US Army reviewing PTSD diagnostic practices

Review comes after 100s of soldiers being treated for post-traumatic stress disorder had diagnoses reversed.

US soldier arriving in Kuwait after leaving Iraq 311 (R) (photo credit: REUTERS)
US soldier arriving in Kuwait after leaving Iraq 311 (R)
(photo credit: REUTERS)
WASHINGTON - The US Army has started a system-wide review to ensure its mental healthcare facilities are not engaging in the "unacceptable" practice of considering treatment costs in making a diagnosis, Army Secretary John McHugh told a US Senate hearing on Wednesday.
Lieutenant General Patricia Horoho, the Army surgeon general, initiated the review in response to the discovery that hundreds of soldiers being treated for post-traumatic stress disorder had their diagnoses reversed after being seen by psychiatrists at the Madigan Army Medical Center in Washington state.
The medical center is located at Joint Base Lewis McChord, the home base of Staff Sergeant Robert Bales, who is suspected of killing 16 people, including nine children, in a shooting rampage in Afghanistan this month.
Bales was on his fourth deployment to a war zone in the past 10 years. His civilian lawyer told Reuters last week that PTSD would likely be part of the defense.
PTSD is a huge issue for the Defense Department. A recent Army study estimated as many as 20 percent of the more than 2 million US troops who served in Iraq and Afghanistan could suffer from post-traumatic stress disorder. Cost of care could range between $4 billion and $6.2 billion, it said.
The Army is looking at whether doctors at the medical center were influenced by the cost of PTSD diagnosis in terms of pensions and other benefits. One psychiatrist said the cost to taxpayers was $1.5 million over the lifetime of a soldier on medical retirement, the Seattle Times reported.
The review being carried out by the Army inspector general aims to ensure that standardized diagnostic procedures are followed by all psychiatrists "and equally important that fiscal considerations are not in any way a part of the evaluations," McHugh said. "It's simply unacceptable."
Referring to Bales, Representative Bill Pascrell, founder of a US congressional task force on brain injuries, told reporters he wanted to "cradle this soldier in our arms" while condemning his actions until it could be determined what happened to him and whether he was properly tested and treated.
Bales had received a traumatic head injury and lost part of a foot during previous deployments in Iraq. The incident raised questions about the stress of repeated deployments, but McHugh said four was not uncommon.
"We have in the military writ large over 50,000 folks in uniform who have had at least four deployments," McHugh told members of the defense panel of the Senate Appropriations Committee.