Monday, May 19, 2008

Combat PTSD or Adjustment Disorder? Saving Money, Not Lives

Stress Management and Relief

Last year, a firestorm erupted when it was found that 24,000 or
more OEF/OIF veterans had been booted out of the military
with Personality Disorder discharges. PD (once labeled "Section 8")
discharges are a quicker and more cost-efficient way of dealing with
service members who are exhibiting problematic behavior.

The problem, of course, was that some of the discharged were
combat-injured Purple Heart recipients who may have instead been
coping with PTSD, a fact that would allow them access to VA health
care benefits to treat their condition.

This week, we've moved from the military's diagnoses of Personality
Disorder over PTSD to a Texas VAMC PTSD program coordinator
advising that Adjustment Disorder diagnoses should be handed out
over that of PTSD. The reason given? Saving money.

From the Washington Post:
"Given that we are having more and more compensation seeking
veterans, I'd like to suggest that you refrain from giving a diagnosis
of PTSD straight out," Norma Perez wrote in a March 20 e-mail to
mental-health specialists and social workers at the Department of
Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Tex.
Instead, she recommended that they "consider a diagnosis of
Adjustment Disorder." VA staff members "really don't . . . have time
to do the extensive testing that should be done to determine PTSD,"
Perez wrote.

"Adjustment disorder is a less severe reaction to stress than PTSD
and has a shorter duration, usually no longer than six months, said
Anthony T. Ng, a psychiatrist and member of Mental Health America,
a nonprofit professional association.

"Veterans diagnosed with PTSD can be eligible for disability
compensation of up to $2,527 a month, depending on the severity of
the condition, said Alison Aikele, a VA spokeswoman. Those found to
have adjustment disorder generally are not offered such payments,
though veterans can receive medical treatment for either condition. ...

"Veterans Affairs Secretary James B. Peake said in a statement that
Perez's e-mail was "inappropriate" and does not reflect VA policy. It
has been "repudiated at the highest level of our health care organization,"
he said. "VA's leadership will strongly remind all medical staff that trust,
accuracy and transparency is paramount to maintaining our relationships
with our veteran patients," Peake said."

Citizens for Responsibility and Ethics in Washington (CREW) and VoteVets
released a copy of the email on Thursday.

### of Part One

The VA has set up a 24-hour suicide hotline round-the-clock access to mental health professionals. The number is 1-800-273- 8255 (TALK). To learn more about PTSD-- visit the National Center for PTSD website. -----------------------------------> Flashback, Posttraumatic Stress Disorder, Suicide, and the Lessons of WAR by Penny Coleman

and---> I Can Still Hear Thier Cries, Even In My Sleep... A Journey Into PTSD By E. Everett McFall

Both Books are Available on


i.m. small said...


On false pretext they sent me off
To murder and create,
But there, ´twas hard to hold aloof
Vacuity of hate,
And now the matter rests with me
But I don´t rest at all,
And it may be PTSD
But I´m not blessed at all.

We are the men "that don´t fit in,"
There´s no more fitting now,
Because nobility struck tin
With which men did endow
Their fantasy, as left a mess
All scrambled in my mind,
So I was left with PTS
And D not far behind.

The army sez that my SD
Existed pre post-trauma,
So not a dime will give to me
Except I have my Momma
To tell me, hold my temper down
But she has never been there,
Where cognizance emerged full-blown
Smack in the midst of sin there.

I thought that I could be a hero,
That I could go to school,
But concentration nearly zero
Has made me look the fool,
And I may know the alphabet
My teachers taught to me,
But first, in their disorder, set
Now PTS and D.

I never knew the kind of rage
As in my brain inhabits,
But not a player on the stage
It is not shooting rabbits
That got me to an awful fix,
Though you might find it funny,
PTSD plays funny tricks,
I wouldn´t hurt Bugs Bunny--

And yet at minor provocation
I´d take a schoolbus out--
It´s all because I served a nation
That didn´t have a doubt:
Derangement by rage reinforced
Has got me drinking liquor,
But while I cauterize the worst
Hostility grows thicker.

So all young men who go to war,
Although your cause be noble--
They´ll show you that esprit de corps
But leave you with the trouble,
A peck of trouble, as with P
Preceding T and S,
And then at last a final D,
To lodge at your address.

Wherever you may go, and with
Self-medication helping,
There is no helping with the myth:
Hostility keeps whelping
Despite nobility pronounced
On all the TV stations--
PTSD, when they have pounced,
One´s burden, not the nation´s.


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