Report Addresses Veterans' Care

This is a great question.

Fortunately, this topic has received considerable attention lately.

Notably, on July 25, 2007, the House Veterans Affairs Committee held a hearing on this topic, at which Veterans for America testified.

Veterans for America's prepared statement is here: http://veterans.house.gov/hearings/schedule110/july07/07-25-07/7-25-07forrester.shtml. Audio of the hearing and statements of all witnesses can be found on the right-hand column of this webpage: http://veterans.house.gov/hearings/index.html.

In addition, the Government Accountability Office (GAO), the investigative arm of Congress, recently announced that it will be conducting a thorough review of preexisting personality disorder dismissals.

One of Veterans for America's chief activities is ensuring that troops who have served in Iraq, Afghanistan, and elsewhere are treated fairly -- that their service is honored (for more information on Veterans for America work, visit www.veteransforamerica.org).

Veterans for America has been disheartened to learn from some service members, who clearly have service-connected mental health problems and/or traumatic brain injuries, that they were first diagnosed with a service-connected mental health problem such as PTSD only to later be told that they had a preexisting personality disorder.

While both the Army Regulation and the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) are very clear on what constitutes a Personality Disorder, the evidence that we've gathered indicates that, in some cases, this diagnosis is being arrived at hastily. In addition, some in the military health care system appear to be attempting to defend the broken practices of the past. Fortunately, other military leaders have clearly stated to Veterans for America that they know that problems such as poor mental health treatment has existed and that the military is working to do a better job of honoring our commitment to those who have served our country in the military.

For more regarding Veterans for America's stance on what we owe those who have served in our military, I have provided a link to an essay by Bobby Muller, President of Veterans for America, entitled "What does America owe to those who serve?" -- http://www.veteransforamerica.org/index.cfm/page/weblog/subpage/display_blog/bid/486CA50C-123F-747A-1B0769A57C558D42

There are some alarming numbers being reported in the media that require setting the record straight. The number referenced above covers all military services for the period 2001-2007. It is not limited to service members who have served in Iraq or Afghanistan. About 70,000 soldiers were discharged from the Active Army in 2006. Of those discharged, 1,086 were separated for personality disorder, of which 295 of those individuals had served in a theater of combat. To the uniformed, civilian, and contract health care professionals that care for these soldiers, the thought of even one person being inappropriately discharged for personality disorder is disturbing. With that in mind, the Acting Surgeon General, Major General Gale Pollock, directed each and every one of those 295 records be reviewed by behavioral health professionals to verify that appropriate actions were taken and that all health concerns were considered in the discharge. That extensive record review is currently underway.

A Personality Disorder is a diagnosis that must be made by a psychiatrist or Ph.D. level clinical psychologist. There are actually ten different specific personality disorders, each with a set of characteristic behaviors. One common characteristic shared by all individuals with a personality disorder is that they have extreme difficulty modifying their problem behaviors and generally do not respond well to psychological treatment. A personality disorder is a long-standing, maladaptive behavior. These problem behaviors are typically disruptive to a military unit and are often associated with discipline problems. When a service member is judged to be unlikely to change or respond to clinical treatment, these behaviors can form the basis of an administrative separation.

There is a review mechanism for any service member who feels a mistake was made, and a special hotline number is below. A board is convened for correction of military records, if someone has been wrongfully discharged or diagnosed with a personality disorder.

Wounded Soldier and Family Member Hotline:

1-800-984-8523

overseas DSN 312-328-0002

stateside DSN 328-0002

email: wsfsupport@conus.army.mil

Marines 1-800-847-1597

Navy 1-800-368-3202

Air Force 1-800-433-0048

Another misnomer is that separating a service member for personality disorder is simply an administrative decision made by a member of the chain of command to do away with problem personnel. Separation on the basis of personality disorder is authorized only if a diagnosis is made by a psychiatrist or doctoral-level clinical psychologist with the required DOD professional credentials and privileges. The disorder must be so severe that the member's ability to function effectively in a military environment is significantly impaired. Existing military clinical quality assurance processes such as routine peer review of provider records also reduce the likelihood of provider deviation from the community standard of care. To protect their legal rights, every service member pending separation for a personality disorder is afforded the opportunity to consult with an attorney prior to separation. Additionally, former service members who believe that they were improperly or unfairly separated may petition their service's Discharge Review Board or Board for Correction of Military Records for administrative review of their cases. Legal counselors advise service members of this right prior to their separation.