Saturday, May 17, 2008

VA psychologist to staff: don't diagnose PTSD

Judith Graham

A furor has erupted over a psychologist’s email directing staff at a Texas veterans facility to withhold diagnoses of post-traumatic stress disorder from soldiers returning from Afghanistan and Iraq.

In the email, Norma J. Perez, PTSD program coordinator at the Olin E. Teague Veterans’ Center in Temple, Texas, tells staff “given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out.”

Instead, she advises “consider a diagnosis of Adjustment Disorder.”

Veteran Affairs staff “really don’t ... have the time to do the extensive testing that should be done to determine PTSD,” Perez wrote.

VA Secretary James Peak immediately called Perez’s email “inappropriate” and insisted that it didn’t reflect VA policy, the Washington Post reported Friday. In a statement, Peak said the staffer’s action was “repudiated at the highest level of our health care organization.”

Oddly, Peake indicated that Perez – a psychologist – was staying in her job, after becoming “extremely apologetic” when counseled.

That infuriated people writing comments at the Washington Post’s Web site, who called Perez a “no good dirt bag” and recommended that she be given “100 lashes” and “fired for dereliction of duty.”

What’s at stake is veterans’ ability to get disability and health care benefits from the VA. A diagnosis of “adjustment disorder” doesn’t deliver the same level of benefits as would a diagnosis of PTSD, Paul Sullivan, the executive director of Veterans for Common Sense, told CBS news.

“VA staff across the country are working their hearts out to get our veterans the care they need and deserve,” U.S. Sen. Patty Murray (D-Wash.) told CBS. “But emails like these make their jobs far more difficult.”

The chairs of the House and Senate Veterans Affairs Committees promised Friday to investigate the matter, and Sen. Barack Obama (D.-Ill.) called Perez’s email “outrageous” in a statement calling for a probe.

Rep. Bob Filner (D-Calif.), who heads the House committee, said he wanted to know whether the Texas psychologist was acting on orders. “Where is she getting it from,” Filner said he wanted Peake to explain, according to the Associated Press. “Why is she saying this? Who is giving her the order?”

VA spokewoman Alison Aikele told the AP Friday that Perez was just making a suggestion. “We’re not aware of any other instances where this happened,” Aikele said.

Just last month, the Rand Corp. released a report estimating that about 300,000 soldiers who served in Iraq or Afghanistan have PTSD or major depression. And last week, a separate furor arose over yet another series of emails that appeared to indicate that VA officials didn’t want to disclose the number of veterans who commit suicide – as many as 18 a day, according to some estimates.

Have you or a family member had trouble getting a diagnosis of PTSD from the Defense Department or the VA? What do you think of the way soldiers are evaluated for these conditions?