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August 10, 2012

Armywide News

Army standardizes PTSD diagnosis, treatment

By David Vergun, Army News Service

WASHINGTON, D.C. — The Army, along with the other military services and the Department of Veterans Affairs, is standardizing the diagnosis and treatment of post-traumatic stress disorder, known as PTSD.

“No matter where Soldiers are getting care or seeking help for PTSD or any other medical issue, we want to ensure we are doing it the same way,” said Lt. Col. Christopher Warner, the Army Surgeon General’s psychiatric consultant and deputy commander, Clinical Services, Bassett Army Community Hospital, Fort Wainwright, Alaska.
PHOTO: Soldiers on an operation in Dora, Iraq. U.S. Army file photo
Soldiers often have delayed reactions to traumatic events that may take years to manifest. Pictured above are Soldiers on an operation in Dora, Iraq, in June 2007. Army Medical Command Policy Memo advocates standardizing the diagnosis and care of Soldiers suffering from PTSD. 
(U.S. Army file photo )

Warner said standardization increases a Soldier’s level of trust and fairness in the system.

The Army medical community now is being trained on guidelines spelled out in Army Medical Command Policy Memo 12-035 (April. 10, 2012), Policy Guidance on the Assessment and Treatment of Post-Traumatic Stress Disorder, Warner said.
The memo emphasizes the urgency of the issue.

“The majority of servicemembers with PTSD do not seek treatment, and many who do seek treatment drop out before they can benefit,” the memo reads. “There are many reasons for this, including stigma, other barriers to care, and negative perceptions of mental health care. Lack of trust in military behavioral health professionals has been identified as one important predictor of servicemembers not utilizing services. Therefore, it is critical that Army behavioral health professionals do everything they can to advocate for and provide care in a patient-centered manner that reassures patients that they will not be judged and that their primary concerns will be addressed.”

PTSD is a widespread problem. It occurs in 3 to 6 percent of servicemembers with no deployment experience and in 5 to 25 percent of servicemembers who have been deployed to combat zones. Combat frequency and intensity are the strongest predictor of the condition, according to the policy memo.

“Patient-centered care within a culture of trust requires that care providers focus on patients’ primary concerns, and these diagnoses, when inappropriately used, can damage therapeutic rapport and interfere with successful care,” the memo reads.

Lt. Gen. Robert B. Brown, I Corps commander, speaking at an Aug. 2 press conference at Madigan Army Medical Center, Joint Base Lewis-McChord, Wash., agreed that the patient-centered care approach and standardization is best.

“Our number one concern is taking care of Soldiers and their Families,” he said. “Cost doesn’t play a part in military medicine. We want them to have world-class medical care.” Other aspects of standardization for PTSD care are being addressed. For example, some medications used in the past were found to not be the best choices for PTSD, said Warner.

A cutting-edge development within the Army for the prevention of PTSD that the committee is looking at, for example, would be Comprehensive Soldier Fitness, which increases a Soldier’s resiliency, he said.

Standardization is not limited to Army Medical Command Policy Memo 12-035. The Army, VA and other services are standardizing the administration of treatment, using the Integrated Disability Evaluation System, or IDES.

Warner said the IDES, in conjunction with the Army Physical Evaluation Board, determines whether or not a service member should stay in service or transition to the VA system as a medical retiree. If the latter, the servicemember is guided through the process of transitioning from Army to VA care, while he or she is still on active duty, to ensure no loss of coverage or break in treatment, he explained.

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