The army has found no evidence of a systemic problem with changing the diagnosis of soldiers with PTSD. But a new task-force report still had recommendations to improve behavioral-health care.
By Gene Johnson, The Seattle Times
“An Army task force that reviewed more than 150,000 casesfound no evidence that diagnoses of post-traumatic stress disorder were reversed in excessive numbers in the post 9/11 era.
But the task force did document other problems that still hamper the diagnosis and treatment of soldiers with PTSD, according to findings released Friday.
Improving mental-health care has been a high priority for the Army as suicide rates in recent years have swelled. Last year, it tallied 350, the highest yearly total on record.
The task force was formed last year in response to complaints from soldiers at Joint Base Lewis-McChord who believed their PTSD diagnoses were improperly reversed by doctors at Madigan Army Medical Center. Some tagged as possible malingerers said they felt humiliated by the change in diagnosis, which also put at risk their chances for pensions and other medical-retirement benefits.
Reviewing records back to 2001, the task force found that more than 6,400 soldiers’ behavioral-health diagnoses had been modified. But in evaluations for medical discharges for those soldiers, there were about as many new PTSD diagnoses as there were cases from which the diagnosis was removed.
“I can’t stress enough that what happened at JBLM was not a systemic issue,” said Lt. Gen. Patricia Horoho, the Army surgeon general, during a Friday briefing with reporters.
The 58-page report contains 47 recommendations to improve the complex diagnosis and evaluation process for medical discharges.
Some of the report’s recommendation are already being implemented, according to Army officials. They include “embedding” behavioral health-care providers in brigades, improving guidance for soldiers and families, and designating a director of psychiatric health at each installation.
Sen. Patty Murray, D-Wash., last year investigated the complaints of JBLM soldiers and pressed the Army to examine the behavioral-health-care system.
“The only way to truly make headway on reversing the troubling trends we have seen, including the fact that suicide deaths continue to outpace combat deaths, is to change the culture associated with identifying and treating behavioral-health conditions,” Murray said in a statement released Friday.
At Madigan, the controversy over the reversal of PTSD diagnoses was stoked by concerns that a screening team led by forensic psychiatrists might have been reversing diagnoses to try to reduce the cost to taxpayers of pensions and other medical retirement benefits. The forensic team typically used tests such as the Minnesota Multiphasic Personality Inventory to assess the severity of PTSD symptoms, or whether symptoms were feigned.
Army officials say an as-yet-unreleased investigation of Madigan found no evidence diagnoses were changed to save taxpayers money. But the Army last year did end the use of forensic psychiatrists on the Madigan screening teams.
Horoho, the Army surgeon general, said Friday that Madigan was the only medical center where forensic teams screened soldiers, and that introduced what she called “variance” into the Army’s diagnostic efforts.
Last year, the Army established new review teams that re-evaluated 257 soldiers. Fifty-seven percent of those soldiers did have PTSD, according to the task-force report.”
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Originally published March 8, 2013.