Pre and post deployment support

[reed11b]

Soldiers deploying and returning from deployment’s are run the gambit of “helpful” briefings and screenings by the DOD and VA. Unit FSGs and the community service agencies of each branch have greatly increased the benefits and support available to both soldiers and their spouses. While these programs all seem positive in and of themselves, (Battlemind, Yellow Ribbon, PDHRA, Strong Bonds, WTU’s, etc etc.) they have all been created ad-hoc, and some have limited public awareness, such as the strong bonds program. My focus is social service needs and mental health, though medical treatment falls into this. My question is, if you were to create a comprehensive program for the returning vets, what programs would you keep or model your plan on; what programs are redundant or of negative benefit? All feedback is beneficial
Reed

[Ken White]

let me suggest with personal AND family experience at returning from several wars that the current focus on such support assumes everyone needs pretty much the same thing and the need or desirability for such support is universal. I strongly doubt that. Predeployment or post deployment, tour location, length and efforts / job while deployed all have an effect and every individual and family situation is different.

My assessment of today's efforts is that it is significant overkill for most. I understand the (presumed?) difficulty in a large organization of tailoring such support as opposed to offering high volume, one size fits all solutions but I would also suggest that many people are being exposed to ideas they might never get on their own. The current processes offer excessive support that is excessive for most, adequate for a few and inadequate for a few more; the effort needs to be tailored and that, to me, means a psychological assessment for each person -- a very difficult but not impossible task -- or, better yet, such an assessment before service entry and rejection of those likely to need heavy support.

An idea which ought to fire up the PC crowd...:wry:

[reed11b]

-- or, better yet, such an assessment before service entry and rejection of those likely to need heavy support.

An idea which ought to fire up the PC crowd...:wry:

A true assessment or a simple review of existing history and the resulting go/no-go from it? I would agree if a true assessment was involved as MH diagnosis is not an exact science and I have meet many diagnosed as ODD that I would diagnose as "teenagers". A diagnosis does not make true, but a suitability screening may pay dividends. On a historical note, we had extensive MH screening during WWII and high no-go rates from them, but they had very little impact on MH casualties during that conflict, hence why we no longer use them. One thing that I do advocate for is a required mental health screening for combat vets w/i a certain period of there redeployment if they are involved in any UCMJ disciplinary actions or civilian legal violations. I feel this is often our first warning sign with a vet that fails to self-disclose.
Reed

[Ken White]

A true assessment or a simple review of existing history and the resulting go/no-go from it? ... On a historical note, we had extensive MH screening during WWII and high no-go rates from them, but they had very little impact on MH casualties during that conflict, hence why we no longer use them.True but theoretically we're 65 years smarter today. Such an assessment won't be a panacea nor will it catch 'em all but I do believe it would be better than today's shotgun approach.
...One thing that I do advocate for is a required mental health screening for combat vets w/i a certain period of there redeployment if they are involved in any UCMJ disciplinary actions or civilian legal violations. I feel this is often our first warning sign with a vet that fails to self-disclose.
ReedMakes sense; those that stay in are fairly well covered by the system; those that ETS -- or the RC folks -- have a different problem...

[reed11b]

True but theoretically we're 65 years smarter today. Such an assessment won't be a panacea nor will it catch 'em all but I do believe it would be better than today's shotgun approach...
What research and studies exist, suggest that is incorrect, at least in regards to MH casualties. The reason for this is that, while a history of pre-existing mental health issues make PTSD more likely, the majority of soldiers diagnosed with PTSD have had NOsignificant MH history. There is also a large body of deployed soldiers w/ MH histories that have had no Combat related MH troubles. I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME. Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.
Reed

[Ken White]

wrong direction. Don't look for pre-existing issues, they're obviously not reliable as a forecast mechanism, not what I intended at all.

Look for the mental outlook that can and will tolerate stress. Hire more sociopaths -- and yes, I'm quite serious.
...while a history of pre-existing mental health issues make PTSD more likely, the majority of soldiers diagnosed with PTSD have had NOsignificant MH history.Obviously.
...There is also a large body of deployed soldiers w/ MH histories that have had no Combat related MH troubles.Also obviously. I'd add that the combat flip out is variable, can occur early or later and that the number of triggers available on the battlefield is vast. MH issues in general do not show how well combat stress will be tolerated, people are too variable -- but the sociopathic trend, if not total, can aid in acceptance of most combat stressors.
...I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME.Gee, thanks. I appreciate your appreciation. Always good to deal with experts even if they do go in the wrong direction..:rolleyes:
...Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.ReedNothing to do with combat stress; in fact the guy with minor disciplinary problems is probably more tolerant of combat stress than the average straight arrow. We probably should stop trying to throw 'em all out of the service and exercise a little leadership. :cool:

[reed11b]

wrong direction. Don't look for pre-existing issues, they're obviously not reliable as a forecast mechanism, not what I intended at all.

Look for the mental outlook that can and will tolerate stress. Hire more sociopaths -- and yes, I'm quite serious.

OK, but not eneogh sociopaths exist to fill the Army's need, and many of us "straight arrows" develop sociopathic traits in service. This thread is now waaaaay of target, I'm looking for what social service and mental health programs that exist should be kept, wich can go and what needs to be changed.
Reed

[Ken White]

...This thread is now waaaaay of target, I'm looking for what social service and mental health programs that exist should be kept, wich can go and what needs to be changed. ReedI merely suggested that a focussed psychological screening to detect those who may be better able to tolerate combat stress might be worth exploring. That seems consistent with what you asked.

IIRC, several recent research projects using a variety of methods including MRIs have determined that many people have a distinct aversion to violence while others seem to tolerate it well. That tracks with my observation over a number of years. The Sociopath tendency should not be totally rejected; most of us have a variety of little pathys in there and it seems to me that screening merits consideration.

With that, I'll leave you the floor.

[Stan]

I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME. Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.


Hello Reed,
Not to be a wise old retired NCO herein, but exactly what would you have expected from Ken having read your quotes below?

Let's get a little less personal with the seniors and respect the fact that Ken's background and experience is significant and plays a much larger role than some acronym SME.

Back in my days, SME translated to 15 years minimum.

Regards, Stan


4 years active duty paratrooper (mortars) and responded to Hurricane Katrina in 2005 as an untrained mental Health Specialist.


This seems to be important on a page w/ so many high grade officers and NCO's; I am a career smartass SPC. Turned down PLDC twice.

[reed11b]

Hello Reed,
Not to be a wise old retired NCO herein, but exactly what would you have expected from Ken having read your quotes below?

Let's get a little less personal with the seniors and respect the fact that Ken's background and experience is significant and plays a much larger role than some acronym SME.

Back in my days, SME translated to 15 years minimum.

Regards, Stan
My knowledge comes from schooling and that I work as a outreach and education coordinator for the Readjustment Counseling Service (part of the VHA), not my military experience. I am not SME, but I do have solid specific knowledge on this topic (MH and PTSD). Sorry I touched a nerve w/ you salty old-timers, but the topic IS important. Perhaps instead of just being defensive you could make some valid suggestions.
Reed

[Stan]

Similar to my response to your PM...

I applaud your continued service and education.

No nerves touched here with me, but I'm not going to discount my military leadership education (aka PLC) in order to fix what you have indicated is a shortfall.

For the record, we attack the subject, not the members that post their thoughts and opinions.

Let's keep the thread and posts professional.

[jmm99]

for me because I think immediately of sociopaths as we think of that term in the criminal justice system - serial criminals (whether murder, rape, robbery or theft), who lack any empathy and are extremely self-centered.

I don't think that is what you are really saying, Ken - since IMO none of the criminal sociopaths I've known would have been at all useful in the military.

Slap may well have an opinion on this which is based on more experience - despite his relative youth.

There are personality types (probably galore) who can hack violence - even when it is of the cold-blooded kind. I think of three friends over the years (two still with us in the Copper Country) who were Marine snipers in Nam and who seem to have been relatively untouched by the experience. If anything, it seems to have been a positive thing - that from an outside observer who is not into their heads, but just a guy who drank a fair amount of beer with them.

On the other hand, there are personality types (again probably galore) who cannot hack violence. And, a bunch in between. So, it would seem useful to expand on some personality profiles as you guys know them (no need for shrink jargon).

Both Ken and Reed recognize what they are willing to call "sociopathy" - Ken in other threads as well as here; Reed here:


OK, but not eneogh sociopaths exist to fill the Army's need, and many of us "straight arrows" develop sociopathic traits in service.

I conclude that what you must mean as "sociopathic traits" are different from how I would use the term as a lawyer.

If what Reed said was meant, it seems to me that "sociopathic traits" or lack of same is an issue which is far from off-topic - since the support required will vary with the personality profile (METT-TC, to borrow from you guys).

[Ken White]

(Sociopath don't quite do it) for me because I think immediately of sociopaths as we think of that term in the criminal justice system - serial criminals (whether murder, rape, robbery or theft), who lack any empathy and are extremely self-centered.Your prerogative to think of it in that manner -- and logical that you should do so. Not being burdened by being a Lawyer or a Psychologist, I do not have to be so precise. I use the term to indicate those tendencies that mirror your description, lacking empathy and being self centered and I contend that about half the people I have known in an overlong life have those traits to one extent or another. Quite obviously, the full blown legal and psychologically diagnosed Sociopath in the strictest sense of the term is not a desirable person -- and would, as you say, not be good as a Soldier.

However, as I said, we are all blends of numerous pathologies and traits both inherited and acquired so some of the sociopathic tendencies serve to insulate an individual from the horror of war -- or allow him or her to better accept the reality of war and deal with it. I mentioned several experiments that have indicated that those who can accept violence as opposed to those who categorically reject it or are repelled to such an extent that they literally freeze momentarily can be identified by various assessments including MRI scans.
There are personality types (probably galore) who can hack violence - even when it is of the cold-blooded kind. I think of three friends over the years (two still with us in the Copper Country) who were Marine snipers in Nam and who seem to have been relatively untouched by the experience. If anything, it seems to have been a positive thing - that from an outside observer who is not into their heads, but just a guy who drank a fair amount of beer with them.

