A quarter of US war vets diagnosed with mental
disorder: study 
Published: Monday March 12, 2007
 


A quarter of the Afghanistan and Iraq war veterans
treated with US government-funded health care have
been diagnosed with a mental disorder, according to a
study published Monday.

And when psychosocial disorders such as domestic
violence were included, the number of war veterans
suffering from mental illnesses rose to 31 percent.

The instances of mental illness among recently
discharged troops and members of the National Guard
are significantly higher than those of a study
published last year which examined active duty troops,
the lead researcher told AFP.

That study found that while a third of returning
troops were accessing mental health services, only 12
percent were diagnosed with a mental illness or
psychosocial disorder.

"That's a big difference," said Karen Seal, a
physician and researcher at the San Francisco Veterans
Affairs Medical Center.

Of significant concern was the finding that 56 percent
of those diagnosed had more than one mental illness,
Seal said.

"When people have more than one diagnosis they become
more challenging to diagnose and, more importantly, we
believe are more challenging to treat," she explained.

The study comes just days after the Bush
administration vowed a "comprehensive review" of
veteran care following revelations that soldiers being
treated at the renowned Walter Reed Army Medical
Center were living in a building with mold-covered
walls, infestations of mice and cockroaches, and holes
in the ceiling.

That scandal exposed a broader problem with the
under-funding of the VA system, said Joe Davis, a
spokesman for the Veterans of Foreign Wars.

With a backlog of more than 860,000 medical claims and
waiting times of up to a year for treatment, many of
the troops coming home are not getting the help they
need, Davis said.

And that includes treatment of mental disorders, which
are a predictable result of the kinds of stresses
troops face under combat, Davis said.

"War changes everybody and everybody is going to have
to deal with it in one way or another," Davis said.

"The military is not doing enough on the preventative
side or the treatment side because the military's role
is to patch them up and send them to the VA. The VA is
not doing enough because they did not prepare for the
huge influx of new customers coming in from the wars
and they haven't budgeted for it."

Early detection and treatment is critical, the study
authors wrote, if the military is to prevent chronic
mental illness among troops "which threatens to bring
the war back home as a costly personal and public
health burden."

The results also "signal a need for improvements in
the primary prevention of military service-related
mental health disorders, particularly among our
youngest service members," the authors concluded.

The researchers examined the records of 103,788
veterans of these operations who were first seen at
Veterans Affairs facilities between September 30,
2001, and September 30, 2005. About 29 percent of war
veterans accessed VA health care facilities, the study
found.

The most common diagnosis was post-traumatic stress
disorder among 13 percent of troops, followed by
anxiety and adjustment disorders among six percent of
troops and depression and substance abuse among five
percent of troops.

More than half of the troops studied were younger than
30 years of age, 13 percent were women, nearly a third
were members of ethnic minority groups and nearly half
were veterans of the National Guard or Reserve
components, the study found.

The troops most at risk were those aged 18 to 24, the
study found, but mental illnesses were common among
all subgroups.

The study was published in the Journal of the American
Medical Association' s Archives of Internal Medicine.

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The Army is ordering injured troops to go to Iraq

*At Fort Benning, soldiers who were classified as medically unfit to fight
are now being sent to war. Is this an isolated incident or a trend?*

*By Mark Benjamin*

Mar. 11, 2007 | "This is not right," said Master Sgt. Ronald Jenkins, who
has been ordered to Iraq even though he has a spine problem that doctors say
would be damaged further by heavy Army protective gear. "This whole thing is
about taking care of soldiers," he said angrily. "If you are fit to fight
you are fit to fight. If you are /not/ fit to fight, then you are /not/ fit
to fight."

As the military scrambles to pour more soldiers into Iraq, a unit of the
Army's 3rd Infantry Division at Fort Benning, Ga., is deploying troops with
serious injuries and other medical problems, including GIs who doctors have
said are medically unfit for battle. Some are too injured to wear their body
armor, according to medical records.

On Feb. 15, Master Sgt. Jenkins and 74 other soldiers with medical
conditions from the 3rd Division's 3rd Brigade were summoned to a meeting
with the division surgeon and brigade surgeon. These are the men responsible
for handling each soldier's "physical profile," an Army document that lists
for commanders an injured soldier's physical limitations because of medical
problems -- from being unable to fire a weapon to the inability to move and
dive in three-to-five-second increments to avoid enemy fire. Jenkins and
other soldiers claim that the division and brigade surgeons summarily
downgraded soldiers' profiles, without even a medical exam, in order to
deploy them to Iraq. It is a claim division officials deny.

