DOD and VA "efforts" made having PTSD worse

Wounded Times
Kathie Costos
June 21, 2014

Military/veteran families and civilian families live in a different worlds. They settle for what the press tells them but we walk around with our eyes bugging out and brows raised so high they almost hit our hair line. My forehead wrinkles get deeper every years but that is just the way it. While we know what we live with the rest of the population think they have just discovered our pain,,,,again. How could they keep forgetting what they read last year or the year before or the year before that? How could they keep forgetting being upset for us over and over again?

The DOD and the VA can't prove if their "efforts" to address PTSD work, but then again, they say they just don't even know. That is the problem. All these years the DOD has been pushing Comprehensive Soldier Fitness. Before that, it was Battlemind. These "efforts" actually make PTSD worse while preventing servicemen and women from seeking help. Why? Because when soldiers are told they can "train their brains to be mentally tough" that translates into "if I have PTSD then I am mentally weak."

It seems that everyone is shocked by the report from Institute of Medicine except veterans and families. None of us are shocked at all. What is shocking is it took them so long to report on what we've been living with all these years.

IOM REPORT: DEFENSE/VA HAVE NO CLUE IF $9.3 BILLION WORTH OF PTSD TREATMENT WORKS
Nextgov
Bob Brewin
June 20, 2014

The Defense and Veterans Affairs departments spent $9.3 billion to treat post-traumatic stress disorder from 2010 through 2012, but neither knows whether this staggering sum resulted in effective or adequate care, the Institute of Medicine reported today.

DOD spent $789.1 million on PTSD treatment from 2010 through 2012. During that same time period, VA spent $8.5 billion, with $1.7 billion treating 300,000 Iraq and Afghanistan veterans.

DOD lacks a mechanism for the systematic collection, analysis and dissemination of data for assessing the quality of PTSD care, and VA does not track the PTSD treatments a patient receives, other than medications, in its electronic health record, IOM said in the congressionally mandated 301-page report, “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment.”

IOM estimated 5 percent of all service members have PTSD. Eight percent of those who served in Iraq and Afghanistan have been diagnosed with the condition. The number of veterans of all eras who sought care from VA more than doubled from 2003 to 2012 -- from approximately 190,000 veterans (4.3 percent of all VA users) in 2003 to more than a half million veterans (9.2 percent of all VA users) in 2012.

For those treated for PTSD in the VA system in 2012, 23.6 percent (119,500) were veterans of the Iraq and Afghanistan wars.
read more here

BATTLEMIND-RESILIENCE-COMPREHENSIVE UNFITNESS
Kathie Costos, posted on Wounded Times and in the book, THE WARRIOR SAW, SUICIDES AFTER WAR

If the military had ordered weapons that turned out to be more dangerous for the troops than they were for the enemy, they would have canceled the contracts. In the case of contracts and programs to prevent Post Traumatic Stress Disorder and reduce military suicides, they did not come to the obvious conclusion these programs were more dangerous than doing nothing.

BATTLEMIND was the granddaddy. This program was later called Resilience Training and Comprehensive Soldier Fitness.

This was the claim made in 2009 about Battlemind

“The study found that in Soldiers who had seen extensive combat, Battlemind training resulted in a 14 percent reduction in severity of post-traumatic stress disorder symptoms.

And while 60 percent of Soldiers without the training reported sleep problems, just 30 percent of those who'd had the Battlemind class said they were having trouble sleeping after returning home.

Validation claim
Adler said the study validates the efficacy of the training, which aims to prevent or reduce psychological problems by giving Soldiers detailed information about what to expect, how to deal with problems and assurance that their experiences are both shared and manageable.

"It's not just the events you might be exposed to," she said. "It's also the thoughts you might have, feelings you might have...it helps put the experience in perspective."

Adler did not say whether the study had determined the training's effects on other commonly reported difficulties, such as irritability or depression.

The Battlemind material was developed after years of gathering data about deployments and reintegration. More than 80,000 troops filled out surveys since at least 2003 providing data on the typical effects of combat and the typical problems after coming home.

"What's normal, what you can expect," Adler said.

