AWOL Soldier Refusing Deployment Because of Severe PTSD
Friday 05 November 2010
by: Sarah Lazare, t r u t h o u t | Report
http://org2.democracyinaction.org/o/596 ... d_KEY=2735
"I am just trying to get help," insisted Jeff Hanks, active duty US Army infantryman, who has served in Iraq and Afghanistan. "My goal in this situation is to simply heal. And they wonder why there are so many suicides." Jeff spoke rapidly over the phone from Virginia, where he, his wife and his two young daughters are staying while he is AWOL from the military. Days earlier, Jeff had walked out of an airport, refusing to board a plane headed for Kuwait, which was to be his first stop on his way back to Afghanistan.
During his mid-September leave from his second combat tour with the 101st Airborne Division, Jeff sought help from Fort Bragg and Fort Campbell military doctors for post-traumatic stress disorder (PTSD) and physical wounds sustained in battle. Yet, just as his treatment was getting started, his command interfered, insisting that his military health care providers grant him clearance for immediate deployment. His providers acquiesced, even though they had not completed preliminary testing.
Jeff, who has trouble being in large crowds of people and difficulty controlling his anger, says he is in no state to deploy back to the war from which he is still struggling to heal. The 30 year-old soldier decided that his only choice was to go AWOL. Jeff plans to turn himself into his command at Fort Campbell on Veterans Day, November 11. He will be accompanied by supporters, including members of Iraq Veterans Against the War.
As the war in Afghanistan stretches into its tenth year, now the longest war in US history, Jeff's story has become all too familiar in a military that is overextended and exhausted, pushing soldiers beyond their mental and physical capacities in order to fill the ranks. The wars in Iraq and Afghanistan have been marked by staggering rates of trauma and suicide. Between 20 percent and 50 percent of all service members deployed to Iraq and Afghanistan have suffered PTSD.[1] Suicide rates among active duty service members are twice as high as that of the civilian population and veterans with PTSD are six times more likely to attempt suicide.[2]
In response to these developments, Iraq Veterans Against the War have launched a campaign - Operation Recovery - calling for an end to the deployment of traumatized troops. This 2,000-strong organization, comprised of veterans and active duty troops who have served since September 11, 2001, insists that Jeff's situation is not isolated, but rather, has become endemic to the current wars in Iraq and Afghanistan. "Many troops currently deployed to combat theater suffer from Post-Traumatic Stress Disorder, Traumatic Brain Injury [TBI] and Military Sexual Trauma," says Jason Hurd, a former soldier who served in Iraq and is active in the Operation Recovery Campaign. "We find this situation unacceptable and demand an end to these inhumane deployments."
Mental and Physical Wounds
Jeff, who grew up in Beebe, Arkansas, deployed to Iraq in 2008, a tour that eventually earned him a Combat Infantry Badge. During his time in Iraq, Jeff saw "the most brutal things of any of his deployments," he says. "It really bothered me. I think about it all the time." Jeff's Iraq deployment was marked by stressful combat patrols that kept him "always on edge." In 2008, he was witness to the aftermath of a car bomb explosion in a crowded marketplace in Balad, Iraq. It resulted in what he describes as "mass casualties." He saw one little girl, the age of his oldest daughter at the time, who had been gravely injured by the bomb, but still alive. "I can still see that little girl," he says. "I dream about her to this day."
Jeff says that he and others in his unit were not given adequate care for the mental wounds they sustained in battle, with mental health professionals only coming for short visits once a month. He describes his only experience seeing a therapist in Iraq: "It was a total joke," he says. "The guy just sat there and wrote stuff down and nothing ever came of it."
Jeff tells of one person in his unit who developed a severe drinking problem during his tour. "I know it stemmed from stuff he saw in Iraq," says Jeff. The command never pursued mental counseling of any kind for him. They told us not to speak to him and they eventually just kicked him out. He probably didn't get disability pay or anything."
"When I came home from Iraq I changed a lot. I noticed I had a lot of anger problems and I couldn't sleep," says Jeff. Family and friends noticed as well, and Jeff's coldness and distance began to eat away at his marriage, says his wife Christina. "When he came back from Iraq, he would look at me so cold. There was nothing in his eyes. That was the thing that bothered me the most. He was so unlike himself. The old Jeff used to joke around, he used to go out and socialize." The couple separated and Christina was left alone to raise their two daughters.
Jeff says that, back at the Fort Campbell, Kentucky, base where he was stationed, suicide was a widespread problem among the 101st Airborne Division. "There were multiples suicide attempts on base in Kentucky. For a while, we were having people kill themselves every other day," says Jeff.
After serving in Iraq, Jeff was deployed to Afghanistan May 3 of this year. "In Afghanistan, there is more of a constant threat than there is in Iraq," says Jeff, describing a deployment defined by constant mortar attacks, unclear missions and low morale among US soldiers. "We had no clear mission and nothing got done. We basically just sat in a valley waiting to get hit," he says. In one incident, five US soldiers were hit by a roadside bomb. "One died for sure and I don't know about the rest," says Jeff. "We had to sit on base and wait for them to be stabilized. We heard them screaming. It stuck with me. You can never get rid of that sound."
Jeff says that, like Iraq, medical treatment in Afghanistan was scarce and inadequate. "Combat stress people hardly ever came to the base. And it is hard to talk in a situation like that, since you are still in the war and on edge all the time," he says. On top of limited resources, people in Jeff's unit were teased and belittled when they asked for mental or physical health care. One private, who was blown back into a building after a mortar attack, complained of headaches and nausea to his command. "He was made fun of by the command in front of everybody," he says. "There is a saying in the military: What, you got sand in your vagina?" Jeff is certain that this dissuaded many who needed care from seeking it. "It keeps you from seeking help. I didn't seek help. I wanted to, but I would be ostracized."
Three weeks before going on leave from Afghanistan, a mortar went off near Jeff, blowing him up against a wall. He still suffers severe headaches from the incident.
Coming Home
When he went on leave from Afghanistan in mid-September, Jeff began to notice how profoundly he had been affected by his combat experience. He describes being seized with uncontrollable anger, having panic attacks at the slightest stimuli and being unable to relate to his family and loved ones.
Having reconciled with his wife Christina, he had been looking forward to spending time with her and the kids. "I had been so excited to see my family when I came home on leave," he says. "But when I was actually around them, they were just completely overwhelming."
"My daughters see how much Jeff has changed," says Christina. My older one says that daddy is not as nice as he used to be. She says 'I don't like daddy anymore.'"
In one incident, when Jeff and Christina were shopping at Walmart, Jeff was temporarily left alone when his wife went browsing in a different aisle. "I freaked out. There were too many people around me. I couldn't be left alone." Christina says she returned to find Jeff frantically insisting that they leave immediately.
Jeff tells of being afraid to sleep in the same bed as his wife, concerned that he would attack her in his sleep.
One day, Hank was overwhelmed with anger when a police officer "copped an attitude" toward his dad who had asked the officer for directions to a baseball game. "It triggered something in me," says Jeff. "I really wanted to hurt him."
"His mother has called me many times in tears about this," says Christina. "She knows her son and she knows he is different."
Jeff became concerned about whether he was fit for his imminent deployment. "If you have trouble controlling your anger at home, what are you going to do when you are in a situation holding a loaded weapon?" he asks.
In the Raleigh, North Carolina, airport where he was to catch a plane to Kuwait, Jeff had a panic attack in response to a stranger loudly clapping his hands. "I freaked out and was just like I gotta go. I can't do this," he says. Jeff walked out of the airport and checked himself into the Fort Bragg Emergency Room, the nearest military hospital.
Jeff was told by Fort Bragg doctors that they could not diagnose anything beyond the airport panic attack, because he was based out of Fort Campbell. Jeff arranged to meet his Fort Campbell command, where he was listed as AWOL for failing to board his plane. At Fort Campbell, he was passed around to various social workers, who eventually scheduled him an appointment with a mental health care doctor for Monday morning, October 11, at the Fort Campbell Medical Center. However, the Thursday before the appointment was to take place, Jeff's sergeant called him and said he needed to get immediate clearance to go back to Afghanistan that Friday, meaning he would never get to go to his scheduled appointment. Jeff later found out that his command called his doctors and order them to give him immediate clearance.
"I hadn't even been seen by a professional doctor," he says. "All I want is treatment. They were the ones who sent me over there. Now they won't even give me help when I need it." Jeff says he was determined to get help one way or another: "At that point, my only option was to leave."
Jeff has since been diagnosed by two civilian psychiatric professionals as having severe PTSD. He is currently weighing his options for meeting his urgent mental health care needs.
A Widespread Problem
"The redeployment of traumatized troops is a horrible problem," says Ethan McCord, a veteran whose unit was shown in the "Collateral Murder" video distributed by WikiLeaks. "I was denied treatment for the mental and physical wounds I sustained in battle, like so many others."
"In multiple units across all branches we're seeing commanders order service members to the battlefield who just aren't serviceable, says Chantelle Bateman, a former Marine who served in Iraq. "Rather than repairing them, we are sacrificing their long term well-being, their immediate safety and that of the people they are serving with."
As the wars drag on, veterans are demanding an end to the overextension and redeployment of wounded soldiers. On October 7, the ninth anniversary of the Afghanistan war, dozens of Iraq and Afghanistan veterans marched from Walter Reed Medical Center to Capitol Hill in Washington, DC, to announce Operation Recovery. A campaign statement reads: "While we recognize that we must stop the deployment of all soldiers in order to end the occupations in Iraq and Afghanistan, we see the deployment of soldiers with Post Traumatic Stress Disorder, Traumatic Brain Injuries and Military Sexual Trauma as particularly cruel, inhumane and dangerous. Military commanders across all branches are pushing service members far past human limits for the sake of 'combat readiness.' We cannot allow those commanders to continue to ignore the welfare of their troops who are, after all, human beings."
According to the Department of Defense (DoD), even if a military medical professional deems a service member unfit to deploy, a commanding officer can waive medical evaluation and order the service member into combat[3]. While the DoD is not forthcoming about the rate at which this occurs, high rates of PTSD and multiple deployments suggest that cases like Jeff's are common. Almost 30 percent of troops on their third deployment suffer severe mental health problems. By 2008, nearly 33 percent of troops had served two tours to Iraq or Afghanistan, while 10 percent had served three tours, trends that can only increase as the war in Afghanistan reaches its tenth year. Today over 11,000 troops have served six tours, with each tour greatly increasing a service member's chances of developing mental health problems, including PTSD, TBI and combat stress, as well as military sexual trauma, caused by rape and sexual assault from within the ranks.[4]
Top military brass acknowledges that suicides and violent crimes plague the military, with four combat veterans recently killing themselves at Fort Hood, Texas, in one week, one of them a suspected murder-suicide still under investigation. "The emergency issue for me right now is the suicide issue," said Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, the highest-ranking person in the US armed forces.
The recently exposed kill team in Afghanistan, in which US troops hunted, killed and mutilated Afghan civilians, collecting their body parts as trophies, involved at least one soldier who was on a cocktail of medications for TBI.
"They are sending troops right back into the situation that traumatized them before they have the time to heal," says McCord. It's ruining our youth in the military. Operation Recovery is trying to stop this."
Jeff remains determined to get the mental and physical health care he needs and is working with the Operation Recovery team of Iraq Veterans Against the War and Courage to Resist to figure out how to meet his immediate health care needs. "Five to ten years from now, these people are not going to care about me. I don't want to be a basket case. I don't want to go to a school play of my kid's and freak out in a big crowd," he says. "I just want help and they want to send me back to war instead of helping me."
Footnotes:
1. Seal, K. H., Bertenthal, D., Maguen, S., Gima, K., Chu, A., and Marmar, C. R. (2008). "Getting beyond 'Don't ask; don't tell': An evaluation of US Veterans Administration post-deployment mental health screening of veterans returning from Iraq and Afghanistan." American Journal of Public Health, 98, 714–720. See also "Comparisons of PTSD rates" Journal of Traumatic Stress - Volume 23, Issue 1, February 2010.
2. "Suicide and PTSD," Department of Veterans Affairs; Armen Keteyian "Suicide Epidemic Among Veterans," CBS News, November 13 2007; and Mark Thompson "Invisible Wounds: Mental Health and the Military" CNN, August 22 2010.
3. DDI 1332.14(8)c Updated: March 29, 2010.
4. The Alaska Army National Guard: A "Tremendous Shortfall," a report of the Veterans For America National Guard Program, October 15, 2008 and Mark Thompson, "America's Medicated Army" Time, June 5, 2008.
HEAVY Things Are Happening......finally.....
by J.B. Stone » 11/ 10/ 10 9:25 am
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 11/ 10 10:44 am
DEAR READERS:
Please don't confuse my revelation of Project 112/SHAD with some sort of reminiscence. They are two totally different things. I don't feel comfortable enough here to talk about whatever frivolities I may have participated in. But rather I feel that I am one of the LUCKY ones. I lived to tell the story. Many fine individuals went agonizingly to untimely graves locked in a land of secrecy where up is down, wrong is right, and then it's all twisted in some nightmarish blender along with everything you ever believed about our country.
I have another motivation. Kristen Amber Stone [my only daughter] was born at Thanksgiving Time in 1980. She'd be thirty now. Instead she lived for six painful and trauma ridden days. She was born six weeks premature at two pounds, one ounce and suffered from Hyalin Membrane Disease, a perforated intestine which was operated on at the ripe old age of three days, unrelenting pain, oozing red from seemingly every orifice, and had severe hemorraging in her brain, constantly convulsing from seizures and more....I won't go into the really sad details as it makes me cry still. I had to make the decision to withdraw the life support systems from her.
As she lay dying in her mother's arms, I grasped her tiny hand [she was SO small that her hand barely reached around my finger and had withered to one pound, eight ounces] and told her, "Kristen, you haven't had a very good time here. You'll be going somewhere better. Although I can't do anything more to help you, I promise you this.....I will do EVERYTHING humanly possible to prevent this from happening to anyone else's daughter."
She smile sweetly and 20 minutes later she was dead. I hadn't even realized how beautiful she was until the nurses removed all the wires and tubes from her face. I'm crying now.
~~~~~~~~~~~~
I meant it when I said those words. I'm not finished yet. I will keep that promise until I die.
.....aaaaah, yes. Project SHAD, the gift that keeps on giving.
We're coming up on the one year anniversary of my Mother's death soon. This is a somber time of year for me.
Happy Thanksgiving...!!!
Be thankful you're not me.
Please don't confuse my revelation of Project 112/SHAD with some sort of reminiscence. They are two totally different things. I don't feel comfortable enough here to talk about whatever frivolities I may have participated in. But rather I feel that I am one of the LUCKY ones. I lived to tell the story. Many fine individuals went agonizingly to untimely graves locked in a land of secrecy where up is down, wrong is right, and then it's all twisted in some nightmarish blender along with everything you ever believed about our country.
I have another motivation. Kristen Amber Stone [my only daughter] was born at Thanksgiving Time in 1980. She'd be thirty now. Instead she lived for six painful and trauma ridden days. She was born six weeks premature at two pounds, one ounce and suffered from Hyalin Membrane Disease, a perforated intestine which was operated on at the ripe old age of three days, unrelenting pain, oozing red from seemingly every orifice, and had severe hemorraging in her brain, constantly convulsing from seizures and more....I won't go into the really sad details as it makes me cry still. I had to make the decision to withdraw the life support systems from her.
As she lay dying in her mother's arms, I grasped her tiny hand [she was SO small that her hand barely reached around my finger and had withered to one pound, eight ounces] and told her, "Kristen, you haven't had a very good time here. You'll be going somewhere better. Although I can't do anything more to help you, I promise you this.....I will do EVERYTHING humanly possible to prevent this from happening to anyone else's daughter."
She smile sweetly and 20 minutes later she was dead. I hadn't even realized how beautiful she was until the nurses removed all the wires and tubes from her face. I'm crying now.
~~~~~~~~~~~~
I meant it when I said those words. I'm not finished yet. I will keep that promise until I die.
.....aaaaah, yes. Project SHAD, the gift that keeps on giving.
We're coming up on the one year anniversary of my Mother's death soon. This is a somber time of year for me.
Happy Thanksgiving...!!!
Be thankful you're not me.
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 11/ 10 10:48 am
...You know when they hand-selected Sailors for Project 112/SHAD, they chose young motivated men from the Warrior Class in the best health so that they could track any medical deviations, etc.
They just never planned ahead realizing that some would continue to fight until they die as they had sworn an oath to do
"I, (NAME), do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the orders of the President of the United States and the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice. So help me God."
