QUOTE
"I am under a lot of pressure to not diagnose PTSD"
A secret recording reveals the Army may be pushing its medical staff not to diagnose post-traumatic stress disorder. The Army and Senate have ignored the implications.
Editor's note: Last June, during a medical appointment, a patient named "Sgt. X" recorded an Army psychologist at Fort Carson, Colo., saying that he was under pressure not to diagnose combat veterans with post-traumatic stress disorder. Listen to a segment of the tape here.
April 8, 2009 | FORT CARSON, Colo. -- "Sgt. X" is built like the Bradley Fighting Vehicle he rode in while in Iraq. He's as bulky, brawny and seemingly impervious as a tank.
In an interview in the high-rise offices of his Denver attorneys, however, symptoms of the damaged brain inside that tough exterior begin to appear. Sgt. X's eyes go suddenly blank, shifting to refocus oddly on a wall. He pauses mid-sentence, struggling for simple words. His hands occasionally tremble and spasm.
For more than a year he's been seeking treatment at Fort Carson for a brain injury and post-traumatic stress disorder, the signature injuries of the Iraq war. Sgt. X is also suffering through the Army's confusing disability payment system, handled by something called a medical evaluation board. The process of negotiating the system has been made harder by his war-damaged memory. Sgt. X's wife has to go with him to doctor's appointments so he'll remember what the doctor tells him.
But what Sgt. X wants to tell a reporter about is one doctor's appointment at Fort Carson that his wife did not witness. When she couldn't accompany him to an appointment with psychologist Douglas McNinch last June, Sgt. X tucked a recording device into his pocket and set it on voice-activation so it would capture what the doctor said. Sgt. X had no idea that the little machine in his pocket was about to capture recorded evidence of something wounded soldiers and their advocates have long suspected -- that the military does not want Iraq veterans to be diagnosed with PTSD, a condition that obligates the military to provide expensive, intensive long-term care, including the possibility of lifetime disability payments. And, as Salon will explore in a second article Thursday, after the Army became aware of the tape, the Senate Armed Services Committee declined to investigate its implications, despite prodding from a senator who is not on the committee. The Army then conducted its own internal investigation -- and cleared itself of any wrongdoing.
When Sgt. X went to see McNinch with a tape recorder, he was concerned that something was amiss with his diagnosis. He wanted to find out why the psychologist had told the medical evaluation board that handles disability payments that Sgt. X did not, in fact, have PTSD, but instead an "anxiety disorder," which could substantially lower the amount of benefits he would receive if the Army discharged him for a disability. The recorder in Sgt. X's pocket captured McNinch in a moment of candor. (Listen to a segment of the recording here.)
"OK," McNinch told Sgt. X. "I will tell you something confidentially that I would have to deny if it were ever public. Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead]." McNinch told him that Army medical boards were "kick[ing] back" his diagnoses of PTSD, saying soldiers had not seen enough trauma to have "serious PTSD issues."
"Unfortunately," McNinch told Sgt. X, "yours has not been the only case ... I and other [doctors] are under a lot of pressure to not diagnose PTSD. It's not fair. I think it's a horrible way to treat soldiers, but unfortunately, you know, now the V.A. is jumping on board, saying, 'Well, these people don't have PTSD,' and stuff like that."
Contacted recently by Salon, McNinch seemed surprised that reporters had obtained the tape, but answered questions about the statements captured by the recording. McNinch told Salon that the pressure to misdiagnose came from the former head of Fort Carson's Department of Behavioral Health. That colonel, an Army psychiatrist, is now at Fort Lewis in Washington state. "This was pressure that the commander of my Department of Behavioral Health put on me at that time," he said. Since McNinch is a civilian employed by the Army, the colonel could not order him to give a specific, lesser diagnosis to soldiers. Instead, McNinch said, the colonel would "refuse to concur with me, or argue with me, or berate me" when McNinch diagnosed soldiers with PTSD. "It is just very difficult being a civilian in a military setting."
McNinch added that he also received pressure not to properly diagnose traumatic brain injury, Sgt. X's other medical problem. "When I got there I was told I was overdiagnosing brain injuries and now everybody is finding out that, yes, there are brain injuries," he recalled. McNinch said he argued, "'What are we going to do about treatment?' And they said, 'Oh, we are just counting people. We don't plan on treating them.'" McNinch replied, "'You are bringing a generation of brain-damaged individuals back here. You have got to get a game plan together for this public health crisis.'"
When McNinch learned he would be quoted in a Salon article, he cut off further questions. He also said he would deny the interview took place. Salon, however, had recorded the conversation.
