America's North Shore Journal

Veterans’ Administration
2006

Post-Traumatic Stress Disorder (PTSD) is an ailment resulting from exposure to an experience involving direct or indirect threat of serious injury or death. The trauma may be experienced alone, as in rape or assault, or in the company of others, as in military combat.

The events that can cause PTSD are called “stressors.” They include natural disasters (floods, earthquakes), accidents (car accidents, airplane crashes, large fires) or deliberate man-made disasters (bombing, torture, death camps).

Symptoms include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, hyper alertness, anxiety and irritability. The disorder apparently is more severe and longer lasting when the stress is of human design.

Approximately 317,000 veterans with a primary or secondary diagnosis of PTSD received treatment at VA medical centers and clinics in FY 2005. More than 50,000 veterans received PTSD-related services at Vet Centers during FY 2005.

Nearly 16,000 Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) veterans were seen for PTSD at VA medical centers from fiscal year 2002 to 2005. Another 3,000 OIF/OEF veterans were seen in VA’s Vet Centers during that period.

Returning Combat Veterans

VA’s orientation toward returning combat veterans incorporates a public health approach to care.

Education and training of returning troops, their families, other providers in the community and the population in general will help to ensure that they are informed on issues of health promotion, availability of employment and educational benefits and of health care opportunities.

In 2005, Congress mandated that three Centers of Excellence in mental health care, with particular emphasis on PTSD, be recognized in the VA medical centers at Waco, Texas, Canandaigua, N.Y., and San Diego. Plans for these three sites are under development.

A Mental Illness Research, Education and Clinical Center (MIRECC) was established at the Durham VA Medical Center in 2004 to focus on issues of post-deployment health for returning OIF/OEF veterans. It will collaborate with the National Center for PTSD and the nine other MIRECCs, as well as with DoD and VA’s Office of Research and Development and VA’s Employee Education Service.

VA Medical Center Programs

VA operates an internationally recognized network of more than 160 specialized programs for the treatment of PTSD through its medical centers and clinics. One notable program consists of PTSD clinical teams that provide outpatient treatment, working closely with other VA treatment programs, including Vet Centers and the community.

VA operates a variety of specialized outpatient PTSD programs, including 108 PTSD clinical teams, seven outpatient Women’s Stress Disorder and Treatment Teams and nine PTSD day hospitals.

There are also specialized inpatient units, brief-treatment units and residential rehabilitation programs around the country. A special focus in the program has included underserved and minority populations, such as African Americans, Hispanics and Native Americans. A specialized PTSD inpatient treatment unit serves women veterans at the Palo Alto, Calif., VA Medical Center’s Menlo Park Division and others are being established.

VA earmarked an additional $29 million for expansion of PTSD and OEF/OIF services in FY 2006. It is anticipated that these resource increases, and additional resources in support of other mental health programs (e.g., substance use disorder treatment programs, mental health in Community Based Outpatient Clinics) will be effective in meeting the needs of veterans suffering from PTSD and associated war related disorders.

VA’s Under Secretary for Health has a Special Committee on PTSD. The committee assesses VA’s capacity to diagnose and treat PTSD and provides guidance on VA’s education, research and benefits activities regarding PTSD.

Vet Centers

VA readjustment counseling is provided through 207 community-based Vet Centers in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands and Guam. Vet Centers are located outside of medical facilities, often in shopping malls and other community settings.

The Vet Center mission features a mix of direct counseling and help accessing other programs to help veterans improve their social and economic prospects after the military. The Vet Centers provide psychological counseling for veterans exposed to war trauma or sexually assaulted during military service, family counseling, community outreach and education, and extensive social services and referral activities.

Vet Centers are staffed by interdisciplinary teams that include psychologists, nurses and social workers. Vet Center teams reflect ethnic and gender diversity and include many veterans, most having served in a combat theater of operations.

Eligibility for Vet Center services includes all Vietnam theater veterans, other Vietnam era veterans who accessed Vet Center care prior to January 1, 2004, and any other veteran who served in any war, armed conflict or peacekeeping mission. Eligibility for sexual trauma counseling at Vet Centers is open to any veteran, regardless of period of service.

Vet Centers have added 100 newly returned combat veterans as outreach workers to assist troops in transition from military to civilian life. They provide a natural connection to separating service members, reaching out to them on issues of readjustment and PTSD.

National PTSD Center

VA established the National Center for Post-Traumatic Stress Disorder in 1989, with a mandate to promote research into the causes and diagnosis of the disorder, to train health care and related personnel in diagnosis and treatment, and to serve as an information resource for professionals across the United States and, eventually, around the world. The center consists of seven divisions with distinct but complementary responsibilities: behavioral science, women’s health sciences, clinical neurosciences, education, evaluation, Pacific Islands ethnocultural, and executive and resource center divisions.

The center is committed to approaching PTSD through a focus on research, education and consultation. These three threads weave the center’s work together in a way that brings science into practice and ensures that clinical concerns guide scientific priorities.

The National Center has come to be viewed as a world leader in PTSD research. Current research at the center includes large-scale clinical trials, as well as studies on the epidemiology, diagnosis, psychobiology and treatment of PTSD, including collaborative studies with the Department of Defense on factors that strengthen a person against the development of stress-related disorders.

Among its many educational programs, the center provides regular satellite broadcasts and publishes two newsletters, which highlight the latest developments in research and clinical practices for PTSD. The National Center also offers a monthly five-day clinical training program free of charge to VA staff, and maintains a nationally recognized Web site (http://www.ncptsd.va.gov/ncmain/index.jsp) with information about trauma and PTSD.

The Web site includes documents such as the Iraq War Clinician Guide to help clinicians diagnose and treat veterans returning from Operation Iraqi Freedom, and a bibliographic database of more than 21,000 articles. The National Center also provides consultation to clinicians, scientists and policy makers concerning treatment, research and education regarding PTSD.

Veterans Being Compensated for PTSD

More than 200,000 veterans were listed by the VA in 2005 as having PTSD as a service-connected disability.

PERIOD	as of Sept 2005
Pre WWII	0
WWII	25,278
Korea	10,944
Vietnam	179,713
Gulf War I	19,356
Peacetime	9,087
TOTAL	244,846

PTSD Resources for serving military and veterans:

• The National Center for PTSD
• National Institute of Mental Health
• PTSDSupport.net
• Iraq Veterans Against the War PTSD page
• New York State Office of Mental Health
• Military blogger – Jimbo at Blackfive
• Military blogger – Kat at John of Argghhh
• Military blogger – Grim at Blackfive