thedrifter
07-15-07, 06:48 AM
Pendleton officials say stress disorder rates leveling off
By: MARK WALKER - Staff Writer
CAMP PENDLETON ---- An increase in the number of cases of post-traumatic stress disorder among Camp Pendleton Marines and sailors after the invasions of Afghanistan and Iraq has leveled off in the last 12 months, according to base officials.
"While there were steady increases in PTSD cases since 2003, the rate appears to have stabilized over the past year," 1st Lt. Lawton King said in a written statement. "Based on the current data, about five of every 1,000 Marines in the Camp Pendleton area has been diagnosed with PTSD."
The base's numbers, however, don't agree with the figures reported in a recent Pentagon study.
While Camp Pendleton says that less than 1 percent of its troops are suffering from the disorder, the Pentagon report released in June suggested that up to one-third of the Marines who have served in Iraq and Afghanistan are suffering from some form of post-traumatic stress, a rate equal to that experienced by troops who served in Vietnam.
Camp Pendleton officials do not directly contest the Pentagon study, but maintain their numbers accurately reflect what the base is experiencing.
In treatment: 130
At Camp Pendleton, about 130 service members are currently undergoing treatment for fully developed post-traumatic stress disorder, up from an average of 40 before the U.S. invasion of Iraq, according to King.
Through February, 1,828 Camp Pendleton service members have been treated for the combat-related disorder since the 2002 invasion of Afghanistan, he said.
In the last year, the base hospital has treated 671 active-duty Marines and sailors suffering from some form of post-traumatic stress, according to King, who helped compile the figures in response to a request from the North County Times.
One of the people who helped compile the figures, Capt. Joseph Sarachene, said Friday that better education and early intervention efforts are helping to reduce the numbers at Camp Pendleton.
"We're educating them (the troops) on their way over and on their way home," said Sarachene, a base psychiatrist. "As long as man has been fighting, there has been combat stress. The No. 1 factor is how psychologically prepared an individual is."
Reservists, too
The Pentagon study released in June stated that 31 percent of active-duty Marines have suffered some symptoms related to post-traumatic stress. It also found that 43 percent of Marine reservists reported suffering from anxiety, depression or related problems.
Sarachene suggested that the Pentagon study does not clearly distinguish between cases of medically diagnosed post-traumatic stress disorder and troops suffering short-term problems during their initial weeks back on U.S. soil.
"When they first get home, they can have some of those symptoms," he said. "That is combat stress and not real, long-term impairment. Most will heal and be OK."
The Department of Veterans Affairs said last year that about one of every six Iraq and Afghanistan veterans has some form of combat stress problem.
Outside the base gates, the San Marcos Veterans Center is seeing an increasing number of Iraq war veterans, according to Joe Costello, a treatment team leader for the agency that treats veterans under a contract with the federal government.
"We are seeing significant numbers of folks coming back with PTSD or a number of symptoms related to trauma," he said. "They're coming back with problems from IED explosions, small-arms fire and simply being in a combat zone for a year."
At urging of Congress
Congress has moved in recent months to spur the military to have a greater sensitivity to the problem, something one former Marine colonel said was long overdue.
"We need to get a better system into place," retired Col. Ana Smythe said in a recent interview. "We sent them, and many are coming home broken."
Smythe, who worked at San Diego's Marine Corps Recruit Depot before joining the Military Officers Association of America in Washington, where she works on legislative issues and sits on its health care committee, said that better recognition and treatment was needed, particularly for troops whose emotional problems lead to criminal acts.
"We aren't fixing them, and when they get in trouble as a result of behavioral issues stemming from PTSD, we slap them down," she said.
By any other name
In the Civil War, troops suffering mental health problems from their combat experiences were said to have "exhaustion" or "soldier's heart." In World War I, it was "chronic fatigue." In World War II, it was called "shell shock."
What those troops experienced was psychological trauma stemming from the things they did and saw in combat.
Recognized as a diagnosable and treatable medical condition by the American Psychiatric Association in 1980, the disorder can be triggered by sights or smells, can lead to acts of violence, substance abuse, divorce, job loss, homelessness and suicide.
