Really? So they will give me $3000 a month in a 100% disability rating, but not a $4 medal?
This is a fine example of government logic.

I had to see no fewer that a dozen VA doctors before I got rated. I had to see three Social Security doctors before I got my SS disability for PTSD. If these experienced, licensed professionals who have worked in the field for decades are so easy to fool, shouldn’t we be looking at the licensure and qualifications of our doctors? If they are fooled so easily, do we really want them doctoring mentally ill patients and prescribing what could potentially be life-threatening drugs?

If they are so easy to trick, should we be handing out medical degrees to them?

What I have not read so far, and if I have overlooked it please forgive me, is the physical problems that are associated with PTSD. Cronic Joint Pain, fibro mialga (spelling) High blood presure ect. It would seem to me that these conditions along with a diagnosis of combat related PTSD with a compensation rating would qualify someone for the purple heart. Although I have combat related PTSD with a compensated rating or over 50% I never considered trying or even thinking about the purple heart because of the stigma mentioned above. I have heard of another award given to those who suffer from agent orange called the silver rose or something to that effect, however it is not recognized by the military. Maybe that would be another route to look at. A seperate but equal award for PTSD recognized by the Military and our government.

I can also see the need of the government to decline the Purple Heart award to those of us who suffer from PTSD due to the fact that a qualified person can claim and be awarded a montly compensation of $1,000 for having the award. Something that I have also not yet read in this debate. Can you imagine the amount of money that the government would have to compensate the masses of our troops with this horrible disorder. God forbid there be back pay to the point of diagnosis. It would seem that our government would rather spend money on bailing out big buisness rather than recognize the families that have lost income, broken up, suffered injury and or dont know the returning soldier/father/husband anymore due to the life changing challenges that come with this disorder.

thank you.

Perhaps it is appropriate to create a new medal for secondary injuries resulting from combat. This would cover PTSD, TBI, and many physical ailments that are now common such as back problems from wearing 60 pounds of body armour 24/7.

I do not wish to diminish the seriousness of PTSD- it has greatly impacted out lives. And for the record- while many argue that PTSD is “fakable” so too are many other things that get diagnosed- physical and mental health.

To Dr. Howe and other mental health professionals I pass to you an insightful cliche, “We have met the enemy and it is US.” Sir, you make the comment about the state of our leaders in the Pentagon. Well, I worked in the Pentagon for over four years at both Air Staff, and for the Defense Intelligence Agency (DIA). You are aware Dr. Howe that the Pentagon is not run by Generals and Admirals (I’m not defending poor decision made by uniformed pros) but the DOD is run by US, meaning civilians like you and now I. Worse yet, those civilians are political appointees of whichever party claims the White House and sometimes Congress. Like every other decision made at the Pentagon or even at the VA that is also stacked with political appointees, PTSD or mental health in general IS NOT a medical decision it is a POLITICAL DEBATE AND DECISION. If your ideology calls for using only citizens and non-citizens that VOLUNTEER to fight and die for questionable reasons or economic necessity, your pool of willing participants is limited. Your political ideology calls for keep as many of the limited number of willing actors in combat as possible to avoid asking or demanding the rest of society to make any SACRIFICE. Given any of these willing volunteers who change their mind an out or loophole like loosening up PTSD is not only EXPENSIVE to U.S. taxpayers, it cuts down on how many troops we can send back into combat if they are sane or not. These are frankly the same arguments made during and after Vietnam in order to deny the existance of PTSD then. (1) Congress almost had a heart attack at the COSTS of WAR that called for ignoring certain cost the easy way by denying they exists. (2) The Pentagon had a nervous breakdown thinking about how many troops in the Sir No Sir movement it could legally lose if they had the PTSD out. It would also increase the number of youngsters they would have to DRAFT to replace them. (Something off the table for NOW). (3) Lastly, it was not as easy for the so-called liberal Psychiatrist and Psychologist to get the VA to buy off on accepting PTSD as a diagnosis as most traditional Veterans groups like the Purple Heart Gang would want us to believe. The VA fought long and hard to deny the existence of PTSD, because just like NOW, the VA would be overwhelmed with the number of patients seeking help at a time the VA was telling Congress and the American people it had the means to care for America’s Veterans. Right!
Lastly, Dr. Howe, what I meant by the enemy being us, I meant that professionals within the Mental Health community are just as quilty as any leader in the Pentagon of allowing this situation to go on without speaking out with a united voice. Why? Dr. Howe, I was dropped like a hot potato by a Private Psychiatrist who helped me get my VA rating. He was all supportive until my views of war and G.W Bush tended to not jive with his. Our counseling sessions degraded into political debates that history and intellect show I won. Most Bi-polar patients do not have a Masters Degree or are capable of achieving a doctorate if they wanted to, and he couldn’t deal with that. I tried using the VA Mental Health Clinic but ran into a Retired Air Force Psychiatrist who has strong pro-war opinions and strongly felt that officers like me should show no weakness such as mental illness let alone PTSD. My courtship with the VA did not last long. Frankly, I’m not surprised. I may be a little insane but I’m still intelligent. I do see things other people do not see, but they are not hullucinations they are real. I see things in Congress, in the VA, that most people would believe were imaginary or too strange to be true. Example: the same Physcian who look down on me with stigma that as a military officer I should not give into PTSD, I frequently watched this same doctor pace the hallways of the VA Mental Health clinic impatiently waiting for his next patient. Frankly, before my appointment with him, I thought he was a patient the way he paced and the long star in his gaze in no way related to combat but he was NUTS. Point: before pointing fingers at Pentagon leadership deserved or not – PHYSICIAN HEAL THYSELF! Fixing corruption at the Pentagon is easy, especially temporarily, until the next group of incompetent or politically correct or incorrect leaders come in, but fixing the wounds with the Medical profession are a much harder nut to crack.