~~~~~~~~~~~~~
"support and defend the Constitution of the United States against all enemies, foreign ***AND DOMESTIC***"
I took that very seriously then as I do now.
I think my actions underscore my intent.
They attacked us by stealth as if WE were the Enemy.
Now, they get to feel OUR wrath.
Some think it's "anger" that drives me forward. I'm DONE getting angry. I'm getting EVEN.
A dear man who helped save my life and prevented me from going homeless in 2002 when the physicality of my situation drove me down told me that I was NEVER going to get "compensation" from the U.S. Department of Defense or the Department of Veterans Affairs, but that if I persevered I MIGHT get some validation. One MORE reason for me to sally forth.
Helping to change the Law that governs the actions of the VA-DoD regarding Project 112/SHAD is a small portion of that. I'll NEVER "untake" that oath.
They just never planned ahead realizing that some would continue to fight until they die as they had sworn an oath to do
"I, (NAME), do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the orders of the President of the United States and the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice. So help me God."
~~~~~~~~~~~~~
"support and defend the Constitution of the United States against all enemies, foreign ***AND DOMESTIC***"
I took that very seriously then as I do now.
I think my actions underscore my intent.
They attacked us by stealth as if WE were the Enemy.
Now, they get to feel OUR wrath.
Some think it's "anger" that drives me forward. I'm DONE getting angry. I'm getting EVEN.
A dear man who helped save my life and prevented me from going homeless in 2002 when the physicality of my situation drove me down told me that I was NEVER going to get "compensation" from the U.S. Department of Defense or the Department of Veterans Affairs, but that if I persevered I MIGHT get some validation. One MORE reason for me to sally forth.
Helping to change the Law that governs the actions of the VA-DoD regarding Project 112/SHAD is a small portion of that. I'll NEVER "untake" that oath.
The Shadowy Group, bringing
you the.... BEST... In
BEAVER PRODUCTS
For over 200 Years...!!!
~~~~~
Our Motto: We DO give a dam!!!
Opinions posted on Free Dominion are those of the individual posters and are not necessarily the opinion of Free Dominion or its operators. Free Dominion does not advocate violence, hate speech or an overthrow of the government.
you the.... BEST... In
BEAVER PRODUCTS
For over 200 Years...!!!
~~~~~
Our Motto: We DO give a dam!!!
Opinions posted on Free Dominion are those of the individual posters and are not necessarily the opinion of Free Dominion or its operators. Free Dominion does not advocate violence, hate speech or an overthrow of the government.
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 13/ 10 11:28 am
CURRENT VA PROJECT 112/SHAD WEB PAGES:
www.vba.va.gov/VBA/benefits/factsheets/misc/chembio.doc
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
www.publichealth.va.gov/exposures/shad/basics.asp
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
id=1252
www.publichealth.va.gov/exposures/shad/ ... viders.asp
www.publichealth.va.gov/exposures/shad/ ... eating.asp
www.publichealth.va.gov/exposures/shad/ ... public.asp
www.publichealth.va.gov/exposures/shad/research.asp
www.publichealth.va.gov/exposures/shad/resources.asp
www.publichealth.va.gov/exposures/shad/ ... nefits.asp
www.vba.va.gov/VBA/benefits/factsheets/misc/chembio.doc
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
www.publichealth.va.gov/exposures/shad/basics.asp
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
id=1252
www.publichealth.va.gov/exposures/shad/ ... viders.asp
www.publichealth.va.gov/exposures/shad/ ... eating.asp
www.publichealth.va.gov/exposures/shad/ ... public.asp
www.publichealth.va.gov/exposures/shad/research.asp
www.publichealth.va.gov/exposures/shad/resources.asp
www.publichealth.va.gov/exposures/shad/ ... nefits.asp
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 13/ 10 1:43 pm
J.B. Stone wrote:J.B. Stone wrote:CURRENT VA PROJECT 112/SHAD WEB PAGES:
www.vba.va.gov/VBA/benefits/factsheets/misc/chembio.doc
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
www.publichealth.va.gov/exposures/shad/basics.asp
https://iris.va.gov/scripts/iris.cfg/ph ... .php?p_faq
id=1252
www.publichealth.va.gov/exposures/shad/ ... viders.asp
www.publichealth.va.gov/exposures/shad/ ... eating.asp
www.publichealth.va.gov/exposures/shad/ ... public.asp
www.publichealth.va.gov/exposures/shad/research.asp
www.publichealth.va.gov/exposures/shad/resources.asp
www.publichealth.va.gov/exposures/shad/ ... nefits.asp
My MISTAKE, there are TEN PAGES of links:
http://www.index.va.gov/search/va/va_se ... btn=Search
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 15/ 10 12:56 pm
Here's some interesting footage I just fortuitously found:
http://www.youtube.com/watch?v=JBfjU3_XOaA
The USS Granville S. Hall, YAG-40, that I served on was within several miles of the blast zone on various occasions during the tests. The ship had a special "crow's nest" on the forward mast, designed to catch radioactive fallout. I can find NO record of the interior of the ship EVER being decontaminated, either during the 50's [nuke period] OR in the 60-70's [Bio-Chem period]. No joke, we used to set off alarms whenever we'd enter or leave the ship channel in Pearl Harbor due to the radioactive nature of the hull.
http://www.youtube.com/watch?v=JBfjU3_XOaA
The USS Granville S. Hall, YAG-40, that I served on was within several miles of the blast zone on various occasions during the tests. The ship had a special "crow's nest" on the forward mast, designed to catch radioactive fallout. I can find NO record of the interior of the ship EVER being decontaminated, either during the 50's [nuke period] OR in the 60-70's [Bio-Chem period]. No joke, we used to set off alarms whenever we'd enter or leave the ship channel in Pearl Harbor due to the radioactive nature of the hull.
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 15/ 10 3:20 pm
Here We Go.....AGAIN:
Blue Water Veterans Denied Coverage for Agent Orange Exposure
http://www.kitv.com/video/25793471/detail.html
Blue Water Veterans Denied Coverage for Agent Orange Exposure
http://www.kitv.com/video/25793471/detail.html
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 19/ 10 7:27 pm
ANYONE WHO THINKS THERE HAS BEEN A LULL IN BIO-CHEM DEVELOPMENT ACTIVITY IS A FOOL.....
New Study Questions Safety of Proposed Biodefense Laboratory
Tuesday, Nov. 16, 2010
By Martin Matishak
Global Security Newswire
This November 16 article should have stated that a calculation that there is a nearly 70 percent chance a pathogen could escape the planned Bio and Agro-Defense Facility in Kansas was made by a National Research Council panel based on data from a U.S. Homeland Security Department risk assessment. The NRC panel also estimated economic losses of between $9 billion and $50 billion from a postulated foot-and-mouth disease outbreak.
WASHINGTON -- An expert panel said yesterday the U.S. Homeland Security Department has not adequately gauged the potential risks associated with a proposed multimillion-dollar infectious-disease research laboratory in Kansas (see GSN, May 20 ).
(Nov. 16) - A rendering of the U.S. National Bio and Agro-Defense Facility planned for Manhattan, Kansas. In a report issued yesterday, the National Research Council said a government safety evaluation for the proposed facility contained "several major shortcomings" (U.S. Homeland Security Department image).
There are "several major shortcomings" in a department risk assessment of its planned National Bio and Agro-Defense Facility near Manhattan, Kansas, according to a report by the National Research Council, an arm of the National Academy of Sciences. The proposed site is roughly 120 miles west of Kansas City.
The facility's construction is expected to cost between $500 million and $700 million. The 520,000-square-foot center, slated to begin construction in 2012, would study highly infectious animal-borne pathogens, some of which could pose a threat to humans. It would replace the Plum Island Disease Center located near Long Island, New York, which was established in 1937.
The new site would also be the world's third Biosafety-Level 4 Pathogen laboratory to work with large animals. The other two such facilities are in Australia and Canada.
The council calculated that based on estimates in the DHS assessment, which wrapped up in June, that there is a nearly 70 percent chance a disease would escape the laboratory during its planned 50-year operational lifespan. The DHS report estimated the economic losses from a postulated foot-and-mouth disease outbreak at $9 billion to $50 billion.
However, yesterday's 146-page NRC analysis states that the actual amount could be "significantly higher" because the department's assessment did not consider the dangers associated with daily upkeep of large animal holding rooms.
The earlier evaluation was also criticized for inadequately accounting for the planned facility's proximity to Kansas State University College of Veterinary Medicine clinics, where large numbers of sick animals are treated, as well as the university's football stadium, which has a capacity over 55,000. The large animal and human populations at those sites would be potentially susceptible to infections with a zoonotic agent, the report states. About 9.5 percent of the entire U.S. cattle inventory is raised within 200 miles of the Manhattan site.
The DHS assessment also did not account for the lack of adequate medical care in the surrounding area to deal with a potential disease outbreak, the analysis states. There is one medical center nearby and it lacks the resources to handle such an event, according to the report.
"Building a facility that is capable of large animal work on a scale greater than other high-containment laboratories presents new and unknown risks that could not be accounted for in the DHS risk assessment because of a lack of data and experience," Ronald Atlas, who chaired the research council committee, said yesterday during a telephone press conference.
"The risk assessment should be viewed as a starting point, and given more time, it could have progressed further. As more information emerges, an updated analysis could be appropriate," said Atlas, co-director of the Center for Health Preparedness at the University of Louisville in Kentucky.
Despite its critique, the newly minted report does not question the basic requirement for such a research center.
"There is a need for a facility like the NBAF to be constructed and operated in the United States," it states.
In July the Government Accountability Office released a report that said the Homeland Security Department had used "inadequate" site information in its NBAF selection process and labeled the decision to place the new facility in a natural disaster-prone state as "scientifically indefensible."
Federal auditors noted that the facility would be located in the heart of "tornado alley," a region of the country prone to tornadoes.
Based on those concerns, Congress instructed the department to complete a site-specific "biosafety and biosecurity risk assessment" of the proposed laboratory before construction funds would be obligated. Lawmakers also directed the National Research Council to conduct an independent evaluation of that study to determine its adequacy and validity.
Atlas stressed that the council evaluated the project's overall safety, not whether its location is appropriate, though the panel did take the location's risk into account during its review.
The committee made no recommendations about whether or how the project should proceed, though individual panelists yesterday offered some suggestions about how the group's concerns could be addressed.
While many of the general conclusions reached by the Homeland Security Department's risk assessment were valid, the evaluation did not fully account for how the site's BSL-3 agriculture laboratory and BSL-4 pathogen laboratory would operate; how pathogens might be released; and which animal populations might be exposed, according to Atlas.
Overall the NRC committee concluded that the government analysis lacked a "comprehensive" mitigation strategy, including an early-release detection system, for addressing major issues related to a pathogen release, he said.
The development of a contingency plan would have to be drawn up to address that concern, James Roth, a committee member and professor at the Iowa State University College of Veterinary Medicine, told reporters.
The research council and Homeland Security agree that local and regional training for rapid responses to potential outbreaks would have to be increased, he added.
DHS spokesman Chris Ortman said the council's 70 percent calculation for a potential disease outbreak "was based on a notional facility and did not account for any of the recommended mitigation measures that DHS has committed to incorporating into the final design."
The department "will not build or operate the NBAF unless it can be done in a safe manner," he added.
Local and federal proponents of the estimated $650 million dollar project were quick to criticize the 12-member panel's findings.
The research council committee ignored standard mitigation techniques and safety redundancies incorporated into all research facilities, Ron Trewyn, vice president of research at Kansas State University, and Tom Thornton, president of the Kansas Bioscience Authority, said yesterday in a statement.
"This troubling approach is not only misleading and without precedent, it exaggerates risk to an extreme, nonsensical level that would call into question the entire American biocontainment research enterprise, including at the Centers for Disease Control and Prevention," Trewyn said.
Meanwhile, the Sunflower State's entire six-member congressional delegation issued a joint statement saying that construction of the facility "must move forward."
The NRC study "is helpful to DHS as it continues in its design phase of the NBAF facility," said the lawmakers, five Republicans and one Democrat. "However, we are concerned that some of the findings do not seem to account for mitigation and safety plans that DHS has already said would be put in place. These efforts should not be discounted."
"We are confident this facility will be the safest research laboratory in the world and its mission is critical in order to protect our nation's food supply," the statement adds.
However, Representative Timothy Bishop (D-N.Y.), whose district includes Plum Island -- home to the Plum Island Animal Disease Center -- voiced concerns about the safety and ultimate cost of the Kansas site.
“The National Research Council report confirms that DHS has not properly accounted for the significant risk that a dangerous animal pathogen could escape from NBAF into the heart of cattle country, with devastating consequences,” Bishop said today in a statement to Global Security Newswire. “DHS also has not properly accounted for the cost of the facility, which is spiraling towards a billion dollars.”
Congress budgeted $32 million last year for work on the facility. The majority of that funding is to go toward design and planning. President Obama's fiscal 2011 budget proposal called for another $40 million for the proposed laboratory.
Atlas yesterday declined to say whether Congress should now release funds intended for the biodefense center, saying lawmakers should reach their own conclusions from the research council's study.
He and other committee members also said their analysis made no judgment on what amount of risk pertaining to the facility would be acceptable.
"We did recognize that there's a risk to not having a facility like this," Roth told reporters. "There's no zero risk. It will never be zero risk for building it and it's also not zero risk for not building it."
New Study Questions Safety of Proposed Biodefense Laboratory
Tuesday, Nov. 16, 2010
By Martin Matishak
Global Security Newswire
This November 16 article should have stated that a calculation that there is a nearly 70 percent chance a pathogen could escape the planned Bio and Agro-Defense Facility in Kansas was made by a National Research Council panel based on data from a U.S. Homeland Security Department risk assessment. The NRC panel also estimated economic losses of between $9 billion and $50 billion from a postulated foot-and-mouth disease outbreak.
WASHINGTON -- An expert panel said yesterday the U.S. Homeland Security Department has not adequately gauged the potential risks associated with a proposed multimillion-dollar infectious-disease research laboratory in Kansas (see GSN, May 20 ).
(Nov. 16) - A rendering of the U.S. National Bio and Agro-Defense Facility planned for Manhattan, Kansas. In a report issued yesterday, the National Research Council said a government safety evaluation for the proposed facility contained "several major shortcomings" (U.S. Homeland Security Department image).
There are "several major shortcomings" in a department risk assessment of its planned National Bio and Agro-Defense Facility near Manhattan, Kansas, according to a report by the National Research Council, an arm of the National Academy of Sciences. The proposed site is roughly 120 miles west of Kansas City.
The facility's construction is expected to cost between $500 million and $700 million. The 520,000-square-foot center, slated to begin construction in 2012, would study highly infectious animal-borne pathogens, some of which could pose a threat to humans. It would replace the Plum Island Disease Center located near Long Island, New York, which was established in 1937.
The new site would also be the world's third Biosafety-Level 4 Pathogen laboratory to work with large animals. The other two such facilities are in Australia and Canada.
The council calculated that based on estimates in the DHS assessment, which wrapped up in June, that there is a nearly 70 percent chance a disease would escape the laboratory during its planned 50-year operational lifespan. The DHS report estimated the economic losses from a postulated foot-and-mouth disease outbreak at $9 billion to $50 billion.
However, yesterday's 146-page NRC analysis states that the actual amount could be "significantly higher" because the department's assessment did not consider the dangers associated with daily upkeep of large animal holding rooms.
The earlier evaluation was also criticized for inadequately accounting for the planned facility's proximity to Kansas State University College of Veterinary Medicine clinics, where large numbers of sick animals are treated, as well as the university's football stadium, which has a capacity over 55,000. The large animal and human populations at those sites would be potentially susceptible to infections with a zoonotic agent, the report states. About 9.5 percent of the entire U.S. cattle inventory is raised within 200 miles of the Manhattan site.
The DHS assessment also did not account for the lack of adequate medical care in the surrounding area to deal with a potential disease outbreak, the analysis states. There is one medical center nearby and it lacks the resources to handle such an event, according to the report.
"Building a facility that is capable of large animal work on a scale greater than other high-containment laboratories presents new and unknown risks that could not be accounted for in the DHS risk assessment because of a lack of data and experience," Ronald Atlas, who chaired the research council committee, said yesterday during a telephone press conference.
"The risk assessment should be viewed as a starting point, and given more time, it could have progressed further. As more information emerges, an updated analysis could be appropriate," said Atlas, co-director of the Center for Health Preparedness at the University of Louisville in Kentucky.
Despite its critique, the newly minted report does not question the basic requirement for such a research center.
"There is a need for a facility like the NBAF to be constructed and operated in the United States," it states.
