Wednesday, April 8, 2009

Salon on Army PTSD diagnosis scandal

Many of my forensic psychology students have signed up with the military after getting their graduate degrees. A main reason is to get the student loan monkey off their back; the military will forgive their massive debts. That is hard to resist. But at what price service?

Today's Salon features an audiotape of civilian psychologist Douglas McNinch explaining to a combat veteran the pressure the military puts on treatment providers not to diagnose Posttraumatic Stress Disorder:

(CLICK ON THE IMAGE ABOVE TO LISTEN TO THE AUDIOTAPE)
"I will tell you something confidentially that I would have to deny if it were ever public. Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead]."
The audiotape, secretly recorded by a patient labeled "Sgt. X," confirmed what "wounded soldiers and their advocates have long suspected -- that the military does not want Iraq veterans to be diagnosed with PTSD."

Why not? Because Posttraumatic Stress Disorder would require paying for expensive, intensive treatment, including possibly lifelong disability payments. Large numbers of vets suffering from severe trauma might also dampen public enthusiasm for war, and make recruitment even more difficult than ever.

After the tape surfaced, the Senate Armed Services Committee refused to investigate, and the Army conducted its own internal investigation that cleared itself of any wrongdoing. What a surprise.

Perhaps some of you have seen Michael Moore's award-winning documentary, Fahrenheit 9/11, which shows predatory recruiters prowling shopping malls in poor communities scouring for fresh meat. Or the harrowing movie Stop-Loss, about how hard it is for some to get out of the Army once they have served their time.

Many young people come home damaged or destroyed, with invisible but severe traumatic brain injuries (as I blogged about two years ago) or severe psychological trauma. After the military chews them up and spits them out, psychologists like my former students are supposed to put them back together again.

But, hey, it's really not that bad. It's only Anxiety Not Otherwise Specified. How hard can that be to treat?

"COMING HOME" is the title of the excellent Salon investigative series about U.S. Army troops who have returned from Iraq. Focusing on troops at Fort Carson, Colorado, Salon reporters reviewed more than two dozen incidents of suicide, suicide attempts, prescription drug overdoses and murder, much of which "could have been avoided if the Army did a better job of recognizing and treating the symptoms of post-traumatic stress disorder."

Those of you who are attending next week's Forensic Training Institute in Oakland, California, will get to hear more about diagnostic shenanigans and the controversy over forensic use of the PTSD diagnosis. (Hopefully it's not too late to sign up, if you haven't done so already.)

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