Dano, I too was diagnosed with Bi-Polar II, but having the same wife for over 40 years who has coped with my PTSD and Bi-Polar over the last decade, thank God I need no POT.

However, you also touch on a very valid stigma point that bothers me. Everytime I park in a handicapped parking spot with my legal HC license plate based on my 100% VA service-connected disability I fear someone questioning my disability status. If it’s a cop, frankly I’ll patiently deal with it. However, if it is some ignorant clown, I’m afraid my Bi-Polar will kick in and floor them. Seriously, despite lord knows how many old fashion, traditional, and nationalistic Veteran organizations have a PTSD support section, just how sincere are they about a treatment and cure let alone a Veteran or any citizen getting tax payer compensation? Quite a few went on record during and shortly after Vietnam that PTSD was a conspiracy by left-wing Mental Health professionals, I believe they call them liberals, to scam the U.S. taxpayer to pay veterans benefits for an illness that did not exist. It wasn’t until the attrition of the WWII generation that dominated these groups and the influx of younger Vietnam Vets that any of them even took Agent Orange or PTSD at least cosmetically serious. Hopefully, there is CHANGE in the Air for most younger veterans are not going to join their Grandfathers and Fathers bar and bingo club that wear funny looking hats, these kids gave up when they left the military.
Example: take a closer look at the Purple Heart Association Boys, do they have a subdivision that deals with Drug Abuse and Mental Health like let’s say Vietnam Veterans of America? That said, given the recent ignorant commentary and undue influence of that small organization with both Congress and the Pentagon, exactly how many young Veterans with PTSD, and lord only knows how many in denile who have yet to return from Iraq, etc or are consistantly sent back with Mental Illness are going to join the Purple Heart Gang even if we had a purple heart? Not too many of us younger and brighter Veterans.

Major Bobby Hanafin,
U.S. Air Force-Retired

I’ll be taking a closer look at the Purple Heart Association via various charity watch dog organizations to see just how efficient they are at what they say they do for us young troops and military families.

I predict that I will not be surprised by what I find.

On a final note, I ran into the same problems with image and stigma when I tried to apply for educational handicapped status in college.

It finally reached the point where my wife and I began thinking that WHAT, one needs to have a leg or arm amputated or some other disfigurement or abnormality that increases both our stigma and decreases our appearance in order to have our disability status recognized and respected. Nope, I’d rather not be handicapped or rely on tax payer compensation to survive if I had to give up a limb.

I’d like to comment on each response that pushes my buttons, for I already decided to extract and comment on certain points raised by Dr. Aletta and take them up with leaders of younger 21st Century Veterans Organizations that tend to be well quite forward thinking compared to the 19th and early 20th century mentality of most VSOs.

ClinicallyClueless wrote, “Thank you for sharing this information and I’m glad that you also put the positive in it, that at least they considered it.”

Frankly, though a positive the fact that the Pentagon is considering it yes opens a door, but that is the only bright light in this story. Quesiton is WHY IS THE PENTAGON JUST NOW CONSIDERING IT? BETTER YET, HOW, WHAT, OR WHY IS THE DOD DOING WITH THE VA OR ANYOTHER PTSD EXPERTISE IN CONSIDERING IT? Dr. Aletta touched on some of the Whys and what for’s of this bright side.

The Pentagon IG also began asking Questions about the mismanagement and misuse of taxpayer funds to pay a Pentaogn PR firm to manage its propaganda program America Support You.mil. In fact, there are factions within the Pentagon itself beginning to ask a lot of QUESTIONS, could that be in anyway related to the decider (Bush) going out the door? We shall see.

ClinicallyClueless, also wrote, “I recently had a debate with a friend about faking PTSD or it being an arbitrary catch all diagnosis. However, when I went over the specific of how it is diagnosed and how I experience it, it changed his mind and he respected me more for it. Very satisfying. More education on mental illness for everyone!!”