The 3,900-strong 3rd Brigade is now leaving for Iraq for a third time in a
steady stream. In fact, some of the troops with medical conditions
interviewed by Salon last week are already gone. Others are slated to fly
out within a week, but are fighting against their chain of command, holding
out hope that because of their ills they will ultimately not be forced to
go. Jenkins, who is still in Georgia, thinks doctors are helping to send
hurt soldiers like him to Iraq to make units going there appear to be at
full strength. "This is about the numbers," he said flatly.

That is what worries Steve Robinson, director of veterans affairs at
Veterans for America, who has long been concerned that the military was
pressing injured troops into Iraq. "Did they send anybody down range that
cannot wear a helmet, that cannot wear body armor?" Robinson asked
rhetorically. "Well that is wrong. It is a war zone." Robinson thinks that
the possibility that physical profiles may have been altered improperly has
the makings of a scandal. "My concerns are that this needs serious
investigation. You cannot just look at somebody and tell that they were
fit," he said. "It smacks of an overstretched military that is in crisis
mode to get people onto the battlefield."

Eight soldiers who were at the Feb. 15 meeting say they were summoned to the
troop medical clinic at 6:30 in the morning and lined up to meet with
division surgeon Lt. Col. George Appenzeller, who had arrived from Fort
Stewart, Ga., and Capt. Aaron K. Starbuck, brigade surgeon at Fort Benning.
The soldiers described having a cursory discussion of their profiles, with
no physical exam or extensive review of medical files. They say Appenzeller
and Starbuck seemed focused on downplaying their physical problems. "This
guy was changing people's profiles left and right," said a captain who
injured his back during his last tour in Iraq and was ordered to Iraq after
the Feb. 15 review.

Appenzeller said the review of 75 soldiers with profiles was an effort to
make sure they were as accurate as possible prior to deployment. "As the
division surgeon and the senior medical officer in the division, I wanted to
ensure that all the patients with profiles were fully evaluated with clear
limitations that commanders could use to make the decision whether they
could deploy, and if they did deploy, what their limitations would be while
there," he said in a telephone interview from Fort Stewart. He said he
changed less than one-third of those profiles -- even making some more
restrictive -- in order to "bring them into accordance with regulations."

In direct contradiction to the account given by the soldiers, Appenzeller
said physical examinations were conducted and that he had a robust medical
team there working with him, which is how they managed to complete 75
reviews in one day. Appenzeller denied that the plan was to find more warm
bodies for the surge into Baghdad, as did Col. Wayne W. Grigsby Jr., the
brigade commander. Grigsby said he is under "no pressure" to find soldiers,
regardless of health, to make his unit look fit. The health and welfare of
his soldiers are a top priority, said Grigsby, because [the soldiers] are
"our most important resource, perhaps the most important resource we have in
this country."

Grigsby said he does not know how many injured soldiers are in his ranks.
But he insisted that it is not unusual to deploy troops with physical
limitations so long as he can place them in safe jobs when they get there.
"They can be productive and safe in Iraq," Grigsby said.

The injured soldiers interviewed by Salon, however, expressed considerable
worry about going to Iraq with physical deficits because it could endanger
them or their fellow soldiers. Some were injured on previous combat tours.
Some of their ills are painful conditions from training accidents or, among
relatively older troops, degenerative problems like back injuries or
blown-out knees. Some of the soldiers have been in the Army for decades.

And while Grigsby, the brigade commander, says he is under no pressure to
find troops, it is hard to imagine there is not some desperation behind the
decision to deploy some of the sick soldiers. Master Sgt. Jenkins, 42, has a
degenerative spine problem and a long scar down the back of his neck where
three of his vertebrae were fused during surgery. He takes a cornucopia of
potent pain pills. His medical records say he is "at significantly increased
risk of re-injury during deployment where he will be wearing Kevlar, body
armor and traveling through rough terrain." Late last year, those medical
records show, a doctor recommended that Jenkins be referred to an Army board
that handles retirements when injuries are permanent and severe.

A copy of Jenkins' profile written after that Feb. 15 meeting and signed by
Capt. Starbuck, the brigade surgeon, shows a healthier soldier than the
profile of Jenkins written by another doctor just late last year, though
Jenkins says his condition is unchanged. Other soldiers' documents show the
same pattern.

One female soldier with psychiatric issues and a spine problem has been in
the Army for nearly 20 years. "My disease is deteriorating," she said over
dinner at a restaurant near Fort Benning. "My spine is separating. I can't
carry gear." Her medical records include the note "unable to deploy
overseas." Her status was also reviewed on Feb. 15. And she has been ordered
to Iraq this week.

The captain interviewed by Salon also requested anonymity because he fears
retribution. He suffered a back injury during a previous deployment to Iraq
as an infantry platoon leader. A Humvee accident "corkscrewed my spine," he
explained. Like the female soldier, he is unable to wear his protective
gear, and like her he too was ordered to Iraq after his meeting with the
division surgeon and brigade surgeon on Feb. 15. He is still at Fort Benning
and is fighting the decision to send him to Baghdad. "It is a numbers issue
with this whole troop surge," he claimed. "They are just trying to get those
numbers."

