking, and health problems in veterans is needed.

Remember as you read the following they have been doing research on PTSD for 40 years!

World-first study looks at PTSD's toll on Vietnam veterans' bodies
ABC Australia
By Tom Fowles
Posted about 10 hours ago

World-first research into the effects of post-traumatic stress disorder on Vietnam veterans, including Test cricketer Tony Dell, will be unveiled in Brisbane next month.

The study looked at 300 veterans, half of them with PTSD, to work out the physical impact of the disease.

Former Test cricketer and PTSD sufferer Mr Dell, who served in Vietnam in the late 1960s, was one of the first to take part in the study.

"Lots of people with PTSD actually die younger from the physical ailments that you actually become more susceptible to," he said.

He said he hoped the research provided encouragement for the Federal Government to take action against the debilitating condition.

"We hope to go back to the Prime Minister and the Defence Minister and say 'You have to do something'," Mr Dell said.

"In army terms, you've marked time for too long. It's flown under the radar. It's underfunded, it's misunderstood and here's a definite way forward for you."

The full extent of the physical toll that PTSD places on the body will be announced at the PTSD 2015 international forum in Brisbane between September 10-11.
read more here

Editorial Board is wrong on Joint Base Lewis-McChord and PTSD

The News Tribune Editorial Board is wrong on Joint Base Lewis-McChord and PTSD
by
Chaplain Kathie

The best place to start on this is the claim that "it’s gotten more aggressive about teaching soldiers to recognize the signs that may signal a colleague is contemplating suicide" because it has been going on for years. The claims of the military doing anything that works on PTSD has been trumped by reality. If anything they were doing was actually working, there would be a decrease in suicides, attempted suicides, arrests and a lot less phone calls to the Suicide Prevention Hotline. For the editors of TNT to make this kind of claim shows one thing. They have not been paying attention. If they had, they would be just as sickened by the outcomes as everyone else.

JBLM has problems, but it’s hardly ‘on the brink’ of disaster
Post by TNT Editorial Board
The News Tribune on Dec. 28, 2011
This editorial will appear in Thursday’s print edition.

Is Joint Base Lewis-McChord “on the brink,” as claimed in a Los Angeles Times article and headline Monday? (The brink of what is never spelled out, but it’s safe to assume that it’s not “on the brink of something good.”)

The Times cites an article that appeared a year ago in Stars and Stripes that described JBLM as “the most troubled base in the military.” That billing was based on the courts martial of a group of Stryker soldiers for murdering civilians in Afghanistan, a much-publicized – and disputed – complaint by Oregon National Guardsmen of second-class treatment at Madigan Army Medical Center, and increased steroid use among soldiers.

The Times article adds to the list by citing several suicides and crimes committed by soldiers who returned to the South Sound after deploying to war zones, including the tragic case in April of a combat medic being treated for depression and other conditions. He shot his wife and himself, and their 5-year-old son was later found dead in the family’s Spanaway home. (Read about that case here.) The “base on the brink” description of JBLM came from a local veterans group that was not named in the Times article. The reporter says the group is Iraq Veterans Against the War – hardly an unbiased observer.

It’s true that the Army has been slow to recognize the mental health issues facing its soldiers, especially combat troops who have had multiple deployments. But it is starting to address those issues. At Madigan this year, it opened the $52 million “warrior transition” barracks that can accommodate more than 400 wounded or psychologically impaired soldiers and their families.

And it’s gotten more aggressive about teaching soldiers to recognize the signs that may signal a colleague is contemplating suicide.

read more here

This is the first point they missed.

It was around the same time the DOD came out with the flawed notion servicemen and women can "train their brains" to become tough enough to prevent PTSD.

1. REPORT DATE
01 NOV 2006
Methods:

“Battlemind” is the Soldier’s inner strength to face fear and adversity in combat with courage. The two components of Battlemind are self-confidence and mental toughness; strengths that all Soldiers must have to successfully perform in combat.

The key precept in Battlemind Training is that all Soldiers have the necessary skills to successfully transition home. By building on the Soldiers’ existing skills and inner mental strengths, the transitioning home process can be enhanced.

Through Battlemind Training, Soldiers are shown how their combat skills, if not adapted for home, may interfere with their transitioning process. Battlemind training focuses on ten specific skills, using the word B-A-T-T-L-E-M- I-N-D, and emphasizing how it is possible to avoid the problems that can occur when Soldiers go, in a matter of hours, from the battlefield to the home front.
Buddies (cohesion) vs. Withdrawal
Accountability vs. Controlling
Targeted Aggression vs. Inappropriate Aggression
Tactical Awareness vs. Hypervigilance
Lethally Armed vs. “Locked and Loaded” at home
Emotional Control vs. Anger/Detachment
Mission Operational Security (OPSEC) vs. Secretiveness
Individual Responsibility vs. Guilt Non-defensive (combat)
Driving vs. Aggressive Driving
Discipline and Ordering vs. Conflict
read more here

The problem with this is it makes the soldiers believe it is their fault if they end up with PTSD, enforces the idea they are defective or mentally weak and did not train properly. Training them to face combat is what bootcamp is for. Evidently they haven't discovered that yet. Whatever else this program offers, which could be very beneficial, the rest of the message was trumped by telling them it is their fault if they end up with PTSD.

The fact is, this program doesn't work because everything it "attempted" to avoid increased, including drunk driving and minor crimes that have resulted in the necessity of communities offering Veterans Courts to get them help instead of jail time.

The common rate used by most experts on PTSD point to 1 out of 3, meaning 2 will walk away without PTSD. Some use 1 out of 5, meaning 4 will walk away from the same traumatic experience without PTSD. Any program claiming to prevent PTSD should have to prove the test subjects are among the group more likely to develop PTSD, but they didn't have to prove anything before this was put into practice in the DOD. Everything coming out of the DOD thus far has shown they don't understand what causes PTSD or makes one more apt to be suffering from it.

None of the reports coming out on combat and PTSD are new.

A copy of this hangs over my desk to remind me of what was known and when we knew it. It was a study done on Vietnam veterans. The report not only supported the need for Veterans Centers because of the reluctance of Vietnam veterans to go to the VA, but supported the need for them to be able to come together with others. Talk therapy was vital in healing these men and women, but as psychologist are being replaced by psychiatrists handing out prescriptions instead of listening, there is more numbing going on than healing.

The report also stated that there were 500,000 Vietnam veteran with PTSD along with warning the numbers would go up in the following 10 years. Two later reports put the number of suicides between 150,000 and 200,000. As you can see, the link between combat and PTSD has been studied for a very, very long time, so none of the new studies have shown any progress or we wouldn't be seeing higher negative reports.

We would be seeing more reports on the different types of PTSD being addressed. While there are many causes connected to different traumatic events, combat is in a class by itself. The duration has a lot to do with it because they do not feel safe while deployed then the fact of redeployment will not allow them to feel the threat is over. Keep in mind, most Vietnam veterans did one tour of duty. Some of the men and women of today's wars have been deployed multiple times. The number of exposures during deployment are one component to all of this but then there is the fact they are participants in them. They are not just bystanders. They are not responders showing up after the fact but we seem to be able to understand emergency responders with PTSD better. In New York they studied responders after 9-11 with PTSD even though they were not there when the planes hit the Twin Towers. These men and women are right there when it all happens and then exposed to more attacks.

Joint Base Lewis-McChord has been using the same type of program as Battlemind under Comprehensive Soldier Fitness "program aims to equip troops mentally Brig. Gen. Rhonda Cornum of Gulf War fame has been deployed to lead the military's new program to prepare soldiers for the psychic trauma of war and its aftermath." This just received another $125 million in funding even though there is no proof it has done any good at all. While the reporter Kim Murphy, Los Angeles Times, said it was "new" it has been around since 2009.

The article also stated "The suicide rate among our soldiers is at an all-time high. The number of soldiers suffering from post-traumatic stress is also high. And the stress of long separations due to combat is felt by our family members too," Gen. George W. Casey Jr., the Army's chief of staff, wrote in an article about the program this year. "As such, we are starting not with a blank slate but rather with the challenge of having the preponderance of our force influenced in some way — both positively and negatively — by the effects of sustained, protracted conflict."

So how can a program like this be allowed to claim it is anything "new" when the results have been so deadly for this long?

When editors and reporters do not know what they are reporting on, we end up with them defending all the wrongs that have been done to the men and women serving this country. We end up with veterans still reluctant to go to the VA or seek help for PTSD because they have been "trained" to see PTSD as their fault. We see suicides go up at the same time the Suicide Prevention Hotline phone calls flood in. Had any of these programs worked, there wouldn't be so many reaching the point where suicides seems to be their only option. We see so many veterans being arrested there is a need for a special court for them. We see employers unwilling to hire them because they don't understand what PTSD or the simple fact that unlike the general population the combat veterans are actually better employees because of what their last job was.

We see thousands of claims waiting for processing yet this simple fact never makes it into the veterans suicide reports. If they do not have an approved claim, they are not counted by the VA. If they are not active military, they are not counted by the DOD. Each branch of the military has their own numbers but they only include active duty.

One more thing reporters and editors need to understand is the fact there are over 2 million veterans of Iraq and Afghanistan but very few of them are causing any kind of trouble. They have allowed the fear of PTSD take over the minds of the general public because they will not address the reality of what PTSD is, what causes it and what these men and women are like any more than they address what they need to heal.