On the other hand, there are personality types (again probably galore) who cannot hack violence. And, a bunch in between. So, it would seem useful to expand on some personality profiles as you guys know them (no need for shrink jargon).More elegantly said than by me but that's the point...
I conclude that what you must mean as "sociopathic traits" are different from how I would use the term as a lawyer.Certainment!
If what Reed said was meant, it seems to me that "sociopathic traits" or lack of same is an issue which is far from off-topic - since the support required will vary with the personality profile (METT-TC, to borrow from you guys).I'd think so...

[MikeF]

On monday, I'm so gonna find a psychiatrist to explain my sociopathic tendacies in warfare when I positively identify my enemy. It must be something to do with the way my mom treated me as a child.

Reed- despite my lack of humor (my daughter will probably not attend college now that the economic sky has fallen; hopefully, y'all have at least smiled if not laughed so we can get back on topic), I would encourage you to take a knee and allow us to get back to your original discussion.

IMO, Ken is right-outside of his so-called PC crowd. Freudian SME's thought and regard evolved throughout the last 65 years. From shell shock to PTSD to TBIs, advances are being made.

Futhermore, I would assert that the answer to your original question is the typical timeless Ken statement of METT-TC coupled with leadership. A Patreaus/Odierno/Caldwell must be tasked with this very important subject if we hope for some resolve on our wounded (and yes, I have plenty of wounded that I care deeply about).

Initially, Ken was only suggesting that we have a holistic approach during the recruitment process and post-deployment period.

cheers,

mike

[120mm]

My experience has been that the Medical Service Corps has seized the moment to create a bigger niche for themselves in the Army.

The great majority of anger I've experienced, post-deployment, has been righteous anger directed toward this or that weaselly MSC officer putting requirement after requirement on our notably non-combat unit, making it difficult to train/have time with my family.

I am still fully convinced that Army Doctors put a ton of people on "medical hold" primarily to create the Walter Reed crisis and therefore increase their budget/officer staffing.

On a related issue, a co-worker, who has just returned from a year-long non-combat deployment, has been required, along with the rest of his section, to attend PTSD counselling sessions. When he asked to be let out of this un-paid requirement, he was automatically diagnosed with PTSD.

[slapout9]

Slap may well have an opinion on this which is based on more experience - despite his relative youth.



I missed this somehow, you know how us young folks are. IMHO a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.

[reed11b]

On a related issue, a co-worker, who has just returned from a year-long non-combat deployment, has been required, along with the rest of his section, to attend PTSD counselling sessions. When he asked to be let out of this un-paid requirement, he was automatically diagnosed with PTSD.

What does your non-combat deployed co-worker do? Feel free to PM me, I may have some insight. I am hearing a lot of animosity towards Army MH, does this extend to VA and Vet Center counselors as well? What about ACS services? While not quite what I was asking for this is still useful.
Reed

[Ken White]

... a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.I'm wit you!!! :cool:

[reed11b]

I missed this somehow, you know how us young folks are. IMHO a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.
Research says that is difficult and unlikly. One study that supports that shows higher rates of PTSD among LEO's then comabt vets! Emotions are addictive in a sense. Open those flood gates and it is hard to close them again. I'm as type "B" as one can get, but I have been restless and wanting to go back ever since I deployed to Iraq in '03. I think the "instant" mode switcher is a myth or at the very least, very very rare.
Reed

[Ken White]

Research says that is difficult and unlikly. One study that supports that shows higher rates of PTSD among LEO's then comabt vets! Emotions are addictive in a sense. Open those flood gates and it is hard to close them again. I'm as type "B" as one can get, but I have been restless and wanting to go back ever since I deployed to Iraq in '03. I think the "instant" mode switcher is a myth or at the very least, very very rare.
Reedand little more.

My estimate is that the number of folks who can successfully make that switch is about 30%. Another 30% are not designed for combat or LE like stress (though many can and will do it if forced with varying MH results) and the remainder can hack it and are generally but varyingly successful in tolerating the trauma. Willingness or ability (desire or wishes have little to do with it) to accept violence is the issue; that simple.

Interesting how those estimates track with the 1/3 Rule on wars... :cool:

[MikeF]

Looks like universal screening is coming...I'm interested in who the "mental health professionals" will be.

http://www.usatoday.com/news/military/2008-10-12-ptsd_N.htm


The Pentagon's top uniformed officer is calling for all returning combat troops, from privates to generals, to undergo screening for post-traumatic stress with a mental health professional, a move aimed at stemming an epidemic of psychological issues among veterans.


"I'm at a point where I believe we have to give a (mental health) screening to everybody to help remove the stigma of raising your hand," Mullen said. "Leaders must lead on this issue or it will affect us dramatically down the road."

[reed11b]

Looks like universal screening is coming...I'm interested in who the "mental health professionals" will be.

http://www.usatoday.com/news/military/2008-10-12-ptsd_N.htm

I am doubtful as to whether this is the right way to go. PTSD screening is based solely on patient disclosure. It is not like a blood draw to look for an antibody, some soldiers have a pretty good idea what they can safely disclose and what they can not to either receive or avoid a PTSD diagnosis.
Reed

[Stan]

I am doubtful as to whether this is the right way to go. PTSD screening is based solely on patient disclosure. It is not like a blood draw to look for an antibody, some soldiers have a pretty good idea what they can safely disclose and what they can not to either receive or avoid a PTSD diagnosis.
Reed

Hey Reed,
Not to be the devil's advocate herein, but what exactly is a pretty good idea what can be safely disclosed?

What happens to a returning soldier diagnosed with PTSD? He/She enters rehab, no longer fit for promotion, no longer eligible for yet another tour in Iraq?

I know there were some when I retired who flat out refused to disclose health issues, but that's slightly different when entering the civilian world without sight or hearing. Or is it?

Regards, Stan

[reed11b]

Hey Reed,
Not to be the devil's advocate herein, but what exactly is a pretty good idea what can be safely disclosed?

What happens to a returning soldier diagnosed with PTSD? He/She enters rehab, no longer fit for promotion, no longer eligible for yet another tour in Iraq?

I know there were some when I retired who flat out refused to disclose health issues, but that's slightly different when entering the civilian world without sight or hearing. Or is it?

Regards, Stan
Depends on the field and to a greater degree the chain of command. If the soldier needs a top secret clearance for there job then promotion is certainly at risk. They risk being med boarded out, being sent to the WTU, which on some posts are despised. If the soldier is not sent to WTU or med boarded out, then they are able to return to future deployments, though this was not always the case. Failure to get PTSD treatment will result in long term detriments to physical as well as mental health.
Many educated soldiers are aware that the intrusive memories aspect of PTSD is the key to diagnosis and will withhold disclosure if they do not want the PTSD stigma or falsely disclose it if they are malingering (it does happen, but not as often as some people fear IMO)
The article comment about a therapist being able to diagnose PTSD in five minutes is complete Bravo Sierra, and if I were ever to catch wind of a counselor doing it, I would be slinging HEAT rounds like it was going out of style. Takes a great deal of time to accurately diagnose PTSD and even then it is not an exact science by any means. I hope managed to communicate my points clearly.
Reed

[patmc]

SEC Gates released guidance this year that for Security Clearance Applications and Investigations, the question covering seeking mental health or counselling will be amended to exclude combat deployment related issues.

They are trying to encourage people to get help, and not hide issues which only makes them worse. Unless the medical issues are so great that the Soldier cannot function, commits violent acts, or abuses alcohol/drugs, it should not come up in his/her security check. If the Soldier is doing those things, he/she needs help.

[MikeF]

I'm gonna have to step out of academia and put my stetson and jump boots back on to dive into this one....

Any "mental health specialist" clown that thinks he can diagnose PSTD within five minutes should be rejected from any military sponsored assesment. The majority of my TBI soldiers lied to the medics, Docs, and 1SGs to get back into the fight. After 8-10 IED attacks, I forced them into submission. Now, they are trying to recover. Don't be fooled to be fooled with the assertion that universal assessment is the magic answer- the boys (and girls) can outwit any psychologist/psychiatrist looking for causation. Unfortunately, those truly affected with PTSD will surround themselves with layers upon layers of defense.

Others, the self-described 'victims' of the war- will tell any tale to receive benefits undeserved.

One of my best soldiers is currently in a WTU. He shared the following humorous story.

"Sir, I was given a free fishing trip for four wounded soldiers. In the WTU formation, I asked if anyone would like to take it. 30 soldiers came to me wishing to attend. I told them that only combat veterans could take the trip. 25 walked away. WTF??? Sir, what is going on here?"

I couldn't answer him. For the first time, I had to tell him that there was nothing I could do.

Back to Reed's original post. What do we do? What do we do for the warriors not the victims?

I don't know.

v/r

Mike

[reed11b]

SEC Gates released guidance this year that for Security Clearance Applications and Investigations, the question covering seeking mental health or counselling will be amended to exclude combat deployment related issues.

They are trying to encourage people to get help, and not hide issues which only makes them worse. Unless the medical issues are so great that the Soldier cannot function, commits violent acts, or abuses alcohol/drugs, it should not come up in his/her security check. If the Soldier is doing those things, he/she needs help.

