Though improvements are there to be seen in the treatment and care of our military suffering from post-traumatic stress disorder and depression, it's not enough. An issue is both quick diagnosis and quick and proper care for all. Anything less is a violation of the covenant this nation has entered with the men and women we send into harms way. In exchange for their service and sacrifice, we, as a nation, commit to bringing them home; to heal, restore and reinstate them to their proper place in our society. We continue to fall far short of fulfilling this duty.
I make this assessment based on a massive and unprecedented study by the RAND Corporation on the U.S. military and the Department of Veterans Affairs treatment of military cases of PTSD. It contains both good and bad news.
There have been vast improvements in how the Army and other service branches follow up with inpatient cases of PTSD within the first month following their release from hospital care. Since 2009, the military increased mental health professionals on staff by 42 percent in an effort to be more aggressive in treating service members during this initial post-hospitalization period. The RAND study examined 40,000 cases and is the largest of its kind ever conducted by the military. The results show that nearly 86 percent of those with PTSD or depression had a follow-up session with a mental health specialist within seven days after being discharged. The rate jumped to more than 95 percent for those seeing a therapist within 30 days, according to the study.
Here's where the results turn a bit darker. According to military research, the most vulnerable period for suicide by soldiers is during the first year after being released from hospital care. The suicide rate for soldiers in this group during the first year of release from inpatient care was found to be 264 cases per 100,000 soldiers, far outpacing the national suicide rate of 13 per 100,000.
Also, according to the study, only a third of troops with PTSD, as well as less than a quarter of those diagnosed as clinically depressed, receive even the bare minimum number of therapy sessions after being diagnosed.
"We just don't have enough mental health professionals to meet the demand," Brad Carson, acting principal deputy undersecretary of defense for personnel and readiness told USA Today. In the short term, he anticipates that the military will turn increasingly to civilian therapists, vetted by the Pentagon, for support.
Among the RAND study recommendations is to make it a requirement for soldiers to attend a counseling session if one is missed. It also suggests that no one be discharged during a weekend or holiday to avoid losing track of follow-up care. Getting a good start at treatment and adequate follow up care is seen by mental health professionals as a key area where the military health system needs to improve, even though its level of success is said to currently outpace both that of civilian medical care and the Department of Veterans Affairs.
"As a nation, we have a responsibility and opportunity to provide the healing, support and guidance required for combat veterans and their families to prepare for their new mission — a life of passion, purpose and service — here at home," says wounded warrior Ken Falke on the website for Boulder Crest Retreat, a wellness center providing combat-related stress recovery programs free of charge to active-duty, reserve and National Guard personnel, veterans and their family members.
Falke is part of a growing grassroots movement seeking ways beyond conventional government treatment programs to manage military deployment stress injuries. As I reported in Oct., 2014, veterans of war turning to a holistic approach to healing such wounds has historic roots. In World War I, soldiers were turning to planting and harvesting gardens in battlefield trenches as a way of dealing with battlefield stress. What became known as "garden therapy" was later used to treat shell-shock, the forerunner of Post Traumatic Stress Disorder. Known as horticulture therapy, it was also practiced in U.S. veterans' hospitals during World War II.
Today in the U.S., non-profit groups such as Ithaca's Veterans' Sanctuary (working in partnership with Cornell University's Center for Transformative Action), as well as other organizations like the Farmer Veteran Coalition, are creating opportunities for former military personnel to take up farming as a supplementary approach to dealing with recovery and reintegration into civilian life. Boulder Crest Retreat in Bluemont, Vermont uses holistic medicine to help form bonds among veterans with combat-related stress, combining group therapies and activities to prepare them to lead happier, more productive civilian lives. Its Warrior PATHH program (Progressive and Alternative Therapies for Healing Heroes) integrates therapeutic peer support and life coaching with yoga, music therapy, equine therapy, kayaking, gardening and other activities. Veteran military mentors are also on hand to support participants. Participants at Boulder Crest do not have to be clinically diagnosed with PTSD.
"Think about how military service works: It's a band of their own, and that's what's unique about Boulder Crest," Falke told Fox News in 2015. "People are able to open up more and form bonds more as opposed to sitting in traditional therapy."
If anything is clear, it's that the government can use all the help it can get.
According to the New York Times, since 2001, more than 300,000 people (about 13 percent of total troops) have been forced out of the military with less-than-honorable discharges. Though congress has recognized in recent years that some of these discharges were the fault of dysfunctional screening for PTSD and other combat injuries, records show that the Army Review Boards Agency — the office with legal authority "to correct an error or remove an injustice" in military records — has to date rejected a vast majority of cases that involve PTSD claims, denying veterans the medical coverage they desperately need.
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