"He went to Fort Lewis to kill himself to prove a point,"

"He went to Fort Lewis to kill himself to prove a point,"
by
Chaplain Kathie

" 'Here I am. I was a soldier. You guys didn't help me.' "

Those were the words Josh Barber's widow told a reporter in the article below. That's the real issue here. For all the talk about what's being done, no one is talking about what does not work and may in fact cause more harm than good. What good does it do to tell wounded veterans we're doing this and we're doing that but they still don't get the help they need? As for the "programs" they have in place, some are good but some are bad but they still use them. We don't know why they do and the widows, well they only know they sent their husbands into combat expecting they would be taken care of if they were wounded but they end up with a stranger needing help that never seems to come in time.

If anyone other than the government said they had a program that would cut down the number of PTSD cases, attempted suicide and successful ones, would you really believe them without proof? Wouldn't there have to be years of clinical trails and scrutiny from psychologist and psychiatrists from around the world before they even began to offer the program?

RELEASE #2008-01-04-1 Jan. 4, 2008

‘BATTLEMIND’ PROGRAM SEEKS TO HELP SOLDIERS DEAL WITH COMBAT EXPERIENCES
By Susan Huseman
U.S. Army Garrison Stuttgart Public Affairs Office
STUTTGART, Germany – Every Soldier headed to Iraq and Afghanistan receives“Battlemind” training designed to help him deal with combat experiences, but few know the science behind the program. Dr. Amy Adler, a senior research psychologist with the Walter Reed Army Institute of Research's U.S. Army Medical Research Unit Europe visited Patch Barracks here to explain the support and intervention program to an audience of medical, mental health and family support professionals.

The Battlemind system includes separate pre-deployment training modules for Soldiers,unit leaders, health care providers and spouses. Psychological debriefings are given during deployment and upon redeployment. There are also a post-deployment module forspouses and several post-deployment modules for Soldiers. Not every Soldier who deploys is at risk for mental health problems; the main risk factor is the level of combat experienced, Adler said.

Army studies show the greater the combat exposure a Soldier encounters, the greater the risk for mental health problems, including post traumatic stress disorder, depression,anger and relationship problems. When Soldiers first return home, they may not notice any problems; sometimes it takes a few months for problems to develop.For those in the medical community, “Our challenge was how to develop interventions that can get at all these things,” Adler said. “How do you develop a mental health training (program) of some sort that's going to prevent that eventual increase over time?“We realized we needed to develop some kind of alternative,” Adler continued. “Therewas no existing mental health training that made sense for these sets of questions. It’s not like there was something ‘off-the-shelf’ in civilian literature that would begin to address this.”

Post-deployment health briefings didn’t specifically target Soldiers going into combat and coming back with adjustment challenges, so researchers at the Walter Reed Army Institute of Research began to define their objectives for a mental health training program. Adler said the team needed to develop something that was “going to make sense for different phases of the deployment cycle.”“For example,” she said, “the existing mental health brief (at the time) was the same for pre- and post-deployment. That doesn’t make sense. The challenges are different.”“Secondly,” she continued, “we wanted to make sure it was integrated. If we tell somebody something at (pre-deployment), we want to make sure whatever theme we’regoing for or concept we’re trying to communicate, it’s going to connect with the same information that we’re going to talk about at (post-deployment).”The result? “Battlemind,” a term used to describe combat readiness that the researchers felt was appropriate for the training they were designing.

Adler called it a Soldier’s inner strength to face fear and adversity in combat with courage, labeling it “resiliency.”The Battlemind system is built on findings from surveys and interviews given to Soldiers and Marines returning from Iraq and Afghanistan. In fact, many of the researchers themselves have deployed.The research team gathered Soldiers’ accounts of specific events and incidents, turning them into teaching tools that warriors can relate to. “Some of these stories tell more than any briefing ever could,” Adler said.The first Battlemind product was a mental health post-deployment briefing. It quickly became a training system supporting Soldiers and families across the seven phases of the deployment cycle.

As part of her presentation here, Adler discussed various challenges in developing arelevant pre-deployment mental health briefing for Soldiers.“You have 45 minutes -- maybe an hour -- to tell Soldiers, before they deploy to Iraq, something about mental health,” she said. "What are you going to tell them? You don’t want to sugar-coat it, but you don’t want to teach them a whole lot of new information right at a time when they are focused on the task ahead of them.”The researchers first chose to identify the reality of combat and deployment. It may sound rudimentary, but earlier research found that soldiers were not telling other Soldiers what to expect.

Soldiers didn’t want to sound as if they were bragging, Adler said. Pre-deployment Battlemind tells Soldiers what they are likely to see, to hear, to think and to feel while deployed by describing the worst-case scenario.For the post-deployment phase, Battlemind addresses safety concerns and relationship issues, normalizes combat-related mental health reactions and symptoms, and teachesSoldiers when they should seek mental health support for themselves or for their buddies.The researchers realized that this post-deployment briefing, the original Battlemind, was not enough. The Soldiers they talked to were raw, edgy and angry. Another training program, Battlemind II, was developed to be given three to six months into redeployment.The system reemphasizes normal reactions and symptoms related to combat and“Battlemind checks,” which are signs that indicate mental health support is needed.“If you’re still carrying a weapon around with you during the three- to six-month postdeployment phase; ... if you’re still looking around for snipers; if your sleep is still really messed up; these might be signs that your transition is not going smoothly,” she explained. “These are signs that you need to get help."

The problem with Battlemind is that it does not work because of the mixed message they are giving.

Psychiatr News May 4, 2007
Volume 42, Number 9, page 2
© 2007 American Psychiatric Association

Professional News


Combat Stress Should Be Considered Preventable, Manageable
http://pn.psychiatryonline.org/cgi/content/full/42/9/2
Aaron Levin
The stresses of combat in Iraq or Afghanistan need to be seen in a context that is broader than just that of PTSD risk—a context of resiliency and recovery
Soldiers returning from war in Iraq and Afghanistan often bear the psychic scars of battle, but a closer understanding of their experience can help reintegrate them into civilian life and avoid overpathologizing their conditions, said two clinicians who have studied and treated posttraumatic stress disorder (PTSD).

"We need to move from an obsession with PTSD to focus on combat stress, injury prevention, and management," said Charles Figley, Ph.D., a professor at Florida State University's College of Social Work and director of the university's Traumatology Institute and Psychosocial Stress Research Program

Figley spoke at a conference on mental health needs of returning soldiers and their families in Columbia, Mo., sponsored by the International Medical and Educational Trust at the University of Missouri.

Calling wartime trauma "combat stress injury" would place it in the same light as other war wounds: preventable and manageable, if sometimes irreversible, said Figley.

However, prevention and management must begin early, he said. Troops should acknowledge the likelihood and fact of injury beginning in boot camp. Before they are wounded, troops believe they are invulnerable and even after physical injury, often deny they are hurt. To a soldier, injury, whether physical or psychological, is a source of embarrassment. They have to move from denial to needing to talk about their injuries, said Figley. click link above for more

I am not a psychologist or a psychiatrist but in a sense that makes me more qualified to understand what all this mumbo jumbo sounds like to average people. First they are giving the impression that PTSD can be "prevented" but they have yet to understand why some are wounded by PTSD and others walk away. (More on this later) So how can they claim it can be preventable if they don't even know the detail? It's either one out of three, which happens to be the percentage most professionals go by or one out of five, which gets tossed around a lot but no one seems to know exactly who gets signaled out when traumatic events strike. In order to prevent it they would have to prevent humans from being exposed to traumatic events all together.

The "manageable" part, yes that is possible but that comes with knowing what it is, being treated for it and finding the best way to live your life living with it. No small task but it is possible.

I need to stress here that Battlemind is not a total bust. It does have a lot of good points like trying to make sure they get the point across this is nothing to be ashamed of, along with some other points but the problem is this information comes after this part.

"Battlemind is the Soldier's inner strength to face fear and adversity with courage. Key components include:
Self confidence: taking calculated risks and handling challenges.
Mental toughness: overcoming obstacles or setbacks and maintaining positive thoughts during times of adversity and challenge."

They actually think that you can just make your mind tough enough to handle it! What kind of a message does this send? Do they really, really think that it's only those with weaker minds? After all this is what they are telling the troops at the same time they want to deliver the message there is nothing to be ashamed of.

I tell the story often of how one of the visits to the Orlando VA, I was talking to a couple of Iraq veterans. One was a Marine. He was a tough looking Marine until he began to cry and apologized for it. I had on my Chaplain shirt so he knew who he was talking to but he still felt he needed to apologize for showing emotion. When I told him that it was actually good for him to release some of his pain at that moment he told me that I didn't understand. "I'm a Marine. We're supposed to be tough enough to take it." It took a lot of talking before he understood that he did his duty and was tough enough to get through having his life and his buddies lives on the line until they were all out of danger before he even began to think of what was going on inside of him. This is what Battlemind does. It tells them their minds are not tough enough. This damages them more than anything else ever could and reinforces the idiotic attitude that only weak minded people crash. If this was the case then they'd all be crashing in combat and not after they have already returned home. How much tougher can these men and women get to be able to do that? Did the creators of Battlemind ever think of that?

The next part about Battlemind is the lack of time they are exposed to it before they go into combat. This is from VetsVoice.

BATTLEMIND: A Guide to PTSD for Military Members and their Spouses
by: Combat Infantry Bunny
Sat Dec 29, 2007 at 13:48:29 PM EST

.........From my understanding from those deployed, they are already requiring soldiers about to redeploy this, but my friend said it was just lumped in with all the other random redeployment briefings and no one really cared.

In addition, PTSD is a post-deployment thing and a refresher is sometimes necessary. Anyway, reading this brochure and explanations for PTSD really made sense, especially when I realized I pretty much fit every description re: PTSD behavior. Again, it made me realize I had made the right decision to seek help and I hope that everyone that reads this will forward it to any military personnel they know who may have PTSD and/or to their families who may be trying to understand what their soldier is going through, I think the following explains it very well:

Battlemind is the Soldier's inner strength to face fear and adversity with courage. Key components include:
• Self confidence: taking calculated risks and handling challenges.
• Mental toughness: overcoming obstacles or setbacks and maintaining
positive thoughts during times of adversity and challenge.

