Advice to Stop PTSD Diagnoses Triggers Probe (Obama's letter instrumental)

[usregimechange]

More and more military veterans returning from Iraq and Afghanistan are seeking help and compensation for post-traumatic stress disorder. That has created concern by veterans and others that the government could try to minimize the problem of PTSD to save money. An incident at a veterans' hospital near Fort Hood, the Army post in Texas that is one of the nation's largest military bases, has stoked that concern.

In an e-mail, a psychologist at the Olin E. Teague Veterans' Center in Temple, Texas, advised her staff to stop diagnosing veterans with PTSD to save money. The e-mail became public last week. The head of the Department of Veterans Affairs insists that's not VA policy.

Psychologist Norma Perez was hired last summer to help coordinate a PTSD program at the center, which draws a lot of veterans. Not long afterward, Perez announced she would disband a dozen or so PTSD therapy groups, in which about 140 veterans met monthly with a clinical counselor. Perez wanted to replace the long-term groups with short-term plans — lasting no longer than three months — that focus on coping skills and cognitive processing therapy. The VA uses a broad range of therapies for PTSD, including group therapy.

Some veterans in the program said Perez told them that long-term group therapy doesn't work. Some vets accused Perez of personally trying to destroy their groups. But Kim Larsen, a former Army medic and Vietnam vet with PTSD, who attended two VA forums about the plan to disband the groups, had a different impression. He thought Perez was simply the messenger. Then he saw an e-mail from Perez to her staff, advising them to "refrain from giving a diagnosis of PTSD straight out...." It was dated March 20...

Congressional leaders and Democratic presidential candidate Sen. Barack Obama called for an investigation, and the inspector general of the VA has begun one.

http://www.npr.org/templates/story/story.php?storyId=90744878&ft=1&f=1001


Obama's letter that triggered the investigation:

Dear Secretary Peake:

I am writing to express my serious concerns about reports that a psychologist at a Texas Veterans Affairs (VA) facility told staff members to refrain from diagnosing veterans with post-traumatic stress disorder (PTSD).

According to today's Washington Post, Norma Perez, a psychologist at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Texas, sent an email to other staffers saying: "Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out." She then suggested the alternative diagnosis of "Adjustment Disorder," adding that VA staff members "really don't . . . have time to do the extensive testing that should be done to determine PTSD."

Simply put, Ms. Perez's email is outrageous. As you well know, PTSD is the most prevalent mental disorder afflicting our returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans. In order to receive their deserved benefits, these brave men and women must endure a long and arduous process. To hear that a VA official is promoting misdiagnoses of soldiers to save money is unacceptable and is tantamount to fraud.

You have said that Ms. Perez's email is "inappropriate," but more must be done. I call on the Department to open an investigation into the following:

1) Whether Ms. Perez was advised to send this e-mail or give this instruction at the urging of her superiors at the Teague Center.

2) Whether staff members at the Teague Center followed Ms. Perez's advice, and if so, how many veterans were affected by incorrect diagnoses.

3) Whether officials at other veterans centers have given some similar admonitions to staff members charged with diagnosing PTSD.

4) Whether this is an incident or a trend. I understand that the VA keeps detailed information on the number of diagnoses of PTSD and adjustment disorder. Your investigation must look at changes in the number of both diagnoses over time, both system-wide and on a facility-by-facility basis.

5) What is being done to ensure that any veterans affected by this instruction do not fall through the cracks. All veterans given an incorrect diagnosis should be given redress both in their diagnoses and their subsequent disability benefits.

6) Whether there are any trends among veterans who have committed suicide recently to determine whether any were wrongly diagnosed with adjustment disorder. Your investigation should include a survey of root cause analyses of recent veteran suicides.

7) Whether there are other instances across the VA bureaucracy of veterans with legitimate cases of PTSD being swept under the rug for budgetary reasons or for expediency. Why, for instance is the number of approved benefits claims for PTSD at the Veterans Benefits Administration decreasing at a time when diagnoses for PTSD at the Veterans Health Administration are increasing?


Too many veterans see the VA as a bureaucracy with the singular goal of denying services and benefits to veterans. This recent incident merely serves to promote that impression. I request that you advise me by no later than Friday, May 23, 2008, as to whether you will open such investigation.

Thank you.


Sincerely,

Barack Obama
United States Senator

http://obama.senate.gov/press/080516-obama_demands_v/

[Diane R]

1. While Hillary Clinton comes unglued, Barack Obama shows leadership.

[BlooInBloo]

2. To hell with Clinton, what did *McCain* do about it?

[usregimechange]

4. Answer: Nothing.

[otherlander]

3. To the greatest page!