In July the Government Accountability Office released a report that said the Homeland Security Department had used "inadequate" site information in its NBAF selection process and labeled the decision to place the new facility in a natural disaster-prone state as "scientifically indefensible."
Federal auditors noted that the facility would be located in the heart of "tornado alley," a region of the country prone to tornadoes.
Based on those concerns, Congress instructed the department to complete a site-specific "biosafety and biosecurity risk assessment" of the proposed laboratory before construction funds would be obligated. Lawmakers also directed the National Research Council to conduct an independent evaluation of that study to determine its adequacy and validity.
Atlas stressed that the council evaluated the project's overall safety, not whether its location is appropriate, though the panel did take the location's risk into account during its review.
The committee made no recommendations about whether or how the project should proceed, though individual panelists yesterday offered some suggestions about how the group's concerns could be addressed.
While many of the general conclusions reached by the Homeland Security Department's risk assessment were valid, the evaluation did not fully account for how the site's BSL-3 agriculture laboratory and BSL-4 pathogen laboratory would operate; how pathogens might be released; and which animal populations might be exposed, according to Atlas.
Overall the NRC committee concluded that the government analysis lacked a "comprehensive" mitigation strategy, including an early-release detection system, for addressing major issues related to a pathogen release, he said.
The development of a contingency plan would have to be drawn up to address that concern, James Roth, a committee member and professor at the Iowa State University College of Veterinary Medicine, told reporters.
The research council and Homeland Security agree that local and regional training for rapid responses to potential outbreaks would have to be increased, he added.
DHS spokesman Chris Ortman said the council's 70 percent calculation for a potential disease outbreak "was based on a notional facility and did not account for any of the recommended mitigation measures that DHS has committed to incorporating into the final design."
The department "will not build or operate the NBAF unless it can be done in a safe manner," he added.
Local and federal proponents of the estimated $650 million dollar project were quick to criticize the 12-member panel's findings.
The research council committee ignored standard mitigation techniques and safety redundancies incorporated into all research facilities, Ron Trewyn, vice president of research at Kansas State University, and Tom Thornton, president of the Kansas Bioscience Authority, said yesterday in a statement.
"This troubling approach is not only misleading and without precedent, it exaggerates risk to an extreme, nonsensical level that would call into question the entire American biocontainment research enterprise, including at the Centers for Disease Control and Prevention," Trewyn said.
Meanwhile, the Sunflower State's entire six-member congressional delegation issued a joint statement saying that construction of the facility "must move forward."
The NRC study "is helpful to DHS as it continues in its design phase of the NBAF facility," said the lawmakers, five Republicans and one Democrat. "However, we are concerned that some of the findings do not seem to account for mitigation and safety plans that DHS has already said would be put in place. These efforts should not be discounted."
"We are confident this facility will be the safest research laboratory in the world and its mission is critical in order to protect our nation's food supply," the statement adds.
However, Representative Timothy Bishop (D-N.Y.), whose district includes Plum Island -- home to the Plum Island Animal Disease Center -- voiced concerns about the safety and ultimate cost of the Kansas site.
“The National Research Council report confirms that DHS has not properly accounted for the significant risk that a dangerous animal pathogen could escape from NBAF into the heart of cattle country, with devastating consequences,” Bishop said today in a statement to Global Security Newswire. “DHS also has not properly accounted for the cost of the facility, which is spiraling towards a billion dollars.”
Congress budgeted $32 million last year for work on the facility. The majority of that funding is to go toward design and planning. President Obama's fiscal 2011 budget proposal called for another $40 million for the proposed laboratory.
Atlas yesterday declined to say whether Congress should now release funds intended for the biodefense center, saying lawmakers should reach their own conclusions from the research council's study.
He and other committee members also said their analysis made no judgment on what amount of risk pertaining to the facility would be acceptable.
"We did recognize that there's a risk to not having a facility like this," Roth told reporters. "There's no zero risk. It will never be zero risk for building it and it's also not zero risk for not building it."
-
J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 22/ 10 9:24 am
Project 112/Project SHAD: Basics
http://www.publichealth.va.gov/exposure ... basics.asp
From 1962 to 1974, the Department of Defense's Deseret Test Center in Fort Douglas, Utah planned and conducted a series of biological and chemical warfare vulnerability tests. These tests are known as Project 112 and Project SHAD and consisted of both land-based and sea-based tests at different locations.
Learn about:
* Tests by Land and by Sea
* U.S. Service Member Participation in Tests
Tests by Land and by Sea
Land-based tests were conducted to learn about how chemical and biological agents behave under a variety of environmental and climatic conditions.
Ship-based tests, known as Project SHAD (an acronym for Shipboard Hazard and Defense), were conducted to identify the vulnerability of U.S. warships to chemical and biological attacks and procedures to respond to such attacks.
The Department of Defense (DoD) used a wide range of agents in the tests, including the biological warfare agents Coxiella Burnetii, Francisella tularensis, and Staphylococcal Enterotoxin B, and the nerve agents sarin, VX, tabun and soman.
Go to DoD’s Project 112/SHAD – Shipboard Hazard and Defense Web site* to learn more about the tests and agents used.
back to top
U.S. Service Member Participation in Tests
Approximately 6,000 U.S. service members were involved in conducting chemical tests to defend against biological and chemical weapons threats. Most of these participants served in the Navy and Army, and some served in the Marine Corps and Air Force. Most were involved in Project SHAD. Go to DoD’s Project 112/SHAD – Shipboard Hazard and Defense Web site* to learn more about the tests, including what units or ships were involved.
VA is committed to reaching every living Veteran involved in Project 112/Project SHAD, based on rosters developed with DoD, and informing them of VA services available to them. When DoD provides VA the names of test participants, VA sends letters to these Veterans to inform them about the tests and what to do if they have related health concerns.
If you have not received a letter from VA informing you of your participation in Project 112/Project SHAD and need help verifying your possible participation:
* Call VA at 1-800-749-8387
* Call DoD at 1-800-497-6261
http://www.publichealth.va.gov/exposure ... basics.asp
From 1962 to 1974, the Department of Defense's Deseret Test Center in Fort Douglas, Utah planned and conducted a series of biological and chemical warfare vulnerability tests. These tests are known as Project 112 and Project SHAD and consisted of both land-based and sea-based tests at different locations.
Learn about:
* Tests by Land and by Sea
* U.S. Service Member Participation in Tests
Tests by Land and by Sea
Land-based tests were conducted to learn about how chemical and biological agents behave under a variety of environmental and climatic conditions.
Ship-based tests, known as Project SHAD (an acronym for Shipboard Hazard and Defense), were conducted to identify the vulnerability of U.S. warships to chemical and biological attacks and procedures to respond to such attacks.
The Department of Defense (DoD) used a wide range of agents in the tests, including the biological warfare agents Coxiella Burnetii, Francisella tularensis, and Staphylococcal Enterotoxin B, and the nerve agents sarin, VX, tabun and soman.
Go to DoD’s Project 112/SHAD – Shipboard Hazard and Defense Web site* to learn more about the tests and agents used.
back to top
U.S. Service Member Participation in Tests
Approximately 6,000 U.S. service members were involved in conducting chemical tests to defend against biological and chemical weapons threats. Most of these participants served in the Navy and Army, and some served in the Marine Corps and Air Force. Most were involved in Project SHAD. Go to DoD’s Project 112/SHAD – Shipboard Hazard and Defense Web site* to learn more about the tests, including what units or ships were involved.
VA is committed to reaching every living Veteran involved in Project 112/Project SHAD, based on rosters developed with DoD, and informing them of VA services available to them. When DoD provides VA the names of test participants, VA sends letters to these Veterans to inform them about the tests and what to do if they have related health concerns.
If you have not received a letter from VA informing you of your participation in Project 112/Project SHAD and need help verifying your possible participation:
* Call VA at 1-800-749-8387
* Call DoD at 1-800-497-6261
-
J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 23/ 10 10:56 am
DETAILS, DETAILS......
Army tested 17 pounds of Agent Orange chemical on sections of Fort Detrick
http://www.fredericknewspost.com/sectio ... yID=112587
Originally published November 18, 2010
By Megan Eckstein
News-Post Staff
The Army sprayed about 17 pounds of a main Agent Orange ingredient on sections of Fort Detrick between 1944 and 1968, an official announced at a meeting Wednesday night.
Randal Curtis, program manager for the St. Louis district of the Army Corps of Engineers, presented the preliminary Archives Search Report to the Fort Detrick Restoration Advisory Board. The findings were based on technical reports, standard operating procedures, lab notes, maps and photos uncovered in archive and records locations around the country. Curtis' office was tasked with sifting through these documents for any information on 2,4,5-T, one of two main ingredients in Agent Orange.
According to the preliminary report, Fort Detrick was the headquarters of the Chemical Warfare Service's special projects division during and after World War II, making it a hub for offensive and defensive biological research and development. 2,4,5-T was tested at Fort Detrick in three main time periods: 1944-1951, 1953 and 1961-1963.
In the earliest time period, 2,4,5-T was tested in a 62,500-square-foot patch on the main Army installation, now known as Area A. That plot was divided into small sections, about 6 by 18 feet, where different crops were grown. Researchers would use hand-held sprayers and movable barriers to spray different sections with different quantities and combinations of 2,4,5-T and other chemicals. The effectiveness of the plant growth inhibitor was measured in the final crop production, Curtis said -- the goal at first was not to kill the plants, it was to keep the plants from maturing and producing edible crops.
In 1953, the Army began using a truck-mounted sprayer that drove through a sweet potato and soybean field in what is now called Area B and sprayed the plants with 2,4,5-T.
The presentation did not include as much information about all the tests done in the 1960s, but one archived record showed that two 20-by-20-foot test plots of grass and weeds were sprayed with Agent Orange.
Curtis stressed that these findings were based only on what his team found as of the end of October. He said he wanted to continue looking for more details on the Army's use of 2,4,5-T at Fort Detrick, as well as any other contaminants the Army and U.S. Environmental Protection Agency might want to test for in the area.
Lt. Col. James St. Angelo III, director of safety and environment for the Fort Detrick Army Garrison and co-chairman of the RAB, said that although the final report was slated to be finished by the spring, it made little sense to set an arbitrary end date and risk missing out on important information. He would rather monitor how quickly information flows in and end the research based on diminishing returns.
Most of the testing, old maps show, occurred on what was then the northern part of Area A -- somewhere between the Rosemont Gate and the Old Farm Gate along Rosemont Avenue. Fort Detrick has since expanded, and on-post housing extends farther north of where the testing appears to have taken place.
And some of the testing took place at the northern edge of Area B, Curtis' Power Point presentation showed, in the vicinity of Rocky Springs Road. But what appears the most problematic, according to Curtis and Barbara Vichot, and environmental scientist with the Army Public Health Command, is an area on the south side of Area B, along Shookstown Road and just north of Lake Coventry Drive.
Because that area was exposed to "tactical grade" herbicides in 1953, Vichot said, the Army is launching an investigation into the dioxin levels of the soil nearby. It will take 35 soil samples from that area and eight sediment samples from the nearby creek to test against the EPA-allowed dioxin levels. The Army will also take 30 soil samples from land far enough north of Fort Detrick to have not been affected by any Agent Orange testing, and those samples should show the background levels of dioxin, which may occur naturally or may be from all the herbicides used by farmers -- many of which contain the other main ingredient in Agent Orange, 2,4-D.
The information from this investigation will be added to the archival search and the public interviews to determine if any other areas of Fort Detrick need an environmental cleanup.
Joe Gortva, Fort Detrick's restoration project manager, stressed the importance of the public interviews because not all records exist and someone in the community or a former employee might remember a pivotal detail that could help put some pieces of the puzzle together. The research is not easy because many needed records are still classified, are spread out throughout the country and are highly technical.
"It's not going to be fast," Curtis warned, "but we really want to make it good."
Army tested 17 pounds of Agent Orange chemical on sections of Fort Detrick
http://www.fredericknewspost.com/sectio ... yID=112587
Originally published November 18, 2010
By Megan Eckstein
News-Post Staff
The Army sprayed about 17 pounds of a main Agent Orange ingredient on sections of Fort Detrick between 1944 and 1968, an official announced at a meeting Wednesday night.
Randal Curtis, program manager for the St. Louis district of the Army Corps of Engineers, presented the preliminary Archives Search Report to the Fort Detrick Restoration Advisory Board. The findings were based on technical reports, standard operating procedures, lab notes, maps and photos uncovered in archive and records locations around the country. Curtis' office was tasked with sifting through these documents for any information on 2,4,5-T, one of two main ingredients in Agent Orange.
According to the preliminary report, Fort Detrick was the headquarters of the Chemical Warfare Service's special projects division during and after World War II, making it a hub for offensive and defensive biological research and development. 2,4,5-T was tested at Fort Detrick in three main time periods: 1944-1951, 1953 and 1961-1963.
In the earliest time period, 2,4,5-T was tested in a 62,500-square-foot patch on the main Army installation, now known as Area A. That plot was divided into small sections, about 6 by 18 feet, where different crops were grown. Researchers would use hand-held sprayers and movable barriers to spray different sections with different quantities and combinations of 2,4,5-T and other chemicals. The effectiveness of the plant growth inhibitor was measured in the final crop production, Curtis said -- the goal at first was not to kill the plants, it was to keep the plants from maturing and producing edible crops.
In 1953, the Army began using a truck-mounted sprayer that drove through a sweet potato and soybean field in what is now called Area B and sprayed the plants with 2,4,5-T.
The presentation did not include as much information about all the tests done in the 1960s, but one archived record showed that two 20-by-20-foot test plots of grass and weeds were sprayed with Agent Orange.
Curtis stressed that these findings were based only on what his team found as of the end of October. He said he wanted to continue looking for more details on the Army's use of 2,4,5-T at Fort Detrick, as well as any other contaminants the Army and U.S. Environmental Protection Agency might want to test for in the area.
Lt. Col. James St. Angelo III, director of safety and environment for the Fort Detrick Army Garrison and co-chairman of the RAB, said that although the final report was slated to be finished by the spring, it made little sense to set an arbitrary end date and risk missing out on important information. He would rather monitor how quickly information flows in and end the research based on diminishing returns.
Most of the testing, old maps show, occurred on what was then the northern part of Area A -- somewhere between the Rosemont Gate and the Old Farm Gate along Rosemont Avenue. Fort Detrick has since expanded, and on-post housing extends farther north of where the testing appears to have taken place.
And some of the testing took place at the northern edge of Area B, Curtis' Power Point presentation showed, in the vicinity of Rocky Springs Road. But what appears the most problematic, according to Curtis and Barbara Vichot, and environmental scientist with the Army Public Health Command, is an area on the south side of Area B, along Shookstown Road and just north of Lake Coventry Drive.
Because that area was exposed to "tactical grade" herbicides in 1953, Vichot said, the Army is launching an investigation into the dioxin levels of the soil nearby. It will take 35 soil samples from that area and eight sediment samples from the nearby creek to test against the EPA-allowed dioxin levels. The Army will also take 30 soil samples from land far enough north of Fort Detrick to have not been affected by any Agent Orange testing, and those samples should show the background levels of dioxin, which may occur naturally or may be from all the herbicides used by farmers -- many of which contain the other main ingredient in Agent Orange, 2,4-D.
The information from this investigation will be added to the archival search and the public interviews to determine if any other areas of Fort Detrick need an environmental cleanup.
Joe Gortva, Fort Detrick's restoration project manager, stressed the importance of the public interviews because not all records exist and someone in the community or a former employee might remember a pivotal detail that could help put some pieces of the puzzle together. The research is not easy because many needed records are still classified, are spread out throughout the country and are highly technical.
"It's not going to be fast," Curtis warned, "but we really want to make it good."
Officials: No health risk from Agent Orange testing
November 19, 2010 - 11:07am
In response to public concerns regarding a Wednesday night Army admission that 17 pounds of Agent Orange was tested at Fort Detrick between 1944 and 1968, Fort Detrick officials want to reassure the public they are not a health risk.
The U.S. Army Corps of Engineers has been sifting through archival records to determine how much Agent Orange was tested, when and where. As of the end of October, researchers' findings indicated that about 17 pounds of the Agent Orange and its main ingredient, 2,4,5-T, was used during three primary events on Area B and the main post.
But Fort Detrick spokesman Chuck Gordon wrote in a statement Thursday that "USDA reports from 1964 indicate that more than 1.6 million pounds of 2,4,5-T were used by farmers/ranchers in the continental United States, (and) often sprayed the compound at rates of up to 3 pounds per acre. During that same period the average farmer used nearly 50 (pounds) per year compared to Fort Detrick's scientific usage of only about 17 (pounds) during the entire 30-year period -- including indoor laboratory testing."
