Steve Epps, a Vietnam veteran, says when he returned home from the war, a sight, smell or sound could trigger unwanted memories, but back then post traumatic stress disorder wasn’t as easily recognized as it is today. If it had been, Epps is sure he would have been diagnosed.
“The vast majority of vets need help to make the transition from service life to civilian life,” said Epps, who serves as the community service officer for the Proctor-Hopson VFW Post in Jamaica.
Instead of medical and psychiatric treatment, Epps relied on his family and friends to get through the difficult times. Still, today he says he is a more “emotional” person than he was before he entered the service especially when it comes to things like “loyalty to the unit, fellow combatants and showing mercy to an enemy.”
Nearly 8,000 veterans in New York State suffer from PTSD, more than 7,000 suffer from traumatic brain injury and more than 4,000 have both, according to data compiled by the RAND Corporation. The group also estimates that 20 percent of Iraq and Afghanistan veterans suffer from PTSD, 19 percent suffer from TBI and 7 percent have both.
Sen. Kirsten Gillibrand (D-New York) has come up with some suggestions and legislative plans that she hopes will improve the quality and speed with which servicemen and women suffering from PTSD and TBI are treated.
“After being deployed multiple times to Iraq and Afghanistan, thousands of New York veterans are suffering from PTSD and TBI and many are not even aware of it,” Gillibrand said in a statement. “I am concerned that too many new veterans are not getting the best quality treatment they need.”
First, the lawmaker says there needs to be a referenced, functional, standard definition of TBI that is adhered to by both the Department of Defense and Veterans Administration in order to identify and expedite treatment.
Retired Sgt. Marvin Jeffcoat, the former commander for the Queens County VFW, who now serves as the group’s legislative chairman and the co-chairman for the state VFW, says that all reimbursable illnesses and injuries should be uniformly defined, not just TBI.
Gillibrand is also concerned about the increased use of psychotropic medications to treat TBI, which has nearly tripled from approximately 100,000 prescriptions early this decade to more than 300,000 without concrete medical proof as to its effectiveness.
Psychotropic medications temporarily affect a person’s neurochemistry, altering brain function and resulting in changes in perception, mood, consciousness, cognition and behavior.
In a letter to Defense Secretary Robert Gates and VA Secretary Eric Shinseki, Gillibrand asks if there are non-pharmaceutical interventions available that could address the issue. “In particular we must ensure that a heavy reliance on prescription drugs are not used as a stop gap measure in lieu of effective treatments over the long term,” Gillibrand wrote.
Both Epps and Jeffcoat said they do not know vets who are on psychotropic medications, but agree that alternative methods of treatment should be provided such as counselling and socialization through veterans service organizations.
Based on the success of a pilot program with the California National Guard, Gillibrand is co-sponsoring legislation that would place a mental health professional with every guard and Army reserve unit to ensure that soldiers have consistent access to treatment.
The idea is to reduce the shame associated with PTSD among guard and reserve troops who have proven to be particularly susceptible to the illness and getting more of them to seek treatment. In the first four years in Iraq and Afghanistan, more than half of the veteran suicides were guard and reserve members.
In California, the percentage of troops independently seeking treatment almost doubled, but veterans here say the idea won’t fly because there is such a stigma associated with going to see a mental health professional that a soldier would be ridiculed by his or her peers and seen as weak or unstable.
“I wouldn’t have wanted a shrink analyzing me while I was over there,” Epps said, adding that he is a proponent of peer counselling. “I would want to speak to someone who has been there and experienced the same things, not someone who learned about it from a book.”
Jeffcoat, who suffered mild PTSD after his tour in Desert Storm, agreed stating that soldiers are often a tight-knit group who look out for each others’ well being and who are unlikely to turn to an outside source for help.
While Jeffcoat commended Gillibrand for taking an interest in improving healthcare for veterans, he worries that a premature PTSD diagnosis could incorrectly label troops preventing them from finishing their service in the military and impede job opportunities such as those with law enforcement when they get out.
Jeffcoat suggests that changes be made in “cautious increments over time,” in order to “safeguard from pitfalls ensuring the right to serve and to keeping a good soldier in the fight.”
Gillibrand praised the DOD for developing screening procedures to identify PTSD cases service members returning from combat, but thinks the agency should go a step further by requiring an additional screening six to 12 months after combat, because symptoms may not immediately manifest themselves.
“Some guys suppress their psychological injuries for years and then something happens and it all floods out,” Epps said. “Those guys are the hardest to treat.”
Jeffcoat believes additional post-combat screenings should be made available, but they shouldn’t be mandated or restricted to a time limit. “It should be determined by physical need and follow-ups should be determined on a case by case basis,” he said.
Earlier this month Shinseki announced new regulations to make it easier for vets suffering from PTSD to receive government benefits eliminating a rule requiring them to prove what caused their illness. Now they just have to show that their PTSD is connected to conditions surrounding their time in the service. Many lawmakers and veterans advocates praised the move noting that it is nearly impossible for veterans to find records of a firefight or bomb blast that precipitated the disorder.