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VA DOCTORS TO JCS CHAIR: COMBAT TROOPS MUST HAVE

MENTAL HEALTH SCREENINGS BEFORE DISCHARGE -- Senior

VA physicians say too many troops are returning from war

zones with undiagnosed psychological problems and call

for screenings with a gradual discharge process.

For more about veterans and mental health issues, use the VA Watchdog search engine... click here...
http://www.yourvabenefits.org/sesse
arch.php?q=mental+health&op=ph

We have two stories... first is from the L.A. Times... and we get a little different perspective from the American Forces Press Service.

First story here... http://www.latimes.co
m/features/health/la-na-mullen21-20
08sep21,0,5101541.story

Story below:

-------------------------

VA doctors tell Mullen that vets need mental health screenings

Too many troops are returning from war zones with undiagnosed psychological problems, the physicians tell the chairman of the Joint Chiefs of Staff during his visit to the VA hospital in West L.A.

By Peter Spiegel
Los Angeles Times Staff Writer

Senior physicians with the veterans health system in Los Angeles told the top U.S. military officer Saturday that the Pentagon needs to overhaul the way it discharges troops because hundreds are leaving the armed forces with undiagnosed combat-related mental health problems.

Several of the physicians, including the system's chief of staff and its top psychiatrist, advocated mandatory mental health screenings for all service members who retire after serving in war zones.

The doctors said that because of the stigma attached to combat stress disorders, few troops acknowledge or seek help for psychological problems while in the military, meaning most remain undiagnosed until they run into family or work problems in the civilian world. Combat stress disorders become more difficult to treat the longer they remain undiagnosed.

"We need to make it a gradual discharge process with milestones, whether it's six months or a year, whatever it takes," said Dr. Robert Rubin, chief of mental health at the Veterans Administration healthcare system for Greater Los Angeles. "The stigma goes away if they have no choice but to go for the exams."

The doctors and administrators made the recommendation during an hourlong meeting with Navy Adm. Michael G. Mullen, chairman of the Joint Chiefs of Staff, who visited the VA hospital in West Los Angeles during a five-day visit to his hometown.

Since his appointment as Joint Chiefs chairman nearly a year ago, Mullen has stepped up scrutiny of the military healthcare system, saying the Pentagon must improve the way it takes care of troops returning from Iraq and Afghanistan with physical and mental ailments.

As part of that effort, he has ordered a senior officer on his staff to pull together recommendations to make the Pentagon's hand-over of veterans to the VA health system easier and less bureaucratic.

At the VA hospital on Saturday, Mullen said one of his overriding concerns was that the Defense Department loses track of war veterans once they leave the military and is therefore unable to follow their mental and physical health.

"These people who are so precious to us, we don't have much contact with them anymore," Mullen said. "We have to figure out a way to have a system that is integrated, to know where everybody is, so we can rest comfortably that those who have sacrificed so much are taken care of."

But he also warned that it would take legal changes by Congress to overhaul the military discharge process, a fact that could make requiring mental health screenings difficult.

Mullen noted that the Israeli military requires commanders of active-duty units to take care of all wounded veterans who ever served in their regiments, as well as the families of those killed.

The Joint Chiefs chairman is halfway through a weeklong trip to Texas and California, during which he is scheduled to make several stops at mental health facilities for war veterans.

On Thursday, Mullen visited a pilot clinic the Army has set up at Ft. Bliss, Texas, where soldiers with severe post-traumatic stress disorders are aggressively treated by traditional counselors and with holistic therapies such as acupuncture, biofeedback and meditation. He is scheduled to visit a Los Angeles program for homeless veterans Monday.

peter.spiegel@latimes.com

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Second story here... http://www.defens
elink.mil/news/newsarticle.aspx?id=51258

Story below:

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Chairman Reaffirms Commitment to Health Care for Veterans

By Army Staff Sgt. Michael J. Carden
American Forces Press Service

LOS ANGELES – As chairman of the Joint Chiefs of Staff, Navy Adm. Mike Mullen worries a great deal about the systems in place for Iraq and Afghanistan veterans transitioning out of the military, he said today during a visit with health care providers and social workers at the Veterans Affairs Greater Los Angeles Healthcare System here.