Army officials vowed at the Wednesday meeting that if, throughout their continued research, they came across any information suggesting an ongoing public health risk, they would alert residents immediately instead of waiting to include that information in a final report.
All the information found during the archival search will be combined with information from interviews with former employees and nearby residents.
-- Megan Eckstein
Copyright 2010 The Frederick News-Post. All rights reserved.
by From Staff Reports @ The Frederick News-Post
In response to public concerns regarding a Wednesday night Army admission that 17 pounds of Agent Orange was tested at Fort Detrick between 1944 and 1968, Fort Detrick officials want to reassure the public they are not a health risk.
The U.S. Army Corps of Engineers has been sifting through archival records to determine how much Agent Orange was tested, when and where. As of the end of October, researchers' findings indicated that about 17 pounds of the Agent Orange and its main ingredient, 2,4,5-T, was used during three primary events on Area B and the main post.
But Fort Detrick spokesman Chuck Gordon wrote in a statement Thursday that "USDA reports from 1964 indicate that more than 1.6 million pounds of 2,4,5-T were used by farmers/ranchers in the continental United States, (and) often sprayed the compound at rates of up to 3 pounds per acre. During that same period the average farmer used nearly 50 (pounds) per year compared to Fort Detrick's scientific usage of only about 17 (pounds) during the entire 30-year period -- including indoor laboratory testing."
Army officials vowed at the Wednesday meeting that if, throughout their continued research, they came across any information suggesting an ongoing public health risk, they would alert residents immediately instead of waiting to include that information in a final report.
All the information found during the archival search will be combined with information from interviews with former employees and nearby residents.
-- Megan Eckstein
-
J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 24/ 10 6:51 pm
WE'LL NEVER KNOW THE FULL TRUTH....
Special Assignment: Agent Orange at Fort Gordon, Part 1
http://www.wrdw.com/health/headlines/Sp ... 38429.html
Agent Orange is well known for turning jungles from green to brown and making a generation of our soldiers sick. But not only were they using it over there, they were testing it here.
Posted: 6:54 PM Nov 18, 2010
Reporter: Richard Rogers
Email Address: richard.rogers@wrdw.com
Click to play video
Fort Gordon Defoliant Testing Area Sample Summary and Map:
http://media.graytvinc.com/documents/Fo ... nd+Map.pdf
The History of the US Department of Defense Programs for the Testing Evaluation and Storage of Tactical Herbicides - December 2006
http://media.graytvinc.com/documents/Th ... r+2006.pdf
Fort Gordon statement on Agent Orange testing, 19 Nov 10
http://media.graytvinc.com/documents/St ... Nov+10.pdf
AUGUSTA---
It's come to symbolize everything that went wrong in Vietnam. Agent Orange is well known for turning jungles from green to brown. And for making a generation of our soldiers sick. But here's something you might not know about Agent Orange. Not only were they using it over there, they were testing it here.
The United States had a problem in Vietnam. Soldiers were fighting an enemy they couldn't see. An enemy taking cover in the dark jungles there. The solution was a toxic chemical so strong it could turn jungle into a wasteland.
Patrick Burke is an Army veteran. He was there.
"We walked through areas throughout Vietnam that were completely destroyed, burnt," Burke told News 12. "They sprayed the area and we were looking for the enemy."
Starting in early 1962, the U.S. sprayed 20 million gallons of the herbicide over millions of acres. Army veteran Lou Krieger saw it too.
"It's barren, it's just nothing there. It just kills everything that's there. It's total kill," Krieger said.
Krieger and Burke saw it for themselves. Now their mission is to spread the word about dioxin, one of the most dangerous chemicals there is. It's the stuff in Agent Orange.
"Agent Orange is a tactical herbicide," Krieger said. "it's not your Round Up, it's not commercial. It's so far above that. It's so powerful."
But Krieger isn't just talking about Vietnam. He's also talking about Augusta. I sat down with Krieger to look at a map of Fort Gordon.
"So aside from testing Agent Orange in this area, soldiers were actually swimming here for recreation?" I asked.
"Yeah, soldiers from the special forces, they would often train--they talk about going through water sheds down here, like going through the rice paddies with full packs on. Training like that," Kreiger explained.
While the military was burning the jungles of Vietnam with dioxin, they were testing the toxic chemicals here in the Unites States. Here, at Fort Gordon. It was the summer of 1967. Krieger would spend a few months training here before heading overseas.
"Why do you think they were testing Agent Orange here?" I asked.
"The climate, the topography fairly represented what we had over in Vietnam," Krieger said.
The Department of Defense calls Agent Orange and similar chemicals "tactical herbicides". News 12 found paperwork proving they were tested here. In Alvin L. Young, Ph.D.'s 2006 report "The History of the US Department of Defense Programs for the Testing, Evaluation, and Storage of Tactical Herbicides", Fort Gordon is listed under "Site 21", along with two other locations.
The report states tactical herbicides were sprayed on duplicate 3 acre plots, 200 by 600 feet, using a helicopter rigged with two 40 gallon tanks. The document shows they sprayed about 475 gallons of herbicides Blue, Orange and White. A toxic rainbow, marked by a color-coded band around the middle of the drums.
"Personally, I wouldn't want to go anywhere back in there," Krieger said. "I rode back there in my truck, and that's the last I'll ever go back there."
It all took place in a remote part of the sprawling Army post, near a place known then as Camp Crockett. Long forgotten Quonset Huts are all gone now. Cement slabs are all that's left. A pine forest has grown up around it.
"The reforestation program, it says here, was instituted in 1970, so they tried to close that up real quick," Krieger said.
Krieger took lots of pictures when he went back in October. He wanted to see it again for himself.
"There was a couple of people fishing. I wouldn't eat any fish out of there," he said.
So why Fort Gordon? We may have more in common with Southeast Asia than you think. Young's report states, "the Georgia site was described as a warm temperate, humid, moderate rainfall climate with deep, well-drained sands in rolling topography. The vegetation type was an oak hickory-pine forest." And veterans who were at Fort Gordon in 1967 say there was even a Vietnamese Village there too.
If the documents aren't proof enough, meet James Cripps.
"Personally speaking, I sprayed a herbicide that I believe to be Agent Orange," Cripps told News 12.
Cripps was a game warden. He says he remembers spraying Agent Orange around some of the lakes at Fort Gordon.
"Along the sides of the roads, along the trails the fishermen used, to the restrooms, picnic areas," Cripps recalled.
Cripps lives in Tennessee now. He also lives with the health effects of his exposure.
"It's the deadliest poison known to man," he said.
Cripps' medical history made history. He's the first person to prove to the government that he was exposed to Agent Orange not in Vietnam, but in America. In Augusta.
"I won the first ever Agent Orange claim in the continental United States," he said.
That brings us back to Lou Krieger. He doesn't believe he was exposed to Agent Orange here. But he wants to make sure you hear the story...and he wants something else too.
"I'd like to get an apology," he said. "I'd like the truth to come out. We deal with it every day, I mean I've got a VA file that's probably a foot thick."
That's Krieger's mission now: to spread the word about Agent Orange and to make sure veterans get the coverage they need.
As for Fort Gordon, News 12 requested documents related to Agent Orange testing here through the Freedom of Information Act. They sent us the map showing where the chemical was tested. They confirm they tested Agent Orange and Blue here in July 1967. And they conclude there are no known problems associated with it.
Special Assignment: Agent Orange at Fort Gordon, Part 1
http://www.wrdw.com/health/headlines/Sp ... 38429.html
Agent Orange is well known for turning jungles from green to brown and making a generation of our soldiers sick. But not only were they using it over there, they were testing it here.
Posted: 6:54 PM Nov 18, 2010
Reporter: Richard Rogers
Email Address: richard.rogers@wrdw.com
Click to play video
Fort Gordon Defoliant Testing Area Sample Summary and Map:
http://media.graytvinc.com/documents/Fo ... nd+Map.pdf
The History of the US Department of Defense Programs for the Testing Evaluation and Storage of Tactical Herbicides - December 2006
http://media.graytvinc.com/documents/Th ... r+2006.pdf
Fort Gordon statement on Agent Orange testing, 19 Nov 10
http://media.graytvinc.com/documents/St ... Nov+10.pdf
AUGUSTA---
It's come to symbolize everything that went wrong in Vietnam. Agent Orange is well known for turning jungles from green to brown. And for making a generation of our soldiers sick. But here's something you might not know about Agent Orange. Not only were they using it over there, they were testing it here.
The United States had a problem in Vietnam. Soldiers were fighting an enemy they couldn't see. An enemy taking cover in the dark jungles there. The solution was a toxic chemical so strong it could turn jungle into a wasteland.
Patrick Burke is an Army veteran. He was there.
"We walked through areas throughout Vietnam that were completely destroyed, burnt," Burke told News 12. "They sprayed the area and we were looking for the enemy."
Starting in early 1962, the U.S. sprayed 20 million gallons of the herbicide over millions of acres. Army veteran Lou Krieger saw it too.
"It's barren, it's just nothing there. It just kills everything that's there. It's total kill," Krieger said.
Krieger and Burke saw it for themselves. Now their mission is to spread the word about dioxin, one of the most dangerous chemicals there is. It's the stuff in Agent Orange.
"Agent Orange is a tactical herbicide," Krieger said. "it's not your Round Up, it's not commercial. It's so far above that. It's so powerful."
But Krieger isn't just talking about Vietnam. He's also talking about Augusta. I sat down with Krieger to look at a map of Fort Gordon.
"So aside from testing Agent Orange in this area, soldiers were actually swimming here for recreation?" I asked.
"Yeah, soldiers from the special forces, they would often train--they talk about going through water sheds down here, like going through the rice paddies with full packs on. Training like that," Kreiger explained.
While the military was burning the jungles of Vietnam with dioxin, they were testing the toxic chemicals here in the Unites States. Here, at Fort Gordon. It was the summer of 1967. Krieger would spend a few months training here before heading overseas.
"Why do you think they were testing Agent Orange here?" I asked.
"The climate, the topography fairly represented what we had over in Vietnam," Krieger said.
The Department of Defense calls Agent Orange and similar chemicals "tactical herbicides". News 12 found paperwork proving they were tested here. In Alvin L. Young, Ph.D.'s 2006 report "The History of the US Department of Defense Programs for the Testing, Evaluation, and Storage of Tactical Herbicides", Fort Gordon is listed under "Site 21", along with two other locations.
The report states tactical herbicides were sprayed on duplicate 3 acre plots, 200 by 600 feet, using a helicopter rigged with two 40 gallon tanks. The document shows they sprayed about 475 gallons of herbicides Blue, Orange and White. A toxic rainbow, marked by a color-coded band around the middle of the drums.
"Personally, I wouldn't want to go anywhere back in there," Krieger said. "I rode back there in my truck, and that's the last I'll ever go back there."
It all took place in a remote part of the sprawling Army post, near a place known then as Camp Crockett. Long forgotten Quonset Huts are all gone now. Cement slabs are all that's left. A pine forest has grown up around it.
"The reforestation program, it says here, was instituted in 1970, so they tried to close that up real quick," Krieger said.
Krieger took lots of pictures when he went back in October. He wanted to see it again for himself.
"There was a couple of people fishing. I wouldn't eat any fish out of there," he said.
So why Fort Gordon? We may have more in common with Southeast Asia than you think. Young's report states, "the Georgia site was described as a warm temperate, humid, moderate rainfall climate with deep, well-drained sands in rolling topography. The vegetation type was an oak hickory-pine forest." And veterans who were at Fort Gordon in 1967 say there was even a Vietnamese Village there too.
If the documents aren't proof enough, meet James Cripps.
"Personally speaking, I sprayed a herbicide that I believe to be Agent Orange," Cripps told News 12.
Cripps was a game warden. He says he remembers spraying Agent Orange around some of the lakes at Fort Gordon.
"Along the sides of the roads, along the trails the fishermen used, to the restrooms, picnic areas," Cripps recalled.
Cripps lives in Tennessee now. He also lives with the health effects of his exposure.
"It's the deadliest poison known to man," he said.
Cripps' medical history made history. He's the first person to prove to the government that he was exposed to Agent Orange not in Vietnam, but in America. In Augusta.
"I won the first ever Agent Orange claim in the continental United States," he said.
That brings us back to Lou Krieger. He doesn't believe he was exposed to Agent Orange here. But he wants to make sure you hear the story...and he wants something else too.
"I'd like to get an apology," he said. "I'd like the truth to come out. We deal with it every day, I mean I've got a VA file that's probably a foot thick."
That's Krieger's mission now: to spread the word about Agent Orange and to make sure veterans get the coverage they need.
As for Fort Gordon, News 12 requested documents related to Agent Orange testing here through the Freedom of Information Act. They sent us the map showing where the chemical was tested. They confirm they tested Agent Orange and Blue here in July 1967. And they conclude there are no known problems associated with it.
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 11/ 26/ 10 1:05 pm
THIS IS NOT A GOOD SIGN......
Civilian soldiers' suicide rate alarming
By Gregg Zoroya, USA TODAY
National Guard soldiers who are not on active duty killed themselves this year at nearly twice the rate of 2009, marring a year when suicides among Army soldiers on active duty appear to be leveling off, new Army statistics show.
Eighty-six non-active-duty Guard soldiers have killed themselves in the first 10 months of 2010, compared with 48 such suicides in all of 2009.
The reason for the rise in suicides among these "citizen soldiers" is not known. It may be linked to the recession, says Army Col. Chris Philbrick, deputy commander of an Army task force working to reduce suicides.
Philbrick said investigations into the suicides of soldiers not on full-time-active status have found that some were facing stressful situations such as home foreclosures, debt and the loss of a job.
Other factors have played a role in the suicides, including relationship problems, depression, substance abuse, combat stress and mild brain injuries, Philbrick says.
The rise comes as the rate of suicides leveled among full-time active-duty Army soldiers, National Guard members and reservists following years of increases, Philbrick says. Among that group, there were 132 confirmed or suspected suicides in the first 10 months of this year compared with 140 such suicides for the same period in 2009.
That positive trend among active-duty troops was more than offset by the rise in suicides among non-active-duty National Guard members.
There were 252 confirmed or suspected suicides among active and non-active Army members through October of this year. There were 242 such deaths in all of 2009.
Active-duty soldiers have greater access to programs and mental health resources, Philbrick says. New efforts aimed at reducing suicides among that group may be beginning to have an effect. "We do whatever we can to drive down these numbers," Philbrick says. "But it doesn't happen overnight."
The Army has launched a series of programs aimed at breaking down a stigma among soldiers against seeking mental health treatment. It has also initiated two studies — a $50 million, five-year investigation by the National Institute of Mental Health in 2009 and this year, a $17 million research consortium — aimed at understanding why the suicides are happening and how to stop them.
Army suicides have been climbing since 2007, bringing the rate to 22 per 100,000 soldiers. The rate among civilians within the same age group is 20 per 100,000. The Marine Corps has seen an increase since 2008 and its rate is 24 per 100,000. But there, too, the trend may be downward.
There were 45 confirmed or suspected cases of suicides among Marines through October of this year compared with 53 suicides for the same period last year, Marine Corps statistics show.
http://www.usatoday.com/news/military/2 ... 6_ST_N.htm
Civilian soldiers' suicide rate alarming
By Gregg Zoroya, USA TODAY
National Guard soldiers who are not on active duty killed themselves this year at nearly twice the rate of 2009, marring a year when suicides among Army soldiers on active duty appear to be leveling off, new Army statistics show.
Eighty-six non-active-duty Guard soldiers have killed themselves in the first 10 months of 2010, compared with 48 such suicides in all of 2009.
The reason for the rise in suicides among these "citizen soldiers" is not known. It may be linked to the recession, says Army Col. Chris Philbrick, deputy commander of an Army task force working to reduce suicides.
Philbrick said investigations into the suicides of soldiers not on full-time-active status have found that some were facing stressful situations such as home foreclosures, debt and the loss of a job.
Other factors have played a role in the suicides, including relationship problems, depression, substance abuse, combat stress and mild brain injuries, Philbrick says.
The rise comes as the rate of suicides leveled among full-time active-duty Army soldiers, National Guard members and reservists following years of increases, Philbrick says. Among that group, there were 132 confirmed or suspected suicides in the first 10 months of this year compared with 140 such suicides for the same period in 2009.
That positive trend among active-duty troops was more than offset by the rise in suicides among non-active-duty National Guard members.
There were 252 confirmed or suspected suicides among active and non-active Army members through October of this year. There were 242 such deaths in all of 2009.