True, and hats of to SEC Gates for having the courage to do the single thing that would have the greatest effect on MH stigma. However this is going to take time to filter down from the top, and for soldiers, a closed minded or uninformed chain of command is often the greater immediate threat from a MH diagnosis.
To step back to Stan for a minute, you actually made an extremely valid point that I failed to address on my first response, what exactly DOES happen to a soldier diagnosed w/ PTSD? There is no one answer and it is very chain of command driven. I have seen soldiers that were a train wreck that the chain of command denied counseling for because they were afraid to lose the soldier and soldiers that certainly had some degree of PTSD that commanders refused to allow to have counseling because they were afraid that it would prevent there ability to discipline and rehabilitate the soldier. On top of this Army civilian MH providers vary greatly in quality. Some are fantastic, unfortunately my personnel experience is that most are not. I have seen them belittle patients, mis-diagnose, over-diagnose, over-medicate and show greater allegiance to the process then the client. Same goes for many VA clinicians. I have also seen superb chain of commands that have made referrals when appropriate and dealt with less then clinical challenges in-house very effectively.
My focus is PTSD awareness training for first-line leaders to help them differentiate between MH and disciplinary issues and stress self-help skills for the individual soldiers and families. Army chain of commands seem to universally care about there troops, so I feel this will help reduce a lot of the chain of command errors I have seen. It's a start anyway.
Reed

[120mm]

So, I imagine this will be yet another mandatory, unpaid requirement for reservists, that will potentially jeapordize our freedom and constitutional rights? (No, sir, you can't own a gun. It says right here, that you've been diagnosed as having PTSD....)

I will quit the military before I allow some worthless M/H hack the power to stigmatize me for life.

My own story of Medical Service Corps incompetence includes being put on "Indefinite Medical Hold" for a childhood hearing loss, upon my return from Iraq. We're now on the cusp of giving even more power to these worthless, incompetent hacks.

Show me a Medical Service Corps officer with even a scintilla of honor, and I will eat my hat....

[selil]

What does your non-combat deployed co-worker do? Feel free to PM me, I may have some insight. I am hearing a lot of animosity towards Army MH, does this extend to VA and Vet Center counselors as well? What about ACS services? While not quite what I was asking for this is still useful.
Reed

My mother in-law was a senior psychiatrist working at the Richmond Vet Admin hospital with a specialty post traumatic stress disorder. When she retired they moved her entire case load to psychologists. They called her back to consult on several cases because they had so many suddenly having issues. A psychologist is not a psychiatrists no matter what they say. It is a cost saving measure. When she left they were clocking her time (keeping track) which was part of an efficiency metric. I don't know the details and what I've stated is basically all I think I know about it as I'm not that close but there seems to be issues in the system

[AdamG]

Remember all the VFW halls when we were kids, with the old guys from WWII and Korea? The cheap beer, BBQs and BS sessions where a home-brewed version of peer counseling for PTSD.

So these spiffy programs with fresh-faced, shiney happy counselors are going to share exactly what frame of reference with the guys getting off the planes from Kuwait?

If you want to effectively treat PTSD, A) you're going to need BTDT counselors and B) you're going to have to leave the door and/or phone line open for when Joe gets around to admitting to himself "I need to talk to that counselor guy".

Next year will be the second and LAST time I'm demobbing : there'll be one thing on my mind - 1. how fast can we do this Kabuki dance and 2. when do I see my girlfriend? My motivators at that point will be the same as Joe's, even tho' I'm a (comparitively) old guy and I'm aware of the importance of monitoring my own emotional state.

You want to make this work, with limited resources in Alaska? I'd whistle up your state VFW coordinator and work with him to create a gateway for us - so whether it's the day after we get home or three years later, we can reach out for someone to talk to and not necessarily have to do it after two or six pitchers of Bud.

[ODB]

First let me say I do think there are those that truely need help, have come across some of the finest fighting men in the world who have reached there mental limits and broke. On the other hand I see this as the new exit strategy for anyone who does not want to truely earn their paycheck and that ever so popular college money.

In my opinion this doesn't need to be addressed by outside organizations as an all encompassing answer. Nothing pisses me off more than having to get off a plane only to get on a bus to take me to get some screening before I can go home to the family. To many this is a cause of issues more than what they experienced during their deployment. The responsibility truely lies on every single one of us in the service today. It is our responsibility to know our peers, subordinates, and superiors. Only when you know those around you can you tell when something is not right. We are afterall only human and some things affect us differently than others and we all have a breaking point. To think these mental health types can figure some of us out is the best comedy I have come across. An example of this is the fact that a majority of those I work with including myself fail every psychological exam we take, why is this? Am I a sociopath? Ask my wife and she will most definately tell you yes, yet I am not out running around killing people in my spare time. Simple answer is do I have the capability to things many others do not, yes but also do I have a clear cut line drawn on when to use that capability and when not to, yes. I have done it for years, who I am at work is not who I am at home.

I have seen a few who have "broke", the unit moved them into a different position for a while to get their mind right, to come to terms with what they were dealing with, and they are back in the fight as I type this. Unfortunately too many organizations and individuals have their hidden agendas and thus we end up with what we have now.

Just my .02 from what I have experienced.

[Stan]

So these spiffy programs with fresh-faced, shiney happy counselors are going to share exactly what frame of reference with the guys getting off the planes from Kuwait?

Good point Adam. It was just following Zaire's first uprising and civil war and State decided to send us a USG shrink to make sure we were still OK. My boss MAJ D elected I take our Boston Whaler with 90 raging ponies across the river and retrieve the shrink at dusk. As luck would have it, Zaire and Congo were exchanging tracers and the light show was up to its usual fantastic. I think I made it half way across the Zaire river when the shrink hugged the hull and begged to be returned to Brazzaville.

... We (I) never saw him again :confused:

[Ken White]

...I have seen a few who have "broke", the unit moved them into a different position for a while to get their mind right, to come to terms with what they were dealing with, and they are back in the fight as I type this. Unfortunately too many organizations and individuals have their hidden agendas and thus we end up with what we have now.Good units fix their problems. Unfortunately, for the last 30 plus years, the Army has failed to push that philosophy and punish those who fail and has instead elected to punish everyone for the failures of a few...

Blanket 'remedies' almost never work.

[reed11b]

I have seen a few who have "broke", the unit moved them into a different position for a while to get their mind right, to come to terms with what they were dealing with, and they are back in the fight as I type this. Unfortunately too many organizations and individuals have their hidden agendas and thus we end up with what we have now.

Just my .02 from what I have experienced.
Sounds like the Army tenets of combat stress control. PIE, Proximity, Immediacy, and Expectancy. They are key to army stress control for a reason, there success rate is high. But not 100%. We still owe it to those that it does not work for to have effective readjustment programs in place.
I also agree that blanket solutions do not work, but there is a lack of awareness by the chain-of-command about many non-medical social service programs available for there troops. Blanketing individual troops w/ briefing after briefing IS counter productive ( I have been a participant on both ends of many a "briefing too far" myself) but awareness needs to be there. ACS is a start, but they should be developing connections w/ the units and I have not seen them do that at the bases that I work with. As I have stated earlier, I feel the key is training leaders in a professional and respectful manner (i.e. NOT by power point briefing) how to recognize possible warning signs and to what resources are available. I say this because I still meet Co. level leadership and higher that does not realize that soldiers can see Vet Center counselors as well as Army Behavioral Health and that Vet Center records are not shared w/ the DOD. Again, thanks for the feedback and please keep it coming, even if only to say you do not like or trust my chosen field.;)
Reed

[reed11b]

Good point Adam. It was just following Zaire's first uprising and civil war and State decided to send us a USG shrink to make sure we were still OK. My boss MAJ D elected I take our Boston Whaler with 90 raging ponies across the river and retrieve the shrink at dusk. As luck would have it, Zaire and Congo were exchanging tracers and the light show was up to its usual fantastic. I think I made it half way across the Zaire river when the shrink hugged the hull and begged to be returned to Brazzaville.

... We (I) never saw him again :confused:
And that is exactly why my goal is to become a Behavioral Health Science Officer. I have some "been there-done that" under my belt and can meet the soldiers where they are at both physically and in context. Again, Vet Center counselors are currently running at about 80% combat veterans.
Reed

[jmm99]

Had to pull back from this thread a couple of days ago - too many Ghosts of Christmases Past came back to haunt - a confluence of several stars which are now back to their places in the firmament (in an improved condition). All that Bravo Sierra means that I really don't want to (shouldn't) get into this discussion much.

But, the references to "sociopathy" (by so many here) continues to bother me. I think the process (that is, Ken's 30% who can hack violence and can continue to do so) is a form of dissociation - here, I think, a positive form of dissociation.

Here is a Wiki ref to dissociation - mostly aimed at the clinical type, but useful anyway.

http://en.wikipedia.org/wiki/Dissociation

I am talking more about a sub-clinical type, which I will try to describe. Situation of physical danger; mind (Ego, whatever you want to call it) separates from body; situation of great clarity with body responding as mind directs (but Ego is not really directing, you can see the whole scene unfold with great clarity without being involved - I can't be killed or hurt); no wasted moves; threat resolved; mind and body back to normal. QED.

Now, there is some long-term cost to all that, which I won't discuss here. But, is what I described something that others here have experienced ? Am I making any sense ?

[Steve Blair]

Makes a good deal of sense, JMM. No worries there. Personally, I think we as a society tend to be far too quick these days to smack a "...pathy" or other sort of tag on things that really might not need them at all. I also think that (in line with what Adam posts) that in this day and age of supposedly instant communication and the supposed comprehension that goes with it that we miss some of the more basic forms of communication (as in face-to-face listening). Technology won't fix everything, no matter how much some may wish it, and neither will slapping labels on everything.

[selil]

A bunch of the stuff you are talking about (sociopathy, psychopathy) are determined by outside factors like culture and environment. It is a clinical illness to be paranoid unless everybody is out to get you. Part of the problem is the way society deals with violence. In "Violence: A microsociological theory" Randall Collins says that humans just plain aren't wired to do violence and to prove it extensively based his argument on SLA Marshall.

A variety of people have refuted Collins and Marshall over the years.

The willingness to engage in violence, or acts of violence in a targeted and efficient manner is neither understood or explained well in the literature. Basically because it is a POLITICAL issue.