Another soldier contacted Salon by telephone last week expressed
considerable anxiety, in a frightened tone, about deploying to Iraq in her
current condition. (She also wanted to remain anonymous, fearing
retribution.) An incident during training several years ago injured her
back, forcing doctors to remove part of her fractured coccyx. She suffers
from degenerative disk disease and has two ruptured disks and a bulging disk
in her back. While she said she loves the Army and would like to deploy
after back surgery, her current injuries would limit her ability to wear her
full protective gear. She deployed to Iraq last week, the day after calling
Salon.

Her husband, who has served three combat tours in the infantry in
Afghanistan and Iraq, said he is worried sick because his wife's protective
vest alone exceeds the maximum amount she is allowed to lift. "I have been
over there three times. I know what it is like," he told me during lunch at
a restaurant here. He predicted that by deploying people like his wife, the
brigade leaders are "going to get somebody killed over there." He said there
is "no way" Grigsby is going to keep all of the injured soldiers in safe
jobs. "All of these people that deploy with these profiles, they are
scared," he said. He railed at the command: "They are saying they don't care
about your health. This is pathetic. It is bad."

His wife's physical profile was among those reevaluated on Feb. 15. A copy
of her profile from late last year showed her health problems were so severe
they "prevent deployment" and recommended she be medically retired from the
Army. Her profile at that time showed she was unable to wear a protective
mask and chemical defense equipment, and had limitations on doing pushups,
walking, biking and swimming. It said she can only carry 15 pounds.

Though she says that her condition has not changed since then, almost all of
those findings were reversed in a copy of her physical profile dated Feb.
15. The new profile says nothing about a medical retirement, but suggests
that she limit wearing a helmet to "one hour at a time."

Spc. Lincoln Smith, meanwhile, developed sleep apnea after he returned from
his first deployment to Iraq. The condition is so severe that he now suffers
from narcolepsy because of a lack of sleep. He almost nodded off
mid-conversation while talking to Salon as he sat in a T-shirt on a sofa in
his girlfriend's apartment near Fort Benning.

Smith is trained by the Army to be a truck driver. But since he is in
constant danger of falling asleep, military doctors have listed "No driving
of military vehicles" on his physical profile. Smith was supposed to fly to
Iraq March 9. But he told me on March 8 that he won't go. Nobody has
retrained Smith to do anything else besides drive trucks. Plus, because of
his condition he was unable to train properly with the unit when the brigade
rehearsed for Iraq in January, so he does not feel ready.

Smith needs to sleep with a CPAP (continuous positive airway pressure)
machine pumping air into his mouth and nose. "Otherwise," he says, "I could
die." But based on his last tour, he is not convinced he will be able to be
in places with constant electricity or will be able to fix or replace his
CPAP machine should it fail.

He told me last week he would refuse to deploy to Iraq, unsure of what he
will be asked to do there and afraid that he will not be taken care of.
Since he won't be a truck driver, "I would be going basically as a number,"
says Smith, who is 32. "They don't have enough people," he says. But he is
not going to be one of those numbers until they train him to do something
else. "I'm going to go to the airport, and I'm going to tell them I'm not
going to go. They are going to give me a weapon. I am going to say, 'It is
not a good idea for you to give me a weapon right now.'"

The Pentagon was notified of the reclassification of the Fort Benning
soldiers as soon as it happened, according to Master Sgt. Jenkins. He showed
Salon an e-mail describing the situation that he says he sent to Army
Surgeon General Lt. Gen. Kevin C. Kiley. Jenkins agreed to speak to Salon
because he hopes public attention will help other soldiers, particularly
younger ones in a similar predicament. "I can't sit back and let this happen
to me or other soldiers in my position." But he expects reprisals from the
Army.

Other soldiers slated to leave for Iraq with injuries said they wonder
whether the same thing is happening in other units in the Army. "You have to
ask where else this might be happening and who is dictating it," one female
soldier told me. "How high does it go?"

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VA ordering review of 1,400 clinics after Walter Reed controversy

http://www.boston.com/news/nation/washington/articles/2007/03/12/va_ordering_review_of_1400_clinics_after_walter_reed_controversy/

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3rd Official Out In Walter Reed Scandal

http://www.nbc30.com/news/11232521/detail.html

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Walter Reed, on the cheap

http://www.salon.com/news/feature/2007/03/06/walter_reed/?source=rss

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Military docs give up too quickly on brain damaged vets

http://wwwcapitolhillblue.com/cm/content/view/224/2/

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Democrats say wounded vets treated 'on the cheap

http://www.cnn.com/2007/POLITICS/03/10/dems.radio.ap/index.html

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American Legion to help at Walter Reed

http://www.airforcetimes.com/news/2007/03/TNSreedlegion070306/

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Outsourcing Walter Reed

http://www.tompaine.com/articles/2007/03/06/outsourcing_walter_reed.php

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Behind the Mess at Walter Reed

http://www.americanprogress.org/issues/2007/03/walter_reed.html

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U.S. Army Medical Corps Firings