Active-duty soldiers have greater access to programs and mental health resources, Philbrick says. New efforts aimed at reducing suicides among that group may be beginning to have an effect. "We do whatever we can to drive down these numbers," Philbrick says. "But it doesn't happen overnight."
The Army has launched a series of programs aimed at breaking down a stigma among soldiers against seeking mental health treatment. It has also initiated two studies — a $50 million, five-year investigation by the National Institute of Mental Health in 2009 and this year, a $17 million research consortium — aimed at understanding why the suicides are happening and how to stop them.
Army suicides have been climbing since 2007, bringing the rate to 22 per 100,000 soldiers. The rate among civilians within the same age group is 20 per 100,000. The Marine Corps has seen an increase since 2008 and its rate is 24 per 100,000. But there, too, the trend may be downward.
There were 45 confirmed or suspected cases of suicides among Marines through October of this year compared with 53 suicides for the same period last year, Marine Corps statistics show.
http://www.usatoday.com/news/military/2 ... 6_ST_N.htm
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J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 12/ 01/ 10 2:06 pm
THE NEW WRINKLES JUST KEEP COMING....
Posted at 3:22 PM ET, 11/24/2010
CIA brain experiments pursued in veterans’ suit
By Jeff Stein
http://voices.washingtonpost.com/spy-ta ... rsued.html
The CIA is notorious for its Cold War-era experiments with LSD and other chemicals on unwitting citizens and soldiers. Details have emerged in books and articles beginning more than 30 years ago.
But if military veterans have their way in a California law suit, the spy agency’s quest to turn humans into robot-like assassins via electrodes planted in their brains will get far more exposure than the drugs the CIA tested on subjects ranging from soldiers to unwitting bar patrons and the clients of prostitutes.
It’s not just science fiction -- or the imaginings of the mentally ill.
In 1961, a top CIA scientist reported in an internal memo that "the feasibility of remote control of activities in several species of animals has been demonstrated…Special investigations and evaluations will be conducted toward the application of selected elements of these techniques to man," according to “The CIA and the Search for the Manchurian Candidate,” a 1979 book by former State Department intelligence officer John Marks.
“[T]his cold-blooded project,” Marks wrote, “was designed … for the delivery of chemical and biological agents or for ‘executive action-type operations,’ according to a document. ‘Executive action’ was the CIA's euphemism for assassination.”
The CIA pursued such experiments because it was convinced the Soviets were doing the same.
Victims have sought justice for years, in vain. Now, almost 40 years later, a federal magistrate has ordered the CIA to produce records and witnesses about the LSD and other experiments “allegedly conducted on thousands of soldiers from 1950 through 1975,” according to news accounts.
U.S. Magistrate Judge John Larsen’s Nov. 17 order exempted the agency from having to testify about electrode tests on humans, but Gordon P. Erspamer, lead attorney for the veterans, says “we are pursuing this as well.”
“There is no question that these experiments were done,” Erspamer said by e-mail Tuesday, “but defendants say that they used private researchers and test subjects drawn from prisons, hospitals and nursing homes as subjects, not active duty military [personnel]. CIA said it had no one knowledgeable on this topic.”
Erspamer, senior counsel in the San Francisco office of Morrison & Foerster, said “several” CIA witnesses “are…still alive,” naming some that have been publicly identified, but opting to keep secret others before he calls them.
Papers filed in the case describe “electrical devices implanted in brain tissue with electrodes in various regions, including the hippocampus, the hypothalamus, the frontal lobe (via the septum), the cortex and various other places,” Erspamer said, drawing on [research papers] (http://media.washingtonpost.com/wp-srv/ ... cument.pdf) written by government scientists.
“We believe that one of our plaintiffs was given a septal implant at [Edgewood Arsenal] (www.edgewoodtestvets.org),” he said, based on an MRI he has “showing a ‘foreign body’ on the border between the septum and the frontal lobe.”
“A lot of this work was done out of Tulane University using a local state hospital and funding from a cut-out (front) organization called the Commonwealth Fund,” he continued, again drawing on the research papers.
“We tried to get docs from Tulane, but they told us that they were destroyed in the hurricane flooding.”
The CIA claims that at least some of the documents should remain classified as “state secrets.” But Magistrate Larson told the agency to come back with a better rationale, a "supplemental declaration explaining with heightened specificity" why the documents should be protected after all these years.
Posted at 3:22 PM ET, 11/24/2010
CIA brain experiments pursued in veterans’ suit
By Jeff Stein
http://voices.washingtonpost.com/spy-ta ... rsued.html
The CIA is notorious for its Cold War-era experiments with LSD and other chemicals on unwitting citizens and soldiers. Details have emerged in books and articles beginning more than 30 years ago.
But if military veterans have their way in a California law suit, the spy agency’s quest to turn humans into robot-like assassins via electrodes planted in their brains will get far more exposure than the drugs the CIA tested on subjects ranging from soldiers to unwitting bar patrons and the clients of prostitutes.
It’s not just science fiction -- or the imaginings of the mentally ill.
In 1961, a top CIA scientist reported in an internal memo that "the feasibility of remote control of activities in several species of animals has been demonstrated…Special investigations and evaluations will be conducted toward the application of selected elements of these techniques to man," according to “The CIA and the Search for the Manchurian Candidate,” a 1979 book by former State Department intelligence officer John Marks.
“[T]his cold-blooded project,” Marks wrote, “was designed … for the delivery of chemical and biological agents or for ‘executive action-type operations,’ according to a document. ‘Executive action’ was the CIA's euphemism for assassination.”
The CIA pursued such experiments because it was convinced the Soviets were doing the same.
Victims have sought justice for years, in vain. Now, almost 40 years later, a federal magistrate has ordered the CIA to produce records and witnesses about the LSD and other experiments “allegedly conducted on thousands of soldiers from 1950 through 1975,” according to news accounts.
U.S. Magistrate Judge John Larsen’s Nov. 17 order exempted the agency from having to testify about electrode tests on humans, but Gordon P. Erspamer, lead attorney for the veterans, says “we are pursuing this as well.”
“There is no question that these experiments were done,” Erspamer said by e-mail Tuesday, “but defendants say that they used private researchers and test subjects drawn from prisons, hospitals and nursing homes as subjects, not active duty military [personnel]. CIA said it had no one knowledgeable on this topic.”
Erspamer, senior counsel in the San Francisco office of Morrison & Foerster, said “several” CIA witnesses “are…still alive,” naming some that have been publicly identified, but opting to keep secret others before he calls them.
Papers filed in the case describe “electrical devices implanted in brain tissue with electrodes in various regions, including the hippocampus, the hypothalamus, the frontal lobe (via the septum), the cortex and various other places,” Erspamer said, drawing on [research papers] (http://media.washingtonpost.com/wp-srv/ ... cument.pdf) written by government scientists.
“We believe that one of our plaintiffs was given a septal implant at [Edgewood Arsenal] (www.edgewoodtestvets.org),” he said, based on an MRI he has “showing a ‘foreign body’ on the border between the septum and the frontal lobe.”
“A lot of this work was done out of Tulane University using a local state hospital and funding from a cut-out (front) organization called the Commonwealth Fund,” he continued, again drawing on the research papers.
“We tried to get docs from Tulane, but they told us that they were destroyed in the hurricane flooding.”
The CIA claims that at least some of the documents should remain classified as “state secrets.” But Magistrate Larson told the agency to come back with a better rationale, a "supplemental declaration explaining with heightened specificity" why the documents should be protected after all these years.
-
J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 01/ 27/ 11 2:55 pm
YEPPERS, THEY CLOSED THAT THERE BIO-CHEMICAL WEAPONS FACILITY THEY SURE DID......HONEST...!!!
Utah base open after missing nerve agent vial located, officials say
By the CNN Wire Staff
January 27, 2011 12:02 p.m. EST
The Dugway Proving Ground is in the Great Salt Lake Desert southwest of Salt Lake City, Utah.
* NEW: The lockdown was prompted by an inventory discrepancy
* NEW: The missing vial was found about 5 a.m. ET
* NEW: No one was ever in danger, authorities say
* The base is 85 miles southwest of Salt Lake City
http://www.cnn.com/2011/US/01/27/utah.b ... wn/?hpt=T2
(CNN) -- A Utah military facility that tests chemical and biological weapons was opened Thursday after a nearly 12-hour lockdown that officials said was prompted by a missing vial of "nerve agent."
"On January 26, during a routine inventory of sensitive material in the chemical laboratory, Dugway officials discovered a discrepancy between the records and the agent on hand," said a statement issued by the U.S. Army's Dugway Proving Ground. "As a precaution, the commander immediately locked down the installation and began efforts to identify the cause of the discrepancy."
The facility was put on lockdown about 7:25 p.m. ET on Wednesday, spokeswoman Paula Thomas said. Authorities said only that the move was "to resolve a serious concern within the Test Area."
The discrepancy was found to be less than a milliliter, or less than one-fourth of a teaspoon, of VX "nerve agent," the statement said.
A vial containing 1 ml was located about 3 a.m. Thursday (5 a.m. ET), the statement said. As of about 6:15 a.m., authorities said personnel had been allowed inside and would be allowed to go home shortly.
"All personnel are uninjured and safe," the facility said in a news release. "The public is safe as well."
VX is an amber-colored, odorless and tasteless oily liquid that does not evaporate easily unless temperatures are high, officials said. "It evaporates very slowly, almost like motor oil."
People can be exposed to the agent through skin contact -- the most toxic way -- or through eye contact or inhalation, the statement said. VX affects the body's ability to carry messages through the nerves.
About 1,500 employees and contractors are stationed at the proving ground, which covers 798,214 acres and is located in the Great Salt Lake Desert, around 85 miles southwest of Salt Lake City.
"Testers here determine the reliability and survivability of all types of military equipment in a chemical or biological environment," according to Dugway officials.
Utah base open after missing nerve agent vial located, officials say
By the CNN Wire Staff
January 27, 2011 12:02 p.m. EST
The Dugway Proving Ground is in the Great Salt Lake Desert southwest of Salt Lake City, Utah.
* NEW: The lockdown was prompted by an inventory discrepancy
* NEW: The missing vial was found about 5 a.m. ET
* NEW: No one was ever in danger, authorities say
* The base is 85 miles southwest of Salt Lake City
http://www.cnn.com/2011/US/01/27/utah.b ... wn/?hpt=T2
(CNN) -- A Utah military facility that tests chemical and biological weapons was opened Thursday after a nearly 12-hour lockdown that officials said was prompted by a missing vial of "nerve agent."
"On January 26, during a routine inventory of sensitive material in the chemical laboratory, Dugway officials discovered a discrepancy between the records and the agent on hand," said a statement issued by the U.S. Army's Dugway Proving Ground. "As a precaution, the commander immediately locked down the installation and began efforts to identify the cause of the discrepancy."
The facility was put on lockdown about 7:25 p.m. ET on Wednesday, spokeswoman Paula Thomas said. Authorities said only that the move was "to resolve a serious concern within the Test Area."
The discrepancy was found to be less than a milliliter, or less than one-fourth of a teaspoon, of VX "nerve agent," the statement said.
A vial containing 1 ml was located about 3 a.m. Thursday (5 a.m. ET), the statement said. As of about 6:15 a.m., authorities said personnel had been allowed inside and would be allowed to go home shortly.
"All personnel are uninjured and safe," the facility said in a news release. "The public is safe as well."
VX is an amber-colored, odorless and tasteless oily liquid that does not evaporate easily unless temperatures are high, officials said. "It evaporates very slowly, almost like motor oil."
People can be exposed to the agent through skin contact -- the most toxic way -- or through eye contact or inhalation, the statement said. VX affects the body's ability to carry messages through the nerves.
About 1,500 employees and contractors are stationed at the proving ground, which covers 798,214 acres and is located in the Great Salt Lake Desert, around 85 miles southwest of Salt Lake City.
"Testers here determine the reliability and survivability of all types of military equipment in a chemical or biological environment," according to Dugway officials.
-
J.B. Stone - Posts: 47724
- Joined: 04/ 11/ 03 10:01 am
- Location: Northwest Montana
by J.B. Stone » 02/ 03/ 11 12:09 am
THINGS IMPROVING ON THE PTSD FRONT....
PTSD's Diagnostic Trap
By Sally Satel | Policy Review
Tuesday, February 1, 2011
http://www.aei.org/article/103105
Military history is rich with tales of warriors who return from battle with the horrors of war still raging in their heads. One of the earliest examples was enshrined by Herodotus, who wrote of an Athenian warrior struck blind "without blow of sword or dart" when a soldier standing next to him was killed. The classic term--"shell shock"--dates to World War I; "battle fatigue," "combat exhaustion," and "war stress" were used in World War II.
Modern psychiatry calls these invisible wounds post-traumatic stress disorder (PTSD). And along with this diagnosis, which became widely known in the wake of the Vietnam War, has come a new sensitivity--among the public, the military, and mental health professionals--to the causes and consequences of being afflicted. The Department of Veterans Affairs is particularly attuned to the psychic welfare of the men and women who are returning from Operation Iraqi Freedom and Operation Enduring Freedom. Last July, retired Army General Eric K. Shinseki, secretary of Veterans Affairs, unveiled new procedures that make it easier for veterans who believe they are disabled by wartime stress to file benefit claims and receive compensation."[Psychological] wounds," Shinseki declared, "can be as debilitating as any physical battlefield trauma."
This is true. But gauging mental injury in the wake of war is not as straightforward as assessing, say, a lost limb or other physical damage. For example, at what point do we say that normal, if painful, readjustment difficulties have become so troubling as to qualify as a mental illness? How can clinicians predict which patients will recover when a veteran's odds of recovery depend so greatly on nonmedical factors, including his own expectations for recovery; social support available to him; and the intimate meaning he makes of his distress? Inevitably, successful caregiving will turn on a clear understanding of post-traumatic stress disorder.
According to the Columbia reanalysis, the psychological cost of the war was 40 percent lower than the original NVVRS estimate.
One of the most important and paradoxical lessons to emerge from these insights is that lowering the threshold for receipt of disability benefits is not always in the best interest of the veteran and his family. Without question, some veterans will remain so irretrievably damaged by their war experience that they cannot participate in the competitive workplace. These men and women clearly deserve the roughly $2,300 monthly tax-free benefit (given for "total," or 100 percent, disability) and other resources the Veterans Administration offers. But what if disability entitlements actually work to the detriment of other patients by keeping them from meaningful work and by creating an incentive for them to embrace institutional dependence? And what if the system, well-intentioned though it surely is, does not adequately protect young veterans from a premature verdict of invalidism? Acknowledging and studying these effects of compensation can be politically delicate, yet doing do is essential to devising reentry programs of care for the nation's invisibly wounded warriors.
What Is PTSD
The most recent edition of the Diagnostic and Statistical Manual (DSM IV) of the American Psychiatric Association defines PTSD according to symptoms; their duration; and the nature of the "trauma" or event. Symptoms fall into three categories: re-experiencing (e.g., relentless nightmares; unbidden waking images; flashbacks); hyper-arousal (e.g., enhanced startle, anxiety, sleeplessness); and phobias (e.g., fear of driving after having been in a crash). These must persist for at least 30 days and impair function to some degree. Overwhelming calamity--or "stressor," as psychiatrists call it--of any kind, such as a natural disaster, rape, accident, or assault, can lead to PTSD.
Notably, not everyone who confronts horrific circumstances develops PTSD. Among the survivors of the Oklahoma City bombing, for example, 34 percent developed PTSD, according to a study by psychiatric epidemiologist Carol North. After a car accident or natural disaster, fewer than 10 percent of victims are affected, while among rape victims, well over half succumb. The reassuring news is that, as with grief and other emotional reactions to painful events, most sufferers get better with time, though periodic nightmares and easy startling may linger for additional months or even years.
In contrast to the sizeable literature on PTSD in civilian populations and in active-duty soldiers, data on veterans are harder to come by. To date, the congressionally mandated National Vietnam Veterans Readjustment Study (NVVRS) remains the landmark analysis. Data were collected during 1986 and 1987 and revealed that 15.2 percent of a random sample of veterans still met criteria for PTSD. Yet, a number of scholars found those estimates to be improbably high (e.g., if roughly one in six Vietnam veterans suffered from PTSD, as the NVVRS suggests, this would mean that virtually each and every soldier who served in combat--a ratio of 1 combatant to every 6 in support specialties--developed the condition). To help clarify the picture, a team of researchers from Columbia University undertook a reanalysis of the NVVRS. After their results appeared in Science in 2006, it became impossible for responsible researchers to consider the original findings of NVVRS as definitive.
