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Thursday, May 15, 2008

The VA Is Sick of Your Inconvenient Diseases

posted by on May 15 at 13:35 PM

Today, the Department of Defense announced a $2.3 million award to the University of Cincinnati to study brain trauma and post-traumatic stress disorder.

But, according to an email leaked to a citizens’ advocacy group, VA bosses are discouraging social workers and psychiatrists from diagnosing PTSD in veterans because it’s inconvenient:


In the words of Melanie Sloan, the righteously outraged director of Citizens for Responsibility and Ethics in Washington, “the VA is calling on its employees to deliberately misdiagnose returning veterans in an effort to cut costs.”

Which isn’t just outrageous—it’s outrageously dumb.

Ignoring PTSD now will only cost the VA, with interest, in the next few decades. As this WSJ story reports, PTSD is both underreported and lasting:

Many military personnel are reluctant to seek counseling for PTSD because they are afraid that seeking help would harm their careers. A recent survey by the American Psychiatric Association found that 75% of military personnel felt that asking for assistance would reduce their chances for promotion.

Undoubtedly, some people fake PTSD—but the incentives lean towards underreporting, not overreporting.

Military officers and psychologists fear that veterans of the two wars will suffer mental-health problems for decades to come, a largely hidden cost of the current conflicts.

There’s a financial cost to this, but more importantly there’ll be a cost in lives if we don’t get a handle on this problem now,” Sen. Christopher Bond (R., Mo.) said in a recent interview.

Money for research is good. Money for treatment is imperative.

RSS icon Comments


The way Republicans treat veterans is something I have never been able to comprehend. Their motives usually make sense to me, and with veterans it seems like such a no-brainer issue for the right wing. Yet they insist on taking a beating year after year for neglecting veterans. What is wrong with them?

Posted by elenchos | May 15, 2008 1:55 PM


The real question is why do the troops insist on mostly voting Republican. Talk about voting against your own interests.

Posted by keshmeshi | May 15, 2008 2:01 PM

Uh, generally VA officials (or any VA staff for that matter) don't use Yahoo to communicate via email. We have our own email system. Evidenced to the Stranger staffers by the "" at the end of the email address I am using to post this... Has it been proven that this email is even real, or is someone trying to stir things up?

Posted by DanFan | May 15, 2008 2:05 PM

DanFan, the Yahoo account could be the account to which the whistleblower forwarded the .gov email for safe handling, no?

Posted by tomasyalba | May 15, 2008 2:09 PM

I would agree to that.

That said, is not very fun to deal with from a network aspect ...

Posted by Will in Seattle | May 15, 2008 2:11 PM

Another two cents: I work in the Mental Health Department of a VA hospital. I don't work with veterans directly (I deal with the training programs for Psychiatrists and Psychologists) but I have not seen or heard any evidence of anything like this occuring. We have several staff working on PTSD research right now, and several programs (indeed, a whole wing of the hospital) devoted entirely to PTSR (Post Traumatic Stress Recovery). Maybe this is true; maybe not, but my guess is, if this email was really sent by a VA "official" to social workers or clinicians, it was probably an outlying (i.e. rural) clinic that is low on staff and funding. I'm sure it didn't come from the top.

Posted by DanFan | May 15, 2008 2:13 PM


Which again takes us back to the question of why the GOP has left anywhere without enough VA funding. Especially rural areas where their base is.

Posted by elenchos | May 15, 2008 2:50 PM


If you look at the top of the e-mail, you'll see that it was forwarded. Most of the forwarding e-mail address is blotted out, except for the domain name:

Posted by keshmeshi | May 15, 2008 2:51 PM

Does the e-mail go on to mention jobs at the Post Office and how nothing could possibly go wrong?

Posted by Original Andrew | May 15, 2008 3:05 PM

@6 - I doubt it was just an isolated incident.

With Republicants, you have to expect the worst, and not trust but verify.

Posted by Will in Seattle | May 15, 2008 3:09 PM

I work for a company that gives vocational assessments and counseling to Veterans.

A lot of the people who come to us are very sick in several different ways, but they're usually well diagnosed.

Posted by tabletop_joe | May 15, 2008 3:15 PM

I don't know where my comment went, but this is just the tip of a trillion-dollar iceberg. The VA is in the wrong, but it's understandable in a way, because there's no way in hell they're ever going to have the resources they need to deal with the problems just now coming into the system. They can't afford it. WE can't afford it.

The number of ways in which the Iraq War is going to bankrupt America have barely begun. The cost of the war itself is just the beginning.

Posted by Fnarf | May 15, 2008 3:28 PM

Benefit of the doubt:

Not diagnosing PTSD when you haven't tested for it ain't necessarily a bad thing.

Posted by umvue | May 15, 2008 3:48 PM

@12 - maybe if we implement a tax on millionaires and billionaires to pay for it ...

Never give Republicans the benefit of the doubt, they'll steal your milkshake.

Posted by Will in Seattle | May 15, 2008 4:12 PM

Right on, Will! Show me the money! Give me back my son! You can't handle the truth! Phone home! Frankly, my dear, I don't give a damn!

Posted by Fnarf | May 15, 2008 5:20 PM

A friend is suing the forest service claiming PTSD caused by the job. He openly admits he's using this as an excuse because he got into a fist fight on the job. So he's saying he "just snapped" under the pressure of the job.

Posted by true story | May 15, 2008 6:31 PM

DanFan @6 has there been any success using propranolol for PTSD at the VA? It was written up a while back as an off label use but I haven't heard anything further.

Posted by LMSW | May 15, 2008 9:47 PM

I'm going to have to stay anonymous, and I'm going to be mighty brief here. Maybe later I'll educate you more.

See what 13 said, and reread the email. Do not assume that the previous level of diagnoses of PTSD being given were, although they were the norm until that point ,correct. Consider the possibility that VA medical facilities are tossing out PTSD diagnoses like candy.

And the ripple effect of such generosity on that over diagnosis? Not much.

There are many different balls in the air here -- military, VA's VHA, and VA's VBA. They've ball been "mashed" into the concept of "VA" in this post. Three different, giant empires here, folks.

Posted by File Boy | May 15, 2008 9:53 PM

Some of them don't have to suffer with mental health problems for years though. The good news is that all this PTSD (no, not PTSD- just something else totally NOT related to the U.S. Government's treatment of soldiers, I mean) has resulted in incredibly high suicide rates for veterans!

Some of them just drive themselves into cement pile-ons like my cousin, saving the U.S. Government TONS of money! Hoo-ray! They're probably doing that for our economy, those loveable soldiers!

Posted by Sara | May 15, 2008 10:40 PM

@17 - creatine works better.

Posted by Will in Seattle | May 16, 2008 12:14 AM

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