“One of the priorities for me is [the welfare of] the wounded coming out this war and the families of the fallen,” Mullen said. “These people are so precious to us, and [the military] doesn’t have contact with them any more after they’re pushed back into society.”

Once servicemembers separate from the military, they can register with the Veterans Affairs Department, which is responsible for helping them integrate back into society. VA assists veterans with health-care needs, entitled benefits and finding employment.

But what happens to those who don’t register and suffer physical injuries? What happens to those who received physical treatment but were too embarrassed to seek mental help?

Some may get on with their lives without any issues. Others may suffer from depression, alcoholism or drug addiction. Many may have difficulties holding a job, and some end up in jail. Post-traumatic stress disorder and traumatic brain injuries have become more and more common for veterans of the wars in Iraq and Afghanistan.

The single biggest issue Mullen has noticed during visits with wounded servicemembers at polytrauma medical centers, such as Walter Reed Army Medical Center in Washington, D.C., is that they want their lives back, he said. They’re eager to get back to their units or shift back into society and just move on with their lives, he added.

Unfortunately, many servicemembers are so eager to separate from the military that they’ll forego seeking psychiatric care for possible PTSD or TBI. For these reasons, there are significant issues with veterans struggling or becoming homeless due to undiagnosed, service-related disabilities, he said.

In the Los Angeles area, around 35,000 veterans have been treated through VA systems. However, only some veterans took it upon themselves to seek help. Many veterans were sought out in jails and on the streets here by VA social workers, said Bill Daniels, community care chief here.

The relationship and interface with between VA and the Defense Department is a challenge in itself, said Ron Norby, director for the VA Desert Pacific Healthcare Network, which provides services to more than a million veterans across southern California and Nevada.

Norby has been working with veterans and servicemembers since serving in the Vietnam War as a Navy nurse. The current military-to-civilian transition system is pretty much the same as when he was discharged, he said. Once he finished his paperwork and left his unit, that was it, he added.

But the problem with identifying mental disorders doesn’t fall on the military checking up on people after separation, he said. Rather, the screening process needs to be more extensive to catch PTSD or TBI.

Norby and his staff agree that anyone discharged from the military or who has ever been in a theater of war should have a one-on-one consultation with a physician. Many suggest that everyone returning from deployment should be screened before they get back to the United States, he said.

“The faster we can catch the symptoms, the more we can help,” Norby said.

During the chairman’s visit here, he met with several veterans being treated for mental disorders. He expressed his gratitude for their service and let them know that taking care of them is a priority of the Defense Department.

One former Army reservist, who asked not to be identified, has been attending group sessions and speaking to psychiatrists here for a little more than a month for PTSD from combat in Iraq in 2004, he said. He’s been battling alcoholism, unemployment and depression since 2005.

“The care is great, and I’m slowly getting back on my feet,” the veteran said. “I didn’t think talking to a shrink or group therapy would help.”

The veteran said he enjoys being part of a group again, and that it’s one of the things he misses most about the military.

“Everyone comes from different situations and have different needs, but we all deal with our anger or depression or alcoholism together,” he said.

According to the annual consensus produced by VA homeless centers nationwide in 2007, an estimated 154,000 veterans in the United States are homeless. About 51 percent of those veterans served in the armed forces after the Vietnam War. About 45 percent indicated substance abuse and medical problems. At least 20 percent saw combat.

Mullen said the nation owes its veterans the care they need.

“We as a country have to figure out a way to have a system that is integrated and [in which] we know where everyone is,” the admiral said. “We need to make sure those who’ve sacrificed so much are taken care of.”

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