Pre and post deployment support

[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...

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

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...TAM&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/arch..._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/militar...aindrugs_N.htm

[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/militar...aindrugs_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]

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.