Batttlemind skills helped you survive in combat, but may
cause you problems if not adapted when you get home.

Every letter in B-A-T-T-L-E-M-I-N-D, refers to a different behavior, as shown below:

Buddies (Cohesion) vs. Withdrawal
Accountability vs. Controlling
Targeted Aggression vs. Inappropriate Aggression
Tactical Awareness vs. Hypervigilance
Lethally Armed vs. "Locked and Loaded" at Home
Emotional Control vs. Anger/Detachment
Mission Operational Security vs. Secretiveness
Individual Responsibility vs. Guilt
Non-defensive (combat) driving vs. Aggressive Driving
Discipline and Ordering vs. Conflict

While he does say that Battlemind does have some good points the first point made was that it was introduced lumped in with a bunch of other stuff. This was first reported by the BBC that uncovered only 11 1/2 minutes of Battlemind are provided when they arrive "in country" along with the two days of operational briefings they have to get through.

They will be left thinking they can toughen their minds enough to not have to face PTSD and that also means that if anyone does, they are not tough enough. This includes their buddies and some of the others in their unit they may not happen to like very much and if they should end up wounded by it, well then, they must not be tough enough either. This is why Battlemind does not work and as a matter of fact very well could contribute to the increase in suicides and attempted suicides.

Army suicides rise as time spent in combat increases
By Gregg Zoroya, USA TODAY
FORT LEWIS, Wash. — Josh Barber, former combat soldier, parked outside the Army hospital here one morning last August armed for war.

A cook at the dining facility, Barber sat in his truck wearing battle fatigues, earplugs and a camouflage hood on his head. He had an arsenal: seven loaded guns, nearly 1,000 rounds of ammunition, knives in his pockets. On the front seat, an AK-47had a bullet in the chamber.

The "smell of death" he experienced in Iraq continued to haunt him, his wife says. He was embittered about the post-traumatic stress disorder (PTSD) that crippled him, the Army's failure to treat it, and the strains the disorder put on his marriage.

Despite the firepower he brought with him, Barber, 31, took only one life that day. He killed himself with a shot to the head.

"He went to Fort Lewis to kill himself to prove a point," Kelly Barber says. " 'Here I am. I was a soldier. You guys didn't help me.' "

Barber's suicide is part of a larger story — the record number of soldiers and combat veterans who have killed themselves in recent years, at a time when the Pentagon has stretched deployments for combat troops to meet President Bush's security plans in Iraq. In 2007, the Army counted 115 suicides, the most since tracking began in 1980. By October 2008, that record had been surpassed with 117 soldier suicides. Final numbers for 2008 have not been released.

Suicides among Iraq and Afghanistan veterans doubled from 52 in 2004 to 110 in 2006, the latest statistics available, according to the Department of Veterans Affairs (VA).

And the suicide rate among Iraq and Afghanistan veterans is outpacing the rate among civilians, a disturbing trend because the military screens troops for mental health issues and servicemembers typically are healthier than civilians, says Han Kang, a VA epidemiologist. click link for more

So why are they still using it and why are they still pushing it as if it has done any good at all? As I said, there are some really great points to this program but they come after that damage has already been done. Believe me, I'm no genius, so I don't have all the answers but if I can figure out what harm this program has done, this bunch of "egg heads" should have been able to look past their books and see into the people this would be delivered to. They are not genius material either. They are just men and women willing to lay down their lives for what this nation asks of them. They are common people just like most Americans and words do matter to them. You can't tell them in your first breathe that they can train their brain to be tough and then follow that up with "Oh by the way, if you don't, you may end up with PTSD and need help so here's what you do then." The damage is already done to them. After that they can repeat it until they are blue that PTSD is nothing to be ashamed of and they need to ask for help because it's already in there that it's their fault.

Army finally acknowledges Combat PTSD is different!

UPDATE
Well that didn't end well. Given the latest reports, he still doesn't really get it. The suicide numbers are up and so are the attempted suicides.

Why is he still in the position he's in with these kinds of results?

Don't tell my husband but after reading what Col. Castro had to say, I think I'm in love! Most of what you'll read in this article will seem to be something you read before. You have. But not from someone in the military. It has all been on this blog but largely ignored by the people who have publicity, power and money. I think they may really have a chance of saving the lives of our troops and helping them heal if this guy is on the job.

I suggest when you are done reading all of this you click the link to read the rest because there is a lot more.

Army research looks at new PTSD treatment
June 20, 2012
By Rob McIlvaine

Photo Credit: Courtesy photo
Col. Carl Castro, director of the Military Operational Medicine Research Program.

WASHINGTON (Army News Service, June 20, 2012) -- While there are no simple cures for post-traumatic stress disorder, a leading military researcher said progress is being made with a new treatment method and a number of recent studies.

Col. Carl Castro, director of the Military Operational Medicine Research Program, has been funding studies into post-traumatic stress disorder, known as PTSD, over the past five years, and he said the results are beginning to come in.

"I really think the next eight to nine months are going to be the most exciting as the data comes on line and we can start saying, okay, this is really working, we really know what we're doing here, let's do this," Castro said.

Castro's program funds studies into PTSD at the U.S. Army Medical Research and Materiel Command, Fort Detrick, Md.

"Some of the early initial data," Castro said, "looks like we can really treat Soldiers in a two-week compressed time frame. And then we're also looking to see about follow-up, modifying the treatment as we go: the grief, the anger, the second guessing."

Traditionally, he said, psychotherapy is one session per week for 10 weeks. But with the new compressed time frame the Army will use individual and group therapy because Castro wants to take advantage of the natural bonding and cohesion that exists within the military to facilitate recovery.

NO SILVER BULLET

"There's no 'take this drug and you're cured.' There's no, 'come talk to me for 10 minutes and you're cured,' or 'Go to this web link and go through this 20-minute training and you're cured.' There's none of that although people will promise that. I can assure you that does not exist. If it did exist, I'd be the first one saying let's do that," Castro said.

Castro said PTSD can result from many different kinds of exposures: rape, physical assault, earthquakes, national disasters and combat.

"Our current treatments, both psycho and drug therapies, were developed to treat rape and assault victims and had never been validated for use for combat-related PTSD.

"So one of the first things we did was to fund a huge baseline of studies to confirm that the current treatments are effective for treating service members with combat-related PTSD," Castro said. "We wanted to first establish a very solid baseline. We funded these studies about four or five years ago, and they are just now winding up."

As a result it does look like the psycho therapies are effective, but they are not as effective for treating combat-related PTSD as they are for treating rape and sexual assault victims with PTSD.

COMBAT DIAGNOSIS OFTEN DIFFICULT

"Doctor Amy B. Adler and I wrote a paper on why combat-related PTSD is very different than rape or sexual assault PTSD. If you look at the diagnostic criteria for PTSD, it implies that there are no symptoms or reactions present prior to the traumatic event, so all of the reactions and symptoms occur after the event," he said.

In the military, many of the symptoms and reactions that are part of the diagnosis of PTSD are present before a traumatic event ever occurs, he said. For example, having sleep problems and sleep difficulties is a symptom and reaction to trauma.

"But in the military when you deploy to Iraq or Afghanistan or anywhere, your sleep is probably already disrupted. So you're probably already not sleeping well prior to ever being exposed to a traumatic event," he said.

The Diagnostic and Statistical Manual, or DSM, is the criteria by which mental health diagnoses are made.

It's done through the event and the reaction to the event, Castro said. So, the DSM says what should happen when a person is confronted with a traumatic event, they should be horrified, helpless and freeze.

"But Soldiers don't do that. When they're in combat and they see things, their training kicks in, they go on auto pilot and they function. So, even the immediate reaction is very different. And the symptoms can be very different, but if the symptoms are already present before the event, how can the trauma be the cause of those symptoms and reactions?" he asked.

'SUFFERING WHILE FUNCTIONING'

There are symptoms and reactions missing from the DSM that Soldiers often talk about, like extreme anger, grief, second guessing. Castro said the nature of impairment for Soldiers is often quite different than for civilians. The DSM says things such as work, family and life should be disrupted.

"But because of the military structure, Soldiers are still able to show up for work, perform their jobs and carry on, but still have all the symptoms: drinking problems, nightmares; so we call that suffering while functioning," he said.

Castro noted that when Soldiers leave the Army, the military life goes away and then those Soldiers now as civilians come unraveled and they end up going to the Department of Veterans Affairs.

Soldiers are expected to be exposed to traumatic events. They train for it, prepare for it and the Army has them sign wills in case something happens.

Nobody expects to walk down the street and be sexually assaulted or attacked. If there's a dangerous area of town, people stay away.

"But in the military, by its very nature, Soldiers go to dangerous places, so they prepare and train for it," Castro said.

For people not in the military, the traumatic event is unexpected, it's unwanted, it's discrete, it's a single event. Unlike the military, where it's expected, there's multiple and varied events that occur over time, and quite honestly, Castro said, a lot of Soldiers are looking forward to going into combat to prove their courage, and see if they've got what it takes.

ISSUE ABOUT PTSD MISDIAGNOSIS

"The first incidence of this happening was at Fort Carson, Colo., where Soldiers were being dismissed with personality disorders and saying it wasn't related to PTSD, then they'd end up in a Veterans Administration medical hospital. The VA would then say 'this is absolutely post-traumatic stress disorder,'" he explained.

"This is an important distinction because if you have a personality disorder it's an administration separation from the military, but if you have PTSD, it's a medical board disability separation and that's where the money, etc., comes into play," Castro said.