According to the Columbia reanalysis, the psychological cost of the war was 40 percent lower than the original NVVRS estimate--that is, 9.1 percent were diagnosed with PTSD at the time of the study. The researchers arrived at this prevalence rate by considering information--collected by the original NVVRS investigators but not used--on veterans' functional impairment (i.e., their ability to hold a job, fulfill demands of family life, maintain friendships, etc). However, the Columbia team used a rather lenient definition of "impairment," stipulating that even veterans with "some difficulty" but who were "functioning pretty well" despite their symptoms had PTSD. This spurred yet another reanalysis. In a 2007 article in the Journal of Traumatic Stress, Harvard psychologist Richard McNally took the definition of impairment up a notch so that only veterans who had at least "moderate difficulty" in social or occupational functioning could qualify as having PTSD. In doing so, he further reduced the estimate of affliction to 5.4 percent. If nothing else, this analytic sequence--from the NVVRS, to the Columbia reevaluation, and to the McNally recalibration--serves as an object lesson in the definitional fluidity of psychiatric syndromes.
From the wars in Iraq and Afghanistan, researchers have collected data on thousands of active-duty servicemen, but very little on veterans of those conflicts. The most rigorous evaluation to date appeared in the Archives of General Psychiatry last summer. It was conducted by investigators at the Walter Reed Army Institute of Research who applied rigorous and uniform diagnostic standards. This distinguished their work from other studies on the current Gulf wars, which were deficient in one or more ways: failure to perform in-depth diagnostic assessments; use of broad sampling that did not distinguish combat from support personnel; or assessment by snapshot rather than longitudinal follow-up. The Walter Reed team assessed over 18,000 army soldiers in infantry brigade combat teams at three points: pre-deployment (to establish a baseline); three months after deployment; and at twelve months post-deployment. After three months the rate of PTSD (symptoms accompanied by "serious impairment") was 6.3 percent higher than the pre-deployment baseline. At a year, it was 7.3 percent higher.
The New VA Rule
On July 12, 2010, General Shinseki penned an op-ed in USA Today ("For Vets with PTSD, End of an Unfair Process") announcing a new Veterans Administration rule making it easier for veterans suffering from PTSD to file disability claims. Part of the rule was straightforward: The VA would no longer require that a veteran provide documentation of his exposure to combat trauma, seeing how such paperwork is often very difficult for veterans to obtain. Streamlining the lumbering claims bureaucracy is one thing, and welcome it is, but the new rule does not end there. It also establishes that noninfantry personnel can qualify for PTSD disability if they had good reason to fear danger, such as firefights or explosions, even if they did not actually experience it. "[If] a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity, he is eligible for a PTSD benefits," according to the Federal Register. This is a strikingly novel amendment. The idea that one can sustain an enduring and disabling mental disorder based on anxious anticipation of a traumatic event that never materialized is a radical departure from the clinical--and common-sense--understanding that traumatic stress disorders are caused by events that actually do happen to people.[1] However, this is by no means the first time that controversy and ambiguity have swirled around the diagnosis of PTSD.
During the Civil War, some soldiers were said to suffer "irritable heart" or "Da Costa's Syndrome"--a condition marked by shortness of breath, chest discomfort, and pounding palpitations that doctors could not attribute to a medical cause. In World War I, the condition became known as "shell shock" and was characterized as a mental problem. The inability to cope was believed to reflect personal weakness--an underlying genetic or psychological vulnerability; combat itself, no matter how intense, was deemed little more than a precipitating factor. Otherwise well-adjusted individuals were believed to be at small risk of suffering more than a transient stress reaction once they were removed from the front.
In 1917, the British neuroanatomist Grafton Elliot Smith and the psychologist Tom Pear challenged this view. They attributed the cause more to the experiences of war and less to the character or fiber of soldiers themselves. "Psychoneurosis may be produced in almost anyone if only his environment be made 'difficult' enough for him," they wrote in their book, Shell Shock and Its Lessons. This triggered a feisty debate within British military psychiatry, and eventually the two sides came to agree that both the soldier's predisposition to stress and his exposure to hostilities contributed to breakdown. By World War II, then, military psychiatrists believed that even the bravest and fittest soldier could endure only so much. "Every man has his breaking point," the saying went.
The story of PTSD, as we know it today, starts with the Vietnam War. In the late 1960s, a band of self-described antiwar psychiatrists--led by Chaim Shatan and Robert Jay Lifton, who was well known for his work on the psychological damage wrought by Hiroshima--formulated a new diagnostic concept to describe the psychological wounds that the veterans sustained in the war. They called it "Post-Vietnam Syndrome," a disorder marked by "growing apathy, cynicism, alienation, depression, mistrust, and expectation of betrayal as well as an inability to concentrate, insomnia, nightmares, restlessness, uprootedness, and impatience with almost any job or course of study." Not uncommonly, the psychiatrists said, these symptoms did not emerge until months or years after the veterans returned home. Civilian contempt for veterans, according to Messrs. Shatan and Lifton, further entrenched their hostility and impeded their return.
This vision inspired portrayals of the Vietnam veteran as a kind of "walking time bomb," "living wreckage," or rampaging loner, images immortalized in films such as "Taxi Driver" and "Rambo." In the summer of 1972, the New York Times ran a front-page story on Post-Vietnam Syndrome. It reported that 50 percent of all Vietnam veterans--not just combat veterans--needed professional help to readjust, and contained phrases such as "psychiatric casualty," "emotionally disturbed," and "men with damaged brains." By contrast, veterans of World War II were heralded as heroes. They had fought in a popular war, a vital distinction for understanding how veterans and the public give meaning to their wartime hardships and sacrifice.
Historians and sociologists note that the high-profile involvement of civilian psychiatrists in the wake of the Vietnam War was another feature that set those returning soldiers apart. "The suggestion or outright assertion was that Vietnam veterans have been unique in American history for their psychiatric problems," writes the historian Eric T. Dean Jr. in Shook over Hell: Post-Traumatic Stress, Vietnam, and the Civil War. As the image of the psychologically injured veteran took root in the national conscience, the psychiatric profession debated the wisdom of giving him his own diagnosis.
PTSD Becomes Official
In 1980, the American Psychiatric Association adopted post-traumatic stress disorder (rather than the narrower post-Vietnam syndrome) as an official diagnosis in the third edition of its Diagnostic and Statistical Manual. A patient could be diagnosed with PTSD if he experienced a trauma or "stressor" that, as DSM described it, would "evoke significant symptoms of distress in almost everyone." Rape, combat, torture, and fires were those deemed to fall, as the DSM III required, "generally outside the range of usual human experience." Thus, while the stress was unusual, the development of PTSD in its wake was not.
No longer were prolonged traumatic reactions viewed as a reflection of an individual's constitutional vulnerability. Instead, stress-induced syndromes were a natural process of adapting to extreme stress. With the introduction of PTSD into the psychiatric manual, the single-minded emphasis on the importance of one's pre-morbid state in shaping response to crisis gave way to preoccupation with the trauma itself and its supposed leveling effect on human response. Surely, it was wrong of earlier psychiatrists to attribute war-related pathology solely to the combatant himself, but the DSM III definition embodied an equal but opposite error: It obliterated the role of an individual's own characteristics in the development of the condition. Not surprising, perhaps, this blunder served a political purpose. As British psychiatrist Derek Summerfield put it, the newly minted diagnosis of PTSD "was meant to shift the focus of attention from the details of a soldier's background and psyche to the fundamentally traumatic nature of war."
Shatan and Lifton clearly saw PTSD as a normal response. "The placement of post-traumatic stress disorder in [the DSM] allows us to see the policies of diagnosis and disease in an especially clear light," writes combat veteran and sociologist Wilbur Scott in his detailed 1993 account The Politics of Readjustment: Vietnam Veterans Since the War. The diagnosis of PTSD is in the DSM, Mr. Scott writes, "because a core of psychiatrists and Vietnam veterans worked conscientiously and deliberately for years to put it there . . . at issue was the question of what constitutes a normal reaction or experience of soldiers to combat." Thus, by the time PTSD was incorporated into the official psychiatric lexicon, it bore a hybrid legacy--part political artifact of the antiwar movement, part legitimate diagnosis.
Over the years, the major symptoms of PTSD have remained fairly straightforward--re-experiencing, anxiety, and phobic avoidance--but what counted as a traumatic experience turned out to be a moving target in subsequent editions of the DSM. In 1987, the DSM III was revised to expand the definition of a traumatic experience. The concept of stressor now included witnessing harm to others, such as a horrific car accident in progress. In the fourth edition in 1994, the range of "traumatic" events was expanded further to include hearing about harm or threats to others, such as the unexpected death of a loved one or receiving a fatal diagnosis such as terminal cancer oneself. No longer did one need to experience a life-threatening situation directly or be a close witness to a ghastly accident or atrocity. As long as one experienced an "intense fear, helplessness, or horror" in response to a catastrophic event (e.g., after watching the September 11 terrorist attacks on television, or being in a minor car accident) he could conceivably qualify for a diagnosis of PTSD if symptoms of re-experiencing, arousal, and phobias persisted for a month.
There is pitched debate within the field of traumatology as to whether a stressor should be defined as whatever traumatizes a person. True, a person might feel "traumatized" by, say, a minor car accident--but to say that a fender-bender counts as trauma alongside such horrors as concentration camps, rape, or the Bataan Death March is to dilute the concept. "A great deal rides on how we define the concept of traumatic stressor," says Richard J. McNally. In the civilian realm, he says, "the more we broaden the category of traumatic stressors, the less credibly we can assign causal significance to a given stressor itself and the more weight we must place on personal vulnerability." In the context of war, too, while anticipatory fear of being thrust in harm's way could conceivably morph into a crippling stress reaction, this will almost surely be more likely among individuals who struggled with anxiety-related problems prior to deployment. Surely, their distress merits treatment from military psychiatrists, but the odds that such symptoms persist after separation from the military, let alone harden into a serious, lasting state of disablement, are probably very low.
The Troubled VA Disability System
Secretary Shinseki's move to reduce the bureaucratic hurdles to the VA disability system and broaden eligibility for PTSD will add to the already accelerating stream of veterans who are applying to enter it. Thus, it is imperative that the VA turn its attention to that system itself. Two overarching problems need remedies. The first is the culture of clinical diagnosis. Some disability evaluators now use a detailed interview checklist to gauge the degree to which daily function is impaired, but its implementation is uneven across medical centers. Thus, it is still easy for clinicians--especially those whose diagnostic skills were honed during the Vietnam era--to label problems such as anxiety, guilt over comrades who died, and chronic sleep disturbance mental illnesses. This is facile, of course, as symptoms splay out along a continuum ranging from normal, if painful, readjustment difficulties to chronic, debilitating pathology. Further, not all symptoms of distress in someone who has been to war reflexively signal the presence of PTSD, as some clinicians seem to think. Among veterans whose problems are indeed war-related, however, the distinction between reversible and lasting incapacitation matters greatly when the veteran is seeking disability status. And this brings us to the second matter: the inadvertent damage that disability benefits themselves can sometimes cause.
Imagine a young soldier wounded in Afghanistan. His physical injuries heal, but his mind remains tormented. Sudden noises make him jump out of his skin. He is flooded with memories of a bloody firefight, tormented by nightmares, can barely concentrate, and feels emotionally detached from everything and everybody. At 23 years old, the soldier is about to be discharged from the military. Fearing he'll never be able to hold a job or fully function in society he applies for "total" disability (the maximum designation, which provides roughly $2,300 per month) compensation for PTSD from the VA. This soldier has resigned himself to a life of chronic mental illness. On its face, this seems only logical, and granting the benefits seems humane. But in reality it is probably the last thing the young soldier-turning-veteran needs--because compensation will confirm his fears that he is indeed beyond recovery.
While a sad verdict for anyone, it is especially tragic for someone only in his twenties. Injured soldiers can apply for and receive VA disability benefits even before they have been discharged from the military--and, remarkably, before they have even been given the psychiatric treatment that could help them considerably. Imagine telling someone with a spinal injury that he'll never walk again--before he has had surgery and physical therapy. A rush to judgment about the prognosis of psychic injuries carries serious long-term consequences insofar as a veteran who is unwittingly encouraged to see himself as beyond repair risks fulfilling that prophecy. Why should I bother with treatment? he might think. A terrible mistake, of course. The months before and after separation from the service are periods when mental wounds are fresh and thus most responsive to therapeutic intervention, including medication.
Told he is disabled, the veteran and his family may assume--often incorrectly--that he is no longer able to work. At home on disability, he risks adopting a "sick role" that ends up depriving him of the estimable therapeutic value of work. Lost are the sense of purpose work gives (or at least the distraction from depressive rumination it provides), the daily structure it affords, and the opportunity for socializing and cultivating friendships. The longer he is unemployed, the more his confidence in his ability and motivation to work erodes and his skills atrophy. Once a patient is caught in such a downward spiral of invalidism, it can be hard to throttle back out. What's more, compensation contingent upon being sick often creates a perverse incentive to remain sick. For example, even if a veteran wants very much to work, he understandably fears losing his financial safety net if he leaves the disability rolls to take a job that ends up proving too much for him. This is how full disability status can undermine the possibility of recovery.
What To Do: Treatment First
For many veterans, the transition between military and civilian life is a critical juncture marked by acute feelings of flux and dislocation. Recall the scene in The Hurt Locker (one of the few scenes, incidentally, that former soldiers have deemed realistic) in which Sergeant William James stares at the wall of cereal boxes in the supermarket, disoriented by the tranquil and often trivial nature of the civilian world. As Sebastian Junger wrote in his powerful book War, "Some of the men worry they'll never again be satisfied with a 'normal life' . . . They worry that they may have been ruined for anything else."
Returning from war is a major existential project. Imparting meaning to the wartime experience, reconfiguring personal identity, and reimagining one's future take time. Sometimes the emotional intensity can be overwhelming--especially when coupled with nightmares and high anxiety or depression--and even warrants professional help. When this happens, the veteran should receive a message of promise and hope. This means a prescription for quality treatment and rehabilitation--ideally before the patient is even permitted to apply for disability status. However, under the current system, when a veteran files a disability claim, a ratings examiner is assigned to determine the extent of incapacitation, irrespective of whether he has first received care.
As part of the assessment, the examiner requests a psychiatric evaluation with a psychiatrist or a psychologist to obtain a diagnosis. If the veteran is diagnosed with PTSD by the clinician, the ratings examiner then assigns a severity index to his disability. The Veterans Benefits Administration recognizes different levels of disability. As detailed in the Code of Federal Regulations, a ten percent severity rating for a mental illness denotes "mild or transient symptoms which [affect] occupational tasks only during periods of significant stress." A patient assigned 30 percent disability has "intermittent periods of inability to perform occupational tasks although generally functioning satisfactorily." A 50 percent rating begins to denote significant deficits including "difficulty in understanding complex commands" and reduced reliability and productivity. The most severe level, 100 percent, corresponds to "total occupational and social impairment."
Something is terribly wrong with this picture. To conclude that a veteran has dismal prospects for meaningful recovery before he or she has had a course of therapy and rehabilitation is premature in the extreme.[2] To be sure, the VA is trying hard to make treatment accessible, but administrators, raters, and clinicians cannot require patients to accept it as a condition of being considered for disability compensation. Absent a course of quality treatment and rehabilitation, evaluators simply do not have enough evidence to make a determination. Unwittingly, this policy has set in motion a growing dependence on the VA and disincentive to meaningful improvement. In 2008, former Senator Richard Burr of North Carolina, then the ranking member of the Senate Veterans Affairs Committee, sought a limited remedy. He introduced the Veterans Mental Health Treatment First Act. The purpose of this bill was to induce new veterans to embark upon a path to recovery. Any veteran diagnosed with major depression, post-traumatic stress disorder, or other anxiety disorders stemming from military activity would be eligible for a financial incentive (which Burr called a "wellness stipend") to adhere to an individualized course of treatment and agree to a pause in claims action for at least a year or until completion of treatment, which ever came first. The bill died in committee.
Don't Fight the Same War Twice
Mental health experts have learned a lot about how not to treat veterans from our experience during the Vietnam era. I speak from my experience as a psychiatrist at the West Haven Veterans Affairs Medical Center in Connecticut from 1988 to 1992, a time of blossoming interest in PTSD within both the VA and the mental-health establishment. Good intentions were abundant, but, in retrospect, much of our treatment philosophy was misguided. For example, clinicians tended to view whatever problem beset a veteran as a product of his war experience. In addition, therapists spent too much time urging veterans to experience catharsis by reliving their war experiences in group therapy, individual therapy, art therapy, and theatre reenactments. Groups of twenty or so veterans were admitted to the hospital and stayed together, platoonlike, for four months. This practice took them out of their communities and away from their families. I remember some of the men coming back from a day's leave from the hospital ward with new war-themed tattoos and combat fatigues--not exactly readjustment! It is clear, in retrospect, that instead of fostering regression, we should have emphasized resolution of everyday problems of living, such as family chaos, employment difficulties, and substance abuse.
