Pentagon is treating troops for PTSD but not sure why

Don't even get me started on this! They are doing it but experts say there is no way to measure if it is working or not, other than the fact the numbers of suicides go up every year along with attempted suicides, more divorces, more just added onto what we already knew 30 years ago. Seems to me that's a good way to know if it's working or not.

Pentagon is treating troops for PTSD, but experts say measurements are lacking

By Megan McCloskey, Stars and Stripes
Mideast edition, Monday, September 14, 2009


WASHINGTON — With an estimated 20 percent of U.S. servicemembers returning from war zones suffering from post-traumatic stress disorder, a burgeoning suicide rate in the ranks and occasional murder or other extreme outbursts of violence, the Pentagon is scrambling to grapple with the mounting psychological fallout from America’s wars in Iraq and Afghanistan.

Combat stress clinics have been set up near the front lines. Troops in training are learning how to gird themselves against mental troubles. Officers are required to watch for signs of suicide risks among their subordinates.

But in a vast military organization obsessed with metrics and measuring every aspect of its performance, experts say there is one glaring gap: The Pentagon has no system in place to evaluate whether its downrange crisis interventions are actually working.

At the stress clinics, or "restoration centers" as the military calls them, servicemembers experiencing acute mental trauma can get a few days’ respite away from the war and consult with nurses, psychologists and psychiatrists. The only outcome the Army measures is what percentage of soldiers are able to quickly return to the front lines: 97 percent.

"[Downrange] the mental health professional’s primary mission is to get people back to duty," said Dr. Mardi Horowitz, a psychiatrist and PTSD authority who helped define the disorder in the 1970s. "It’s not an individual’s health."

Courtesy of the U.S. Army
A 1st Battalion, 32nd Infantry Regiment soldier fires an M4 rifle during a battle with insurgent forces in Barge Matal, Afghanistan, in July. While the military has taken steps to treat mental health disorders stemming from combat, there are no attempts being made to count the number of soldiers who visit combat stress clinics or track their long-term mental health.

Adopting a new coping strategy

"Resiliency" is the new buzzword in the realm of military mental health.

The Pentagon’s focus has turned to preventing debilitating combat stress by teaching coping strategies.

"Our attitude has changed significantly," Capt. Paul Hammer, director of the Naval Combat and Operational Control Center, said. "We’re much more aware of how important mental health is for people’s ability to function."

At the start of the Iraq and Afghanistan wars, troops received only brief mental health training before combat deployments. Now the concept of resiliency is becoming a regular part of training from day one. Beginning in October, the first week of basic training will include anti-stress programs aimed at building coping skills. Formally called Comprehensive Soldier Fitness, the effort will expand to include all levels of Army education.

Studies suggest that mental toughness can be taught in the classroom. However, these initiatives have largely focused on pre- and post-deployment, teaching resiliency skills first for prevention and then for reintegration.

The Army is adapting the idea of resiliency for downrange, reflecting the changing ways mental health professionals are used in the field.

"The model is not to sit there and wait for people to show up. We’ve moved away from that completely," said Lt. Col. Paul Bliese, chief of military psychiatry at the Walter Reed Army Institute of Research. "The behavioral health officer needs to be actively involved in the lives of soldiers in a unit."

Army medics now are trained to spot combat stress and help a soldier cope. Mental health professionals also conduct periodic psychological "debriefings" with a unit — at four and eight months into a deployment, for example — and also do them in response to a critical event. The debriefings last about an hour and allow servicemembers to talk about their reactions to stressors, the goal being to address issues before they can fester. Walter Reed officials recommend the debriefings, but they are not mandatory.

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