PTSD vs. POST-TRAUMATIC STRESS INJURY - PTSI

He said that changing the name is not going to reduce stigma because Soldiers aren't stupid.

"You could call it apple and pineapple salad and people would say, oh, that means you have PTSD.

It's the same thing around the Army, he said. For instance, the Army has Soldier Resilience Centers as the places to go for mental health issues.

"Soldiers know that's where mental health is. They know you go there if you have a mental health problem. You're not going there to build your resilience; they know this," he said.

It's not going to reduce stigma, he said, and it's not going to fool anybody.

Changing the "D" to an "I", isn't going to help the Soldier, at all. It doesn't make the problem go away by calling it an injury.

read more here

Combat May Cause Long Term Problems for Veterans

http://www.thebaynet.com/news/index.cfm/fa/viewstory/story_ID/10776

Combat May Cause Long Term Problems for Veterans
SOUTHERN MARYLAND - 11/11/2008
By Pete Hurrey

The National Alliance on Mental Illness has released a new 14-page brochure on post-traumatic stress disorder, treatment and recovery. It is available online at www.nami.org/PTSD and is intended to help individuals experiencing symptoms or diagnosed with the illness, along with their families and caregivers.

The sad reality of our nation’s current military conflicts in Iraq and Afghanistan is that an increasing number of troops returning from those conflicts experience some level of PTSD. Symptoms can include poor concentration, sleeplessness, nightmares, flashbacks, heightened fear, anxiety and disassociation – feeling “unreal” or cut off from emotions.

“PTSD affects individuals and families,” said NAMI medical director Ken Duckworth, M.D. “Traumatic events produce biological responses that affect the mind, brain, and body. Those changes involve everyone.”

“Over a lifetime, approximately five percent of men and 10 percent of women in the general population are diagnosed with PTSD,” Duckworth said. “Risk factors include the type of trauma, degree of exposure and any prior history of trauma. In most cases, there is a direct physical impact. Proximity in witnessing violent, life-threatening events also makes a difference.”

PTSD sufferers are not limited to military veterans. The disorder was acutely evident, especially in children after Hurricane Katrina slammed into the gulf coast. In that case, affected children displayed the same symptoms as soldiers returning from armed conflict.

In her advocacy work on behalf of Veterans of the Iraq and Afghanistan conflicts, Connie Walker, Capt., USN (Ret.) and the president of NAMI Southern Maryland, has observed the devastation unresolved PTSD can bring to returning Veterans and families of Veterans. In a recent interview, she described PTSD as “an invisible wound that is often misunderstood by family members, and by Veterans themselves."

Walker went on to state that Veterans often pull within themselves when they suffer from the disorder. “Telling them to get a grip or shake it off only makes the situation worse,” said Walker.

She went on to explain that family members find the situation difficult to understand when they discover their loved ones are different after returning from armed conflict.

“Many times, active duty service members and Veterans who have served in combat experience feelings of hopelessness, anxiety, or depression. Between serving in a military culture where historically, disclosing a mental health problem has hurt servicemembers' careers, and their awareness of the stigma that surrounds mental health issues in our society even now,
these men and women are often reluctant or refuse to seek help," said Walker.

NAMI’s new brochure on PTSD addresses these areas: Psychological Trauma & PTSD , Risk Factors for Developing PTSD, The Neurobiology of PTSD, What is PTSD?, PTSD & Co-occurring Disorders, Combat Veterans & Trauma, Children & Trauma, Trauma & the Mental Health System, Family Impact of PTSD, Recovery and Coping, Treatment for PTSD, Medications, and Resources -- including NAMI’s Family-to-Family Education Program and NAMI Connection Recovery Support Groups.

It notes that treatment for PTSD for returning service members and combat veterans can involve several methods depending on the individual and the severity of the problem; and can range from individual therapy, to group therapy, to a combination of therapy and medication. Like any other mental health condition – the sooner a mental health issue is diagnosed and effective treatment can begin, the better.

In discussing resources available, Walker noted that Dr. Mary Vieten (St. Mary’s County) and Dr. Al Brewster (Calvert County) are local specialists in PTSD and combat PTSD. She also said that through this year’s passage of the Maryland Veterans Behavioral Health Act (SB-210), Southern Maryland now has a Regional Resource Coordinator to assist Veterans and family members in connecting with VA services for these issues and other areas of VA assistance. The RRC’s role includes facilitating connections with local providers when timely and regular access to VA services is impeded by distance from VA Medical Centers in Washington and Baltimore. Southern Maryland’s RRC is Arianna Hammond and can be reached at (410) 725-9993.

In recognition of the need for increased services for Veterans and families, earlier this year, NAMI launched a Veterans Resources Center Web link on their Web site at www.nami.org Whether Veterans and families are looking for information on PTSD, mental illness, or how to obtain VA benefits – the Veterans Resources Center provides an extensive list of sites online to find information.

NAMI is the nation’s largest grassroots organization dedicated to improving the lives of individuals and families affected by serious mental illnesses. For more information about NAMI Southern Maryland and programs available in our region, visit their website at www.namisomd.org.

====================

Constance A. Walker, CAPT, USN (Ret)
President, NAMI Southern Maryland
P.O. Box 25
46940 S. Shangri-La Drive, Ste 101
Lexington Park, Maryland 20653

Vietnam Veterans PTSD Research Everything Old is "New" Again

OMG....Yet another "new" study on the link between PTSD and the whole veteran!

"The mind and body are intimately linked, which is why there needs to be a change in the way post-traumatic stress disorder (PTSD) is treated, say Australian researchers."

The date this came out was today, April 3, 2017.

A world-first study of 300 Vietnam veterans, published in the Medical Journal of Australia, has shown PTSD – a condition that affects an estimated one million Australians – is not just psychological.

It wrecks havoc on the body too, impacting the gastrointestinal, cardiovascular and respiratory systems, as well as a sufferers’ sleep.

Based on the findings PTSD should be considered a “full systemic disorder” rather than just a mental health problem, says Miriam Dwyer, CEO of the Gallipoli Medical Research Foundation.

Yes, it really did say that. It seems as if it has shown up all over the Internet as if no one bothered to even check to see if it was something new or not.

This was done in 1999 and is just one of many...

Combat Exposure, Posttraumatic Stress Disorder Symptoms, and Health Behaviors as Predictors of Self-Reported Physical Health in Older Veterans

SCHNURR, PAULA P. Ph.D.1; SPIRO, AVRON III Ph.D.2

Journal of Nervous & Mental Disease: June 1999

We used path analysis to model the effects of combat exposure, posttraumatic stress disorder (PTSD) symptoms, and health behaviors on physical health. Participants were 921 male military veterans from the Normative Aging Study. Their mean age at time of study was 65. Measures of combat exposure, PTSD symptoms, smoking, and alcohol problems were used to predict subsequent self-reported physical health status. Both combat exposure and PTSD were correlated with poorer health. In path analysis, combat exposure had only an indirect effect on health status, through PTSD, whereas PTSD had a direct effect. Smoking had a small effect on health status but did not mediate the effects of PTSD, and alcohol was unrelated to health status. We conclude that PTSD is an important predictor of physical health and encourage further investigation of health behaviors and other possible mediators of this relationship.

This is on the spiritual connection from National Institute of Health 2008 and check the dates referenced.

Little attention has been given to spiritually based approaches for managing posttraumatic stress disorder (PTSD) symptoms in combat veterans. With the wars in Iraq and Afghanistan, there is a growing need for more complementary and holistic therapies to assist combat veterans returning from deployment. Surveyed veterans report that they would use complementary approaches to health care if such programs were available (Bent & Hemphill, 2004; Kroesen, Baldwin, Brooks, & Bell, 2002).We developed a spiritually based group intervention that teaches a series of focusing strategies using mantram repetition, slowing down, and one-pointed attention (Easwaran, 2001, 2005). A mantram is a Sanskrit word meaning “to cross the mind” and is sometimes referred to in the West as “holy name repetition” (Oman & Driskill, 2003) or in the East as “mantra repetition.” Repeating so-called sacred words such as “Om Mani Padme Hum” from Buddhism or holy names such as “Rama Rama,” “Jesus Jesus,” or “Ave Maria,” have been associated with reduced arousal, respirations, enhanced cardiovascular rhythms (Bernardi et al., 2001), and decreased stress and depression (Wolf & Abell, 2003). Unlike other meditative practices, mantram repetition does not require any specific posture, quiet surroundings, eyes closed or any religious/spiritual beliefs. Mantram repetition is easily learned, personal, portable, invisible, and can be readily practiced without changing one’s activities or environment. 

The purpose of this study was to assess the feasibility, effect sizes, and patient satisfaction of this spiritually based group intervention on mantram repetition in a sample of combat veterans with PSTD. The specific aims were to evaluate (a) recruitment and retention of veterans in the program, (b) effect sizes for PSTD symptom severity, psychological and quality of life outcomes, and (c) level of patient satisfaction of the program. These preliminary findings will be used to conduct a larger randomized controlled trial.
Go to:Background and Significance
PSTD is highly prevalent in military veterans (Kulka, et al., 1990). With the War in Iraq, an estimated 12% to 13% of service personnel have met PTSD criteria following combat (Hoge, Auchterlonie, & Milliken, 2006; Hoge, et al., 2004). Standard treatments for PTSD include medication, cognitive-behavioral and exposure-based therapies, eye movement desensitization and reprocessing (EMDR), relaxation or combinations of these (Bradley, Greene, Russ, Dutra, & Westen, 2005; Foa, et al., 1999; Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998; Monson, et al., 2006; Taylor, et al., 2003; Watson, Tuorila, Vickers, Gearhart, & Mendez, 1997). Very little attention, however, has been devoted to the spiritual aspects of managing PTSD or studying complementary therapies to mitigate symptoms. We consider the mantram program as spiritual, not religious, because it does not require an institution, congregation, or some formalized group to be practiced.
The mantram intervention program has been studied in veterans with chronic illness (Bormann, Smith, et al., 2005), health care employees (Bormann, Becker, et al., 2006; Bormann, Oman, et al., 2006), and HIV-infected adults (Bormann, Gifford, et al., 2006). Veterans and employees have reported significant reductions in stress, anxiety, anger and improvements in spiritual well-being and quality of life (Bormann, Becker, et al., 2006; Bormann, Oman, et al., 2006; Bormann, Smith, et al., 2005; Bormann, Smith, Shively, Dellefield, & Gifford, 2007). HIV-infected adults have reported significant reductions in anger and increased spiritual faith/assurance (Bormann, Gifford, et al., 2006). 