Battlemind Training was devised by psychologist COL Carl Castro, along with a colleague. It is based on the psychological theory of expectation, said Castro, now director of Medical Research and Materiel Command's Military Operational Medicine Research Program.

"Everyone does better when they know what to expect," Castro said. "So we said, 'What would be useful to know, based on evidence we had already collected?'"

That the study of the training's effectiveness, conducted in 2005 and 2006 on some 2,000 Soldiers in combat brigade teams, showed modest mental-health gains was expected, Castro said.

"It opens up the door," he said, to more psychological-health training throughout an Army career and, eventually, larger mental-health gains.“ (Study Shows Battlemind Training Effective, Nancy Montgomery, Stars and Stripes)

“Every Soldier headed to Iraq and Afghanistan receives “Battlemind” training designed to help him deal with combat experiences, but few know the science behind the program. Dr. Amy Adler, a senior research psychologist with the Walter Reed Army Institute of Research's U.S. Army Medical Research Unit Europe visited Patch Barracks here to explain the support and intervention program to an audience of medical, mental health and family support professionals.” (Battlemind Program seeks to help soldiers deal with combat experiences, Susan Huseman, US Army Garrison Stuttgart Public Affairs Office, January 4, 2008)

A year later, Gregg Zoroya of USA Today interviewed Josh Barber’s widow. Josh drove to Fort Lewis “to kill himself and prove a point.” Kelly Barber went on to say that, “The "smell of death" he experienced in Iraq continued to haunt him, his wife says. He was embittered about the post-traumatic stress disorder (PTSD) that crippled him, the Army's failure to treat it, and the strains the disorder put on his marriage.” Barber would have had Battlemind Training, but like most of the men and women committing suicide in the military or because of it, this program was the push into the abyss.

In 2007 Charles Figley, Ph.D, Florida State university professor, “College of Social Work and director of “Traumatology Institute and Psychosocial Stress Research Program” was talking about OEF and OIF troops under combat stress. He said "We need to move from an obsession with PTSD to focus on combat stress, injury prevention, and management."

After addressing his thoughts on changing the term from PTSD to “combat stress injury” Figley went on to add “However, prevention and management must begin early, he said. Troops should acknowledge the likelihood and fact of injury beginning in boot camp. Before they are wounded, troops believe they are invulnerable and even after physical injury, often deny they are hurt. To a soldier, injury, whether physical or psychological, is a source of embarrassment. They have to move from denial to needing to talk about their injuries.” (American Psychiatric News, May 4, 2007) Comprehensive Soldier Fitness has just about the same type of claims.

According to reporters at the time, CSF was $125 million dollar failure, however, that was just the original cost.

The $125-million Comprehensive Soldier Fitness program
requires soldiers to undergo the kind of mental pre-deployment tests and training that they have always had to undergo physically. Already, more than 1.1 million have had the mental assessments. (By Kim Murphy, Los Angeles Times December 26, 2011)

From Amazon about Warrior MindSet by Dr. Michael Asken, Loren W. Christensen, Dave Grossman and Human Factor Research Group.
January 1, 2010

“Mental toughness is essential for elite human performance and especially in high stress situations. While mental toughness is a singular value in both military and law enforcement training and missions, too often, there is a disconnect between talking about and actually training it. Warrior MindSet defines mental toughness and describes its critical need and function in the face of the performance degrading effects of combat, mission or response stress. Warrior MindSet provides the psychological skills that comprise mental toughness to optimize performance, success, safety and survival in the field.”

Human Factor Research Group Leadership members are Bruce Siddel, Lt. Col. Dave Grossman, Dr. Steven Stahle and Mark Glueck. According to their website these are among some of their clients.

United States Department of Army SOTF (Delta Force), Ft. Bragg, NC
United States Department of Army Ranger Training Battalion
United States Department of Army Military Disciplinary Barracks, Ft. Leavenworth, KS
United States Department of Army Survival, Escape, Evasion and Resistance School - John F. Kennedy Special Warfare School
United States Department of Army Ranger Training Battalion, Ft. Benning, GA
United States Department of Navy Redcell, Littlecreek, VA
United States Department of Defense Camp Peary, VA
22nd Regiment, SAS, Minister of Defense Hereford, England

In 2006, the Army documented 2,100 attempted suicides; an average of more than five per day. In comparison, there were 350 attempts in 2002, the year before the war in Iraq began.

