Pre and post deployment support

[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.
Reed

and 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...

[MikeF]

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

http://www.usatoday.com/news/militar...-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/militar...-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.

[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

[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

[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.