There are actually older studies, but you get the point. None of the so called "new" studies on PTSD are new at all!

Conclusions

A spiritual program was found to be feasible for veterans with PTSD. They reported moderate to high satisfaction. Effect sizes show promise for symptom improvement but more research is needed.

Keywords: posttraumatic stress disorder, veterans, spirituality, quality of life, mindfulness, intervention, meditation, mind–body relaxation

Schumer backs Hall's bill for PTSD Veterans

FOR IMMEDIATE RELEASE: March 18, 2009

SCHUMER INTRODUCES GROUNDBREAKING VETERAN'S HEALTH BILL; WILL AFFECT OVER 150,000 IRAQ AND AFGHANISTAN VETERANS WHO HAVE YET TO BE TREATED FOR POST TRAUMATIC STRESS DISORDER


Study Finds One In Five Of Our Nation's Veterans Suffer From PTSD And Over Half Of Current Iraq And Afghanistan Soldiers Afflicted Have Gone Without Treatment

Stringent VA Policies Require Vets to Tie Post Traumatic Stress Disorder To Specific Incident Before Receiving Treatment

Schumer Introduces Legislation That Will Free Vets From Onerous "Burden Of Proof" Regulations, Help Treat the 1.8 Million Service Members Deployed Since 2001


U.S. Senator Charles E. Schumer today announced that he is introducing legislation that will lower the burdensome threshold that veterans of the Iraq and Afghanistan wars have to meet to receive treatment for Post Traumatic Stress Disorder (PTSD). Current regulations set by the Department of Veterans Affairs (VA) require that veterans pinpoint the stressor that triggered their PTSD, even if they have already been diagnosed. Stringent policies require that veterans track down incident reports, buddy statements, present medals, and overcome other hurdles to meet the threshold that VA mandates in order to receive desperately needed treatment and support. Schumer’s legislation will help simplify the process for the hundreds of thousands of veterans needing treatment. The legislation will apply to veterans of all previous United States Conflicts. Companion legislation has been introduced in the House of Representatives by Congressman John Hall.

“We need to remove the barriers that prevent our soldiers and veterans from receiving care,” said Schumer. “In an era where mental injuries are stigmatized and in a war where danger can strike in any place, it is clear that the current VA regulations are in need of change. This legislation will help our brave men and women access the treatment and support they need.”

Currently, a veteran diagnosed with PTSD must prove that the stressor triggering the PTSD occurred during “combat with the enemy”. This means that the service member must prove that the trigger for PTSD occurred during personal participation in a fight with a military adversary or hostile unit force in order to receive care from the Veteran’s Health Administration. If the veteran cannot meet this burden of proof, or suffers from PTSD triggered by service in a combat zone but not in direct combat with the enemy, they must pay for their own care out-of-pocket or through private insurance. This stringent requirement prevents many service members from receiving care because their injuries were sustained during service in a combat zone but not during direct engagement with the enemy. This is especially true for women, who are prohibited from serving in combat roles and therefore have a difficult time meeting the burden of proof.

The stringent regulations and burden-of-proof requirements present a significant barrier to treatment for service members suffering from mental health disorders that already carry a great stigma. Since October 2001, about 1.8 million U.S. troops nationally, and 66,000 from Upstate New York, have deployed to the wars in Iraq and Afghanistan, with many exposed to prolonged periods of combat-related stress or traumatic events. Early evidence suggests that the psychological toll of the deployments may be disproportionately high compared with physical injuries. According to a study from the RAND corporation, the nation's largest independent health policy research program, nearly 20 percent of military service members who have returned from Iraq and Afghanistan report symptoms of post traumatic stress disorder (PTSD)or major depression, and only half of those afflicted have sought treatment. Among those who do seek help for PTSD or major depression, only about half receive treatment because of the many barriers preventing them from getting the treatment and support they need.

Because of these stringent regulations, the disability claims backlog at the VA tops 800,000, a great majority of which are Vietnam Veterans seeking compensation for PTSD. These facts are a clear indication that current regulations at the VA are too strict for veterans, past and present, who are seeking disability benefits. In an effort to ensure that veterans suffering from PTSD have greater access to the critical care they need, Senator Schumer today introduced legislation that lowers the burdensome threshold that veterans have to meet to receive compensation.

The Compensation Owed for Mental Health Based on Activities in Theater Act, or the COMBAT PTSD Act, would expand the definition of ‘combat with the enemy” in Title 38, USC to include active service in a theater of combat. This would essentially establish service in combat as the presumptive stressor for the incurrence of PTSD. The veteran would still need to be clinically diagnosed with PTSD, but, he or she would no longer need to “prove” that a specific event caused this diagnosis or that the specific trigger was an event during direct combat with the enemy.

According to the Rand study, unless treated, PTSD, depression, and TBI can have far-reaching and damaging consequences. Individuals afflicted with these conditions face higher risks for other psychological problems and for attempting suicide. They have higher rates of unhealthy behaviors — such as smoking, overeating, and unsafe sex — and higher rates of physical health problems and mortality. Individuals with these conditions also tend to miss more work or report being less productive. These conditions can impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat trauma across generations. There is also a possible link between these conditions and homelessness. The damaging consequences from lack of treatment or under-treatment suggest that those afflicted, as well as society at large, stand to gain substantially if more have access to effective care.

The COMBAT PTSD Act would ensure that more service members afflicted with PTSD would be able to receive treatment. This is especially relevant in New York. In total, New York has the fourth largest veteran population in the country and has sent over 70,000 troops to Iraq and Afghanistan. There are almost 12,000 New York service members currently deployed in Iraq and Afghanistan theatres of combat.

Here is how the numbers break down across the state:

· There are 82,250 veterans living in the Capital Region, approximately 5,700 of which served in Iraq or Afghanistan. There are 900 Capital Region service members currently deployed in Iraq and Afghanistan.
· There are 79,200 veterans living in Central New York, approximately 5,500 of which served in Iraq or Afghanistan. There are 900 Central New York service members currently deployed in Iraq and Afghanistan.
· There are 140,810 veterans living in the Hudson Valley, approximately 9,800 of which served in Iraq or Afghanistan. There are 1,600 Hudson Valley service members currently deployed in Iraq and Afghanistan.
· There are 386,670 veterans living in the North Country, approximately 26,900 of which served in Iraq or Afghanistan. There are 4,400 North Country service members currently deployed in Iraq and Afghanistan.
· There are 84,600 veterans living in the Rochester-Finger Lakes Region, approximately 5,900 of which served in Iraq or Afghanistan. There are 960 Rochester-Finger Lakes Region service members currently deployed in Iraq and Afghanistan.
· There are 57,030 veterans living in the Southern Tier, approximately 4,000 of which served in Iraq or Afghanistan. There are 650 Southern Tier service members currently deployed in Iraq and Afghanistan.
· There are 125,270 veterans living in the Western New York, approximately 8,700 of which served in Iraq or Afghanistan. There are 1,400 Western New York service members currently deployed in Iraq and Afghanistan.
In addition to the obvious obligations we have to our veterans, this legislation makes fiscal sense. According to the study, if 50 percent of those needing care for PTSD and depression received treatment and all care was evidence-based, this larger investment in treatment would result in cost savings overall. If 100 percent of those needing care for PTSD and depression received treatment and all care was evidence-based, there would be even larger cost savings. The cost of depression, PTSD, or co-morbid PTSD and depression could be reduced by as much as $1.7 billion, or $1,063 per returning veteran. These savings come from increases in productivity, as well as from reductions in the expected number of suicides.
Given these estimates, evidence-based treatment for PTSD and major depression would pay for itself within two years. No reliable data are available on the costs related to substance abuse, homelessness, family strain, and other indirect consequences of mental health conditions. If these costs were included, savings resulting from effective treatment would be higher, according to the study.
Senator Schumer introduced the COMBAT PTSD Act in the Senate today. The legislation has been introduced in the House of Representatives by Congressman John Hall. The legislation has been endorsed by the Iraq and Afghanistan Veterans of America (IAVA), Veterans of Foreign Wars (VFW), The American Legion, Veterans for Common Sense (VCS), National Guard Association of the US (NGAUS), National Legal Veterans Services Program (NVLSP), Ex Prisoners of War, and Disabled American Veterans (DAV).

http://schumer.senate.gov/new_website/record.cfm?id=309985

This version: Referred in Senate. This is the text of the bill after moving from the House to the Senate before being considered by Senate committees. This is the latest version of the bill available on this website.

http://www.govtrack.us/congress/billtext.xpd?bill=h110-5892
Text:
Summary Full Text
Cost:
less than $1 per American in 2009.
This is computed from a Congressional Budget Office report, merely by dividing the estimated cost of $60,000,000 by the U.S. population. The figure is extracted from the report automatically and may be incorrect. See the report for details.
Status:
Introduced
Apr 24, 2008
Reported by Committee
Apr 30, 2008
Passed House
Jul 30, 2008