The good news is that most of these inpatient programs are now shuttered. Studies showed them to be largely ineffective. What followed over the years was a wholesale shift away from cathartic reenactment of war trauma and a growing emphasis on forward-looking rehabilitation and evidence-based treatments such as cognitive therapy, behavioral desensitization (some techniques involving virtual reality recreations of combat scenarios), and medication if needed. The VA does appear to be making serious efforts to ensure that all mental health clinics are equipped to offer state of the art treatment for PTSD.
Some clinicians, myself included, would even like to see the diagnosis of PTSD downplayed altogether in favor of trying to understand patients' symptoms in context. As Texas psychiatrist Martha Leatherman puts it, "behaviors such as easy startling, hypervigilance, and sleep disturbance that are common in combat situations are normal, survival mechanisms," she says. Unfortunately, when they return, veterans are told that these symptoms mean PTSD. "This stirs up visions of Vietnam veterans living under bridges," Leatherman says, "and then, in a panic, they apply for disability compensation for PTSD so that they won't end up homeless too." Regrettably, the legacy of Vietnam era PTSD haunts the current generation of veterans. "It has been very troubling to me to see OEF/OIF veterans who truly need mental health treatment refuse it because it would mean having an illness that is associated with Vietnam-era chronicity and thus is incurable." The clinicians' job, of course, is not to incite morbid preoccupations, but to dispel misconceptions about Vietnam veterans (the vast majority of whom went on to function well) and steer veterans, as early as possible, to healthier interpretations of their symptoms. Early intervention also leverages the well-established fact that prognosis after trauma greatly depends on what happens to the individual in its immediate wake. That is why serious attention must be paid to the everyday problems that beset many veterans during the readjustment period, such as financial stress, marital discord, parenting strains, occupational needs.[3]
Finally, the balkanization of the veteran's services complex demands attention. The federal Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA) tend to operate in separate universes. The VBA is geared toward helping veterans maximize benefits and gives little to no attention to improving their clinical situation. On the other hand, the VHA is focused on treatment, as it should be, but doesn't extend its expertise to helping veterans with the financial hardships they face. (These can be the kinds of problems that might lead a patient to turn to disability compensation--not because he is incapable of work but because the reliable check is a rational solution to his financial woes.) County-based Veterans Service Officers actively help veterans file for disability--not necessarily a bad thing at all, but because they are advocates, their job is to get a veteran what he wants, which is not necessarily in his best clinical interest. Lastly, the Veteran Service Organizations which, as a matter of principle, are driven to funnel largesse to their constituents, tend to be extremely suspicious of proposed reforms of the disability system, as they were of Senator Burr's proposal. With the missions of both agencies and the agendas of pressure groups all working at cross purposes, disability reform is a daunting challenge indeed.
Anyone who fights in a war is changed by it, but few are irreparably damaged. For those who never regain their civilian footing despite the best treatment, full and generous disability compensation is their due. Otherwise, it is reckless to allow a young veteran to surrender to his psychological wounds without first urging him to pursue recovery.
Over the last hundred years or so, psychiatry has taken very different perspectives on war stress: from an overly harsh, blame-the-soldier stance in World War I, to the healthy recognition in World War II that even the most psychologically healthy individual can develop war-related symptoms, to the misguided expectation in the wake of Vietnam that lasting PTSD was routine. The new VA rule, which expands PTSD disability eligibility to noncombatants who have experienced the dread of harm but have not had an actual encounter with it, alters the meaning yet again. What should have been a welcome bureaucratic reform by the VA--waiving documentation that might be difficult or impossible to obtain--ended up distorting the diagnosis. Add to this the practice of conferring disability status upon a veteran before his prospects for recovery are known, and the long journey home will now be harder than it already is.
Sally Satel, M.D., is a resident scholar at AEI.
Notes:
1. The new rule is actually quite confusing. See the Federal Register, 75:133 (July 13, 2010), 39847, available online at http://www.thefederalregister.com/d.p/2 ... 2010-16885. (This and subsequent weblinks accessed December 13, 2010.) While the Federal Register states that a diagnosis of PTSD cannot be made "in the absence of exposure to a traumatic event," in keeping with the formal psychiatric conception of PTSD, it also says, apparently contrarily, that "constant vigilance against unexpected attack" can constitute a stressor and that PTSD can result from "veteran's fear of hostile military or terrorist activity.
2. Studies of Vietnam veterans have found that 68 to 94 percent of claimants seeking treatment for the first time are also applying for PTSD disability benefits; for review see B. Christopher Frueh, et al., "Disability compensation seeking among veterans evaluated for posttraumatic stress disorder," Psychiatric Services 54 (January 2003), 84-91. According to Nina Sayer and colleagues, "most claimants reported seeking disability compensation for symbolic reasons, especially for acknowledgement, validation and relief from self-blame; see Nina Sayer, et al., "Veterans seeking disability benefits for post-traumatic stress disorder: Who applies and the self-reported meaning of disability compensation," Social Science & Medicine 58:11 (June 2004), 2133-43. I could not find comparable studies on oie and oif veterans, but the Compensation and Pension examiners I interviewed suggest that the "disability first" approach is not uncommon.
3. The problem of fraud, too, cannot be overlooked. See B. Christopher Frueh, et al., "US Department of Veterans Affairs disability policies for PTSD: Administrative trends and implications for treatment, rehabilitation, and research," American Journal of Public Health 97:12 (December 2007), 2143-2145; see also Gail Poyner, "Psychological Evaluations of Veterans Claiming PTSD Disability with the Department of Veterans Affairs: A Clinician's Viewpoint," Psychological Injury and Law 3:2 (2010), 130-2. Poyner, who had received praise from VA personnel for her careful diagnostic evaluations, was told by the VA in 2009 that her services were no longer needed after she began using approved psychological tests to distinguish between veterans who were claiming to have PTSD when they did not and those whose complaints were clinically authentic.
PTSD's Diagnostic Trap
By Sally Satel | Policy Review
Tuesday, February 1, 2011
http://www.aei.org/article/103105
Military history is rich with tales of warriors who return from battle with the horrors of war still raging in their heads. One of the earliest examples was enshrined by Herodotus, who wrote of an Athenian warrior struck blind "without blow of sword or dart" when a soldier standing next to him was killed. The classic term--"shell shock"--dates to World War I; "battle fatigue," "combat exhaustion," and "war stress" were used in World War II.
Modern psychiatry calls these invisible wounds post-traumatic stress disorder (PTSD). And along with this diagnosis, which became widely known in the wake of the Vietnam War, has come a new sensitivity--among the public, the military, and mental health professionals--to the causes and consequences of being afflicted. The Department of Veterans Affairs is particularly attuned to the psychic welfare of the men and women who are returning from Operation Iraqi Freedom and Operation Enduring Freedom. Last July, retired Army General Eric K. Shinseki, secretary of Veterans Affairs, unveiled new procedures that make it easier for veterans who believe they are disabled by wartime stress to file benefit claims and receive compensation."[Psychological] wounds," Shinseki declared, "can be as debilitating as any physical battlefield trauma."
This is true. But gauging mental injury in the wake of war is not as straightforward as assessing, say, a lost limb or other physical damage. For example, at what point do we say that normal, if painful, readjustment difficulties have become so troubling as to qualify as a mental illness? How can clinicians predict which patients will recover when a veteran's odds of recovery depend so greatly on nonmedical factors, including his own expectations for recovery; social support available to him; and the intimate meaning he makes of his distress? Inevitably, successful caregiving will turn on a clear understanding of post-traumatic stress disorder.
According to the Columbia reanalysis, the psychological cost of the war was 40 percent lower than the original NVVRS estimate.
One of the most important and paradoxical lessons to emerge from these insights is that lowering the threshold for receipt of disability benefits is not always in the best interest of the veteran and his family. Without question, some veterans will remain so irretrievably damaged by their war experience that they cannot participate in the competitive workplace. These men and women clearly deserve the roughly $2,300 monthly tax-free benefit (given for "total," or 100 percent, disability) and other resources the Veterans Administration offers. But what if disability entitlements actually work to the detriment of other patients by keeping them from meaningful work and by creating an incentive for them to embrace institutional dependence? And what if the system, well-intentioned though it surely is, does not adequately protect young veterans from a premature verdict of invalidism? Acknowledging and studying these effects of compensation can be politically delicate, yet doing do is essential to devising reentry programs of care for the nation's invisibly wounded warriors.
What Is PTSD
The most recent edition of the Diagnostic and Statistical Manual (DSM IV) of the American Psychiatric Association defines PTSD according to symptoms; their duration; and the nature of the "trauma" or event. Symptoms fall into three categories: re-experiencing (e.g., relentless nightmares; unbidden waking images; flashbacks); hyper-arousal (e.g., enhanced startle, anxiety, sleeplessness); and phobias (e.g., fear of driving after having been in a crash). These must persist for at least 30 days and impair function to some degree. Overwhelming calamity--or "stressor," as psychiatrists call it--of any kind, such as a natural disaster, rape, accident, or assault, can lead to PTSD.
Notably, not everyone who confronts horrific circumstances develops PTSD. Among the survivors of the Oklahoma City bombing, for example, 34 percent developed PTSD, according to a study by psychiatric epidemiologist Carol North. After a car accident or natural disaster, fewer than 10 percent of victims are affected, while among rape victims, well over half succumb. The reassuring news is that, as with grief and other emotional reactions to painful events, most sufferers get better with time, though periodic nightmares and easy startling may linger for additional months or even years.
In contrast to the sizeable literature on PTSD in civilian populations and in active-duty soldiers, data on veterans are harder to come by. To date, the congressionally mandated National Vietnam Veterans Readjustment Study (NVVRS) remains the landmark analysis. Data were collected during 1986 and 1987 and revealed that 15.2 percent of a random sample of veterans still met criteria for PTSD. Yet, a number of scholars found those estimates to be improbably high (e.g., if roughly one in six Vietnam veterans suffered from PTSD, as the NVVRS suggests, this would mean that virtually each and every soldier who served in combat--a ratio of 1 combatant to every 6 in support specialties--developed the condition). To help clarify the picture, a team of researchers from Columbia University undertook a reanalysis of the NVVRS. After their results appeared in Science in 2006, it became impossible for responsible researchers to consider the original findings of NVVRS as definitive.
According to the Columbia reanalysis, the psychological cost of the war was 40 percent lower than the original NVVRS estimate--that is, 9.1 percent were diagnosed with PTSD at the time of the study. The researchers arrived at this prevalence rate by considering information--collected by the original NVVRS investigators but not used--on veterans' functional impairment (i.e., their ability to hold a job, fulfill demands of family life, maintain friendships, etc). However, the Columbia team used a rather lenient definition of "impairment," stipulating that even veterans with "some difficulty" but who were "functioning pretty well" despite their symptoms had PTSD. This spurred yet another reanalysis. In a 2007 article in the Journal of Traumatic Stress, Harvard psychologist Richard McNally took the definition of impairment up a notch so that only veterans who had at least "moderate difficulty" in social or occupational functioning could qualify as having PTSD. In doing so, he further reduced the estimate of affliction to 5.4 percent. If nothing else, this analytic sequence--from the NVVRS, to the Columbia reevaluation, and to the McNally recalibration--serves as an object lesson in the definitional fluidity of psychiatric syndromes.
From the wars in Iraq and Afghanistan, researchers have collected data on thousands of active-duty servicemen, but very little on veterans of those conflicts. The most rigorous evaluation to date appeared in the Archives of General Psychiatry last summer. It was conducted by investigators at the Walter Reed Army Institute of Research who applied rigorous and uniform diagnostic standards. This distinguished their work from other studies on the current Gulf wars, which were deficient in one or more ways: failure to perform in-depth diagnostic assessments; use of broad sampling that did not distinguish combat from support personnel; or assessment by snapshot rather than longitudinal follow-up. The Walter Reed team assessed over 18,000 army soldiers in infantry brigade combat teams at three points: pre-deployment (to establish a baseline); three months after deployment; and at twelve months post-deployment. After three months the rate of PTSD (symptoms accompanied by "serious impairment") was 6.3 percent higher than the pre-deployment baseline. At a year, it was 7.3 percent higher.
The New VA Rule
On July 12, 2010, General Shinseki penned an op-ed in USA Today ("For Vets with PTSD, End of an Unfair Process") announcing a new Veterans Administration rule making it easier for veterans suffering from PTSD to file disability claims. Part of the rule was straightforward: The VA would no longer require that a veteran provide documentation of his exposure to combat trauma, seeing how such paperwork is often very difficult for veterans to obtain. Streamlining the lumbering claims bureaucracy is one thing, and welcome it is, but the new rule does not end there. It also establishes that noninfantry personnel can qualify for PTSD disability if they had good reason to fear danger, such as firefights or explosions, even if they did not actually experience it. "[If] a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity, he is eligible for a PTSD benefits," according to the Federal Register. This is a strikingly novel amendment. The idea that one can sustain an enduring and disabling mental disorder based on anxious anticipation of a traumatic event that never materialized is a radical departure from the clinical--and common-sense--understanding that traumatic stress disorders are caused by events that actually do happen to people.[1] However, this is by no means the first time that controversy and ambiguity have swirled around the diagnosis of PTSD.
During the Civil War, some soldiers were said to suffer "irritable heart" or "Da Costa's Syndrome"--a condition marked by shortness of breath, chest discomfort, and pounding palpitations that doctors could not attribute to a medical cause. In World War I, the condition became known as "shell shock" and was characterized as a mental problem. The inability to cope was believed to reflect personal weakness--an underlying genetic or psychological vulnerability; combat itself, no matter how intense, was deemed little more than a precipitating factor. Otherwise well-adjusted individuals were believed to be at small risk of suffering more than a transient stress reaction once they were removed from the front.
In 1917, the British neuroanatomist Grafton Elliot Smith and the psychologist Tom Pear challenged this view. They attributed the cause more to the experiences of war and less to the character or fiber of soldiers themselves. "Psychoneurosis may be produced in almost anyone if only his environment be made 'difficult' enough for him," they wrote in their book, Shell Shock and Its Lessons. This triggered a feisty debate within British military psychiatry, and eventually the two sides came to agree that both the soldier's predisposition to stress and his exposure to hostilities contributed to breakdown. By World War II, then, military psychiatrists believed that even the bravest and fittest soldier could endure only so much. "Every man has his breaking point," the saying went.
The story of PTSD, as we know it today, starts with the Vietnam War. In the late 1960s, a band of self-described antiwar psychiatrists--led by Chaim Shatan and Robert Jay Lifton, who was well known for his work on the psychological damage wrought by Hiroshima--formulated a new diagnostic concept to describe the psychological wounds that the veterans sustained in the war. They called it "Post-Vietnam Syndrome," a disorder marked by "growing apathy, cynicism, alienation, depression, mistrust, and expectation of betrayal as well as an inability to concentrate, insomnia, nightmares, restlessness, uprootedness, and impatience with almost any job or course of study." Not uncommonly, the psychiatrists said, these symptoms did not emerge until months or years after the veterans returned home. Civilian contempt for veterans, according to Messrs. Shatan and Lifton, further entrenched their hostility and impeded their return.
This vision inspired portrayals of the Vietnam veteran as a kind of "walking time bomb," "living wreckage," or rampaging loner, images immortalized in films such as "Taxi Driver" and "Rambo." In the summer of 1972, the New York Times ran a front-page story on Post-Vietnam Syndrome. It reported that 50 percent of all Vietnam veterans--not just combat veterans--needed professional help to readjust, and contained phrases such as "psychiatric casualty," "emotionally disturbed," and "men with damaged brains." By contrast, veterans of World War II were heralded as heroes. They had fought in a popular war, a vital distinction for understanding how veterans and the public give meaning to their wartime hardships and sacrifice.
Historians and sociologists note that the high-profile involvement of civilian psychiatrists in the wake of the Vietnam War was another feature that set those returning soldiers apart. "The suggestion or outright assertion was that Vietnam veterans have been unique in American history for their psychiatric problems," writes the historian Eric T. Dean Jr. in Shook over Hell: Post-Traumatic Stress, Vietnam, and the Civil War. As the image of the psychologically injured veteran took root in the national conscience, the psychiatric profession debated the wisdom of giving him his own diagnosis.
