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Mental Care for Veterans

By cortex on June 18, 2007.

Another heartbreaking tale of improper medical care for veterans from The Washington Post. This time, the article is about the lack of mental health care for mentally troubled veterans, especially when it comes to Post-Traumatic Stress Disorder (PTSD). While the Army excels at providing emergency trauma care for veterans injured in the body - only ten percent of wounded soldiers have died in this Iraq war, compared to 24 percent for the first Gulf war - the Army and Veterans Administration have consistently failed to adequately care for the injured brain. It's as if the Army still subscribes to some version of dualism, in which the flesh is a machine (and can be fixed) and the mind is just a ghostly presence, immune to proper medical care.

Every month, 20 to 40 soldiers are evacuated from Iraq because of mental problems, according to the Army. Most are sent to Walter Reed along with other war-wounded. For amputees, the nation's top Army hospital offers state-of-the-art prosthetics and physical rehab programs, and soon, a new $10 million amputee center with a rappelling wall and virtual reality center.

Nothing so gleaming exists for soldiers with diagnoses of post-traumatic stress disorder, who in the Army alone outnumber all of the war's amputees by 43 to 1. The Army has no PTSD center at Walter Reed, and its psychiatric treatment is weak compared with the best PTSD programs the government offers. Instead of receiving focused attention, soldiers with combat-stress disorders are mixed in with psych patients who have issues ranging from schizophrenia to marital strife.

Even though Walter Reed maintains the largest psychiatric department in the Army, it lacks enough psychiatrists and clinicians to properly treat the growing number of soldiers returning with combat stress. Earlier this year, the head of psychiatry sent out an "SOS" memo desperately seeking more clinical help.

Individual therapy with a trained clinician, a key element in recovery from PTSD, is infrequent, and targeted group therapy is offered only twice a week.

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That "almost as if" is rather generous. There are no materialists in foxholes.

Physical toughness and fitness can be regimented. Mental toughness, not so much.

I don't think that the ground military or their leadership staff likes to admit that mental preparedness takes a backseat to physical preparedness, so they downplay mental injuries or longterm effects of extreme stress.

Question: How can the army or marines prepare for war mentally so that they wouldn't be prone to PTSD? Would they get hardened by watching Rambo or something like that? Would it be better to visit a slaughterhouse in action and maybe take a few shifts? What can be done as a preventative?

Nevermind. Apparently, "Virtual Iraq" prevents PTSD.

June 18, 2007 - Earlier this week, a reporter was escorted down an Iraqi street during the morning call to prayer. There was a marketplace to the right, nondescript buildings down the road and a few pedestrians milling about. Then a helicopter flew overhead, accompanied by the bone-rattling sound of gunfire. The ground shook as a parked car suddenly exploded, apparently blown up by an insurgent's improvised explosive device. Sniper fire popped from the rooftops. Dazed civilians wandered into the reporter's path'though it was unclear whether they were friendlies, or insurgents in disguise poised for an ambush.

All of this took place over the course of a few minutes on New York's Upper East Side, in the one-window office of a Cornell University Weill Medical College psychologist. The Iraq in question was a simulated one, experienced from inside a virtual-reality helmet, complete with goggles and powerful headphones. Don the helmet, and you are instantly immersed in a disturbingly realistic videogame version of an urban Iraqi battleground. The platform underfoot houses a motor that shakes the ground whenever simulated rockets hit or bombs blast. JoAnn Difede, director of Weill's program for anxiety and traumatic-stress studies, plans to put the virtual-reality helmet to use as part of a counterintuitive therapy aimed at studying, and ultimately healing, soldiers who suffer from posttraumatic stress disorder (PTSD).