During a meeting of President George Bush's Commission on Care for America's Returning Wounded Warriors in San Diego in late May, Army Col. Elspeth Cameron Ritchie said many troops are hesitant to talk about the problem.
A matter of image
She presented a report showing that 59 percent of soldiers and 48 percent of Marines returning from Iraq believed their commanders would treat them differently and perceive them as weak. More than one-third said such an admission would harm their military careers.
Three weeks ago, an advocacy group alleged that troops who came forward with mental health problems at Camp Pendleton were being punished.
The Washington-based Veterans for America also said that, after interviewing Marines and family members, it was clear that some of those troops were being kicked out of the service rather than being treated, allegations subsequently denied by base officials.
Commanders at the unit level are responsible for identifying and getting help for troops exhibiting signs of stress-related issues, according to 1st Lt. King.
A fact sheet released by the base notes that Marines are trained "to be tough, resilient and dedicated. We also want them to be smart about taking care of themselves when they are hurting both physically and psychologically.
"We are working hard to train them to realize that when they need help it is accessible and available and that they should get it," the sheet states.
Measuring sticks
Distinguishing between short-term psychological issues born from combat stress and a full-blown case of post-traumatic stress disorder is part of the evaluation process at Camp Pendleton. The standard in use today calls for four to six weeks of recovery time before an official diagnosis of post-traumatic stress disorder is made.
The measuring sticks that evaluators use include assessing whether a troop suffers from flashbacks, hypervigilance, sleep problems and avoidance of talking about what is bothering them and taking part in normal activities.
The symptoms must be present for at least one month and be severe enough to impair routine activity, according to base officials.
The process starts shortly after Marines and sailors get home from a deployment with the troops undergoing a screening process that includes answering a mental health questionnaire. A follow-up assessment takes place within 90 days.
Widely available help
For Marines and sailors in the brig for committing crimes, base officials rejected Smythe's contention, saying help is available. A mental health worker conducts weekly assessments and follow-ups for inmates exhibiting signs of post-traumatic stress, according to base officials.
They also said a new program being introduced in the brig will have mental health professionals visiting inmates each week and leading group counseling sessions for those who want to participate.
Of the 118 men in the brig last week, about one-third had been deployed and 30 were undergoing treatment for stress disorders, base officials said.
The San Marcos Veterans Center says there is no question that the frequency of deployments ---- many Marines have been to Iraq three or four times ---- is a major factor in the number of troops with problems.
"While there may not be any one traumatic event, the effect of long-term exposure to stress can trigger problems," the center's Costello said. "Just because they are trained does not make them immune."
It's slow going
These days, the center sees about 150 former troops who served in Iraq or Afghanistan, a number that Costello said is expected to increase as the war drags on.
The center works closely with Camp Pendleton, he said, to create a seamless transition for those who are getting out of the service and are in need of counseling services.
Costello also meets regularly with individual units at the base, and he says that despite criticisms from groups who don't think the military is doing enough, he sees a greater acceptance of the issue among officers.
"In the past, they weren't even articulating a sensitivity, but we are now seeing a change in the culture," he said. "There is a part of the warrior mentality that stresses taking care of each other, so the message I try to get across is that help is there for the asking and smart warriors use that resource."
Mattis' view
Lt. Gen. James Mattis, commanding general of Camp Pendleton's 25,000-member I Marine Expeditionary Force, told the North County Times last month that war does "waste spirits and lives."
"Nobody who went ashore at Iwo Jima came off that island the same. Nobody," said Mattis, who also is head of Marine Corps forces throughout the Middle East. Today's Marines are no different.
Mattis maintained there is no stigma attached to troops who seek help.
"Proud young men are sometimes reluctant to bring these things forward, and when asked why, they may say publicly, 'Well, I don't want to hurt my career.'
"In fact, we all have to accept that at times you're going to need a little help. We tell them, 'Listen, if you're going to take a hill, do we just send you up there with a bayonet or do we also give you artillery fire and air support?
"You need some support, you call for it."
Contact staff writer Mark Walker at (760) 740-3529 or mlwalker@nctimes.com.
