CHEAPER DIAGNOSIS? A psychologist at a Veterans’ Center in Texas advised her colleagues in an email to substitute “Adjustment Disorder” diagnoses for Post-Traumatic Stress Disorder (PTSD) to save the center time and money.

A veterans group and nonprofit watchdog group acquired the psychologist’s March 20 email and released it publicly May 15. The secretary of Veterans Affairs (VA) assures vets that this email in no way reflects VA policy.

VA Denies Policy, Perez Keeps Job

Norma Perez, a PTSD program coordinator with the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Tex., wrote in the March 20 email, "Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out." She suggested mental health care specialists and social workers "consider a diagnosis of Adjustment Disorder" instead. (Washington Post, 5/16/08) “Additionally, we really don't or have time to do the extensive testing that should be done to determine PTSD.” (CREW, 5/15/08)

VA Secretary James B. Peake released a statement condemning Perez’s email. "VA's leadership will strongly remind all medical staff that trust, accuracy and transparency is paramount to maintaining our relationships with our veteran patients," Peake said. (Washington Post, 5/16/08) Perez continues to work at the VA hospital in Temple.

The two organizations that uncovered Perez’ email are:

• VoteVets.org— Iraq and Afghanistan veterans lobbying group
• Citizens for Responsibility and Ethics in Washington (CREW)—nonprofit government watchdog group

PTSD Costs Expected to Hit $4 Billion

Military studies show repeated deployments increase a soldier’s chances of developing PTSD. Repeated deployments are the norm in the war on terrorism, with many soldiers returning to Iraq and Afghanistan multiple times. The most deployed unit in the U.S. Army is the 10th Mountain Division 2nd Brigade Combat Team, which served two tours in Afghanistan and two tours in Iraq.

A military-commissioned Rand Corp. study released in April indicates that about 300,000 soldiers who have served in the war on terrorism suffer from PTSD or major depression. That’s about one out of every five of the 1.5 million soldiers deployed during the wars in Iraq and Afghanistan.

The cost? If we include mental health care for these soldiers, factor in their lost productivity, and take into consideration PTSD-related suicides, the anticipated cost is between $4 billion and $6 billion over the next two years.

Congress Questions VA

Chair of the Senate Veterans Affairs Committee, Sen. Daniel K. Akaka (D-Hawaii) requested the VA's Inspector General review diagnoses at the Olin E. Teague Veterans' Center.

Chair of the House Veterans Affairs Committee, Bob Filner (D-Calif.) plans to question Peake before the committee to find out what would have motivated Perez to send out the email in the first place.

Copyright © 2009 Informify

Sources

Official Urged Fewer Diagnoses of PTSD (Washington Post, 5/16/08)

Lawmakers to examine e-mail from VA employee (Associated Press, 5/16/08)

Copy of Norma Perez’ March 20, 2008 email (CREW, 5/15/08)

Question for Readers:

Do you think Norma Perez’ email reflects her opinion alone, or that of the Veterans Affairs Department?