Study Finds PTSD Diagnoses Accurate
A report released Friday by the Army’s surgeon
general found a high degree of validity in the service’s diagnoses and
treatment of post-traumatic stress disorder.
March 13, 2013
A report released
March 8, 2013, by the Army’s surgeon general found a high degree of validity in
the service’s diagnoses and treatment of post-traumatic stress disorder.
Picture here, Col. Michael J. Roy (left), who oversees the exposure therapy at
Walter Reed National Military Medical Center in Bethesda, Md., conducts a
demonstration with Sgt. Lenearo Ashford, of a combat simulator that represents
one of the new forms of post-traumatic stress disorder treatment. Credit U.S.Army
WASHINGTON — A report released Friday by the
Army’s surgeon general found a high degree of
validity in the service’s diagnoses and treatment of post-traumatic
stress disorder.
Lt. Gen. Patricia D. Horoho discussed findings
of the Army Task Force on Behavioral Health during a media roundtable Friday at
the Pentagon. She said their report found “no systemic issues of soldiers
being disadvantaged in the disability process” regarding the diagnoses of
post-traumatic stress disorder, which is known as PTSD.
An independent panel of medical experts
reviewed 154,000 medical records of soldiers dating from 2001 and found “a
diagnostic re-validation rate of 88 percent with regard to PTSD.”
That re-validation percentage means that
reviewers agreed with 88 percent of the PTSD diagnoses soldiers were given. She
said in the remaining 12 percent, the reviewers disagreed with the physicians’
diagnoses — meaning roughly six percent who were diagnosed with PTSD should
not have been and about another six percent should have received a PTSD
diagnoses, but did not.
“This re-validation rate is extraordinary
when compared to diagnostics re-validation rates in the civilian sector,”
the Army surgeon general said, explaining that according to medical literature,
the re-validation rates for PTSD range from 49 to 89 percent, depending on the
diagnoses standards used by physicians.
Horoho said the other good news is that about
80 percent of soldiers diagnosed with PTSD remain on active duty and just 20
percent go through the Integrated Disability Evaluation System, or IDES process
of transitioning to civilian life and care within the Department of Veterans
Affairs.
The 80 percent retention rate “says PTSD
is a diagnosis that can be treatable” and allow soldiers to remain in the
Army, Horoho said.
The diagnostic re-validation report was part
of a larger effort of the Army Task Force on Behavioral Health, directed by
Secretary of the Army John McHugh. The task force looked into all facets of
behavioral health care identification, treatment and delivery Army-wide.
The task force worked closely with the Army
Audit Agency, Army Research Institute, Office of the Inspector General, Army
surgeon general, VA and Centers of Excellence for Psychological Health and
Traumatic Brain Injury, said Samuel B. Retherford, deputy assistant secretary
of the Army for Military Personnel Policy during the media roundtable.
Additionally, the task force interviewed and
surveyed behavioral health care practitioners and soldiers receiving treatment.
The task force also conducted extensive literature reviews regarding behavioral
health care, he said, looking at outcome-based care, which the Army is moving
toward.
The task force corrective action plan calls
for the Army to continue to better collaborate with the VA to improve delivery
of IDES; ensure adequate oversight and controls on standardization of
diagnosis, training and treatment of PTSD; make it easier for soldiers and
providers to track progress through the IDES system; and better locate
providers to places where soldiers are stationed or deployed, Retherford said.
Additionally, the task force called on
diagnostic re-validation studies of behavioral health issues other than PTSD.
On March 5, the secretary signed
implementation guidance for the corrective action plan, which contains the task
force’s recommendations. Quarterly progress reports on the plan will be
delivered to the secretary and most recommendations are expected to be
implemented within a year, he said.
Over the last few years, the Army has about
doubled the number of its behavioral health care providers, Horoho said. Health
care providers include civilian and military social workers, behavioral health
technicians, physical therapists, psychologists and psychiatrists.
Not only has there been an increase in
providers, those providers have been placed where they are needed most, she
said, citing examples of embedded health care teams in Afghanistan and within
brigade combat teams. The Army plans to continue with the expansion, she said,
with the goal of embedding the teams within other units that are not brigade
combat teams, or BCTs.
“We want to get behavioral health care
out of brick and mortar and into the soldier’s lifespace,” she said.
“Soldiers are then more likely to seek behavioral health and other
wellness care.”
Lt. Gen. Howard B. Bromberg, deputy chief of
staff, G-1, echoed Horoho’s enthusiasm for the embeds, adding that the value of
health care embeds is not just in relationship building with soldiers, but also
in building close relationships with commanders. He said the health care
providers can advise the commanders and help bring about cultural change
associated with the stigma of seeking help for behavioral conditions.
Commanders are looking at behavior health in a
new light, said Bromberg, who has overall responsibility for Soldier personnel
readiness and management and is the lead for IDES. They are including
behavioral health plans on their priority checklist right alongside ammunition,
training and other requirements, he said.
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