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More than 280 service members offered third opinion on psych evals

By C. Todd Lopez

WASHINGTON (March 12, 2012) -- The Army will offer 285 service members a chance to have their mental health diagnoses re-evaluated -- a second time.

About 1,600 service members who received medical care at Madigan Army Medical Center at Joint Base Lewis-McChord, Wash., and who were diagnosed with behavioral health problems, also had their medical records evaluated by the forensic psychiatry department at the hospital.

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Of the 1,600, the department changed the diagnosis for 285 patients to something other than post-traumatic stress disorder, known as PTSD. Now, the Army will offer those 285 service members the opportunity to have their medical records evaluated again -- and to possibly undo the changes made by the forensic psychiatric unit.

"What we're looking at is wanting to make sure that our service members received the best care possible," said Surgeon General of the Army Lt. Gen. Patricia D. Horoho, before the House Appropriations Committee, Defense subcommittee, March 8.

The general also told lawmakers that the Army is looking into the variants across its processes. Forensic psychiatry introduces variance into the Integrated Disability Evaluation System process, Horoho said.

The surgeon general told legislators that last year, 17 service members expressed concerns that their initial behavioral health diagnoses had been changed by the forensic psychiatry department. The Army offered to allow those service members to be re-evaluated at Walter Reed National Military Medical Center. Most of the reviews done at Walter Reed changed back the decisions of the forensic psychiatry department.

Two investigations, one at Joint Base Lewis-McChord, and one across Army medicine have been initiated, said Horoho. At Lewis-McChord, the investigation will "look at the climate and the practices and variants and to make sure that we were fairly treating our service members and providing them the best care possible." The second, an inspector general investigation, will look at "variants or systemic issues" across Army medicine. Both investigations are ongoing.


Lawmakers asked the Army's surgeon general if there was a common standard among the military services for diagnosing post-traumatic stress disorder. She told them there was, and that it is being used across the Department of Defense.

"There are Department of Defense guidelines for diagnosing PTSD, which each one of our services follows," she said. "Those guidelines have been in place, and we're all consistent with following those."

The general also told lawmakers that the Army is perusing multiple avenues to treat PTSD, including methods that don't involve medications.

"There's a lot of work that's being done with not just looking at providing medication, but actually looking at yoga and stress reduction, virtual reality and many different forums that we can actually try to help someone with their behavioral health and help them on the healing journey," Horoho said.

She also said that there isn't a single medication to treat PTSD, but instead multiple medications with different levels of efficacy on different patients.

"There are some medications that may work better than others for one individual, and then may not be as effective on another individual," she said.


Horoho told lawmakers that it is the U.S. military -- in places like Afghanistan, and before, in Iraq, that provide the best trauma care in the world.

"Army Medicine is focused on building upon these successes on the battlefield as we perform our mission at home, and is further cementing our commitment to working as a combined team anywhere and any time."

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