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Post Traumatic Stress Disorder: Evaluating Treatment and Screening

ptsd-evaluation-and-screening
ptsd-evaluation-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.


ptsd-evaluation-and-screening

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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.


Comments

annaw from North Texas on July 31, 2011:

That is quite alrightI am just getting to your reply, thank you. Have you heard of The Wingman Project? It is a great organization and I am becoming involved and I love it. I just feel I must do 'something' my heart goes out to all the veterans and their families. Glad you are back. I am too often away for months at a time. I have made a committment to be here everyday moving forward, whether I am publishing or not, it is a great place to be.

carolyn a. ridge on July 30, 2011:

This information is thorough and intense. Our military fighters are fighters for life. First, they fight overseas for us, and our freedom; then they come home and fight for their own freedom, from PTSD. Good job;good luck.

Abigayle Malchow-Rourk (author) from Wisconsin on June 11, 2011:

I thank you for your comment and am sorry it took awhile to respond. I am catching up with my comments and like that you mention the need to remember the Vientnam Veternas. My grandfather served in Vietnaam and though he talked a lot about his service and what he did in the military and after this time frame eluded our conversations. I learned later about PTSD and learned how unfairly treated and how hard it was for them returning to the states after being in this conflict.

I will be researching a little more on that era myself. I agree we need to educate ourselves on other vets to help our current ones. As I understand the vietnaam vets are still struggling even today.

I don't want to downplay the improvements made overall in the diagnosis and treatment of those suffering with post traumatic stress in the military. I want though to point out that the Army has a reputation lately of being the worst in the providing these services to the ones that I believe truly are in need of it. The Army sometimes in my own opinion, is overlooked to the fact they do more rotations in longer intervals downrange. My second husband did one tour for twelve months, went through an overseas PCS move only to be home for a little over a year and in country five months before going downrange again for fifteen months. He earned a combat action badge the first tour, was minorly injured but saw more combat again the second rotation, had personal marrital and family problems as well, developed symptoms in rotation one that after the second fifteen month rotation was not diagnosed as in need of services. Then was told six weeks after his fifteen month rotation he was being sent back to the states in four short weeks with no preperation or assistance with a family including one with Autism. He got to the new duty station finally got some help for PTSD and in the midst of the worst of it got sent downrange again only one year later, filing for divorce that they let become final downrange while suffering PTSD he was in denial of for twelve more months.

Not to mention on the same post we lived on our hospital had a hostage situation because the prior service soldier was dissastisfied with his mental health care.

The Marines, navy, and the Air Force in my research have made great strides even though I know they still suffer the same problems don't get me wrong...but they have a better and bigger success rate for families and service memebers with better care and continous support then the Army. If the Army has the highest rate of suicide statistically and the same for pTSD diagnosis then what is going on?

Last thing I wanted to point out is Fort Stewart from my own personal observations, my own discussions with spouses and soldiers, and statistically the worst divorce rate amony units (one was as high as ninety percent upon returning from IRaq) did some top brass come down and commend the duty station as one of the best for combating PTSD?

annaw from North Texas on April 06, 2011:

I think it is also of utmost importance we do not forget our Vietnam Veterans.Fantastic Hub, worth sitting down with a cup of coffee. Very interesting. You make some great points regarding the diagnosis of PTSD. It seems to me the military has a problem admitting there is something desperately affecting our troops and that despite they are fighting men and women they are quite human.