The various clinical descriptions for ailments of various soldiers can usually be classified into a few different buckets. The problem is that people walking around the street at random can be picked up and fall into similar buckets having never been to combat.

One BIG thing that has to occur is a-political analysis of the issues involving dissociative traumatic stress and brain injury due to experience must be done soon. Another thing is that people doing the studies need to remember that their political dislike for violence should not be allowed to taint the research.

I'm not saying people don't have problems but I am saying the way we treat people is based on highly flawed and politically skewed mumbo jumbo (mumbo jumbo is a scientific term of bull ####).

By the way after I posted my review of Randall Collins book "Violence" he quit speaking to me.

[ODB]

I have wonder for quite some time now about PTSD in todays services vs those in the past. I know there are entirely too many variables to really put a finger on it. My biggest questons are is it more widespread today because now people know what PTSD is and diagnose it as such or is it because society today is much easier than it was 20, 30, 50 years ago therefore people are not as desensitized as they were before. Having led easy, stress free lives today compartively to previous generations. I know the stresses today are different than in the past but generally speaking life is easier than in the past for most. Ultimately is it a combination of both? The services themselves are falling into the trap in mind as well of taking the stressors away that very well may have been the reasons for fewer cases in the past.

I wanted to touch on a previous post about the VFW and what therapy a case of beer and some good BBQ with those you were there with you can do for one. In my opinion it should be built into rotations, 2 weeks as a unit with lots of alcohol and good food, in some sweet resort for all in the unit to decompress and support each other. Part of the issue in my mind is that too many today have lost sight of what a "team" truely is. If only I was the hog with the fuzzy nuts.

Just curious what others thoughts are on these.

I am of the thought if we can figure out who is most and who is least suspect to PTSD then we assign them accordingly throughout the services. In my opinion prevention vs rehabilitation is where we need to look.

[Ken White]

First, recall that in WW I, WW II, Korea and Viet Nam, rotation was individual and not by unit. So you went to war, got through as part of a unit -- and then returned to CONUS as a single soul. What you then did was work through any problems pretty much on your own; most people just sucked it up and kept on plugging along. A few had severe problems and got local or VA help, most did not and worked things out for themselves. Most were content with that.

After Viet Nam, as a result of many things (not least getting a diagnosis insurers would pay for), interest in PTSD rose and for the first time, counseling was offered. A really relatively small percentage of Viet Nam veterans were involved in that -- most just drove on as had their equally numerous Korean War predecessors and their far, far more numerous WW II forebears...

Secondly, I agree that society has lost many stressors and that treatment for mental aberrations is more acceptable and those two factors conspire to raise the acceptability and thus the number of 'sufferers.' Times change and so do mores an attitudes.

Not always for the better... :wry:

As an aside, I agree with your idea on unit rotations decompressing on the way home. :cool:

And I really agree with your 'prevention is better than treatment...'

[AdamG]

Will this be labeled 'PTSD'?

Army to probe 5 slayings linked to Colo. brigade
By P. SOLOMON BANDA
Associated Press Writer
Oct 18, 10:12 AM EDT

DENVER (AP) -- Fort Carson soldiers returning from deployment in Iraq are suspects in at least five slayings, and officials want to know why.

Commander Maj. Gen. Mark Graham announced Friday a task force will examine any commonalities in the five killings, all allegedly committed by soldiers from the post's 4th Brigade Combat Team in the past 14 months. A sixth BCT soldier faces an attempted murder charge.

http://hosted.ap.org/dynamic/stories/S/SOLDIERS_SLAYINGS?SITE=FLTAM&SECTION=US

But wait, there's more.

The issue of homicides by combat-stressed veterans gained national prominence in January, after The New York Times reported that at least 121 Iraq and Afghanistan war veterans had committed a killing in the United States or been charged in one.

But then we read this...

Pfc. Jomar Dionisio Falu-Vives, 24, and Spc. Rodolfo Torres-Gandarilla, 20, face attempted murder charges in the May 26 wounding of Capt. Zachary Zsody, who was shot twice while standing at an intersection. An arrest affidavit released in August said an AK-47 used in the Zsody case was found in Falu-Vives' apartment and it was also used in the June 6 deaths of two people gunned down on the street while putting up signs for a garage sale.

Killed were Cesar Ramirez Ibanez, 21, and Amairany Cervantes, 28. Prosecutors filed murder charges against Falu-Vives on Sept. 15.

Anyone care to be that these two were scumbags before they enlisted and simply reverted back to their default personalities when they got home?Anyone care to bet that the accused have UCMJ actions signed by the above officer in their jackets?

[jmm99]

Anyone care to bet that these two were scumbags before they enlisted and simply reverted back to their default personalities when they got home?Anyone care to bet that the accused have UCMJ actions signed by the above officer in their jackets?

on either of the above propositions - that is my professional lawyer mode talking.

If I were the prosecutor (or defense counsel, for that matter), I would be very interested in their priors (if any) - both pre- and during military service. I would also be interested in any prior psychological workups of record.

The article suggests, as to one of these gems, definite pathology:


The affidavit said Marko told investigators he had violent sex with Lawrence before slitting her throat and leaving her to die in the foothills west of Colorado Springs.

That (to me) does not mean "not guilty by reason of insanity". All jurisdictions should have the alternative verdict form of "guilty, but mentally ill" - which means the criminal is first treated for the mental illness and then serves out the balance of the sentence for the crime.

There are not enough facts in what we know (from the article) to make hasty assumptions. Those facts will develop for those who want to follow the case.

There sure ain't enough facts to speculate that these crimes were proximately caused by the perps' military service - or even that military service was a "but for" causational factor.

PS: A few years ago, a small Houghton County village had four murders in one year (two by a serial killer who killed elsewhere in the area). Based solely on the bare statistics, one could conclude (falsely) that place was the Murder Capital of the USA.

[jmm99]

is the name of a Detroit rock band; but more important here is an alternative verdict to "not guilty by reason of insanity". Here is the background:


Physicians' Weekly
Point/Counterpoint
October 27, 1997
.....
Michigan was the first state to enact guilty but mentally ill. It was a [1975] reaction to a 1974 State Supreme Court decision holding that after 60 days’ confinement, someone acquitted by reason of insanity had to meet the standards of civil commitment. As a result, 64 persons were released, and two committed vicious crimes shortly afterward. ....

http://www.physiciansweekly.com/archive/97/10_27_97/pc.html

The statute as it now stands is a bit lengthy (I've broken it into its parts for comment); but you have to have it before you to understand its logic and the comments.

As a practical matter, the statute will come into play only where (1) the defendant pleads not guilty by reason of mental illness ("insanity"); (2) proofs are offered to support mental illness; and (3) the proofs fail on the element of "lack of substantial capacity".


768.36 Defense of insanity in compliance with MCL 768.20a; finding of “guilty but mentally ill”; waiver of right to trial; plea of guilty but mentally ill; examination of reports; hearing; sentence; evaluation and treatment; discharge; report to parole board; treatment as condition of parole or probation; period of probation; psychiatric reports.

Sec. 36.

(1) If the defendant asserts a defense of insanity in compliance with section 20a of this chapter, the defendant may be found “guilty but mentally ill” if, after trial, the trier of fact finds all of the following:

(a) The defendant is guilty beyond a reasonable doubt of an offense.

(b) The defendant has proven by a preponderance of the evidence that he or she was mentally ill at the time of the commission of that offense.

(c) The defendant has not established by a preponderance of the evidence that he or she lacked the substantial capacity either to appreciate the nature and quality or the wrongfulness of his or her conduct or to conform his or her conduct to the requirements of the law.

OK, so three basic elements; of which, the last one is all important. It is particularly important if "PTSD" is alleged as the mental illness.

E.g., if a defendant could prove by a preponderence (50 yds + a nose) that he had flashbacks so delusional that Mr. McCarthy appeared as an AQ terrorist in Iraq trying to kill the defendant and his unit, he may well get a jury to find the "lack of substantial capacity" element.

On the other hand, if the PTSD proof is that Mr. McCarthy by his big mouth set off the defendant's irresistible submerged anger, leading him to wring McCarthy's neck, I expect the jury might be less agreeable (depends on what they thought of Mr. McCarthy). That defense worked in Anatomy of a Murder (the real case was tried in Marquette, MI, with defense counsel a guy who was usually county prosecutor - later sat on the Michigan Supreme Court - had awesome talents with the ladies, so twas said).


(2) If the defendant asserts a defense of insanity in compliance with section 20a of this chapter and the defendant waives his or her right to trial, by jury or by judge, the trial judge, with the approval of the prosecuting attorney, may accept a plea of guilty but mentally ill in lieu of a plea of guilty or a plea of nolo contendere. The judge shall not accept a plea of guilty but mentally ill until, with the defendant's consent, the judge has examined the report or reports prepared in compliance with section 20a of this chapter, the judge has held a hearing on the issue of the defendant's mental illness at which either party may present evidence, and the judge is satisfied that the defendant has proven by a preponderance of the evidence that the defendant was mentally ill at the time of the offense to which the plea is entered. The reports shall be made a part of the record of the case.

I can't see why a defendant would plead to guilty but mentally ill; unless the bargain was for outright probation, or a much reduced sentence followed by probation. See section 4 below. E.g., if the crime sentence is life or a long term of years, why not bargain for a set term of years under a pure guilty or nolo plea ?


