Incremental Change: Fighting For PTSD War Casualties
Two items in the media caught my attention this week that I believe are worth noting. First, Army Times republished an article by Gregg Zoroya in USA TODAY under the headline "Army may stop notifying COs of counseling". In the article, Zoroya reports:
Army leaders are proposing to end a longtime policy that requires a commanding officer be notified when a soldier voluntarily seeks counseling in hopes of encouraging more GIs to seek aid, according to Army Secretary Pete Geren...
The proposal being worked out between Army personnel and medical commanders is “an important part of a comprehensive effort to reduce the stigma associated with seeking mental health care and to encourage more soldiers to seek treatment,” Geren says in a statement to USA TODAY on Friday.
Possibly spurring Secretary Geren and the Army along may have been Senator Claire McCaskill:
Sen. Claire McCaskill, D-Mo., told Geren in a November letter that current Army policies, such as notifying commanders about soldiers seeking help, “seem oriented to disciplinary concerns,” rather than treatment. Geren told McCaskill on Dec. 22 that he is ordering “an immediate and complete review” of ASAP. Suspending the notification rule, he said, could “assure soldiers the program is not punitive.”
It is heartening to learn that Senator McCaskill (the first woman freely elected a senator in Missouri, thus a "ground-breaker"), a member of the Senate Armed Services Committee is taking up this issue. It is also encouraging that Secretary Geren has been receptive. But these are just small, incremental steps in the overal process that needs to be pursued in terms of changing the perceptions of and treatment of our PTSD and TBI war casualties. Evidence the fact that in the same article, the Army's surgeon general, Lt. General Eric Schoomaker has witheld comment:
Lt. Gen. Eric Schoomaker, the Army surgeon general who urged an end to the policy in October, would not comment. But he is working with Lt. Gen. Michael Rochelle, deputy chief of staff for Army personnel, to change the policy.
Absent a strong endorsement from General Schoomaker, and absent any evidence of a strong endorsement by other principals in the Army's command staff, common sense and logic will tell us that without a strong message being driven from the top command level down through the chain of command, little will change. If General Schoomaker is serious about this, he needs to act sooner, rather than later, and decisively.
The second media item that caught my attention this week was the New York Times editorial on January 12, titled "PTSD and the Purple Heart". In their editorial the Times took the position of supporting the recent decision by the Pentagon to withhold awarding of the Purple Heart to PTSD war casualties. In terms of their position backing the decision by the Pentagon to not recognize PTSD war casualties with the Purple Heart, it seems to me that it is a decision that may be debated and possibly modified as time passes, but not the most urgent issue. The most urgent issue, and which was the most significant point of their editorial was to shed light on the plight of our country's PTSD war casualties. This is one of the issues with the greatest impact facing military families today, gaining acceptance and recognition, and then appropriate care for our military PTSD war casualties.
Service members who have displayed the symptoms of PTSD are true war casualties, and in other wars and other eras this condition was also present, albeit labeled "battle fatigue" or "shell shock." Only relatively recently have health care professionals, law makers, and the general public begun to recognize that PTSD is a "real" combat injury, many times catastropic, in both civilian and military life. Unfortunately, it seems that the military services, as institutions, have not yet fully understood this.
Despite growing recognition in the media over the past few years, grass roots efforts lobbying our law makers and military command, PTSD injuries continue to go untreated. Instead, advocates are witnessing careers in which service members have made a lifetime commitment being nullified and families devastated because military commanders frequently choose to kick out PTSD sufferers (for post-deployment misconduct--the very behavior that the Department of Defense's Mental Health Task Force has identified as being evidence of PTSD is the evidence that commanders use to administratively discharge service members), without benefits of any sort including mental health care, VA administered health care or retirement benefits or any rehabilitative care. In some cases requiring the return of enlistment bonuses.
Untreated PTSD has a societal ripple effect by putting the service member at an increased risk for substance abuse, unemployment, homelessness, criminal activity, partner violence, incarceration, and physical violence--against themselves or others. Appropriate, adequate treatment and rehabilitation for our service members who have suffered PTSD war injuries must be a priority of our military services, the Veterans Administration, our government, our country men and women.
Much more work needs to be done in terms of educating the public at large, our military establishment and our government officials about this issue, and it falls upon all of us, military families, cognizant military and government officials, and cognizant members of the general American public to do this work. No one who is aware of this issue and who wants to see the status quo changed should expect someone else to take up the issue on their behalf. We all have skin in this game as our military family is our last and strongest line of defense to our freedom, and our existence as a sovreign nation.
What members of the active duty military family can do is to spread the word. Educate and advocate with your extended family members, friends, and business associates, ask them to take up this advocacy. Active duty military and their family members also have the right to contact their members of Congress, to raise the Congress' awareness of this issue, and to put pressure on our elected officials to respond adequately.
The same can be said for the general public, as beneficiaries of the service of our active duty military personnel and their families, it is our moral duty to educate and advocate on their behalf with our own family members, our friends and associates. It is our duty to lobby our members of Congress hard for this issue. It is also only our (members of the American public who are not active duty military personnel and do not have members of our nuclear family serving on active duty) to lobby directly with our military command structure. This is something that military personnel cannot do, for obvious reasons, so this is where we, who may have served in the past, we who are not subject to the Uniform Code of Military Justice, can speak for our country men and women who are serving us.
All of this represents incremental efforts, which will all lead to incremental change, which as a strategy, I believe has a better chance of being effective than undertaking any effort to demand immediate change. Like water dripping upon a rock, our individual efforts, over time, will break down the current structure, through incremental change.
To find out who your representatives in Congress are (your member of the House of Representatives and your two Senators) visit Congress.org where you can plug in your address and get the contact information, including telephone numbers and addresses for your Congress persons. You can also write and send emails or letters directly from Congress.org to your Congress persons. You can also find the names and addresses of all of the top Pentagon officials at the Defense Department web site.
To learn more about how lives have been impacted by PTSD war casualties please visit Military Spouse Press to read in their own words what military family members have faced. Military Spouses for Change (MSC) is an advocacy organization and that are providing pro bono case management services to active duty military personnel and veterans who are PTSD war casualties and they are fighting for their rightful benefits and appropriate care. To learn more about MSC or to give them a heping hand, please visit their website.