Kudos to you ClinicallyClueless, I couldn’t have said it better. To you and Dr. Aletta, plus anyone else interested in the relationship between the myth of the Fake Veteran or Faking PTSD, and the old fashion Veterans organizations Google the books “Stolen Valor,” by Burkett, and “Home to War: History of the Vietnam Veterans Movement,” I got my education on the politics and stigma battle of PTSD by reading both. For Clinical professionals I recommend both and passionately encourage all mental health professional to comment on both either in agreement or debunking exactly how ignorant us older Veterans can be for what – mounts to political ideology or at worse saving taxpayer dollars.

Finally, Google, Dr. Sally Satel of the American Enterprise Institute (AEI) she has been the tip of the spear within the Mental Health community (despite her ties to an ultra-right wing think tank) in downplaying the role of PTSD in combat and sugar coating treatment of PTSD. It would go along way to supporting those of us with PTSD, if more professionals within the Mental Health community went out of your way to rebut the political propaganda of your own. Dr. Satel is to the real Veteran PTSD research community (not all experts) what Jane Fonda is to most Vietnam Veteran – GAG!

Dano: You bring up another example (the medical power of attorney) of how mental health stigma puts up barriers. A very good point.

Steve: I do not presume to tell the military what to do. My critique was mostly directed to the NYT reporters for inadequate, and possibly biased, reporting. Having said that, I don’t believe a ‘separate but equal’ medal for soldiers with a mental health injury is the answer.

Nicholas: My heart swelled with pride and gratitude as you described your father and his work. Thank you for your service as well.

Dr. Howe & Margaret: I have hope that attitudes will change with attention being brought to our veterans’ psychiatric needs by advocates such as http://www.giveanhour.org/skins/gah/home.aspx and media like NPR http://www.npr.org/templates/story/story.php?storyId=91342767.

Michele: Thanks for informing me about the medal requirement for vet services. I had no idea. What a bizarre Catch 22. Also thanks for the link to Parasites of the Mind, a very good PTSD resource.

John: Yes, of course, symptoms can be faked, I don’t dispute it. The last sentence in your comment says it all.

Rashin: I agree that clinicians have a responsibility to advocate where we can (See Give An Hour). Still I see the silver lining in the dark cloud. I’m writing this on Martin Luther King Day on the eve of Obama’s inauguration. Many years passed between the Dream and the Reality but it happened.

Although I ,unfortunately, have experienced
PTSD as well as has a brother who served in the marines PTSD is fakable. Many other MH problems are fakable too. I say this based on 25 years of forensic and corrections experience and many evaluations I have personaly conducted.There is support for this statement in the literature too.
My major job responsibility in my first job at a forensic hospital was to determine if people were faking mental illness to avoid responsibility for their behaviors/crimes.
Faking also happens quite commonly in legal cases,compentency evaluations,and cases involving civil suits etc. You would be amazed at what some people will do for money.
The result is that this fakery is harming our veterans as well as others suffering from this and many other problems.
Sadly although the nonprofessional was in a general sense correct it should have been explained by an expert in the field and not just made as a blanket statement.
What to do about it? I’m not really sure but I would rather a few “fakers” get VA benefits than a large number of truly suffering vets not get the benefits they earned.

Thousands of vets are battling the VA healthcare system in order to receive treatment for PTSD, which the military does not very willingly provide.

In fact, according to a lawyer who advocates for vets’ PTSD treatment, “the V.A. requires that a Veteran has achieved one of several service ribbons in order to get PTSD benefits i.e. the Combat Action ribbon, Combat Infantry badge, Purple Heart, Bronze Star with V to name a few.”

How convenient to decide not to award medals if someone is already showing signs of PTSD; if the medal is awarded that would automatically qualify him for treatment and benefits.

I wonder why this is not mentioned at all….

As a 25 year sufferer of PTSD (who is now completely healed), I write a PTSD advocacy blog for awareness, education, treatment and healing.

For more information on this topic visit the blog at http://parasitesofthemind.blogspot.com/2008/11/combat-related-ptsd.html

We should celebrate our vets, not stigmatize or deny them support when they come home from places it would shatter the rest of us to be.

How I got where I’m at is, nothing compared to what these soldiers have been through. I have up until recently, 100% pro military. I still am to a point. But having come to learn of how our soldiers are treated following an injury, one of any type has left me appalled. I am sadly not surprised by this decision, but with your article am holding out hope for a change.

My new question now is, how will this affect the men and women who have decided to make a career out of the military who find themselves in need of “seeing someone” and decline to do so as it would most definitely prevent them from moving up. The announcement last year that seeking psychiatric care would not be held against them is a crock.

I do believe that PTSD has been used in some area’s as a catch all. But having it and still being completely debilitated with it at times, leaves no doubt in my mind that the Purple Heart should be awarded to those soldiers who unfortunately must now learn how to live with it.