(3) If a defendant is found guilty but mentally ill or enters a plea to that effect which is accepted by the court, the court shall impose any sentence that could be imposed by law upon a defendant who is convicted of the same offense. If the defendant is committed to the custody of the department of corrections, the defendant shall undergo further evaluation and be given such treatment as is psychiatrically indicated for his or her mental illness or retardation. Treatment may be provided by the department of corrections or by the department of community health as provided by law. Sections 1004 and 1006 of the mental health code, 1974 PA 258, MCL 330.2004 and 330.2006, apply to the discharge of the defendant from a facility of the department of community health to which the defendant has been admitted and to the return of the defendant to the department of corrections for the balance of the defendant's sentence. When a treating facility designated by either the department of corrections or the department of community health discharges the defendant before the expiration of the defendant's sentence, that treating facility shall transmit to the parole board a report on the condition of the defendant that contains the clinical facts, the diagnosis, the course of treatment, the prognosis for the remission of symptoms, the potential for recidivism, the danger of the defendant to himself or herself or to the public, and recommendations for future treatment. If the parole board considers the defendant for parole, the board shall consult with the treating facility at which the defendant is being treated or from which the defendant has been discharged and a comparable report on the condition of the defendant shall be filed with the board. If the defendant is placed on parole, the defendant's treatment shall, upon recommendation of the treating facility, be made a condition of parole. Failure to continue treatment except by agreement with the designated facility and parole board is grounds for revocation of parole.

Here is the key to the statute: sentence for the crime, with mental health evaluation and treatment ancillary to the conviction.


(4) If a defendant who is found guilty but mentally ill is placed on probation under the jurisdiction of the sentencing court as provided by law, the trial judge, upon recommendation of the center for forensic psychiatry, shall make treatment a condition of probation. Reports as specified by the trial judge shall be filed with the probation officer and the sentencing court. Failure to continue treatment, except by agreement with the treating agency and the sentencing court, is grounds for revocation of probation. The period of probation shall not be for less than 5 years and shall not be shortened without receipt and consideration of a forensic psychiatric report by the sentencing court. Treatment shall be provided by an agency of the department of community health or, with the approval of the sentencing court and at individual expense, by private agencies, private physicians, or other mental health personnel. A psychiatric report shall be filed with the probation officer and the sentencing court every 3 months during the period of probation. If a motion on a petition to discontinue probation is made by the defendant, the probation officer shall request a report as specified from the center for forensic psychiatry or any other facility certified by department of community health for the performance of forensic psychiatric evaluation.

This part is a diversion path for a defendant who committed a less serious crime, but has a serious mental illness. This portion of the statute was attacked, but held constitutional.


History: Add. 1975, Act 180, Eff. Aug. 6, 1975 ;-- Am. 2002, Act 245, Eff. May 1, 2002
Constitutionality: The Michigan supreme court found that subsection (4) of this section, governing the grant of probation to guilty but mentally ill persons, does not violate the equal protection and due process clauses of the federal and state constitutions. People v. McCleod, 407 Mich. 632, 288 N.W.2d 909 (1980).

You might want to check on whether your state has such a statute; and, if not, ask your favorite legislator "why not".

[AdamG]

I suspect that this issue is also related to PTSD, or will be.

Troops reportedly popping more painkillers

Troops reportedly popping more painkillers By Gregg Zoroya, USA TODAY WASHINGTON — Narcotic pain-relief prescriptions for injured U.S. troops have jumped from 30,000 a month to 50,000 since the Iraq war began, raising concerns about the drugs' potential abuse and addiction, says a leading Army pain expert.

Find this article at:
http://www.usatoday.com/news/military/2008-10-20-paindrugs_N.htm

[AdamG]

JMM

Thanks for the insightful posts. I intend to follow this via open source and will post any updates that cross my screen.



There are not enough facts in what we know (from the article) to make hasty assumptions. Those facts will develop for those who want to follow the case.
.

True enough. I make my hip-shoot call based on prior experience weeding out half a dozen "Group W Bench" residents from my company prior to deployment.

We seem to take dubious characters to war, simply because the Powers That Be demand to see the right numbers and certain command structures don't want to exert the effort to take the blatant liabilities off their DMDs. At this point, Gideon's self-induced attrition from 22k troops to 300 during his march on the Midianites looks better and better.

*
PS: Hey, looky here!

http://www.denverpost.com/news/ci_10758345

Salazar announced Friday that he had sent a letter to Army Secretary Pete Geren requesting that he personally visit the base and initiate a comprehensive review of all violent acts by Fort Carson soldiers since they served in Iraq or Afghanistan.

The Colorado senator also asked the Army to do several other reviews, including whether soldiers allegedly involved in recent murders had been given criminal or medical waivers to fulfill recruitment quotas.

[120mm]

I suspect that this issue is also related to PTSD, or will be.

Troops reportedly popping more painkillers

Troops reportedly popping more painkillers By Gregg Zoroya, USA TODAY WASHINGTON — Narcotic pain-relief prescriptions for injured U.S. troops have jumped from 30,000 a month to 50,000 since the Iraq war began, raising concerns about the drugs' potential abuse and addiction, says a leading Army pain expert.

Find this article at:
http://www.usatoday.com/news/military/2008-10-20-paindrugs_N.htm

Well, provided that I received a lifetime supply of Valium to treat my vertigo, in theater, without a prescription, I can see where abuses can happen.

[AdamG]

It's not just the Army...

http://www.nydailynews.com/news/us_world/2008/11/05/2008-11-05_brooklyn_marine_sergeant__wife_tortured_-2.html

A Brooklyn-raised Marine sergeant and his new bride were tortured and killed execution-style in their California home - allegedly by four other Marines under his command.

Sgt. Jan Pawel Pietrzak, who was raised in Bensonhurst, and his wife, Quiana, were found bound and gagged in the ransacked house, each shot in the head.

*

Charged with murder and other crimes are Pvt. Emrys John, 18, of Maryland; Lance Cpl. Tyrone Miller, 20, of North Carolina; Pvt. Kevin Darnell Cox, 20, of Tennessee, and Pvt. Kesuan Sykes, 21, of California.

Lawyers for the men could not be reached for comment.

Pietrzak's mother said she can't understand how Marines could have committed such a crime.

"Don't the Marines screen out people like this?" she said. "Didn't they know they had murderers under their roof?"

and then -
http://www.nydailynews.com/news/us_world/2008/11/06/2008-11-06_confession_in_torture_slay_of_brooklynra-2.html

They did it for the money.

The four Marines charged with murdering their Brooklyn-raised sergeant and his bride confessed they were looking for an easy score when they burst into the couple's California home with guns drawn, court papers revealed Thursday.

Three of them ratted out Pvt. Emrys John as the triggerman who ended the torture of Sgt. Jan Pawel Pietrzak and his wife, Quiana, by shooting them in the back of their heads.

*

All of the suspects say that Quiana Jenkins-Pietrzak was sexually assaulted, but each says it was the other three who did it, the papers say.

*
On his MySpace page, Miller referred to himself as a "Cripgeneral." Investigators are now checking whether he had ties to the violent Crips street gang.

[Rex Brynen]

Too many stressed soldiers slipping through cracks: report (http://www.cbc.ca/health/story/2008/12/17/military-stress.html)
'Canadian Forces members are strained almost to the breaking point,' says military ombudsman
Last Updated: Wednesday, December 17, 2008 | 11:41 AM ET
CBC News


Some Canadian military personnel who have post-traumatic and operational stress injuries are not getting the care and attention they need, according to a report released Wednesday by the military ombudsman.

While senior military leaders have talked about a strong commitment to deal with post-traumatic stress disorder, or PTSD, and its devastating effects, the commitment hasn't reached down to the community level, interim ombudsman Mary McFadyen said.

There is a lack of care and support for soldiers across the country, she said in the 62-page report.

When one mother said her son was on the verge of committing suicide, she went to his supervising officer in Petawawa, who told her to suck it up, Susan Ormiston of CBC News reported. It's an experience the ombudsman confirmed is happening, based on interviews with 360 people across the country.

The full report can be downloaded from the DND/CF Ombudsman here:

A Long Road to Recovery: Battling Operational Stress Injuries (http://www.ombudsman.forces.gc.ca/rep-rap/sr-rs/osi-tso-3/index-eng.asp)

Second Review of the Department of National Defence and Canadian Forces’ Action on Operational Stress Injuries, December 2008.

[reed11b]

According to one local expert, military stigma (http://www.adn.com/opinion/view/story/610947.html) attached to mental health plays a big role on getting soldiers in. Want to bet it would still play a big role even if "screenings" were mandatory?
Reed

[120mm]

According to one local expert, military stigma (http://www.adn.com/opinion/view/story/610947.html) attached to mental health plays a big role on getting soldiers in. Want to bet it would still play a big role even if "screenings" were mandatory?
Reed

Interesting article, and great to see an SWC member get their name in print. Just a few comments, though:

I think most "treatment" for PTSD is over-formalized. To me, sitting around, drinking beer, and telling war stories is valid and useful treatment. It should be THE focus of the Army's treatment effort. "The system" is overly formal, even without going into stigma issues for treatment, and if you enter it, you run the risk of losing your rights. I had PTSD long before it was "cool", and found that my healing started once I met my wife and could finally talk about it to someone. I'm still quite warped, but I've come to quit worrying and learned to accept it.

Second, I've mentioned the dangers earlier of overly focusing on PTSD; Depending on an individual's resistence level, you can talk someone into "getting" PTSD. I've seen entire units go down from faux food poisoning, and seen people with PTSD who never experienced anything more stressful than having to stand in the chow line.

Third, all this publicity is disingenous, imo. The press is all over PTSD and TBI because it makes good sensationalism and plays right into the "Veterans are ticking timebombs" meme. Enough with the damned publicity, already.

And fourth and finally: the professional warriors (who are, I believe, the minority) are NOT in the military "for their health" despite what the hand-wringing panty-wetters like to think. Quit bothering us with your PTSD crap if we reject it. It eats up valuable training time, along with all the other CYA bull-crap that the risk averse are pushing.

Otherwise, appreciate what you're doing, Reed.