A secret recording reveals the Army may be pushing its medical staff not to diagnose post-traumatic stress disorder. The Army and Senate have ignored the implications.
Editor's note: Last June, during a medical appointment, a patient named "Sgt. X" recorded an Army psychologist at Fort Carson, Colo., saying that he was under pressure not to diagnose combat veterans with post-traumatic stress disorder. Listen to a segment of the tape here.
April 8, 2009 | FORT CARSON, Colo. -- "Sgt. X" is built like the Bradley Fighting Vehicle he rode in while in Iraq. He's as bulky, brawny and seemingly impervious as a tank.
In an interview in the high-rise offices of his Denver attorneys, however, symptoms of the damaged brain inside that tough exterior begin to appear. Sgt. X's eyes go suddenly blank, shifting to refocus oddly on a wall. He pauses mid-sentence, struggling for simple words. His hands occasionally tremble and spasm.
For more than a year he's been seeking treatment at Fort Carson for a brain injury and post-traumatic stress disorder, the signature injuries of the Iraq war. Sgt. X is also suffering through the Army's confusing disability payment system, handled by something called a medical evaluation board. The process of negotiating the system has been made harder by his war-damaged memory. Sgt. X's wife has to go with him to doctor's appointments so he'll remember what the doctor tells him.
But what Sgt. X wants to tell a reporter about is one doctor's appointment at Fort Carson that his wife did not witness. When she couldn't accompany him to an appointment with psychologist Douglas McNinch last June, Sgt. X tucked a recording device into his pocket and set it on voice-activation so it would capture what the doctor said. Sgt. X had no idea that the little machine in his pocket was about to capture recorded evidence of something wounded soldiers and their advocates have long suspected -- that the military does not want Iraq veterans to be diagnosed with PTSD, a condition that obligates the military to provide expensive, intensive long-term care, including the possibility of lifetime disability payments. And, as Salon will explore in a second article Thursday, after the Army became aware of the tape, the Senate Armed Services Committee declined to investigate its implications, despite prodding from a senator who is not on the committee. The Army then conducted its own internal investigation -- and cleared itself of any wrongdoing.
When Sgt. X went to see McNinch with a tape recorder, he was concerned that something was amiss with his diagnosis. He wanted to find out why the psychologist had told the medical evaluation board that handles disability payments that Sgt. X did not, in fact, have PTSD, but instead an "anxiety disorder," which could substantially lower the amount of benefits he would receive if the Army discharged him for a disability. The recorder in Sgt. X's pocket captured McNinch in a moment of candor. (Listen to a segment of the recording here.)
"OK," McNinch told Sgt. X. "I will tell you something confidentially that I would have to deny if it were ever public. Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead]." McNinch told him that Army medical boards were "kick[ing] back" his diagnoses of PTSD, saying soldiers had not seen enough trauma to have "serious PTSD issues."
"Unfortunately," McNinch told Sgt. X, "yours has not been the only case ... I and other [doctors] are under a lot of pressure to not diagnose PTSD. It's not fair. I think it's a horrible way to treat soldiers, but unfortunately, you know, now the V.A. is jumping on board, saying, 'Well, these people don't have PTSD,' and stuff like that."
Contacted recently by Salon, McNinch seemed surprised that reporters had obtained the tape, but answered questions about the statements captured by the recording. McNinch told Salon that the pressure to misdiagnose came from the former head of Fort Carson's Department of Behavioral Health. That colonel, an Army psychiatrist, is now at Fort Lewis in Washington state. "This was pressure that the commander of my Department of Behavioral Health put on me at that time," he said. Since McNinch is a civilian employed by the Army, the colonel could not order him to give a specific, lesser diagnosis to soldiers. Instead, McNinch said, the colonel would "refuse to concur with me, or argue with me, or berate me" when McNinch diagnosed soldiers with PTSD. "It is just very difficult being a civilian in a military setting."
McNinch added that he also received pressure not to properly diagnose traumatic brain injury, Sgt. X's other medical problem. "When I got there I was told I was overdiagnosing brain injuries and now everybody is finding out that, yes, there are brain injuries," he recalled. McNinch said he argued, "'What are we going to do about treatment?' And they said, 'Oh, we are just counting people. We don't plan on treating them.'" McNinch replied, "'You are bringing a generation of brain-damaged individuals back here. You have got to get a game plan together for this public health crisis.'"
When McNinch learned he would be quoted in a Salon article, he cut off further questions. He also said he would deny the interview took place. Salon, however, had recorded the conversation.
(more)
http://www.salon.com/news/special/coming_h...009/04/08/tape/
Not good.