On Sun, 4 Mar 2007 Maj. Gen. Ed Scholes USA (ret.) wrote:

Colonel Hunt:

To use your language--this Sunday morning you called in a B-52 strike on the great people of the U.S. Army Medical Corps, and you missed the bad guys. You, like the SECDEF, should have quickly realized that you can not name any military Medic you have seen/known who was not willing to give their all (life if necessary) to give the best care possible (within their capability) to wounded Soldiers. The great Medics at Walter Reed have been doing just that, during 10-16 hr. days since the War on Terror started, in addition to their normal busy patient load. Using the Washington Post as "the authority on Soldier care", even in their Sunday Edition, they admitted that the relieved Commander had taken action to fix those areas that he was aware of and could fix since being there only 6 months. I personally know that the relieved commander and his wife have spent a lifetime in dedicated care to Soldiers and their Families. He has done it in combat, multiple times, with our elite
forces, and in the medical training center. Their ( and other's) " reward " for a lifetime of dedicated care to Soldiers and Families has been disgraceful and disgusting to anyone who knows the truth.

They have been blamed for decades of under funding for Walter Reed. Will those in DOD responsible for this be relieved? Will the idiots who placed Walter Reed on the BRAC list for closure while this nation's military is at war be relieved and disgraced? Being military, you know what it means when this happens to an installation. It gives the bean counters the excuse not to provide funds to fix anything and not to fill personnel shortages.

Many civilians start looking for other jobs near home and no one wants a job in an installation that is closing. Being military, you should know that the superb military medical care provided by the different Services was gutted during the Clinton administration, and funding centralized at the DOD level. That system has only become worse as you must know if any of your friends have to use that system.

Do the folks at Walter Reed experience problems daily? You bet and they deal with them within their capability while keeping their Rucks packed to be ready to replace some Medic in Afghan, Iraq , or Landstuhl, or to be ready to meet a Medevac plane at Andrews or to pick up some grieving loved ones of a Soldier. Are there problems with paperwork? You bet! Have you tried to complete/coordinate VA disability/medical forms or coordinate medical care between the national guard, reserve and active duty systems? I only have a master's degree and I have problems with the forms.

For those who might want a good news story, I would ask you to look at the other 99% of the operations at Walter Reed. A start would be to look at the lives saved and cared for daily, and the enormous efforts required to do this. Look at the amazing programs initiated at Walter Reed for in-patients and out-patients, and for family members/loved ones of wounded Soldiers. Look at how they bring many family members in to be with their Soldier while they are there for treatment. They and the Soldiers get top priority for housing and other needs while on Post. Look at the multitude of programs conducted daily by the military, veteran's groups, and commercial and private organizations/individuals. They provide everything you can imagine to the Soldiers and Families, all free of charge.

If you want to see the results of a complete reversal of public, private, and governmental support for our Troops compared to our Vietnam period, come and visit Walter Reed, and stop taking the long range cheap shots that paints all with the same brush, I have personally witnessed the dedicated, emotional, exhaustive, selfless service of our Medical Troops caring for their fellow Soldiers from Baghdad to Medevac helicopter to Balad Air Base to Medevac plane to Landstuhl to Walter Reed, and other places in U.S. . It doesn't stop and they must always be ready at all times, day and night.

The Medics many times go until they drop from exhaustion. Why? Because they , more then anyone, know the American Soldiers deserve the finest medical care they can give, within their capability. Because they, more then anyone perhaps, know what the horrors of war do to our/their fellow Soldiers, and they are reminded everyday. They wipe their tears and get on with their critical jobs, and thank GOD for them. Will they give priority to unloading a Medevac or trying to save a life over helping a Troop fill out a form? Yes but they get that done too when they can and if they are able.

Are they responsible for the Gov't. complex, stupid funding and contracting processes? Absolutely not but let all the ones responsible and the publicity seekers run to climb on the blame pointing wagon and get their time on T.V. at the expense of all our great Medics since they are being painted with the same brush. Some are no better then the anti-American bunch that stands across the street from Walter Reed with their obscene signs.

Walter Reed and our other military care facilities needs the maximum attention of our national leadership, but the blame must be shared by all.

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Walter Reed woes bring turmoil at the top

http://www.armytimes.com/news/2007/03/tnsharvey070302/

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Committee subpoenas former Walter Reed chief

http://www.armytimes.com/news/2007/03/Weightmansubpoena/

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Walter Reed patients told to keep quiet