The method of choice was a firearm. There is no firm data on Soldiers who had thoughts of suicide. (Suicide Gets Army’s Attention, Army, Debbie Sheehan, Fort Monmouth Public Affairs October 14, 2009)

In 2007, the Army experienced its highest desertion rate since 1980, an 80 percent increase since the United States invaded Iraq in 2003. The warning signs of future retention problems are increasingly apparent: suicide, post-traumatic stress disorder (PTSD), substance abuse, divorce, domestic violence, and murder within the force are on the rise. Recent attention has focused on the growing number of suicides, with the Marine Corps experiencing more suicides in 2008 than since the war began and the Army logging its highest monthly total in January 2009 since it began counting in 1980. Not surprisingly, PTSD rates are highest among Iraq and Afghanistan veterans who saw extensive combat (28 percent). However, military health care officials are seeing a spectrum of psychological issues, even among those without much combat experience. Various surveys provide a range of estimates, with up to half of returning National Guard and Reservists, 38 percent of Soldiers, and 31 percent of Marines reporting mental health problems. (Mind Fitness, Improving Operational Effectiveness and Building Warrior Resilience, Elizabeth A. Stanley and Amishi P. Jha, Army, October 30, 2009)

Battlemind and Comprehensive Soldier Fitness failed. In 2009 I wrote that if they pushed this program suicides would go up.

In the article

In a speech before the international affairs organization the Atlantic Council on Thursday, U.S. Army Chief of Staff Gen. George Casey laid out the virtues of the newly formed initiative, which he called Comprehensive Soldier Fitness.

"We have been looking very hard at ways to develop coping skills and resilience in soldiers, and we will be coming out in July with a new program called Comprehensive Soldier Fitness," said Casey. "And what we will attempt to do is raise mental fitness to the same level that we now give to physical fitness. Because it is scientifically proven, you can build resilience."

If you need proof CSF failed, here it is.

2008 Army = 140; Air Force = 45; Navy = 41; Marine Corps = 42 total 268
2009 Army = 164; Air Force = 46; Navy = 47; Marine Corps = 52 total 309
2010 Army = 160; Air Force = 59; Navy = 39; Marine Corps = 37 total 295
2011 Army = 167; Air Force = 50; Navy = 52; Marine Corps = 32 total 301
A total of 915 Service Members attempted suicide in 2011 (Air Force = 241, Army = 432, Marine Corps = 156, Navy = 86). DoDSERs were submitted for 935 suicide attempts (Air Force = 251, Army = 440, Marine Corps = 157, Navy = 87). Of the 915 Service Members who attempted suicide, 896 had one attempt, 18 had two attempts, and 1 had three attempts.

2012: Army 185, 93 Army National Guard and 47 Army Reserve, but the reports left out the citizen soldiers when they included 48 Marines, 59 Air Force, 60 Navy, total 492

RAND Corp took a hard look at this program and found that resilience training did not even fit with military culture.

Medal of Honor heroes talked about having PTSD, after this training. Dakota Meyer tried to commit suicide. Special Forces veterans talked about having PTSD after this training and some of them committed suicide. Some were discharged like Sgt. Ben Driftmyer.

Those returning are facing serious combat related mental health issues. According to a study conducted by RAND Corp. last year, one in three combat veterans will return home with PTSD, traumatic brain injury or major depression requiring treatment.

"I had spent eight years serving the military. I never got in trouble. Never did anything bad. And I got treated like I was a piece of crap because of it," said Ben Driftmyer, discharged U.S. Army Sergeant and Cottage Grove resident.

Driftmyer was diagnosed with post traumatic stress disorder by Eugene doctors after he was chaptered out from the special forces unit in Baghdad. He suffered several mental breakdowns during his service, but his discharge was classified as "other than medical."

"Because the military didn't want to pay for me for the rest of my life," said Driftmyer.