This bill never became law. This bill was proposed in a previous session of Congress. Sessions of Congress last two years, and at the end of each session all proposed bills and resolutions that haven't passed are cleared from the books. Members often reintroduce bills that did not come up for debate under a new number in the next session.
Last Action:
Jul 31, 2008: Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs.
Related:
See the Related Legislation page for other bills related to this one and a list of subject terms that have been applied to this bill. Sometimes the text of one bill or resolution is incorporated into another, and in those cases the original bill or resolution, as it would appear here, would seem to be abandoned.
Rep. John Hall [D-NY]show cosponsors (78)
Cosponsors [as of 2009-01-09]
Rep. Grace Napolitano [D-CA]
Rep. Gwen Moore [D-WI]
Del. Madeleine Bordallo [D-GU]
Rep. Bob Filner [D-CA]
Del. Eni Faleomavaega [D-AS]
Rep. John Salazar [D-CO]
Rep. Timothy Bishop [D-NY]
Rep. Zachary Space [D-OH]
Del. Donna Christensen [D-VI]
Rep. Barton Gordon [D-TN]
Rep. James McGovern [D-MA]
Rep. John Tierney [D-MA]
Rep. John Conyers [D-MI]
Rep. Henry Cuellar [D-TX]
Rep. Raul Grijalva [D-AZ]
Rep. William Delahunt [D-MA]
Rep. Michael Arcuri [D-NY]
Rep. Eliot Engel [D-NY]
Rep. Michael Thompson [D-CA]
Rep. Nita Lowey [D-NY]
Rep. Charles Rangel [D-NY]
Rep. Robert Wexler [D-FL]
Rep. Stephanie Herseth Sandlin [D-SD]
Rep. Robert Goodlatte [R-VA]
Rep. Keith Ellison [D-MN]
Rep. Nancy Boyda [D-KS]
Rep. Jason Altmire [D-PA]
Rep. Tim Murphy [R-PA]
Rep. Charles Gonzalez [D-TX]
Rep. Dale Kildee [D-MI]
Rep. James McDermott [D-WA]
Rep. Ron Klein [D-FL]
Rep. Collin Peterson [D-MN]
Rep. Thomas Allen [D-ME]
Rep. Zoe Lofgren [D-CA]
Rep. Ciro Rodriguez [D-TX]
Rep. Jim Gerlach [R-PA]
Rep. Jerry Costello [D-IL]
Rep. Harry Mitchell [D-AZ]
Rep. Kirsten Gillibrand [D-NY]
Rep. Joe Courtney [D-CT]
Rep. Joe Donnelly [D-IN]
Rep. Henry Johnson [D-GA]
Rep. Melissa Bean [D-IL]
Rep. Joseph Crowley [D-NY]
Rep. Betty McCollum [D-MN]
Rep. Lynn Woolsey [D-CA]
Rep. Barney Frank [D-MA]
Rep. Steve Kagen [D-WI]
Rep. Phil Hare [D-IL]
Rep. Anthony Weiner [D-NY]
Rep. Maurice Hinchey [D-NY]
Rep. Carolyn Kilpatrick [D-MI]
Rep. Janice Schakowsky [D-IL]
Rep. José Serrano [D-NY]
Rep. Peter Welch [D-VT]
Rep. Virgil Goode [R-VA]
Rep. William Clay [D-MO]
Rep. Russ Carnahan [D-MO]
Rep. Mike McIntyre [D-NC]
Rep. Bob Etheridge [D-NC]
Rep. Christopher Van Hollen [D-MD]
Rep. Joe Baca [D-CA]
Rep. Betty Sutton [D-OH]
Rep. William Jefferson [D-LA]
Rep. Bill Foster [D-IL]
Rep. Robert Brady [D-PA]
Rep. Paul Hodes [D-NH]
Rep. John Murtha [D-PA]
Rep. Elijah Cummings [D-MD]
Rep. Earl Blumenauer [D-OR]
Rep. John Lewis [D-GA]
Rep. Patrick Kennedy [D-RI]
Rep. Brad Ellsworth [D-IN]
Rep. Mike Ross [D-AR]
Rep. Rubén Hinojosa [D-TX]
Rep. Peter DeFazio [D-OR]
Rep. Doug Lamborn [R-CO]

PTSD suicides: How many could have lived?

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Volume 351:13-22
July 1, 2004
Number 1
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Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Charles W. Hoge, M.D., Carl A. Castro, Ph.D., Stephen C. Messer, Ph.D., Dennis McGurk, Ph.D., Dave I. Cotting, Ph.D., and Robert L. Koffman, M.D., M.P.H.

Only 31 percent of soldiers deployed to Afghanistan reported having engaged in a firefight, as compared with 71 to 86 percent of soldiers and Marines who had been deployed to Iraq

Soldiers and Marines who had returned from Iraq were significantly more likely to report that they were currently experiencing a mental health problem, to express interest in receiving help, and to use mental health services than were soldiers returning from Afghanistan or those surveyed before deployment (Table 3). Rates of PTSD were significantly higher after combat duty in Iraq than before deployment, with similar odds ratios for the Army and Marine samples (Table 3).

Significant associations were observed for major depression and the misuse of alcohol. Most of these associations remained significant after control for demographic factors with the use of multiple logistic regression (Table 3). When the prevalence rates for any mental disorder were adjusted to match the distribution of officers and enlisted personnel in the reference populations, the result was less than a 10 percent decrease (range, 3.5 to 9.4 percent) in the rates shown in Table 3 according to both the broad and the strict definitions (data not shown).

For all groups responding after deployment, there was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants, and the prevalence of PTSD. For example, among soldiers and Marines who had been deployed to Iraq, the prevalence of PTSD (according to the strict definition) increased in a linear manner with the number of firefights during deployment:
4.5 percent for no firefights,
9.3 percent for one to two firefights,
12.7 percent for three to five firefights, and
19.3 percent for more than five firefights
(chi-square for linear trend, 49.44; P<0.001).>

Close calls, such as having been saved from being wounded by wearing body armor, were not infrequent. Soldiers who served in Afghanistan reported lower but still substantial rates of such experiences in combat. The percentage of study subjects whose responses met the screening criteria for major depression, PTSD, or alcohol misuse was significantly higher among soldiers after deployment than before deployment, particularly with regard to PTSD. The linear relationship between the prevalence of PTSD and the number of firefights in which a soldier had been engaged was remarkably similar among soldiers returning from Iraq and Afghanistan, suggesting that differences in the prevalence according to location were largely a function of the greater frequency and intensity of combat in Iraq.

The association between injury and the prevalence of PTSD supports the results of previous studies.25 These findings can be generalized to ground-combat units, which are estimated to represent about a quarter of all Army and Marine personnel participating in Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan (when members of the Reserve and the National Guard are included) and nearly 40 percent of all active-duty personnel (when Reservists and members of the National Guard are not included).

The demographic characteristics of the subjects in our samples closely mirrored the demographic characteristics of this population. The somewhat lower proportion of officers had a minimal effect on the prevalence rates, and potential differences in demographic factors among the four study groups were controlled for in our analysis with the use of logistic regression. One demonstration of the internal validity of our findings was the observation of similar prevalence rates for combat experiences and mental health outcomes among the subjects in the Army and the Marine Corps who had returned from deployment to Iraq, despite the different demographic characteristics of members of these units and their different levels of availability for recruitment into the study.

The cross-sectional design involving different units that was used in our study is not as strong as a longitudinal design. However, the comparability of the Army samples and the similarity in outcomes among subjects in the Army and Marine units surveyed after deployment to Iraq should generate confidence in the cross-sectional approach. Another limitation of our study is the potential selection bias resulting from the enrollment procedures, which were influenced by the practical realities that resulted from working with operational units. Although work schedules affected the availability of soldiers to take part in the survey, the effect is not likely to have biased our results. However, the selection procedures did not permit the enrollment of persons who had been severely wounded or those who may have been removed from the units for other reasons, such as misconduct.

Thus, our estimates of the prevalence of mental disorders are conservative, reflecting the prevalence among working, nondisabled combat personnel. The period immediately before a long combat deployment may not be the best time at which to measure baseline levels of distress. The magnitude of the differences between the responses before and after deployment is particularly striking, given the likelihood that the group responding before deployment was already experiencing levels of stress that were higher than normal. The survey instruments used to screen for mental disorders in this study have been validated primarily in the settings of primary care and in clinical populations.

The results therefore do not represent definitive diagnoses of persons in nonclinical populations such as our military samples. However, requiring evidence of functional impairment or a high number of symptoms, as we did, according to the strict case definitions, increases the specificity and positive predictive value of the survey measures.26,27 This conservative approach suggested that as many as 9 percent of soldiers may be at risk for mental disorders before combat deployment, and as many as 11 to 17 percent may be at risk for such disorders three to four months after their return from combat deployment.

Although there are few published studies of the rates of PTSD among military personnel soon after their return from combat duty, studies of veterans conducted years after their service ended have shown a prevalence of current PTSD of 15 percent among Vietnam veterans28 and 2 to 10 percent among veterans of the first Gulf War.4,8 Rates of PTSD among the general adult population in the United States are 3 to 4 percent,26 which are not dissimilar to the baseline rate of 5 percent observed in the sample of soldiers responding to the survey before deployment. Research has shown that the majority of persons in whom PTSD develops meet the criteria for the diagnosis of this disorder within the first three months after the traumatic event.29 In our study, administering the surveys three to four months after the subjects had returned from deployment and at least six months after the heaviest combat operations was probably optimal for investigating the long-term risk of mental health problems associated with combat.

