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FORT CARSON SAYS POST IMPROVING ITS TREATMENT
OF
COMBAT STRESS -- It's been more than 60 years
since G
en. George Patton slapped a soldier suffering
from "battle
fatigue." But some in the Army are still stuck
in the mind-set.

Some background here...
http://www.vawatchdog.org/07/nf07/nfFEB07/nf021507-7.htm
Story here...
http://www.gazette.com/
onset?id=20569&template=article.html
Story below:
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Carson says post improving its treatment of
combat stress
By CARY LEIDER VOGRIN and TOM ROEDER THE
GAZETTE
Leaders at Fort Carson say they’re trying to change Army culture by
leading the way in compassionate care for soldiers with war-caused
mental illness.
But they admit they’ve got a long way to go to shed the stigma that only
cowards suffer combat stress.
It’s been more than 60 years since Gen. George Patton slapped a soldier
suffering from “battle fatigue,” sparking a controversy in the midst of
World War II. But some in the Army are still stuck in the mind-set, says
Maj. Gen. Robert Mixon, commander of the post.
“We’re not going to get rid of all the biases next week,” Mixon said.
“But I tell everyone that bias will not be tolerated.”
The general said people under his command are getting the message, and
Fort Carson is doing more than ever to treat mentally ill soldiers and
return them to the battlefield. The Army gets a big assist from civilian
care providers in Colorado Springs.
Critics, including mental health activist and ex-soldier Andrew Pogany,
say the Army is still letting scores of soldiers slip through cracks.
But even Pogany admits the Army is improving its level of care.
Since 2003, every soldier returning from Iraq or Afghanistan to Fort
Carson has been screened for mental illness symptoms. Unit chaplains are
also asked to identify soldiers who might have mental health
difficulties.
Those soldiers are referred to the post’s 38 licensed mental health
workers, who range from psychiatrists to social workers. Col. Steve
Knorr, the post’s top psychiatrist, said his contingent of mental health
workers has nearly doubled since the Iraq war began in 2003.
Despite national media reports that the military mental health care
system is strained, the Fort Carson system is working, Knorr said.
Col. John Cho, who commands the post hospital, Evans Army Community
Hospital, said the program is effective because it catches problems
early and ensures that at-risk soldiers know where they can get
treatment. Options include going off-post to get help from civilian
doctors through the military’s Tricare insurance program.
Treatment at Fort Carson ranges from a walk-in clinic to group therapy
sessions for patients with ongoing needs, Knorr said. Most soldiers who
have symptoms of mental illness, including post-traumatic stress
disorder, stay in the Army and return to active duty, including many who
are prescribed antidepressants, which Knorr said have proven safe and
effective for deployed troops.
Pogany said the Army provides too little care to soldiers and fails to
tailor programs to individual needs. He also assailed waiting times for
help through Tricare.
Knorr said the waiting time to see a psychiatrist at the post is two
weeks, meeting Defense Department standards, which allow a month.
CIVILIAN FACILITIES
Fort Carson lacks facilities to hospitalize patients for psychiatric
care. Cho said the post couldn’t justify the expense in light of the
available civilian facilities in Colorado Springs.
“We see many active-duty service people from Fort Carson,” said Dr.
Stephanie Purcell, a psychiatrist at St. Francis Behavioral Health
Services. “We certainly are seeing a great deal of post-traumatic stress
disorder.”
Purcell said that at any given time five or six patients in the 26-bed
unit east of downtown are from the military.
The same is true at Cedar Springs Behavioral Health System, CEO Elaine
Crnkovic said.
“When all this started, we saw a lot of people who were stressed about
going to war,” she said. “Now we’re seeing the guys who have gone and
come back — once, twice, three times — and are very anxious about going
back again.”
Crnkovic said the cases at Cedar Springs have become “more complex”
because of multiple traumatic wartime experiences.
“That seems to create layers and layers of the stress, so there’s more
to work through,” she said.
Most soldiers at St. Francis, Purcell said, are referred there from Fort
Carson and voluntarily check themselves in.
Some soldiers, though, are there on an involuntary 72-hour hold. They’ve
been deemed a danger to themselves or others, perhaps because of
psychosis or severe depression. Over three days, they are evaluated and
could be court-ordered to stay longer.
Crnkovic and Purcell also are seeing substance abuse related to PTSD.
“Unfortunately, that is not rare. We do see many people who make an
attempt to deal with their symptoms by using, for example, alcohol or
other substances,” Purcell said.
NORMAL FEELINGS
Brian Butler, clinical training supervisor at the Lighthouse Assessment
Center, an arm of Pikes Peak Mental Health, called PTSD a “sticky
diagnosis,” meaning it typically will have one or two other mental
health or substance abuse issues along with it.
“It’s not an easy diagnosis to make,” he said. “There may be soldiers —
a lot of soldiers — that don’t meet full-blown diagnosis for PTSD but
are suffering from PTS symptoms.”
The Lighthouse is a shortterm stabilization and assessment unit.
“While they’re here, we try to do three things,” Butler said. The first,
he said, is to let soldiers know it’s a place they can talk freely.
Second, they are told many of their feelings are normal. Finally, they
are taught about triggers and how to handle them.
“Oftentimes, soldiers feel they cannot talk about their feelings,” said
Butler, who experienced post-traumatic stress symptoms after coming home
from the Persian Gulf War with the 1st Infantry Division. “Or they may
not know how to express themselves. We let them tell their stories. We
want them to know even the bravest and courageous soldiers have all been
scared, and that it’s OK to feel those things and in fact, it’s normal.”
Soldiers often complain of being uneasy in crowds, feeling anxiety
behind the wheel, being easily angered or experiencing other “this is
not me” feelings.
“The military is all about managing chaos and being in control when
situations are chaotic,” Butler said. “You can imagine how a soldier
feels when they’re feeling out of control in a situation that is normal
and not chaotic.”
Purcell, of St. Francis, said there’s still much to be learned about the
long-term effects of PTSD.
“I think certainly we have a long road ahead of us in terms of
understanding PTSD and in terms of understanding the impact that modern
warfare has on the soldier and the family unit and the progression of
the soldier’s life beyond the military,” she said. “There are tremendous
areas where we are just children in dealing with this field.”
Butler said there is hope for those suffering from PTSD.
“Can you cure it? No,” he said. “Can you adapt to it, treat it and
resolve the symptoms? Absolutely yes.”
REPORT DOCUMENTS MILITARY NEEDS
The American Psychological Association issued a 67-page document last
month titled “The Psychological Needs of U.S. Miliary Service Members
and Their Families: A Preliminary Report.”
The report says that although efforts by individual military mental
health providers are laudable, the military system falls short in its
ability to meet the psychological health needs of deployed personnel and
their families. The report was drafted by the APA Presidential Task
Force on Military Deployment Services for Youth, Families and Service
Members. See the full text of the report at:
www.apa.org/releases/militaryd
eploymenttaskforcereport.pdf
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Larry Scott --