PTSD Becomes Official
In 1980, the American Psychiatric Association adopted post-traumatic stress disorder (rather than the narrower post-Vietnam syndrome) as an official diagnosis in the third edition of its Diagnostic and Statistical Manual. A patient could be diagnosed with PTSD if he experienced a trauma or "stressor" that, as DSM described it, would "evoke significant symptoms of distress in almost everyone." Rape, combat, torture, and fires were those deemed to fall, as the DSM III required, "generally outside the range of usual human experience." Thus, while the stress was unusual, the development of PTSD in its wake was not.
No longer were prolonged traumatic reactions viewed as a reflection of an individual's constitutional vulnerability. Instead, stress-induced syndromes were a natural process of adapting to extreme stress. With the introduction of PTSD into the psychiatric manual, the single-minded emphasis on the importance of one's pre-morbid state in shaping response to crisis gave way to preoccupation with the trauma itself and its supposed leveling effect on human response. Surely, it was wrong of earlier psychiatrists to attribute war-related pathology solely to the combatant himself, but the DSM III definition embodied an equal but opposite error: It obliterated the role of an individual's own characteristics in the development of the condition. Not surprising, perhaps, this blunder served a political purpose. As British psychiatrist Derek Summerfield put it, the newly minted diagnosis of PTSD "was meant to shift the focus of attention from the details of a soldier's background and psyche to the fundamentally traumatic nature of war."
Shatan and Lifton clearly saw PTSD as a normal response. "The placement of post-traumatic stress disorder in [the DSM] allows us to see the policies of diagnosis and disease in an especially clear light," writes combat veteran and sociologist Wilbur Scott in his detailed 1993 account The Politics of Readjustment: Vietnam Veterans Since the War. The diagnosis of PTSD is in the DSM, Mr. Scott writes, "because a core of psychiatrists and Vietnam veterans worked conscientiously and deliberately for years to put it there . . . at issue was the question of what constitutes a normal reaction or experience of soldiers to combat." Thus, by the time PTSD was incorporated into the official psychiatric lexicon, it bore a hybrid legacy--part political artifact of the antiwar movement, part legitimate diagnosis.
Over the years, the major symptoms of PTSD have remained fairly straightforward--re-experiencing, anxiety, and phobic avoidance--but what counted as a traumatic experience turned out to be a moving target in subsequent editions of the DSM. In 1987, the DSM III was revised to expand the definition of a traumatic experience. The concept of stressor now included witnessing harm to others, such as a horrific car accident in progress. In the fourth edition in 1994, the range of "traumatic" events was expanded further to include hearing about harm or threats to others, such as the unexpected death of a loved one or receiving a fatal diagnosis such as terminal cancer oneself. No longer did one need to experience a life-threatening situation directly or be a close witness to a ghastly accident or atrocity. As long as one experienced an "intense fear, helplessness, or horror" in response to a catastrophic event (e.g., after watching the September 11 terrorist attacks on television, or being in a minor car accident) he could conceivably qualify for a diagnosis of PTSD if symptoms of re-experiencing, arousal, and phobias persisted for a month.
There is pitched debate within the field of traumatology as to whether a stressor should be defined as whatever traumatizes a person. True, a person might feel "traumatized" by, say, a minor car accident--but to say that a fender-bender counts as trauma alongside such horrors as concentration camps, rape, or the Bataan Death March is to dilute the concept. "A great deal rides on how we define the concept of traumatic stressor," says Richard J. McNally. In the civilian realm, he says, "the more we broaden the category of traumatic stressors, the less credibly we can assign causal significance to a given stressor itself and the more weight we must place on personal vulnerability." In the context of war, too, while anticipatory fear of being thrust in harm's way could conceivably morph into a crippling stress reaction, this will almost surely be more likely among individuals who struggled with anxiety-related problems prior to deployment. Surely, their distress merits treatment from military psychiatrists, but the odds that such symptoms persist after separation from the military, let alone harden into a serious, lasting state of disablement, are probably very low.
The Troubled VA Disability System
Secretary Shinseki's move to reduce the bureaucratic hurdles to the VA disability system and broaden eligibility for PTSD will add to the already accelerating stream of veterans who are applying to enter it. Thus, it is imperative that the VA turn its attention to that system itself. Two overarching problems need remedies. The first is the culture of clinical diagnosis. Some disability evaluators now use a detailed interview checklist to gauge the degree to which daily function is impaired, but its implementation is uneven across medical centers. Thus, it is still easy for clinicians--especially those whose diagnostic skills were honed during the Vietnam era--to label problems such as anxiety, guilt over comrades who died, and chronic sleep disturbance mental illnesses. This is facile, of course, as symptoms splay out along a continuum ranging from normal, if painful, readjustment difficulties to chronic, debilitating pathology. Further, not all symptoms of distress in someone who has been to war reflexively signal the presence of PTSD, as some clinicians seem to think. Among veterans whose problems are indeed war-related, however, the distinction between reversible and lasting incapacitation matters greatly when the veteran is seeking disability status. And this brings us to the second matter: the inadvertent damage that disability benefits themselves can sometimes cause.
Imagine a young soldier wounded in Afghanistan. His physical injuries heal, but his mind remains tormented. Sudden noises make him jump out of his skin. He is flooded with memories of a bloody firefight, tormented by nightmares, can barely concentrate, and feels emotionally detached from everything and everybody. At 23 years old, the soldier is about to be discharged from the military. Fearing he'll never be able to hold a job or fully function in society he applies for "total" disability (the maximum designation, which provides roughly $2,300 per month) compensation for PTSD from the VA. This soldier has resigned himself to a life of chronic mental illness. On its face, this seems only logical, and granting the benefits seems humane. But in reality it is probably the last thing the young soldier-turning-veteran needs--because compensation will confirm his fears that he is indeed beyond recovery.
While a sad verdict for anyone, it is especially tragic for someone only in his twenties. Injured soldiers can apply for and receive VA disability benefits even before they have been discharged from the military--and, remarkably, before they have even been given the psychiatric treatment that could help them considerably. Imagine telling someone with a spinal injury that he'll never walk again--before he has had surgery and physical therapy. A rush to judgment about the prognosis of psychic injuries carries serious long-term consequences insofar as a veteran who is unwittingly encouraged to see himself as beyond repair risks fulfilling that prophecy. Why should I bother with treatment? he might think. A terrible mistake, of course. The months before and after separation from the service are periods when mental wounds are fresh and thus most responsive to therapeutic intervention, including medication.
Told he is disabled, the veteran and his family may assume--often incorrectly--that he is no longer able to work. At home on disability, he risks adopting a "sick role" that ends up depriving him of the estimable therapeutic value of work. Lost are the sense of purpose work gives (or at least the distraction from depressive rumination it provides), the daily structure it affords, and the opportunity for socializing and cultivating friendships. The longer he is unemployed, the more his confidence in his ability and motivation to work erodes and his skills atrophy. Once a patient is caught in such a downward spiral of invalidism, it can be hard to throttle back out. What's more, compensation contingent upon being sick often creates a perverse incentive to remain sick. For example, even if a veteran wants very much to work, he understandably fears losing his financial safety net if he leaves the disability rolls to take a job that ends up proving too much for him. This is how full disability status can undermine the possibility of recovery.
What To Do: Treatment First
For many veterans, the transition between military and civilian life is a critical juncture marked by acute feelings of flux and dislocation. Recall the scene in The Hurt Locker (one of the few scenes, incidentally, that former soldiers have deemed realistic) in which Sergeant William James stares at the wall of cereal boxes in the supermarket, disoriented by the tranquil and often trivial nature of the civilian world. As Sebastian Junger wrote in his powerful book War, "Some of the men worry they'll never again be satisfied with a 'normal life' . . . They worry that they may have been ruined for anything else."
Returning from war is a major existential project. Imparting meaning to the wartime experience, reconfiguring personal identity, and reimagining one's future take time. Sometimes the emotional intensity can be overwhelming--especially when coupled with nightmares and high anxiety or depression--and even warrants professional help. When this happens, the veteran should receive a message of promise and hope. This means a prescription for quality treatment and rehabilitation--ideally before the patient is even permitted to apply for disability status. However, under the current system, when a veteran files a disability claim, a ratings examiner is assigned to determine the extent of incapacitation, irrespective of whether he has first received care.
As part of the assessment, the examiner requests a psychiatric evaluation with a psychiatrist or a psychologist to obtain a diagnosis. If the veteran is diagnosed with PTSD by the clinician, the ratings examiner then assigns a severity index to his disability. The Veterans Benefits Administration recognizes different levels of disability. As detailed in the Code of Federal Regulations, a ten percent severity rating for a mental illness denotes "mild or transient symptoms which [affect] occupational tasks only during periods of significant stress." A patient assigned 30 percent disability has "intermittent periods of inability to perform occupational tasks although generally functioning satisfactorily." A 50 percent rating begins to denote significant deficits including "difficulty in understanding complex commands" and reduced reliability and productivity. The most severe level, 100 percent, corresponds to "total occupational and social impairment."
Something is terribly wrong with this picture. To conclude that a veteran has dismal prospects for meaningful recovery before he or she has had a course of therapy and rehabilitation is premature in the extreme.[2] To be sure, the VA is trying hard to make treatment accessible, but administrators, raters, and clinicians cannot require patients to accept it as a condition of being considered for disability compensation. Absent a course of quality treatment and rehabilitation, evaluators simply do not have enough evidence to make a determination. Unwittingly, this policy has set in motion a growing dependence on the VA and disincentive to meaningful improvement. In 2008, former Senator Richard Burr of North Carolina, then the ranking member of the Senate Veterans Affairs Committee, sought a limited remedy. He introduced the Veterans Mental Health Treatment First Act. The purpose of this bill was to induce new veterans to embark upon a path to recovery. Any veteran diagnosed with major depression, post-traumatic stress disorder, or other anxiety disorders stemming from military activity would be eligible for a financial incentive (which Burr called a "wellness stipend") to adhere to an individualized course of treatment and agree to a pause in claims action for at least a year or until completion of treatment, which ever came first. The bill died in committee.
Don't Fight the Same War Twice
Mental health experts have learned a lot about how not to treat veterans from our experience during the Vietnam era. I speak from my experience as a psychiatrist at the West Haven Veterans Affairs Medical Center in Connecticut from 1988 to 1992, a time of blossoming interest in PTSD within both the VA and the mental-health establishment. Good intentions were abundant, but, in retrospect, much of our treatment philosophy was misguided. For example, clinicians tended to view whatever problem beset a veteran as a product of his war experience. In addition, therapists spent too much time urging veterans to experience catharsis by reliving their war experiences in group therapy, individual therapy, art therapy, and theatre reenactments. Groups of twenty or so veterans were admitted to the hospital and stayed together, platoonlike, for four months. This practice took them out of their communities and away from their families. I remember some of the men coming back from a day's leave from the hospital ward with new war-themed tattoos and combat fatigues--not exactly readjustment! It is clear, in retrospect, that instead of fostering regression, we should have emphasized resolution of everyday problems of living, such as family chaos, employment difficulties, and substance abuse.
The good news is that most of these inpatient programs are now shuttered. Studies showed them to be largely ineffective. What followed over the years was a wholesale shift away from cathartic reenactment of war trauma and a growing emphasis on forward-looking rehabilitation and evidence-based treatments such as cognitive therapy, behavioral desensitization (some techniques involving virtual reality recreations of combat scenarios), and medication if needed. The VA does appear to be making serious efforts to ensure that all mental health clinics are equipped to offer state of the art treatment for PTSD.
Some clinicians, myself included, would even like to see the diagnosis of PTSD downplayed altogether in favor of trying to understand patients' symptoms in context. As Texas psychiatrist Martha Leatherman puts it, "behaviors such as easy startling, hypervigilance, and sleep disturbance that are common in combat situations are normal, survival mechanisms," she says. Unfortunately, when they return, veterans are told that these symptoms mean PTSD. "This stirs up visions of Vietnam veterans living under bridges," Leatherman says, "and then, in a panic, they apply for disability compensation for PTSD so that they won't end up homeless too." Regrettably, the legacy of Vietnam era PTSD haunts the current generation of veterans. "It has been very troubling to me to see OEF/OIF veterans who truly need mental health treatment refuse it because it would mean having an illness that is associated with Vietnam-era chronicity and thus is incurable." The clinicians' job, of course, is not to incite morbid preoccupations, but to dispel misconceptions about Vietnam veterans (the vast majority of whom went on to function well) and steer veterans, as early as possible, to healthier interpretations of their symptoms. Early intervention also leverages the well-established fact that prognosis after trauma greatly depends on what happens to the individual in its immediate wake. That is why serious attention must be paid to the everyday problems that beset many veterans during the readjustment period, such as financial stress, marital discord, parenting strains, occupational needs.[3]
Finally, the balkanization of the veteran's services complex demands attention. The federal Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA) tend to operate in separate universes. The VBA is geared toward helping veterans maximize benefits and gives little to no attention to improving their clinical situation. On the other hand, the VHA is focused on treatment, as it should be, but doesn't extend its expertise to helping veterans with the financial hardships they face. (These can be the kinds of problems that might lead a patient to turn to disability compensation--not because he is incapable of work but because the reliable check is a rational solution to his financial woes.) County-based Veterans Service Officers actively help veterans file for disability--not necessarily a bad thing at all, but because they are advocates, their job is to get a veteran what he wants, which is not necessarily in his best clinical interest. Lastly, the Veteran Service Organizations which, as a matter of principle, are driven to funnel largesse to their constituents, tend to be extremely suspicious of proposed reforms of the disability system, as they were of Senator Burr's proposal. With the missions of both agencies and the agendas of pressure groups all working at cross purposes, disability reform is a daunting challenge indeed.
Anyone who fights in a war is changed by it, but few are irreparably damaged. For those who never regain their civilian footing despite the best treatment, full and generous disability compensation is their due. Otherwise, it is reckless to allow a young veteran to surrender to his psychological wounds without first urging him to pursue recovery.
Over the last hundred years or so, psychiatry has taken very different perspectives on war stress: from an overly harsh, blame-the-soldier stance in World War I, to the healthy recognition in World War II that even the most psychologically healthy individual can develop war-related symptoms, to the misguided expectation in the wake of Vietnam that lasting PTSD was routine. The new VA rule, which expands PTSD disability eligibility to noncombatants who have experienced the dread of harm but have not had an actual encounter with it, alters the meaning yet again. What should have been a welcome bureaucratic reform by the VA--waiving documentation that might be difficult or impossible to obtain--ended up distorting the diagnosis. Add to this the practice of conferring disability status upon a veteran before his prospects for recovery are known, and the long journey home will now be harder than it already is.
Sally Satel, M.D., is a resident scholar at AEI.
Notes:
1. The new rule is actually quite confusing. See the Federal Register, 75:133 (July 13, 2010), 39847, available online at http://www.thefederalregister.com/d.p/2 ... 2010-16885. (This and subsequent weblinks accessed December 13, 2010.) While the Federal Register states that a diagnosis of PTSD cannot be made "in the absence of exposure to a traumatic event," in keeping with the formal psychiatric conception of PTSD, it also says, apparently contrarily, that "constant vigilance against unexpected attack" can constitute a stressor and that PTSD can result from "veteran's fear of hostile military or terrorist activity.
2. Studies of Vietnam veterans have found that 68 to 94 percent of claimants seeking treatment for the first time are also applying for PTSD disability benefits; for review see B. Christopher Frueh, et al., "Disability compensation seeking among veterans evaluated for posttraumatic stress disorder," Psychiatric Services 54 (January 2003), 84-91. According to Nina Sayer and colleagues, "most claimants reported seeking disability compensation for symbolic reasons, especially for acknowledgement, validation and relief from self-blame; see Nina Sayer, et al., "Veterans seeking disability benefits for post-traumatic stress disorder: Who applies and the self-reported meaning of disability compensation," Social Science & Medicine 58:11 (June 2004), 2133-43. I could not find comparable studies on oie and oif veterans, but the Compensation and Pension examiners I interviewed suggest that the "disability first" approach is not uncommon.
3. The problem of fraud, too, cannot be overlooked. See B. Christopher Frueh, et al., "US Department of Veterans Affairs disability policies for PTSD: Administrative trends and implications for treatment, rehabilitation, and research," American Journal of Public Health 97:12 (December 2007), 2143-2145; see also Gail Poyner, "Psychological Evaluations of Veterans Claiming PTSD Disability with the Department of Veterans Affairs: A Clinician's Viewpoint," Psychological Injury and Law 3:2 (2010), 130-2. Poyner, who had received praise from VA personnel for her careful diagnostic evaluations, was told by the VA in 2009 that her services were no longer needed after she began using approved psychological tests to distinguish between veterans who were claiming to have PTSD when they did not and those whose complaints were clinically authentic.
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