We are continuing to examine this risk in repeated cross-sectional and longitudinal assessments involving the same units. Our findings indicate that a small percentage of soldiers and Marines whose responses met the screening criteria for a mental disorder reported that they had received help from any mental health professional, a finding that parallels the results of civilian studies.30,31,32

In the military, there are unique factors that contribute to resistance to seeking such help, particularly concern about how a soldier will be perceived by peers and by the leadership. Concern about stigma was disproportionately greatest among those most in need of help from mental health services.

Soldiers and Marines whose responses were scored as positive for a mental disorder were twice as likely as those whose responses were scored as negative to show concern about being stigmatized and about other barriers to mental health care. This finding has immediate public health implications. Efforts to address the problem of stigma and other barriers to seeking mental health care in the military should take into consideration outreach, education, and changes in the models of health care delivery, such as increases in the allocation of mental health services in primary care clinics and in the provision of confidential counseling by means of employee-assistance programs. Screening for major depression is becoming routine in military primary care settings,12 but our study suggests that it should be expanded to include screening for PTSD. Many of these considerations are being addressed in new military programs.33 Reducing the perception of stigma and the barriers to care among military personnel is a priority for research and a priority for the policymakers, clinicians, and leaders who are involved in providing care to those who have served in the armed forces.

go here for the parts left out of this post http://content.nejm.org/cgi/content/full/351/1/13

These are some of the known suicides from 2004. How many of them would have lived if the DOD did what was known needed to be done? There were a lot more names found in my research but they were last listed as "under investigation" and I could not find the result.

Staff Sgt. Cory W. Brooks 32 Company A, 153rd Engineer Battalion, South Dakota Army National Guard Philip, South Dakota "Died of non-combat related injuries in Baghdad, Iraq, on April 24, 2004Among them was Army Staff Sgt. Cory W. Brooks, 32, of Philip, S.D., who shot himself in the head on April 24, 2004. In sworn statements, a major and first lieutenant acknowledged they had conducted ""counseling"" with Brooks, and a first sergeant ""detailed his knowledge of SSG Brooks' suicidal ideations.""


Capt. Joshua Byers of the 3rd Armored Cavalry Regiment. August 20, 2004 Report: Two Carson soldiers committed suicide in Iraq Associated Press FORT CARSON, Colo. Two Fort Carson soldiers who died in Iraq took their own lives, according to Army reports released this week.
http://www.armytimes.com/legacy/new/1-292925-314145.php

Spc. Tambo Cox, 20, shot and injured two women April 5 in a Sunland Park, N.M., home because he was angry that his ex-girlfriend ended their relationship. Investigators said Coxlater shot himself during a traffic stop April 6 along Interstate 10 near Deming, N.M. Fort Bliss officials said Cox, originally from Trinidad, has been in the Army since 2004. He served with 3rd Battalion, 43rd Air Defense Artillery.
http://www.armytimes.com/legacy/new/0-ARMYPAPER-1688474.php


PFC Nicholas A. Davis Born April 27, 1986 - July 13, 2005 Dates of service: Jan. 20, 2004 - July 13, 2005 US Army He died at Ft. Knox, KY From his Nick definately died from the results of PTSD. He fell 1250 feet when his parachute failed and was only treated for a broken ankle. From what I can tell, he never received a CAT scan or MRI to check for further damage. He had flashbacks and nightmares and was punished for asking for help. On his final day he asked for help several times and others asked for help for him. Those around him were concerned for him but those in charge did nothing. And that evening he was dead. The records tell how his personality changed for the worse, he became a different person. He also began suffering from tremors and toward the end of his life he began having siezures. Several witnesses put that into their statements...that his superiors did not help him they "put him into a room until he calmed down". He was being discharged and coming home in less than 24 hours. He was found hung by a shoelace on the hook of a latrine stall door.
http://www.killingourown.homestead.com/

Sgt. Michael E. Dooley of the 3rd Armored Cavalry Regiment August 20, 2004 Report: Two Carson soldiers committed suicide in Iraq Associated Press FORT CARSON, Colo. Two Fort Carson soldiers who died in Iraq took their own lives, according to Army reports released this week.
http://www.armytimes.com/legacy/new/1-292925-314145.php

Curtis Green 25 FORT RILEY 12/6/2004 "Over my dead body are they going to make me go back." "I knew he was having dreams, nightmares," Lisset said. "He would wake up at night really sweaty." On Dec. 6, he showed up for work, his uniform pressed, his boots polished. He sang cadence. That night, he was found hanging in his barracks. Sgt. Curtis Greene, 331st Signal Company, was 25
http://www.commondreams.org/cgi-bin/print.cgi?file=/headlines05/0214-09



JEFFREY LUCEY 23 BELCHER, MA HANGING 6/22/2004 'Something happened to Jeff' Jeff Lucey returned from Iraq a changed man. Then he killed himself. By Irene Sege, Globe Staff March 1, 2005 BELCHERTOWN -- Less than three weeks before he committed suicide, Jeffrey Lucey, lance corporal in the Marine Reserves, veteran of Operation Iraqi Freedom, totaled his parents' Nissan Altima.
http://www.boston.com/yourlife/health/mental/articles/2005/03/01/jeff_lucey_returned_from%20_iraq_a_changed_man_then_he_killed_himself/

Private Peter Mahoney On August 10, the funeral of Private Peter Mahoney, a soldier with the Territorial Army (TA) who served for six months in the war against Iraq in 2003, was held at St. Aidan’s church in his hometown of Carlisle, England. On August 3, the 45-year-old father of four had committed suicide by gassing himself in his family car. He died of carbon monoxide poisoning after attaching a hosepipe to the exhaust of the car parked in his garage at his home in Botcherby, on the outskirts of Carlisle. Mahoney was wearing his old TA uniform and had shaved his head in a regulation military style.
http://www.wsws.org/articles/2004/aug2004/army-a23.shtml


1st Class Andre McDaniel was a military accountant 40 COLORADO SPRINGS, CO GUNSHOT 9/1/2004 McDaniel, 40, a father of two, shot himself in August 2004, six weeks after he returned from Iraq. He had recently been arrested for allegedly arranging to have sex with an undercover officer who had posed on the Internet as a 13-year-old girl.
http://www.armytimes.com/legacy/new/1-292925-1166922.php

BRIAN MCKEEHAN 37 FORT EUSTIS HANGING 10/12/04 AP: Soldier Just Back From Iraq Hangs Himself In Jail Police say Brian McKeehan hanged himself with a bedsheet early Saturday in the Virginia Peninsula Regional Jail in James City, about 12 hours after being arrested on a charge of assaulting his wife at their York County home.
http://www.indymedia.org/en/2004/10/861771.shtml

MICHAEL PELKEY FORT SILL, OK GUNSHOT 11/5/2004Capt. Michael Jon Pelkey However, it would become tragically obvious that Michael's worries were not over. Michael met with the therapist on a Monday; the couple celebrated their third wedding anniversary on a Tuesday; and on Friday, November 5, 2004, Stefanie came home to find her husband laying on the bed, dead from a self-inflicted gunshot wound to the chest
http://www.usmedicine.com/article.cfm?articleID=1154&issueID=79

Pfc. David L. Potter 22 Company B, 115th Forward Support Battalion, 1st Cavalry Division Johnson City, Tennessee Died of non-combat related injuries in Baghdad, Iraq, on August 7, 2004 In another case, Pfc. David L. Potter was kept in the war zone despite a diagnosis of anxiety and depression, a suicide attempt and a psychiatrist's recommendation that he be separated from the Army. Potter, 22, told friends that he believed the recommendation had been overruled, leading to a deepening of his depression, a fellow soldier said. On Aug 7, 2004 - 10 days after the psychiatrist recommended he be sent home - Potter took a gun from under another soldier's bed and killed himself. Hartford Courant

Staff Sgt. Jeffrey Jerome Sloss a member of the South Carolina National Guard, seemed fine when he was serving in Iraq. But when he came home to his job as a state trooper, he had trouble concentrating. Sloss committed suicide on May 27, 2004 -- five weeks after his return.

ALEXIS SOTO-RAMIREZ 42 WALTER REED HANGING 1/12/2004 Then there's the case of Spc. Alexis Soto-Ramirez, who served with a unit of the Puerto Rico National Guard. Suffering from chronic back pain that became excruciating during the war, Soto-Ramirez was diagnosed with "psychiatric symptoms" that were "combat-related." He was sent to Walter Reed's "Ward 54"--the in-patient psychiatric unit--where he was supposed to get the best care the military had to offer. Instead, less than a month later, he was dead--having hanged himself with the sash from his bathrobe
http://www.counterpunch.org/colson06062005

ANDREW VELEZ 22 AFGHANISTAN GUNSHOT Spc. Andrew Velez 22 Corps Support Battalion, Theater Support Command Lubbock, Texas Committed suicide by shooting himself in Sharona, Afghanistan, on July 25, 2006. His brother, Spc. Jose A. Velez, was killed in Iraq in November 2004. His brother died the same month two years before.
Spc. Jose A. Velez 23 Company A, 2nd Battalion, 7th Cavalry Regiment, 1st Cavalry Division Lubbock, Texas Killed when his unit came under fire while clearing an enemy strongpoint in Falluja, Iraq, on November 13, 2004. His brother, Spc. Andrew Velez, committed suicide by shooting himself in Afghanistan in August 2006.