[ODB]

Ask many of those I work with and they will claim coming home is their cause, not being in Iraq. It's all the admin bullsh*t that gets us. Reverse SRP, SRP, health assessment surveys pre-deployment and post deployment, terrorism awareness training, unit assessment, safety classes, POSH training, and the list goes on. This is during a 6 month rotation home. At some point these so called experts need to realize they are cause more damage than good. We just want to get back to doing what we knows works, drinking beer and chasing tail. We aren't touchy, feely, sensitive metro males, there are some us out there who still are men. Let's be honest PTSD is the latest and greatest escape clause for many. Hey doc I can't sleep and I have nightmares I want out and I want disability with it, come on........ Don't get me wrong there are legitimate cases but the fraudulent cases outweigh the legitimate ones. So it gets forced down all our throats and causes us an unusual amount of ass pain. Just my perspective on the experts.

[Schmedlap]

It's all the admin bullsh*t that gets us.

I second that and everything else that you wrote. That is why I am now a civilian instead of an Infantry Officer.

A year in Iraq, for me, is no big deal. But for the year that we're back between deployments, when 8 months of that is spent in the field, the other 4 months are pretty valuable. When 2 or 3 out of those 4 are eaten up by what ODB mentioned, that makes for some angry troopers. It also results in some retention issues.

[reed11b]

Don't get me wrong there are legitimate cases but the fraudulent cases outweigh the legitimate ones.
This is the only statement you made that I have issue with. I disagree, though I can see were the perception comes from. The majority of the vets that come into the Vet Center do so way below the radar. They come in on there own time, they adhere to strict confidentiality and do not ask for there records to be shared with the big VA or the DOD. The ones that everybody sees are the loud ones that make a lot of noise, insist on making appointments during duty hours, and they often come from the WTU. Coming from the WTU is not an indicator of faking in itself, but my experience is that the WTU's are something of a poison pill and moral in them goes south very quickly. Very similar in my work with youth in crisis, it would be easy to become jaded and think that most youth do not really need the services they are using (or abusing in this case) because of the very vocal minority that take up for more time and other resources then justified. The reality is that most of the kids using the service need it very badly.
Another reason for some of the questionable PTSD cases is the VA and Army's diagnosis policy. It used to be that a delay in the onset of symptoms was required for a PTSD diagnosis. Now the symptoms only have to last longer then 3 months. Combat Stress readjustment is normal, i.e. more soldiers show the symptomology then not. I personally feel that many of the PTSD diagnosis are really readjustment issues that take a little longer then usual to heal for whatever reason, including the dysfunctional re-deployment screening cycle. If it lasts for a year, but heals minus invasive therapy (EMDR and exposure therapy as opposed to CBT and skills building) it was really readjustment in my mind. Of course I do not speak for the VA so take my opinion for whatever it is worth.
Reed

[ODB]

In today's society where so many people try to justify their existence have we created something out of nothing? I think most of us can agree that war is a life changing experience for most if not all service members. I can tell you how it affected me........I cannot stand admin stuff that has absolutely nothing to with making my ability to take the fight to enemy and come back alive. There has been more screenings and assessments put upon us in recent years than ever before and why? Because some supposed expert somewhere says your not the same person.......well no sh*t, I look at things differently now. If we didn't have the victim mentality in society from the start how many of these people would be better prepared for the realities of war? It is not the Hollywood glory so many think and when they find out the truth they want nothing else to do with it. We have created our own monster and now we must deal with it. Yes I have buddies you have come back mentally unstable, a prime example is 23 year old who did 3 trips in 3 years with a divorce in the middle of it all, losing two team mates, and getting blown up himself. He did not have enough life experience to handle the issues at hand. Only after we got him home and hanging out with us around the bonfire with lots of alcohol did he no longer need meds....he talked about what he was going through with others who had been there in their own experiences. Yes, I am proud to say I belong to an organization that polices it's own and takes care of them. Some shrink who has no clue of what it is like is not going to be able to that. These guys that have legitimate problems need their own guys around them. Now same guy goes to get his VA assessment and is told he needs to prove his injuries are combat related. I guess purple hearts now mean peace time wounds to VA. I have serious issues with the system and will be the first one to tell anyone it's worthless and the experts need to go elsewhere, good units will take care of their own as they have done in the past, when they don't hammer the command for failing their soldiers and quit treating the soldiers as victims. We are an all volunteer force, you signed the contract, sorry the college money is no longer free, sorry you now need to earn it. Then explain why one soldier loses a limb and fights his way back into his job, while the next one is crying poor me?

[reed11b]

Some shrink who has no clue of what it is like is not going to be able to that. These guys that have legitimate problems need their own guys around them. Now same guy goes to get his VA assessment and is told he needs to prove his injuries are combat related.
Vet Center counselors are almost all combat vets. I am a combat vet. Yes, some soldiers readjust w/o therapy, but some do not. Disparaging the men and women who have chosen to serve twice to be available to help you is counter-productive and you are going to succeed in setting me off if you keep up your current rants. It is ok to get help, confidential help from been-there-done-that types that also have educated themselves on how to be a professional counselor, and suggesting that anyone that seeks that help is crybaby i.e.
Then explain why one soldier loses a limb and fights his way back into his job, while the next one is crying poor me?
is complete and total Bravo Sierra and you should be embarrassed to have suggested it, period. That soldier that fought back from losing a limb had a dedicated team of doctors, therapists and medical aides fighting along-side him step for step and soldiers that have psychological wounds deserve the same level of support.
One P.O.ed Reed :mad:

[Stevely]

There has been more screenings and assessments put upon us in recent years than ever before and why? Because some supposed expert somewhere says your not the same person.......well no sh*t, I look at things differently now. If we didn't have the victim mentality in society from the start how many of these people would be better prepared for the realities of war?

"Experts" and the therapeutic culture are a curse on our society that is universal, not just within the military. I think it is only to be expected - we are a crazy society that is working furiously cut itself loose from every last mooring in traditional culture, for the sake of "progress", including all those means that human cultures and societies have developed over the millenia to cope with the vicissitudes of life. These experts and their schemes are the result of trying to replace the natural with the unnatural product of ideologies. The society no longer has deep cultural and spiritual resources to fall back on, and thus no longer understands what you've gone through - no longer understands, really, the human condition - and won't admit and can't imagine that anyone else can, thus you and your comrades are subject to this mad, clueless flailing by mental health professionals, grief counselors, and the rest of the lot. It will only get worse. This is the terminus of a highly abstract culture - it can no longer not only tell truth from falsehood, it no longer even has the vocabulary for it.

"Thinking themselves wise, they became fools."

[Rex Brynen]

"Experts" and the therapeutic culture are a curse on our society that is universal, not just within the military. I think it is only to be expected - we are a crazy society that is working furiously cut itself loose from every last mooring in traditional culture, for the sake of "progress", including all those means that human cultures and societies have developed over the millenia to cope with the vicissitudes of life. These experts and their schemes are the result of trying to replace the natural with the unnatural product of ideologies. The society no longer has deep cultural and spiritual resources to fall back on, and thus no longer understands what you've gone through - no longer understands, really, the human condition - and won't admit and can't imagine that anyone else can, thus you and your comrades are subject to this mad, clueless flailing by mental health professionals, grief counselors, and the rest of the lot. It will only get worse. This is the terminus of a highly abstract culture - it can no longer not only tell truth from falsehood, it no longer even has the vocabulary for it.

Having seen a great many people whose lives have been transformed for the better (and, for that matter, lives have been saved) by dedicated mental health professionals, I have to say this picture bears absolutely no resemblance to the society I know.

I don't think that slagging off mental health workers en masse is either appropriate or very useful.

Having said that, I'll leave it there. I don't that SWJ is a particularly appropriate place to fight out culture wars.

[120mm]

Vet Center counselors are almost all combat vets. I am a combat vet. Yes, some soldiers readjust w/o therapy, but some do not. Disparaging the men and women who have chosen to serve twice to be available to help you is counter-productive and you are going to succeed in setting me off if you keep up your current rants. It is ok to get help, confidential help from been-there-done-that types that also have educated themselves on how to be a professional counselor, and suggesting that anyone that seeks that help is crybaby i.e.
is complete and total Bravo Sierra and you should be embarrassed to have suggested it, period. That soldier that fought back from losing a limb had a dedicated team of doctors, therapists and medical aides fighting along-side him step for step and soldiers that have psychological wounds deserve the same level of support.
One P.O.ed Reed :mad:

The counselors at the VA near Leavenworth must be veterans of the Indian Army then, since they're definitely not US nationals. And they treat the soldiers like ####, as well.

In my experience, nearly losing a limb, and having an undiagnosed major brain trauma/personality change, I find that recovery is 90% or more on the dude with the wounds. And victims are victims. No matter how much you try to help them, they will always wallow in their own misery.

I think you overestimate the impact you actually have as a counselor. Most of the enthusiastic counselors I have met are the same way. Hyper-inflated ego and unreasonable self-image is probably the most prevalent symptom among medical/mental health personnel.

[120mm]

Having seen a great many people whose lives have been transformed for the better (and, for that matter, lives have been saved) by dedicated mental health professionals, I have to say this picture bears absolutely no resemblance to the society I know.

I don't think that slagging off mental health workers en masse is either appropriate or very useful.

Having said that, I'll leave it there. I don't that SWJ is a particularly appropriate place to fight out culture wars.

I disagree. Addiction to mental health treatments is a real and common malady, which has the additional by-product of providing job security to the same mental health professionals.

I don't see a whole bunch of people who outgrow their therapist. I HAVE encountered some very effective mental health professionals, who are able to help someone "get off their top dead center" and then help themselves "get right". But they are in the minority, in my experience.

