Post Traumatic Stress Disorder: Evaluating Treatment and Screening
Post Traumatic Stress Disorder in regards to our combat veteran's returning from Iraq and Afghanistan are in need of a more comprehensive and family integrated involvement style program to evaluate, treat, and diagnose. This would be necessary in re-integration to civilian life especially if the soldier has been deployed multiple times and for a year or more each time in a combat zone. In Fort Lewis, Washington, the MAMC insists upon the need for an intensive interview in face to face fashion. An interview with a trained professional and certified BH/MH one at that. A social worker, psychologist, psychiatrist, and an additional trained professional such as one in family or internal medicine. Currently it seems; Army wide its viewed as 'unnecessary' though in my own personal journey married to a combat veteran of Iraq deployment's and PTSD the Army is blinded by how extensive this need really is.
The common consensus has seemed to be throughout the Army that the overall rate of diagnosis and proper treatment is effective and if its done any more extensively as provided above; then its using valuable resources from other areas targeted as essential and perhaps it would over work their already overworked professionals. That other means for treating soldiers; leaving families out of the equation on a whole, are offered but not encouraged and no definite treatment plans are intensive enough to solve the overwhelming problem of combat related post traumatic stress. With lack of medical assets and recurring and frequent mobilization PTSD treatment and lack of effective care that involves the family as a whole has been swept under the rug. If you look at the statistics just at Fort Stewart in Southern Coastal Georgia you will understand the necessary need of intervention on a more severe level.
90 percent of an infantry unit left married yet came back divorced.
Infidelity and domestic violence is on the rise. According to a military police SGT on patrol at a call near my old home on post; remaining nameless to protect said individual, they divulged that just last rotation they were called to four murder suicides within a few months span of re-deployment. That Army wives were having a higher rate of suicide attempts as well and child services being called even more frequently then ever. The best advice they had to offer was to not live on post, have no military friends, stay away from the unit and force your soldier to seek help for PTSD out of the military scope...into the civilian sector as far away as Savannah Georgia to avoid stigma and unit involvement in pushing for families to divorce. This was just one MP who had been stationed over five years at Fort Stewart and despite all they had known also were victims of PTSD, infidelity, and a divorce.
Recognizing the emerging symptoms of PTSD has finally been that there is a delay in the symptoms surfacing. Low rate of positive symptoms on the Post Deployment Health Assessment given shortly or directly after soldier's re-deploy home from a year long tour of duty in a combat zone. Mandated second screening of all Soldier's at 90-180 days post return of the same PDHRA ( Post Deployment Reassessment). It has been stated by many professionals that this is a very "one size fits all" approach (survey style at that) intended to tabulate these symptoms and then "file them away as an epidemiological review of the state of health and mental health of a deployed force
The PDHA and the PDHRA were not integrated into a "dynamic scheme of diagnosis and treatment." According to Schoomaker, Eric B LTG MIL USA MEDCOM OTSG, it doesn't provide any additional medical intelligence for a repository of historical data. It further stated that LTG Kevin Kiley, while a TSG, had tried to find a correct sequence taking into consideration the timing of interactions with the soldiers returning; a comprehensive evidence based analysis. This was done just prior to his forced retirement in 2007-2008. Schoomaker took up this analysis in 2009; called a Comprehensive BH Plan. Their has been limited support (thus a delay) by the Army Suicide Prevention TF.
A pilot program was started in Hawaii at Schofield and also at 4-25 in Alaska.
Currently they are wanting to formally bring upon the new plan across the entire Army that combines the earlier automated and one on one interviews and survey's with what is called virtual couseling tools. Led by COL (Ret) Charles Hoge, is a team of BH scientists, that are to assess the impact of their efforts in terms of timing and diagnosis, effectiveness of treatment and avoidance of adverse social consequences. Such adverse social consequences would include but not be limited to misconduct, alcohol or drug problems, family discord etc.
An important asset to Schoomaker's plan is CENTER OF THE STUDY OF TRAUMATIC STRESS AND THE UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES UNDER DR BOB URSANO.
The Center for the Study of Traumatic Stress (CSTS) is one of the nation's oldest and most highly regarded, academic-based organizations dedicated to advancing trauma-informed knowledge, leadership, and methodologies.