Army reviewing traumatic stress diagnostic practices

WASHINGTON Thu Mar 22, 2012 3:18am EDT

Commuters drive over ''Freedom Bridge'' over Interstate-5 freeway past thousands of yellow ribbons fluttering in the wind as they enter the Madigan Army Hospital gate of Joint Base Lewis McChord (JBLM), Washington March 12, 2012. REUTERS/Anthony Bolante

Commuters drive over ''Freedom Bridge'' over Interstate-5 freeway past thousands of yellow ribbons fluttering in the wind as they enter the Madigan Army Hospital gate of Joint Base Lewis McChord (JBLM), Washington March 12, 2012.

Credit: Reuters/Anthony Bolante

Related Topics

WASHINGTON (Reuters) - The Army has started a system-wide review to ensure its mental healthcare facilities are not engaging in the "unacceptable" practice of considering treatment costs in making a diagnosis, Army Secretary John McHugh told a U.S. Senate hearing on Wednesday.

Lieutenant General Patricia Horoho, the Army surgeon general, initiated the review in response to the discovery that hundreds of soldiers being treated for post-traumatic stress disorder had their diagnoses reversed after being seen by psychiatrists at the Madigan Army Medical Center in Washington state.

The medical center is located at Joint Base Lewis McChord, the home base of Staff Sergeant Robert Bales, who is suspected of killing 16 people, including nine children, in a shooting rampage in Afghanistan this month.

Bales was on his fourth deployment to a war zone in the past 10 years. His civilian lawyer told Reuters last week that PTSD would likely be part of the defense.

PTSD is a huge issue for the Defense Department. A recent Army study estimated as many as 20 percent of the more than 2 million U.S. troops who served in Iraq and Afghanistan could suffer from post-traumatic stress disorder. Cost of care could range between $4 billion and $6.2 billion, it said.

The Army is looking at whether doctors at the medical center were influenced by the cost of PTSD diagnosis in terms of pensions and other benefits. One psychiatrist said the cost to taxpayers was $1.5 million over the lifetime of a soldier on medical retirement, the Seattle Times reported.

The review being carried out by the Army inspector general aims to ensure that standardized diagnostic procedures are followed by all psychiatrists "and equally important that fiscal considerations are not in any way a part of the evaluations," McHugh said. "It's simply unacceptable."

Referring to Bales, Representative Bill Pascrell, founder of a U.S. congressional task force on brain injuries, told reporters he wanted to "cradle this soldier in our arms" while condemning his actions until it could be determined what happened to him and whether he was properly tested and treated.

Bales had received a traumatic head injury and lost part of a foot during previous deployments in Iraq. The incident raised questions about the stress of repeated deployments, but McHugh said four was not uncommon.

"We have in the military writ large over 50,000 folks in uniform who have had at least four deployments," McHugh told members of the defense panel of the Senate Appropriations Committee.

'VERY CONCERNING'

Patty Murray, a U.S. senator from Washington state, told McHugh it was "very concerning" that 40 percent of the service members with PTSD who were seen by psychiatrists at Madigan "had their diagnosis changed to something else or overturned entirely."

"What it says is that over four in 10 of our service members - many of whom were already being treated for PTSD - and were due the benefits and care that comes with that diagnosis had it taken away by this unit," she said. "They were then sent back into the force or the local community."

General Ray Odierno, the Army chief of staff, said the Army wanted doctors and psychiatrists to have the attitude they were "patient advocates."

"That's the mindset that we're going to work on changing - to make sure that everybody understands that," Odierno said. "We are patient advocates. We are trying to get the best for what is right for our soldiers."

But Murray said senior military leaders had been saying that since the start of the war a decade ago.

"It's really disconcerting after 10 years to find now that that has not been the case," she said.

Murray said it was important to focus on the issue system-wide to make clear that "it isn't the cost of PTSD or any mental health evaluation that is of concern to the Army. ... It is making sure that those men and women get the care."

(Additional reporting by Susan Cornwell; Editing by Peter Cooney)

FILED UNDER:
We welcome comments that advance the story through relevant opinion, anecdotes, links and data. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters. For more information on our comment policy, see http://blogs.reuters.com/fulldisclosure/2010/09/27/toward-a-more-thoughtful-conversation-on-stories/
Comments (4)
jane33w wrote:
Well maybe if Army “guys” were trained, ordered, bullied, whatever it takes to make them STOP LAUGHING AT AND RIDICULING the very idea of PTSD. Start with the macho-feceshead “guy” culture in the barracks, if you need a real place to begin. Remember, these Army “guys” didn’t grow up in sensitive, caring places; they’re escapees from Texas and other backwoods, iggerant bigot strongholds.

Mar 22, 2012 9:31am EDT  --  Report as abuse
bobber1956 wrote:
From the Offical US Army Web Site:

WASHINGTON (Army News Service, March 9, 2012) — The Army will offer 285 service members a chance to have their mental health diagnoses re-evaluated — a second time.

About 1,600 service members who received medical care at Madigan Army Medical Center at Joint Base Lewis-McChord, Wash., and who were diagnosed with behavioral health problems, also had their medical records evaluated by the forensic psychiatry department at the hospital.

Of the 1,600, the department changed the diagnosis for 285 patients to something other than post-traumatic stress disorder, known as PTSD. Now, the Army will offer those 285 service members the opportunity to have their medical records evaluated again — and to possibly undo the changes made by the forensic psychiatric unit.

Mar 22, 2012 10:49am EDT  --  Report as abuse
bobber1956 wrote:
Jane you just describe NOTHING like my upbringing, 28 years of service in the US Army, and nothing any where near what I am like as a person. If your words are what we as slodiers can expect as support we must ask ourselves, “Why do we bother protecting this person’s rights, and freedoms”? Thing is what WE believe is so much better than what you obvious believe we will carry on and continue to sacrice for you to have the right to say what ever you want.

Mar 22, 2012 10:55am EDT  --  Report as abuse
This discussion is now closed. We welcome comments on our articles for a limited period after their publication.