BOYD WICKS JR WILMINGTON, DE 2/1/2004 BOYD WICKS JR WILMINGTON, DE 2/1/2004 Please also remember those who came back after combat and died from post-traumatic stress disorder (PTSD) through suicide. My son, USMC Infantry Sgt. Boyd W. "Chip" Wicks Jr. died that way. After combat in Iraq from March-June 2003, he came back to the U.S. and was discharged in October 2003. In February 2004 he committed suicide. No one seems to want to care about him or the others who have died from PTSD after Iraq combat. Because they didn't die in a war zone or in uniform, they are forgotten, swept aside. They don't fit in anywhere during the services -- no one recalls these dead heroes, who also gave all. It's like having a special needs child in your neighborhood -- it's someone else's problem, it's someone else's heartache.Boyd W. Wicks Sr., Wilmington, Delaware
http://www.cnn.com/2006/US/05/26/ch.feedback/index.html


All three were given antidepressants to help them make it through their tours of duty in Iraq - and all came home in coffins.Warren,44, and Guy, 26, committed suicide last year, according to the military; Hobart, 22, collapsed in June 2004, of a still-undetermined cause.The three are among a growing number of mentally troubled service members who are being kept in combat and treated with potent psychotropic medications - a little-examined practice driven in part by a need to maintain troop strength.Interviews with troops, families and medical experts, as well as autopsy and investigative reports obtained by The Courant, reveal that the emphasis on retention has had dangerous, and sometimes tragic, consequences


Again, these are just from 2004. Timothy Bowman, Jonathan Schultz, Joshua Omvig and all the others should make us wonder how many more of these men and women serving this nation could have lived if the results from above had been taken seriously and the DOD and VA Mental Health care was increased enough to carry the load of actually doing it?

Mental Health Advisory Team IV Findings Released
News & Media - News Releases - May 2007 News Releases
by Jerry HarbenUS Army Medical Command Public Affairs
A team of Army experts who studied the mental health of Soldiers and Marines in Iraq between August and October last year concluded that there is a "robust" system in place to provide mental health care, but issues continue with the stress of a combat deployment. This was the first time Marines had been included in this Mental Health Advisory Team study.

At the request of the leadership in theatre, this team for the first time examined the ethical behavior of U.S. troops so that battlefield ethics training can be improved. They recommended training based on the Army Chief of Staff's "Soldiers' Rules," and such training is being developed by the U.S. Army Training and Doctrine Command as well as by the Marine Corps' Training and Education Command.

"Previous MHATs found that deployment lengths and multiple deployments impact on Soldiers' mental health," said Col. Carl Castro, chief of military psychiatry at Walter Reed Army Institute of Research, who led the Mental Health Advisory Team (MHAT) IV. COL Castro also said that suicide rates in theater remain high.
Castro and his team (psychologist Maj. Dennis McGurk and behavioral health specialist Spec. Matthew Baker) interviewed 1,320 Soldiers and 447 Marines and conducted focus-group sessions with Soldiers, Marines and behavioral-health providers.

The team recommended Soldiers and Marines receive the Army's "Battlemind Training" both before and after deployment. This training helps them identify signs and symptoms of mental distress and access the programs that provide help.
The central findings of the report are:

1. Not all Soldiers and Marines deployed to Iraq are at equal risk for screening positive for a mental-health problem. The level of combat is the main determinant of a Soldier's or Marine's mental-health status.

2. For Soldiers, deployment length and Family separations were the top non-combat deployment issues; due to shorter deployment lengths, Marines had fewer non-combat deployment concerns. The team recommended behavioral-health outreach efforts focus on units that had been in theatre longer than six months. Shorter deployments or longer intervals between deployments would allow Soldiers and Marines better opportunities to "reset" mentally before returning to combat.

3. Only 5 percent of Soldiers reported taking in-theatre rest and relaxation (R&R), even though the average time deployed was nine months. Policies need revision to ensure that those who work "outside the wire" receive R&R opportunities.

4. Soldiers and Marines reported general dissatisfaction with the creation and enforcement of garrison-like rules for such things as uniform appearance in a combat environment.

5. Soldier morale was lower than Marine morale, but was similar to Soldier morale in previous surveys.

6. Overall, Soldiers had higher rates of mental-health problems than Marines. When matched for deployment length and deployment history, Soldiers' mental-health rates were similar to those of Marines.

7. Multiple deployers reported higher acute stress than first-time deployers. Deployment length was related to higher rates of mental-health problems and marital problems.

8. Good NCO leadership was the key to sustaining Soldier and Marine mental health and well-being.

9. Marital concerns were higher than in previous surveys, and these concerns were related to deployment length.

10. Although demographic differences between the Soldiers in Iraq and the broader Army population make comparison difficult, 2003-2006 Operation Iraqi Freedom suicide rates are higher than the average Army rate, 16.1 versus 11.6 Soldier suicides per year per 100,000.

11. Suicide prevention training was not designed for a combat/deployed environment. Training has been revised to include theatre-specific scenarios that describe actions Soldiers or Marines can take to help each other.

12. Approximately 10 percent of Soldiers and Marines report mistreating non-combatants (damaged/destroyed Iraqi property when not necessary or hit/kicked a non-combatant when not necessary). Soldiers that have high levels of anger, experienced high levels of combat or screened positive for a mental-health problem were nearly twice as likely to mistreat non-combatants as those who had low levels of anger or combat or screened negative for a mental health problem.

13. Transition team members, those who advise and train Iraqi forces, have lower rates of mental-health problems compared to Soldiers assigned to U.S. brigade combat teams, although there was an unmet behavioral health care need. The transition team members tend to be more experienced.

14. Behavioral-health providers require additional Combat and Operational Stress Control (COSC) training before deploying to Iraq; very few attended the Army Medical Department Center and School's COSC Course. The Army Surgeon General now has mandated this training for all deploying behavioral-health personnel.

15. There is no standardized joint reporting system for monitoring mental-health status and suicide surveillance of service members in a combat/deployed environment.

"Each service now has its own system. In a joint command, a rollup of the force is difficult to get, because everyone is reporting something different," Castro said of the reporting system.

Besides assessing the state of the force's mental health and capabilities of the mental-health providers, this survey found that line leadership, especially team and squad leaders, had a great influence on their troops' mental condition.

"We used a leadership checklist of what were positive things they wanted leaders to do—such as treat everybody fairly, protect them from unnecessary taskings—and things they don't want leaders to do—such as not taking the same risks as the troops," Castro said.

The team recommended that all junior leader development courses should include behavioral health awareness training.

Recommendations also included giving commanders the same kind of information on their troops' mental health that is provided about physical wounds, and conducting Battlemind Psychological Debriefings to replace current debriefings after deaths, serious injuries and other significant events.

This was the fourth MHAT to study troops deployed for Operation Iraqi Freedom. Together, the surveys constitute an unprecedented attempt to measure troops' mental health and improve mental-health services during combat operations rather than waiting to evaluate after the war.
For immediate release, May 4, 2007.
http://www.armymedicine.army.mil/news/releases/20070504mhat.cfm

Mental health teams to visit Marines in Iraq
Chelsea J. Carter, Associated Press Writer
Monday, February 11, 2008
CAMP PENDLETON - Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.

For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis.

The Navy and Marine Corps aim to change that by sending teams of mental health professionals to the front lines this month, after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.

"We've got a lot of knowledge about the way combat trauma affects people, and having somebody there to guide Marines through it in Iraq means we can respond to it more quickly," Pusateri said.

While psychologists and psychiatrists have long treated military service members on bases and in field hospitals, the deployment of teams of psychological professionals - one per regiment - next month to combat zones marks a new approach in identifying and treating mental health before problems arise.

The teams assigned to the 1st Marine Expeditionary Force - made up of about 11,000 Marines - will include a psychiatric technician, a chaplain and, in some cases, a Naval social worker. Psychiatrists or psychologists could deploy to forward operating bases and, in extreme cases, patrol with units.

Three top commanders of the U.S. Marine Corps' fighting forces recently asked to make the pilot program a permanent fixture.

"Now is the time to adjust fire," the generals wrote in a letter to the commandant. "We must shift the current direction of combat/operational stress control efforts to a more holistic, nested enabling strategy that provides a sound, unified approach."
Marine commandant Gen. James T. Conway is reviewing the request and a decision is expected later this year.

The Army adopted a similar approach last year, and has been deploying behavioral health specialists to patrol with its troops in Iraq and Afghanistan.

"What is probably new here is that we want to address it close on the front lines, and thereby return people both back to combat and back to society healthy," said Navy Capt. Mike Maddox, the 1st Marine Expeditionary Force surgeon.

The push to make the program permanent comes after a report by the Institute of Medicine found post-traumatic stress disorder is the most commonly diagnosed mental disorder among veterans. It affected an estimated 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Figures released by the Marine Corps show a fourfold increase in the number of Marines diagnosed with PTSD - from 394 in 2003 to 1,669 to 2006.

"If we identify a stress and if we can treat it close to the unit, it's less likely that person will be sent back, medevaced out of there," said Cmdr. David Oliver, the 1st Marine Expeditionary Force psychiatrist.

Previously, Marines identified with possible combat-related mental health stress or disorders have been pulled from duty in Iraq and shipped to the U.S. or Germany for assessment and treatment.

Under the expanded program, mental health specialists would be in daily contact with troops at forward bases, working with chaplains to identify potential risks to troops, talking with squad leaders about their troops, and responding to IED explosions and other combat situations that could effect a Marine's mental health.

While certain combat-related mental health conditions may require extended care, most of the cases in Iraq can be treated or eased.

In some cases, Marines or sailors showing signs of stress, such as sleeplessness, anxiety or agitation, may just need a rest.
"In many cases, he's probably not going to have problems if he's given the chance to get some sleep, get some hot chow, take a hot shower," Oliver said.
http://www.redding.com/news/2008/feb/11/mental-health-teams-visit-marines-iraq/

Hot chow? Rest? Take a shower? After all the military has claimed they learned about all of this, this was said in 2008!

As for Battlemind, well, I guess it's better than nothing because it's the only thing they want to use even though if it worked, the numbers would go down and not up.

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