[ODB]

My heart brun is with the supposed experts not those who have been there done that and can help. According to most of these so called mental health experts I'm psycho according to their tests (have failed every psych eval I have taken). If you read most of what I was getting at is that as a society we have taken on the victim role instead of accepting responsibility......thus leading into metally weaker individuals who do not know how to handle the situations they face. This leads into my lost limb comment. It is on the individual, you can choose to be the victim or not and it is that victim who everyone sees, not the guy on one leg doing a scuba certification to see if he can still be on a scuba team with one good leg. Guess what he did it. Another personal example is my best friend has had 7 surgeries in 15 months to fix a shattered foot from an IED and is still not fixed. He told his doctors to cut his leg off below the knee so he could at least get back to doing his job. He was the only guy in the vehicle to survive, he is doing fine. This is the nature of the men I work with so yes when I hear some FOBBIT crying about PTSD from sitting on a FOB for a year I tend to be a bit ticked off. Understand the culture I come from and you easily see why this irrates the hell out of us. On the occasion it happens to one of our own we take care of them. We could go back and forth all day long, to get at the heart of issue is that when enough experts tell you something is wrong you begin to believe something is wrong even though there isn't. Awareness at the individual level is key, we know each other better than anyone, we know when someone is not their self, and we help that individual. This is the way to cut through the BS. Yes not everyone is wired the same way to handle everything thrown at them, but there are ways that lead to prevention. Let's look at the kinder gentler Army of today. When soldiers are no longer pushed, stressed mentally and physically are we doing them a disservice or we helping them? I tend to lean to fact that we are providing a disservice. As standards continue to drop more problems will continue to arise.

[Rex Brynen]

I disagree. Addiction to mental health treatments is a real and common malady, which has the additional by-product of providing job security to the same mental health professionals.

I don't see a whole bunch of people who outgrow their therapist.

I do, all the time. I don't work in the military--I teach--but I often have students coming back to me years after they were encouraged to seek help (for depression, addictions, SIs, EDs, the after-effects of sexual assault, and suicidal feelings) to say how support, counseling, and intervention at the right time changed their lives for the better.

A lot of them tell me they're afraid to tell their family. Afraid they'll look weak. Afraid they won't understand. Afraid they'll be blamed. Frankly, if their parents have attitudes similar to some of those expressed in this thread, I can see why.

At the moment, I'm worried that someone in the military who would benefit from help, will read this thread and not ask for it for fear that asking for help is somehow not "manly" or "warrior" enough to retain the respect of his (or her) peers. That would be a tragedy.

[reed11b]

The counselors at the VA near Leavenworth must be veterans of the Indian Army then, since they're definitely not US nationals. And they treat the soldiers like ####, as well.

In my experience, nearly losing a limb, and having an undiagnosed major brain trauma/personality change, I find that recovery is 90% or more on the dude with the wounds. And victims are victims. No matter how much you try to help them, they will always wallow in their own misery.

I think you overestimate the impact you actually have as a counselor. Most of the enthusiastic counselors I have met are the same way. Hyper-inflated ego and unreasonable self-image is probably the most prevalent symptom among medical/mental health personnel.

1) Vet Centers are part of the VA, but they are sepperate from the medical clinics. If you went to BH&SS at a VA clinic or hospital, then yes they may not have been vets. VA does not = Vet Centers, something that I seem to have difficulty making clear.

2) Those "dudes" that do recover from there severe wounds STILL RECIEVE HELP!! How dense do have to be to realize that mental health is the same way! Yes, the soldier has to have a commitment and desire to get better and if he does not, then yes, no counselor in the freaking world can help him, period BUT... for those that do have the right attitude, help helps, you can not "suck it up" through PTSD and spreading this Bravo-Sierra is going to hurt more soldiers and that ticks me off in a really big way.

3) If you really want to go here..
I think you overestimate the impact you actually have as a counselor. Most of the enthusiastic counselors I have met are the same way. Hyper-inflated ego and unreasonable self-image is probably the most prevalent symptom among medical/mental health personnel. why don't you make an effort to check out a Vet Center first. Otherwise you are just talking out of your Alpha.
Reed
P.S. Rex beat me to the punch, thank you sir for your comments, same to Mr. Blair.

[Steve Blair]

I think everyone should take a deep breath and consider what Rex said above. Specifically:
A lot of them tell me they're afraid to tell their family. Afraid they'll look weak. Afraid they won't understand. Afraid they'll be blamed. Frankly, if their parents have attitudes similar to some of those expressed in this thread, I can see why.

At the moment, I'm worried that someone in the military who would benefit from help, will read this thread and not ask for it for fear that asking for help is somehow not "manly" or "warrior" enough to retain the respect of his (or her) peers. That would be a tragedy.

Sure, therapy or what have you doesn't work for everyone. Sure, the system does overreach when it wants to put people in neat little categories. But it does work for some people some of the time. Maybe we should just scrap the whole system and go over to the WW 2 British system of stamping LMF (lacks moral fiber) on peoples' records and pack them off. Take a look at what happened in Bomber Command after Harris took over.:wry:

Parts of the system don't work. How do we fix that? And it's also important to remember that this is a two-way street...some folks don't want to be helped. They like wallowing in their stuff, as 120mm pointed out, and are often enabled by therapists who are similar. But does that mean we scrap the whole system? I'd hope not.

[jkm_101_fso]

I think this is pretty simple.

The military is required to provide help to those that need it and even those that think they need it and actually may not. So, they have to screen everyone. Not to do so would be negligent. That is what the health professionals are for. They can determine if a soldier doesn't actually require help.

Remember, though, if said professional ends up being wrong, the results could be catastrophic. Naturally, some will inevitably slip through the cracks that don't have a damn thing wrong with them. There are worse things in life.

If you don't need help, don't ask for it; too easy.

Of all the post-deployment mental health screenings I've had to sit through, I think they took up a combined 30 minutes of my time.

The Army has wasted a lot more of my time for much more ridiculous things.

[120mm]

I think this is pretty simple.

The military is required to provide help to those that need it and even those that think they need it and actually may not. So, they have to screen everyone. Not to do so would be negligent. That is what the health professionals are for. They can determine if a soldier doesn't actually require help.

Remember, though, if said professional ends up being wrong, the results could be catastrophic. Naturally, some will inevitably slip through the cracks that don't have a damn thing wrong with them. There are worse things in life.

If you don't need help, don't ask for it; too easy.

Of all the post-deployment mental health screenings I've had to sit through, I think they took up a combined 30 minutes of my time.

The Army has wasted a lot more of my time for much more ridiculous things.

What's worse in life than being thrown out of the military because you are a head case?

I've seen plenty of examples where a man was ruined because the "system" was wrong in the opposite direction. One man I worked with, admitted to having suicidal thoughts several years before, and he was treated like crap and eventually bullied out of the army by those holy and sacred "mental health professionals". The guy next to me in my workspace is on the way to being branded as a PTSD victim and psych case, because he won't "play along" with the PTSD bull#### that the counselor has labelled him with. And this guy never left a FOB, but refuses to "admit" he has PTSD, and the scum-sucking POS mental health professional says this proves he's in "denial". It's like the Spanish Inquisition all over again.

Right now, I am filling out my annual PHA, where, if I were to fill it out without lying my ass off, I'd be kicked out of the army and categorized into some nice psychological "box". I have paused at the question that asks if I've ever has psych eval or counselling. Now, this survey will be seen by every PAC clerk and interested person who has access to my records for the rest of the time I'm in the army, and long after. But the mental health "professionals" are so wrapped up in their little technical worlds, that they don't understand this, and don't care as long as they get their power-game and paycheck.

So, I am forced to abandon my honor and lie in order to be able to continue to serve. But folks like Reed don't give a crap about honor (he said so, himself) and care not a whit how much that costs me and folks like me. Thanks for your help, idiots.... Again, those of us who are warriors, and aren't into the military as a form of social welfare aren't in it for our health.

[120mm]

One more thing. Who are the morons who design the medical questionnaire forms?

I admit to one TBI, non-service related. I am required to fill out a TBI questionnaire because of this. The TBI questionnaire only applies to DEPLOYMENT-RELATED TBI. I MUST fill out the TBI questionnaire, but cannot because none of the questions apply to me.

This is typical poo-flinging monkey medical service bull####. And we want to give these guys more power.... why?

[120mm]

What I would like to see, is a study where groups are given variable amounts of pre- and post- deployment PTSD counselling, and then studied for the incidence and seriousness of PTSD. I'm wondering to what extent "suggestibility" plays in the formation of PTSD.

There were similar studies in WWII, but I'm wondering if they would be deemed ethical, today.

Just in case anyone is interested, I had to argue with the doc to pass my PHA, because my vitals are too low. RHR of 39, BP of 108 over 60 and body temp of 97 degrees. All of which are normal for me, when I'm in shape. One more gripe to add to my laundry list about the medical profession and the lack of actual "thought" that goes through docs' heads. Evidently "normal" once arbitrarily defined by the quacks becomes a graven in stone "fact". Damned near got sent to the Emergency room "just in case".

Evidently you aren't allowed to be in great shape in some "systems." Also, the doc vapor-locked over the TBI questionnaire, just like I thought. If you answer "yes" to the TBI question, you must fill out the questionnaire, which you cannot fill out if your TBI wasn't combat-related.

[reed11b]

120, even though you are high on my sierra list,;):wry: you have a point that the DOD's concept of "universal screening" will not catch everyone it needs to catch and may lead to "false-positives". I also object to the DOD's apparent belief that a counselor is a counselor is a counselor. I work w/ some populations really well, others I am more likely to do more harm then good, so just hiring more counselors is probably not the best answer. There are also some questions on how and why PTSD is diagnosed. When is it PTSD and when is it PTS readjustment? The DSM says any time symptoms last over 3 months it = PTSD. However I have seen individuals rated for PTSD w/i 1-2 months of returning from theatre. Why 3 months? If you have symptoms for 4-6 months but have them go away w/o invasive therapy is it still PTSD? mTBI symptoms almost mirror PTSD symptoms, how often are they mis-diagnosed for each other? Certain established anxiety and depressive disorders can be mis-diagnosed for PTSD as well. For all that, whether it is PTSD, mTBI, pre-existing MH issues, Stress Readjustment, plain old vanilla stress, depression or drugs and alcohol, services do need to be available, and soldiers do need to feel free to use them w/o fear of repercussions. The question is how to best facilitate this with out letting it become more of a public opinion and/or political issue
Reed
"can't we all just get along?"