Ellie
By: MARK WALKER - Staff Writer
CAMP PENDLETON ---- An increase in the number of cases of post-traumatic stress disorder among Camp Pendleton Marines and sailors after the invasions of Afghanistan and Iraq has leveled off in the last 12 months, according to base officials.
"While there were steady increases in PTSD cases since 2003, the rate appears to have stabilized over the past year," 1st Lt. Lawton King said in a written statement. "Based on the current data, about five of every 1,000 Marines in the Camp Pendleton area has been diagnosed with PTSD."
The base's numbers, however, don't agree with the figures reported in a recent Pentagon study.
While Camp Pendleton says that less than 1 percent of its troops are suffering from the disorder, the Pentagon report released in June suggested that up to one-third of the Marines who have served in Iraq and Afghanistan are suffering from some form of post-traumatic stress, a rate equal to that experienced by troops who served in Vietnam.
Camp Pendleton officials do not directly contest the Pentagon study, but maintain their numbers accurately reflect what the base is experiencing.
In treatment: 130
At Camp Pendleton, about 130 service members are currently undergoing treatment for fully developed post-traumatic stress disorder, up from an average of 40 before the U.S. invasion of Iraq, according to King.
Through February, 1,828 Camp Pendleton service members have been treated for the combat-related disorder since the 2002 invasion of Afghanistan, he said.
In the last year, the base hospital has treated 671 active-duty Marines and sailors suffering from some form of post-traumatic stress, according to King, who helped compile the figures in response to a request from the North County Times.
One of the people who helped compile the figures, Capt. Joseph Sarachene, said Friday that better education and early intervention efforts are helping to reduce the numbers at Camp Pendleton.
"We're educating them (the troops) on their way over and on their way home," said Sarachene, a base psychiatrist. "As long as man has been fighting, there has been combat stress. The No. 1 factor is how psychologically prepared an individual is."
Reservists, too
The Pentagon study released in June stated that 31 percent of active-duty Marines have suffered some symptoms related to post-traumatic stress. It also found that 43 percent of Marine reservists reported suffering from anxiety, depression or related problems.
Sarachene suggested that the Pentagon study does not clearly distinguish between cases of medically diagnosed post-traumatic stress disorder and troops suffering short-term problems during their initial weeks back on U.S. soil.
"When they first get home, they can have some of those symptoms," he said. "That is combat stress and not real, long-term impairment. Most will heal and be OK."
The Department of Veterans Affairs said last year that about one of every six Iraq and Afghanistan veterans has some form of combat stress problem.
Outside the base gates, the San Marcos Veterans Center is seeing an increasing number of Iraq war veterans, according to Joe Costello, a treatment team leader for the agency that treats veterans under a contract with the federal government.
"We are seeing significant numbers of folks coming back with PTSD or a number of symptoms related to trauma," he said. "They're coming back with problems from IED explosions, small-arms fire and simply being in a combat zone for a year."
At urging of Congress
Congress has moved in recent months to spur the military to have a greater sensitivity to the problem, something one former Marine colonel said was long overdue.
"We need to get a better system into place," retired Col. Ana Smythe said in a recent interview. "We sent them, and many are coming home broken."
Smythe, who worked at San Diego's Marine Corps Recruit Depot before joining the Military Officers Association of America in Washington, where she works on legislative issues and sits on its health care committee, said that better recognition and treatment was needed, particularly for troops whose emotional problems lead to criminal acts.
"We aren't fixing them, and when they get in trouble as a result of behavioral issues stemming from PTSD, we slap them down," she said.
By any other name
In the Civil War, troops suffering mental health problems from their combat experiences were said to have "exhaustion" or "soldier's heart." In World War I, it was "chronic fatigue." In World War II, it was called "shell shock."
What those troops experienced was psychological trauma stemming from the things they did and saw in combat.
Recognized as a diagnosable and treatable medical condition by the American Psychiatric Association in 1980, the disorder can be triggered by sights or smells, can lead to acts of violence, substance abuse, divorce, job loss, homelessness and suicide.
