PTSD Archives

Gen. Peter Chiarelli, the Army's vice chief of staff, has acknowledged that 106,000 soldiers take psychotropic medications. But the Military Health System cannot track the use of those drugs, the Senate Armed Services Committee said in its report on the 2011 Defense Authorization Act released in June.

The final version of that 924-page bill, which Congress sent to President Obama for his signature yesterday, contains language requiring Defense to find a way to track the use of these medications when troops return from deployment.

The Pentagon evaluates the health of troops when they return from the field through Defense's Post-Deployment Health Reassessment (PDHRA) program, which was set up in 2005 and places an emphasis on mental health assessment.

Until now, the PDHRA did not take a look at psychotropic drugs prescribed to troops during their deployment. The 2011 Defense bill (page 269 of the PDF, if you're looking for the language) mandates that Defense include an assessment of prescribed head drugs in the PDHRA, seemingly a simple exercise for one of the most computerized outfits on the planet.

The Pentagon has a habit of ignoring congressional mandates, something I hope does not happen in this instance, because as Chiarelli said, there is a relationship between overuse of head drugs and the epidemic of soldier suicides.

Despite reports by National Public Radio, Army Brig. Gen. Loree Sutton, who quietly left her position as director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury on Monday, did, indeed, make the Thursday opening of a $56 million center focused on treatment of post traumatic stress disorder and traumatic brain injury.

But the same could not be said for any member of the House or Senate, none of whom could brave the close to 100 degree heat to make the eight-mile trip from the Capitol to the National Naval Medical Center in Bethesda, Md., where the opening of the National Intrepid Center of Excellence was held.

My spies at the Intrepid ceremony carefully eyeballed the audience and reported they could not see any senator or representative sitting with the VIPs in a nicely shaded and fan-cooled tent.

The White House evidently had other priorities yesterday too, the Washington Post reported.

Arnold Fisher, chairman of the Intrepid Fallen Heroes Fund, which ponied up the money for the facility, criticized the lack of White House representation at the ceremony. "These are the very people who decide your fate. . . . We are all here, but where are they?"

Sutton, who, among other things, exchanged hugs with Dr. S. Ward Casscells, former assistant secretary of Defense for health affairs, understands a simple fact lost on all the pols: Showing up means far more to the troops than hollow words of support.

Army Brig. Gen. Loree Sutton, who ran the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury since it was established in November 2007, left that command on Monday in a very low key ceremony, I'm told.

She now works for Army Lt. Gen. Eric Schoomaker in a rather unspecified capacity, a typically well-informed source told me, pending retirement in March 2011.

The centers made no public announcement of Sutton's departure, which I find odd because she was the public face of the Defense Department's megabillion dollar a year effort to combat the "invisible wounds of war."

The centers did announce her replacement, Col. Robert W. Saum, an Army psychologist with a Ph.D. in Cognitive Studies from a dual enrollment at the University of San Francisco and Canterbury University in the United Kingdom.

The Army's surgeon general, Lt. Gen. Eric Schoomaker, issued a memo on June 9 governing the screening requirements for post-traumatic stress disorder and mild Traumatic Disorder (mTBI) for administrative separation of soldiers that stands out as a model of brevity.

The memo, which I'm pleased to pass along here, totals only seven pages, and that includes a two page Behavioral Health form for soldiers facing an administrative separation before their enlistment is up.

The memo tells clinicians to ask solders some really simple questions in the PTSD screenings such as:

"In your life, have you ever had any experience that was so frightening, horrible or upsetting that in the past month you:

Have had nightmares about it or thought about it when you did not want to?"

The same no-nonsense approach applies to questions for mTBI screenings such as:

"During this deployment, did you experience any of the following events?

Blast or explosion (IED, RPG, land mine, grenade etc,)"

The memo follows the new streamlined, six-page disability claims form the Veterans Affairs Department plans to use that I reported on last week. One hopes it is a sign of future policies that do not require the slaying of a whole mess of trees.

Now, if only the Congress could limit itself to doing anything in six or seven pages.

The Veterans Affairs Department completed a study in 1988 that determined up to 30 percent of Vietnam Veterans suffered from post traumatic stress disorder and in 2000 Congress directed VA to do a follow-up study and they want officials to interview the same people they talked to for the first study.

But the Government Accountability Office reported on Wednesday VA did not know how many of the 2,348 participants in the first study could be found so they can participate in the latest one.

PTSD researchers, the GAO noted, suggested the department locate these vets in the same way it did on first go-round: through military and Internal Revenue Service records. Others suggested that Internet searches also could help track down the vets.

What a concept. I'm an easily locatable Vietnam veteran, down to my phone number, street address and probably a bunch of other information I really don't want out there, all thanks to Al Gore, who invented the Internet.

The wonderful thing about this gig is I have the opportunity to explore subjects that resonate with my personal experience and touch the heart. The treatment of troops suffering from post traumatic stress disorder and traumatic brain injury tops the list.

I'm delighted to have Army Brig. Gen. Loree Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, as my guest at the Government Executive Leadership Briefing on April 29 to explore how the Defense Department identifies, tracks and treats PTSD and TBI. The breakfast starts at 7:30 a.m. at the National Press Club in Washington.

Sutton will share the stage with Greg Reger, acting chief for the Innovative Technology Applications Division at the National Center for Telehealth and Technology. The center is headquartered at Joint Base Lewis-McChord in Tacoma, Wash.

Reger will conduct a demonstration of the virtual reality system that the center is testing to treat PTSD, which I think will offer a good insight on how technology can be applied to treat the invisible wounds of war.

If you are interested in attending, just fill out the handy form on the Government Executive website that you can find here.

The Defense and the Veterans Affairs departments offer a wide range of tools to help soldiers and veterans on the brink of suicide, including counseling centers and 800 number help lines.

But people with problems don't fit into tidy boxes, as I found out the day before Christmas when I talked with a friend in the Army's Pentagon press shop. He had just received an e-mail from an Army National Guard Iraq veteran who had found my friend's name in a news article about suicides. The veteran told him she was suicidal. He asked her to call him every day until he found her the help she needed, and last Friday she entered a 90-day treatment program at a VA hospital.

What's the lesson here as we confront increasingly dismal suicide statistics by veterans and active duty troops? Simple, maybe we all have a role to play in helping those we have sent into harms way. That means asking them about combat stress, what they are doing about it, and whether they need help -- and then guiding them to find help.

It also means having a warm and sympathetic heart, which my Army PA friend has, and a realization that suicide prevention is something handled not by a bureaucracy, but people helping each other.