PTSD in Veterans Mental Health

Mental Health Web Site Addresses Differences in Diagnosis of Adjustment Disorder and PTSD in Veterans Mental Health

June 24, 2008 -- On March 20th Dr. Norma Perez, mental health specialist and coordinator of her hospital's Post-Traumatic Stress Disorder (PTSD) clinical team, sent a startling email to her staff.

"Given that we are having more and more compensation seeking veterans," she wrote. "I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder."

We're happy to fund the actions that break our troops, but not to fund the actions that help to put them back together again.
Dr. Perez has since argued that her email was meant to better support veterans who sometimes struggle to get a correct diagnosis. Critics say that her email is a sign that the VA is cutting back on appropriate care for soldiers by using a lesser diagnosis that is not eligible for the same services as Post Traumatic Stress Disorder.

An April 2008 private study found that at least 300,000 American military personnel are suffering from PTSD but according to Pentagon findings only 40,000 veterans have been officially diagnosed.

Mark Dombeck, PhD, Director of MentalHelp.net, says that PTSD can be challenging to identify. He adds that this may be the reasoning behind Dr. Perez's controversial email.

PTSD is a reaction to violent, dangerous trauma that causes intense stress and fear. The intensity of his or her experience causes the trauma to be written into the victim's memory. Veterans suffering from PTSD are unable to turn off obsessive thoughts about their experiences and so are forced to re-live their fear and horror over and over again.

People suffering with PTSD often present with the following symptoms:


Dissociation
Intrusive trauma memories at inconvenient times
Intense clarify of recall
Nightmares or hallucinations
Substance abuse
Reclusive behavior and avoidance
Jumpiness, heightened startle response
Hyperawareness
Guilt over surviving trauma

Treatments for PTSD include medications and psychotherapy.

Accurately diagnosing PTSD can be a time-consuming process and patients need support while they wait for their official diagnosis. Adjustment Disorder can be used as a temporary label for a veteran whose testing is not yet complete but who needs services.

"Adjustment Disorder is a stress disorder in its own right," says Dr. Dombeck. "When it's used to address the need for further testing then it's an appropriate diagnosis. But if it's used for political purposes - like to save the VA from having to pay out money to a disabled veteran - then that amounts to malpractice."

Dr. Dombeck says he is sympathetic to the challenges of the Veteran's Administration but adds that his first concern is for struggling veterans and their need for effective, ongoing mental health support.

"In our current war-time circumstances the serious issue is how quickly can veterans can get the care they need to address their healthcare concerns," says Dr. Dombeck. "We're happy to fund the actions that break our troops, but not to fund the actions that help to put them back together again."

About MentalHelp.net:
The MentalHelp.net website exists to promote mental health and wellness education and advocacy.

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