Transcript health care providers

The war within
US Civil War
During the Civil War
common diagnosis was
nostalgia.
The first military hospital
for the insane was
established in 1863.
The government made no
effort to deal with the
psychiatrically wounded
after the war and the
hospital was closed.
World War I
Soldiers emerged from the
trenches stuttering,
crying, trembling and at
times were even
paralyzed and blind.
Those in charge were
convinced these
soldiers were cowards
or malingerers who
deserved stern
discipline or to be courtmartialed.
World War II
Soldiers who were
traumatized by
witnessing extreme
violence were pulled out
of the front lines for
treatment. This involved
supportive counseling
with the aim of getting
them back to their
fighting comrades within
three days to a week.
Iraq and Afghanistan
Repeated and extended
deployments to Iraq and
Afghanistan are driving
psychological injuries upward,
say military and civilian doctors,
despite a spectrum of new
government programs aimed at
preventing and treating them.
With the advent of the wars in Iraq
and Afghanistan, the Army
started programs to teach
soldiers how to identify signs of
PTSD, prepare mentally for
combat, and remove the stigma
of seeking help
Through trial and error, they've
found that antidepressants help
calm soldiers down enough to
stay and finish their tours.
PTSD defined
a psychiatric disorder that can occur
following the experience or witnessing
of life-threatening events such as
military combat, natural disasters,
terrorist incidents, serious accidents or
violent personal attacks.
Symptoms
Flashbacks, nightmares, depression,
anxiety, removing yourself from
activities you once enjoyed, becoming
emotionally numb and difficulty
maintaining close relationships are just
some of the symptoms of PostTraumatic Stress Disorder (PTSD).
Today, more than 150,000 veterans of the
Iraq and Afghanistan wars have been
officially diagnosed with PTSD. The
number likely is higher because of the
stigma attached to the disorder and also
because some service members have
sought out private treatment rather than
through the Defense Department or
Department of Veterans Affairs
How are our soldiers being
treated for this disorder
today?
College of Psychology
Course listings from the top ten
psychology colleges in the US
only one has a specialized
seminar that is specific to PTSD.
None of the schools offer courses
in dealing with military personnel
beyond treating depression,
anxiety and sleep disorders
Chaplain
•Ecclesiastical endorsement
•Bachelor’s degree
•Not less than 36 hours must be in
theological/ministry and related studies,
consistent with the respective religious
tradition of the applicant
•Pass a military commissioning physical
•Pass a security background investigation
•Ability to work in the Department of
Defense directed religious accommodation
environment.
Tricare – the military's insurance care
company
The following quote is the statement of RADM Christine S. Hunter, USN,
Deputy Director of Tricare Management Activity:
Our efforts to reduce the stigma associated with seeking mental
healthcare have been accompanied by an increase in providers to
meet the growing demand. Together with the Surgeons General and
our TRICARE contractors, we’ve added over 1900 providers to the
military hospitals and clinics, and more than 10,000 added to the
networks. Visits have increased dramatically, with 112,000 behavioral
health outpatients now seen every week. In addition, service
members and their families can access the TRICARE Assistance
Program for supportive counseling via Webcam from their homes, 24
hours a day.
Tricare declined comment when asked by what criteria they contract
professional psychologist and psychiatrist.
In Theater
Medicating soldiers in war brings up a host of difficulties not
faced by doctors back in the States. The brigade
psychiatrist, Dr. Randal Scholman, said he finds himself
making more informal or nontraditional diagnoses.
Deployed soldiers are in a particularly stressful
environment, and often it's hard to tell if a problem is
temporary, he said.
The most common drugs he prescribes are sleeping pills,
followed by antidepressants. Often, he gives a soldier
Prozac or Paxil to treat what he and his colleagues call
"combat operational stress reaction." The disorder — which
is not formally recognized — includes symptoms like sleep
problems, irritability and propensity to anger. Soldiers
describe it as being "on edge, keyed up, jumpy, things like
that," he said.
Through trial and error, they've found that antidepressants
help calm soldiers down enough to stay and finish their
tours.
The
Golden
Hour
R Adams Cowley, M.D., explained in an
interview: "There is a golden hour between life
and death. If you are critically injured you have
less than 60 minutes to survive. You might not die
right then; it may be three days or two weeks
later -- but something has happened in your body
that is irreparable."
But
is there a
“Golden Hour” for
those that are injured
mentally?
Civil service agents, depending on
departmental protocols, are
removed from service to meet with
a psychologist/psychiatrist after
being involved with a shooting.
Soldiers go through suicide and depression briefings
before they are deployed and when they reach the
country, in which they are deployed in, though most
are never introduced to the mental health care
provider or councilor. They are left to their own
conscious to seek mental health care support.
There is no mandatory protocol that states that a
soldier must meet with a mental health care provider
or group therapy session after any mission.
Speaking to commanding officers
and non-commissioned officers,
if they are told that a soldier is
feeling or showing suicidal or
depression tendencies the
soldier is put on suicidal watch
and then taken to medical
professionals. When deployed, if
military personnel has issues
with a situation there are
psychologists, psychiatrists and
pastoral councilors to help.
When speaking to the soldier,
most say that there is no
professional help, save medical
doctors or pastoral counselors,
to talk to. Most soldiers do not
seek help due to the stigma of
having a mental disorder.
Having closed off and numbed themselves in
order to survive, soldiers are then faced with the
task of working their way back toward humanity.
The struggle is to “re-experience himself as a
vital human being.” However, it is not all that
easy, for “one’s human web has been all too
readily shattered, and in rearranging one’s selfimage and feelings, one is on guard against false
promises of protection, vitality, or even modest
assistance. One fends off not only new threats of
annihilation but gestures of love or help.” Robert J. Lifton
If schools are not training psychologists
and psychiatrists to help those with posttraumatic stress disorder, along with
treating the anxiety, depression and
sleeplessness it causes, then why is the
US Government contracting and referring
these professionals to US military
personnel?