You Can Polish a Turd….
An article published in the Los Angeles Times titled ‘Army encourages new way of looking at PTSD‘ discusses changing part of the diagnostic criteria for diagnosing military members with PTSD. This is because the general consensus is to develop PTSD one must have felt “fear, helplessness and horror”.
“There is considerable new evidence that certain aspects of the definition are not adequate for individuals working in the military and other first-responder occupations,” such as firefighting and police work, according to the policy, developed by the U.S. Army Medical Command.
It has been my experience that soldiers (term used all inclusively) are trained not to feel these, but rather to channel this feelings into anger and motivation. They are taught to rely on their training, which by the time they deploy (assuming they have in fact been properly trained) these actions and reactions have become nothing more than a muscle-memory reflex. They no longer have to think, they simply react and they know the rest of their element will do the same. They know their job because it has been drilled into them through their training as well as real world implementation.
In mass-casualty incidents with the 86th Combat Support Hospital, everyone knew their job and knew what was expected of them as well as what to expect of others. To watch it is to truly understand the meaning of ‘organized chaos’. It’s a dance really, with everyone knowing their choreography. Sometimes its unsteady and perhaps a little disjointed but you learn, adjust, and move on. This concept is also true for our civilian counterparts in emergency management.
The article goes on to suggest that clinicians consider all of their patients symptoms rather than a check list approach, which would ultimately denying a soldier has PTSD simply because they don’t reflect the symptom of ‘fear and helplessness’. Having other symptoms such as hyperarousal, anger, nightmares, and flashbacks should be suggestive of PTSD, even in the absence of a declaration of fear. Following this approach would allow these soldiers to receive much needed care and benefits. The author also cautions against throwing medications at the symptoms rather than treating the root of the problems.
However, as beneficial as this change may be, herein lies the crux. An opinion piece in ‘The New York Times’ entitled “Does the VA Get It?” makes some very valid points about the state of VA health care, especially in regards to mental health.
A new applicant for mental health services is supposed to receive an evaluation within two weeks, a standard the department says it meets more than 95 percent of the time. But the inspector general said that fewer than half of veterans received evaluations within 14 days. The rest waited an average of 50 days.
Did you catch that? I’m pretty sure that was the IG pointing out how the VA has been polishing the turd. If anyone wanted to fix the problem the first step would be to cut the bureaucracy. Less paperwork and hoops would mean fewer paper pushers which in turn means more money for health care professionals. More treatment personnel means more appointments and more treatment. It really is common sense…something that has been lacking in our military and government for entirely too long!
So, do we continue to polish and admire the shiny turd or do we start demanding the VA flush their current practices and actually fix the problems?