During a meeting of President George Bush's Commission on Care for America's Returning Wounded Warriors in San Diego in late May, Army Col. Elspeth Cameron Ritchie said many troops are hesitant to talk about the problem.
A matter of image
She presented a report showing that 59 percent of soldiers and 48 percent of Marines returning from Iraq believed their commanders would treat them differently and perceive them as weak. More than one-third said such an admission would harm their military careers.
Three weeks ago, an advocacy group alleged that troops who came forward with mental health problems at Camp Pendleton were being punished.
The Washington-based Veterans for America also said that, after interviewing Marines and family members, it was clear that some of those troops were being kicked out of the service rather than being treated, allegations subsequently denied by base officials.
Commanders at the unit level are responsible for identifying and getting help for troops exhibiting signs of stress-related issues, according to 1st Lt. King.
A fact sheet released by the base notes that Marines are trained "to be tough, resilient and dedicated. We also want them to be smart about taking care of themselves when they are hurting both physically and psychologically.
"We are working hard to train them to realize that when they need help it is accessible and available and that they should get it," the sheet states.
Measuring sticks
Distinguishing between short-term psychological issues born from combat stress and a full-blown case of post-traumatic stress disorder is part of the evaluation process at Camp Pendleton. The standard in use today calls for four to six weeks of recovery time before an official diagnosis of post-traumatic stress disorder is made.
The measuring sticks that evaluators use include assessing whether a troop suffers from flashbacks, hypervigilance, sleep problems and avoidance of talking about what is bothering them and taking part in normal activities.
The symptoms must be present for at least one month and be severe enough to impair routine activity, according to base officials.
The process starts shortly after Marines and sailors get home from a deployment with the troops undergoing a screening process that includes answering a mental health questionnaire. A follow-up assessment takes place within 90 days.
Widely available help
For Marines and sailors in the brig for committing crimes, base officials rejected Smythe's contention, saying help is available. A mental health worker conducts weekly assessments and follow-ups for inmates exhibiting signs of post-traumatic stress, according to base officials.
They also said a new program being introduced in the brig will have mental health professionals visiting inmates each week and leading group counseling sessions for those who want to participate.
Of the 118 men in the brig last week, about one-third had been deployed and 30 were undergoing treatment for stress disorders, base officials said.
The San Marcos Veterans Center says there is no question that the frequency of deployments ---- many Marines have been to Iraq three or four times ---- is a major factor in the number of troops with problems.
"While there may not be any one traumatic event, the effect of long-term exposure to stress can trigger problems," the center's Costello said. "Just because they are trained does not make them immune."
It's slow going
These days, the center sees about 150 former troops who served in Iraq or Afghanistan, a number that Costello said is expected to increase as the war drags on.
The center works closely with Camp Pendleton, he said, to create a seamless transition for those who are getting out of the service and are in need of counseling services.
Costello also meets regularly with individual units at the base, and he says that despite criticisms from groups who don't think the military is doing enough, he sees a greater acceptance of the issue among officers.
"In the past, they weren't even articulating a sensitivity, but we are now seeing a change in the culture," he said. "There is a part of the warrior mentality that stresses taking care of each other, so the message I try to get across is that help is there for the asking and smart warriors use that resource."
Mattis' view
Lt. Gen. James Mattis, commanding general of Camp Pendleton's 25,000-member I Marine Expeditionary Force, told the North County Times last month that war does "waste spirits and lives."
"Nobody who went ashore at Iwo Jima came off that island the same. Nobody," said Mattis, who also is head of Marine Corps forces throughout the Middle East. Today's Marines are no different.
Mattis maintained there is no stigma attached to troops who seek help.
"Proud young men are sometimes reluctant to bring these things forward, and when asked why, they may say publicly, 'Well, I don't want to hurt my career.'
"In fact, we all have to accept that at times you're going to need a little help. We tell them, 'Listen, if you're going to take a hill, do we just send you up there with a bayonet or do we also give you artillery fire and air support?
"You need some support, you call for it."
Contact staff writer Mark Walker at (760) 740-3529 or mlwalker@nctimes.com.
Ellie