[120mm]

The question I have, is that what does the Army do with those folks with PTSD who don't want to be "caught?" If a PTSD sufferer can still function, but chooses to decline treatment, what then?

[120mm]

Here's an interesting, and tangentially related story:

http://www.armytimes.com/news/...nseling_army_011209/


WASHINGTON — Army leaders are proposing to end a longtime policy that requires a commanding officer be notified when a soldier voluntarily seeks counseling in hopes of encouraging more GIs to seek aid, according to Army Secretary Pete Geren.

The potential move comes as combat deployments have been linked with increased alcohol abuse, and the Army Substance Abuse Program is straining to keep pace.

The proposal being worked out between Army personnel and medical commanders is “an important part of a comprehensive effort to reduce the stigma associated with seeking mental health care and to encourage more soldiers to seek treatment,” Geren says in a statement to USA TODAY on Friday.

While this appears to only affect ASAP, I'm wondering what effect it will have on other mental health counselling systems. My beef with ASAP is similar with my beef with mental health counselling: There is just too many negative consequences for reporting, and the system is too formalized.

I once had a soldier who drank three beers and then lay down on his bunk to sleep. The window over his bunk was shattered by a rock thrown by persons unknown, and he was cut by the falling glass. Because he was sleeping off the beers, this was classified as an alcohol-related event and he was mandatory-referred to ASAP. Otherwise, he was a terrific soldier.

[reed11b]

Here's an interesting, and tangentially related story:

http://www.armytimes.com/news/...nseling_army_011209/



While this appears to only affect ASAP, I'm wondering what effect it will have on other mental health counselling systems. My beef with ASAP is similar with my beef with mental health counselling: There is just too many negative consequences for reporting, and the system is too formalized.

I once had a soldier who drank three beers and then lay down on his bunk to sleep. The window over his bunk was shattered by a rock thrown by persons unknown, and he was cut by the falling glass. Because he was sleeping off the beers, this was classified as an alcohol-related event and he was mandatory-referred to ASAP. Otherwise, he was a terrific soldier.

To be honest, this challenges the whole role of the mental health section. Their stated mission is to "advise and assist" the Co. Since I am a big believer in unit focus over individual focus, I agree w/ this. The caveat is that the MH section needs to seriously ramp up the advise portion of their mission and educate leaders, who seem to often be very ignorant about mental health issues. I also feel that there should be an appeal process of some sort where if the MH section or the soldier strongly disagrees with the CO decision they can get a second opinion. The "what else is true" in this case is that we, (the Army) is not unit focused, but is individual focused and if a soldier chooses to self nominate for counseling, under our current way of doing business, he should be able to do it confidentially. Perhaps base MH should be primarily for self referral, and brigade MH section for command referral?
Reed
P.S. 120 I was honored to hear that you value the opinion of a monkey-poo flinging God-complex PTSD pusher :D

[reed11b]

Sorry above post was if policy was a MH policy not an ASAP policy. Same basic beliefs with ASAP however.
Reed

[120mm]

Personally, I don't think the CO of a military unit has ANY right to know which of his soldiers are self-referring. It's part of the "paternalistic bull####" aspect of the Army I detest.

We cannot have strategic corporals, if we treat them like children.

Now, a CO "might" need to know that "X" number of soldiers have self-referred for this or that, or that referrals are increasing/decreasing, but I think it is high time for soldiers to have more of their privacy respected.

A good commander will know what's up, and the risk to a unit and its mission is way overblown by the kind of guy who would self-refer.

A bad commander should either be relieved for cause, or his soldiers should be protected from his/her incompetence/insensitivity by having their privacy protected.

A great commander would be running his own referral show on the side, getting in front of mental health/alcohol abuse issues and dealing with them compassionately and at the lowest possible level.

At no point in the above three acceptable (to me) cases, does a CO have a valid reason to know specifically about a self-referral.

[82redleg]

But if I, as the commander, am responsible for ensuring that my Soldiers:
1- have access to mental health treatment
2- are properly supported in said treatment
3- are not deployed because of said treatment

then I have to know about their recieving treatment. If a Soldier keeps his treatment secret, his chain of command cannot support him.

[Xenophon]

I haven't read the whole thread so forgive me if this has been covered.


I'm looking for what social service and mental health programs that exist should be kept, wich can go and what needs to be changed.

Unfortunately, their quality isn't the issue. These programs are usually conducted immediately or almost immediately after returning to CONUS. No matter how important and well-presented they are, nobody cares (at that point). There is usually ample time to conduct these programs during redeployment in country or in Kuwait, but no resources.

Bottom line: The best way to help the returning veteran is to be available for him if he comes for help, not to make him sit through a canned PowerPoint brief when he should be spending time with his family.

[120mm]

But if I, as the commander, am responsible for ensuring that my Soldiers:
1- have access to mental health treatment
2- are properly supported in said treatment
3- are not deployed because of said treatment

then I have to know about their recieving treatment. If a Soldier keeps his treatment secret, his chain of command cannot support him.

In my experience, I've never seen a commander "support" a soldier in this way. The presumption that the commander is responsible for the minute-to-minute care and feeding of his/her soldiers is paternalistic and degrading, imo.

Regardless of intention, this kind of "support" results in stigmatization at the very least.

I've been a commander, three times, and have dealt with alcohol-related/mental health issues on the "down low" with fairly good results. Partly, I think the attitude that mental health issues don't necessarily mean the soldier is "broken" is key to success. Unfortunately, the formal system imputes "broken-ness" as a start-point.

[Ken White]

...The presumption that the commander is responsible for the minute-to-minute care and feeding of his/her soldiers is paternalistic and degrading, imo.The worse problem is that paternalistic attitude which is pervasive and goes far beyond the mental health problem treats 19 year olds like children and they resent it -- a great deal. it also causes good Officers and NCOs who realize the damage it does to tear their hair out in frustration. So the 'technique' contributes to driving people of all ranks out of the Armed Forces -- not just the Army; the USAF is better about it than the others but all are guilty...
Regardless of intention, this kind of "support" results in stigmatization at the very least.Even if the CO is benign, there will be others in the chain who are not.
...I think the attitude that mental health issues don't necessarily mean the soldier is "broken" is key to success. Unfortunately, the formal system imputes "broken-ness" as a start-point.True. I'd also suggest that EVERYONE is a mental aberration to a degree; as long as the person in question can function, he or she should be left alone to function.

As for predicting, based on the past, any future mental deviance or lack thereof in an operational setting. Heh. Good luck... :wry:

[reed11b]

I agree with 120mm
... so do I! :eek:
Before anybody tries to throw out the "a history of MH correlates to higher rates of future MH" line, keep in mind that the same is true for physical injuries. Do we assume someone that sprains there ankle once is "broken" forever becouse of the increased possibilty of them getting a future sprain? The army is working hard on de-stigmatyzing PTSD, but what about plain old depression or anxiety? What about grief? Chaplains are allowed to keep confidentiality, why not have some available MH resources confidential?
If the soldier is non-deployable or needs long term treatment, then yep, CO needs to know, but otherwise...
Reed

[MikeF]

From an ethics class. Excellent resource for soldiers to read pre and post deployment...

Warrior Transitions: From Combat to Social Contract

By Shannon E. French, Ph.D.
United States Naval Academy
January 2005 JSCOPE

http://www.usafa.edu/isme/JSCOPE05/French05.html


I. Introduction: Penance and Purification

Warriors must not feel that they are stepping into an entirely separate moral universe when they enter a combat zone and that they will never be held accountable for what they do there. As Bernard J. Verkamp explains in his important work, The Moral Treatment of Returning Warriors in Early Medieval and Modern Times, in the early Middle Ages, Christian knights returning from war were required to do penance for acts committed during wartime that were seen as “sinful” (including injuring and killing other humans), even if the war had been judged to be a just war by the Church. As Verkamp explains:

[T]he Christian community of the first millennium generally assumed that warriors returning from battle would or should be feeling guilty and ashamed for all the wartime killing they had done. Far from having such feelings dismissed as insignificant or irrelevant, returning warriors were encouraged to seek resolution of them through rituals of purification, expiation, and reconciliation. To accommodate these latter needs, religious authorities of the period not infrequently imposed various and sundry penances on returning warriors, depending on the kind of war they had been engaged in, the number of their killings, and the intention with which they had been carried out.[1]

On the surface, this seems a bit unfair. You go off to fight a war in what the Church has declared to be a just cause, you survive the horrors of war, and when you return the Church wants you to do penance and ask forgiveness for what you have done? At first blush, this practice seems only designed to produce self-loathing warriors.

In fact, however, those who created the practice did not do so to punish warriors or make them regret their calling. They simply thought they understood what a warrior returning from war needs to do in order to transition successfully back into civilian life. Warriors need to recognize that what they did in service of their country was outside the norms of human existence and cannot be allowed in civilized society. The power of life and death that they were asked to exercise over others for the good of all must be relinquished (at least until they are called to war again). However necessary the evil in which they participated might have been, it was still an evil. By asking for forgiveness, warriors acknowledge that the rules that generally govern the social contract are valid and do apply to them. They accept ownership of their actions and symbolically ask to be allowed back into the fold of their community, released from the guilt of the acts they committed in the “fog of war.”

A vast array of cultures across the globe have understood the need for some form of spiritual cleansing and ritualized transition for the warrior passing from the world of war into the world of peace. In ancient Rome, the Vestal Virgins would bathe returning soldiers from the Legions to purge them of the corruption of war. In Africa, returning Maasai warriors had purification rites, and Native Americans of the Plains tribes conducted sweat lodge ceremonies for their warriors before they could rejoin their tribes.[2] Embedded in these rituals are essential lessons from history about what we need to do for those who have transgressed the moral lines of civil society in order to protect and defend civilization for the rest of us.

v/r

Mike