The other factor in all of this are similar to what Driftmyer faced. Bad paper discharges. Here are the numbers from 2013.

Army

Data obtained by The Associated Press show that the number of officers who left the Army due to misconduct more than tripled in the past three years. The number of enlisted soldiers forced out for drugs, alcohol, crimes and other misconduct shot up from about 5,600 in 2007, as the Iraq war peaked, to more than 11,000 last year.

Navy

The Navy went through a similar process. When the decision was made to cut the size of the 370,000-strong naval force in 2004, the number of sailors who left due to misconduct and other behavior issues grew. In 2006, more than 8,400 sailors left due to conduct issues.

Air Force

The Air Force, which is smaller than the Navy and Army, reported far fewer cases of airmen leaving for misconduct, both for officers and enlisted service members. The number of officers separated from service since 2000 due to a court-martial ranged from a low of 20 in 2001 to a high of 68 in 2007. For enlisted airmen, the number ranged from a high of nearly 4,500 in 2002 to a low of almost 2,900 in 2013.

Marines

Data for the Marine Corps, the military’s smallest service, were not broken out by officers and enlisted personnel. Overall, it showed that Marines leaving the service due to misconduct was about 4,400 in 2007, but has declined to a bit more than 3,000 last year. Those forced to leave for commission “of a serious offense” has nearly doubled from about 260 to more than 500 in the past seven years. The number of Marines who left after court-martial has dropped from more than 1,300 in 2007 to about 250 last year. The Marine Corps also grew in size during the peak war years, and is reducing its ranks.

Yet in all of this every year the DOD says that most of the suicides were committed by servicemembers with no history of deployments.

This is the most important question of all. If Comprehensive Soldier Fitness didnt' work for the troops without being deployed, how did they expect it to work for the troops being sent into combat over and over again?

Simple question they don't seem to want to answer.

One of the latests Medal of Honor heroes from the Vietnam War is Melvin Morris. I met him last month at a fundraiser for a double amputee. We talked for a long time and while he and his wife have been married for 53 years, they told me that he not only has PTSD, but wants to talk to the younger soldiers and veterans to prove to them once and for all that PTSD is not the end of their story. It is just a part of it.

PTSD is caused by trauma and changes lives but the truth is, it doesn't mean they cannot change again. They can heal even though PTSD is a part of them for the rest of their lives, they can live better lives. Their marriages don't have to end. Heck, I've been married to my Vietnam veteran with PTSD for 30 years. Melvin is one example of how the military got it wrong on resilience training.

You can't get more "resilient" than doing what it takes to earn the Medal of Honor. You can't be more resilient than to not just be willing to die for others, but to push past the pain of PTSD until after your buddies are out of danger. Their lives are yet one more scandal but this one has claimed more lives than anything else the VA and the DOD have done. They tried to prevent something they never understood in the first place.

Dakota Meyer's story is yet one more example. Most know his story when he had the Medal of Honor placed on his neck but few knew what happened when he came home. He tried to kill himself.

Meyer got some post-traumatic stress counseling, and moved back in with his father, Mike, on the farm where he grew up in the Kentucky hills.

"You come home to this peaceful place in the country," said Martin. "About as far removed from war as you can get. What was it like coming home?"

"A shocker," Meyer said. "It's hard living here. It's easy fighting, you know, 'cause it's, it's simple. Like, war simplifies life in my mind."

Meyer was home, but his father could see the war was still with his son.

Meyer's father said Dakota asked for new locks on the doors. "Make sure the house was locked up every night. . . . He'd always want to have one or two guns in every vehicle."

"So he always wanted a weapon close," he said, noting that for three months Meyer slept with a weapon - a pistol on his chest.

"Did you try to talk to anybody about it?" Martin asked.

"What's there to talk about?" Dakota replied.

"Get it out of your own mind and into somebody else's?"

"You know, why bother somebody else with it?" Meyer said. "It's just part of it."

Believing he had become a burden to his family, Dakota turned to the bottle. One night driving home he stopped his truck and pulled out a gun.

So many Medal of Honor Heroes have come out about their own battles they should never have to fight that what you read about today is nowhere close to the way it actually is.