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SOC-0110 Midterm: PTSD Policy Recomendation PJS


Department
Sociology
Course Code
SOC-0110
Professor
Paul Joseph
Study Guide
Midterm

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TO: Eric K. Sheneski, Secretary of Veteran Affairs
FROM: Paul Collins
SUBJECT: Reforming PTSD Treatment in the Department of Veteran Affairs
DATE: 9 May 2014
Policy Issue:
Post-traumatic Stress Disorder (PTSD) is an anxiety problem that develops in some people after
extremely traumatic events.1 Soldiers’ experience high rates of this psychological disorder after
serving in combat zones. Due to a variety of intersecting factors, the Department of Veteran
Affairs (VA) has severely underserved our Veterans’ desperate need for psychological care,
resulting in disastrous effects.
Context:
Demographics of PTSD:
Military and veteran populations incur a much greater risk of developing PTSD than the civilian
population. About 30% of men and women who have spent time in combat zones experience
PTSD, with another 20-25% experiencing partial PTSD.2 There is a lifetime prevalence of PTSD
of 13-20% in military personnel who have served in Operation Enduring Freedom and Operation
Iraqi Freedom, and this number may well under-represent the actual prevalence.3 Rates of PTSD
are higher for these wars than any previous conflicts. Factors that increase a service member’s
risk of PTSD include sex (with women incurring higher rates of PTSD), age, and prior exposure
to trauma.4 Of those diagnosed with PTSD only an estimated 50% seek treatment and only half
of those receive “minimally adequate” treatment.5
Legal Structure of the Department of Veteran Affairs:
The bureaucratic legal structure of VA has resulted in many obstacles for veterans with mental
illness seeking medical benefits. To obtain disability benefits of PTSD, veterans must work
through separate administrations within VA. They need to receive a PTSD diagnose from the
1 American Psychological Association. “Post-traumatic Stress Disorder.” May 2014. http://www.apa.org/topics/ptsd/
2 Institute of Medicine. “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial
Assessment.” http://cdn.govexec.com/media/gbc/docs/pdfs_edit/071712bb1.pdf
3 Ibid. p 240
4 Ibid. p 234
5 Rand Corporation (Nonprofit Think tank). “Invisible Wounds of War: Psychological and Cognitive Injuries, Their
Consequences, and Services to Assist Recovery.” 2008
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Veterans Health Administration, and then seek compensation through the Veterans Benefit
Administration.6 During the laborious process, they have to use contradicting standards to
evaluate disability and are deprived of legal representation in the initial claims. Although the
current backlog of pending disability claims is at its lowest point since March 2011, there are
still 344,000 claims pending to be solved, posing huge pressure on both the VA and anxious
veterans.
Consequences:
The aforementioned VA structure combined with widespread high rates of PTSD has led to
deleterious effects for veterans’ seeking care for the psychological effects of war. While many
Veterans with mental health problems do not pursue medical attention for their psychological
trauma7, those who do seek help have reported difficulty navigating the complex VA structure to
obtain the help they need.8 Not properly addressing PTSD in our Veterans has been disastrous.
An estimated 60,000 Veterans experience chronic homelessness, with Veterans being twice as
likely to experience homelessness compared to other adults.9 Even worse, soldiers’ rates of
suicide far exceed rates of suicide in the civilian population.10 It is apparent that the VA severely
fails Veteran needs relating to psychological care.
Synopsis of Recommendations:
1. Protect veterans’ rights to medical benefits within the VA system through legal
representation reform and creation of VA monitor
2. Address wasteful practices and allocate VA resource expansion and redirection
3. Expand the recognition of PTSD and prioritize further and more targeted research on the
prevalence of PTSD in military personnel
Recommendation 1: Protect veterans’ rights to medical benefits within the VA system
through legal representation reform and creation of VA monitor
The present situation of veterans suffering mental illness having difficulty obtaining medical
benefits from VA can be attributed to the complex VA procedures for lodging appeals and
6 U.S. Department of Veteran Affairs. “Compensation” May 2014 http://www.benefits.va.gov/compensation/
7 National Center for PTSD. “Mental Health Effects of Serving in Afghanistan and Iraq.” May 2014.
http://www.ptsd.va.gov/public/PTSD-overview/reintegration/overview-mental-health-effects.asp
8 U.S. Department of Veteran Affairs “Claims Backlog” May 2014.
http://benefits.va.gov/reports/mmwr_va_claims_backlog.asp
9 U.S. Department of Housing and Urban Development. “Annual Homeless Report to Congress 2013.” May 2014.
https://www.onecpd.info/resources/documents/AHAR-2013-Part1.pdf
10 Institute of Medicine of the National Academies. “Treatment for Posttraumatic Stress Disorder in Military and
Veteran Populations.” P 316. May 2014. http://cdn.govexec.com/media/gbc/docs/pdfs_edit/071712bb1.pdf
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