In a sad commentary about the state of affairs of a modern army, the U.S. Secretary of Defense Leon Panetta said on Wednesday that there are “still huge gaps” in the way mental disorders are diagnosed within the military.
With over 150 active military suicides so far in 2012, if you’re in the U.S. military, you’re more likely to have died by your own hand than you were to have died in combat.
This, then, is apparently not a good time to be in the military.
Farah Mohamed, writing for McClatchy Newspapers, has the story.
Panetta made his comments while he was dragged before Congress to discuss the military’s budget.
He made his comments in response to questioning by Senator Patty Murray, who chairs the Senate Veterans’ Affairs Committee. In Murray’s home state of Washington, over 100 soldiers have had their post-traumatic stress disorder (PTSD) diagnoses reversed — denying them benefits and access to mental health care at the VA:
Some patients in Madigan have complained that their diagnoses were lessened or altered in an effort to save money and meet Army cutbacks, Murray said. Others, according to Murray, were accused of exaggerating their conditions and subsequently denied proper medical care.
“You can’t imagine what it’s like to talk to a soldier who was told he had PTSD,” said Murray. “His family was working with him, and then when he went to the disability evaluation system, he was told he was a liar or malingerer. He was taken out of it and he went out in the civilian world not being treated. That’s a horrendous offense.”
The VA is, generally, a great system. Every American would benefit if they had access to the level of care we offer our veterans (shhh — yes, this is a form of socialized medicine, but don’t tell anyone).
The problem arises because each VA hospital and system is run somewhat independently — like little fiefdoms. This means that the care you get at one VA may not resemble the care you get at another. Some VAs have stricter criteria for getting a diagnosis, while others are more lax.
This creates a level of inconsistency in both care and benefits that vets pick up on, because they now communicate across state boundaries thanks to the many online vet communities that exist.
So Joe says, “Hey, I just got diagnosed with PTSD after expressing my fears of loud noises and flashbacks I’d been having after having been involved in that attack that happened outside of Kabul.” Then Henry replies, “Wow, I was in the same attack, and have similar symptoms, but they denied I had PTSD at my VA.”
Which, unfortunately, goes right to the heart of the matter of the wild inconsistency of mental disorder diagnoses across the board. Scientifically-speaking, the interrater reliability of these puppies just stinks. This is a real-world example of the consequences of poor diagnostic reliability across differing VA hospital systems.
There are no easy answers to the problem, since the problem exists not only at a VA system-wide scale, but also more deeply at the level of the mental disorder diagnostic system itself.
Because when you tie benefits to diagnoses, suddenly diagnoses mean a whole lot more to an individual.
Read the full article: Panetta: ‘Huge gaps’ in military’s review of mental health cases