I had the pleasure to meet with Dr. Velandy Manohar of the Community Health Center, Inc. to speak about the important and sometimes sensitive topic of post traumatic stress disorder (PTSD).  On Wednesday, June 27, I was informed that it was Veterans and National PTSD Awareness Day and that the entire month of June serves as a month dedicated to this very important observance.  With only 1% of the US population serving within our armed forces, this is definitely a subject worth attention. In 2011, there were more hospitalizations for mental disorders amongst active-duty service members than for any other major illness or injury, affecting one in five individuals.

Post Traumatic Stress was best described in my research by the Department of Veteran Affairs as a normal reaction to a very abnormal situation such as combat, natural disasters, physical assaults, rape and other life threatening experiences. These reactions can vary and may include a) re-experiencing the event, b) avoiding situations that remind you of the event, c) feeling numb, d) feeling nervous or anxious and e) having difficulty focusing or concentrating. In my opinion, veteran affairs can easily be overlooked and usually get most of their support around national holidays such as Memorial and Veteran’s Day.  Before I met with Dr. Manohar, I thought I had a somewhat generic understanding of PTSD. After sitting down for twenty minutes with him, my new found feelings about not only the disorder were drastically altered but I now had a complete new perspective of how the men and women who suffer from PTSD are cared for after their call to duty.

Dr. Manohar is Psychiatrist here at the health center with a specialty in both Psychosomatic and Addiction Psychiatry.  He has close ties with the military and has written extensive letters and reports about his research within the realm of PTSD.  He gave me three main points to structure his argument. 1) There are a many predisposing factors associated with PTSD 2) the military system at hand 3) the cover up of how/what is being done to treat those who suffer from these disorders.

There are a few factors that really grabbed my attention. The first one was that in most cases, health professionals outside of the military do not make the decision as to who is fit for duty.  Due to our current and long term situation overseas, the system is overstretched and overstrained.  There are available services provided for those who are serving and our veterans but it is difficult to navigate through the system.  It takes multiple doctors to diagnose, treat and prescribe, and continue follow up care for PTSD, Bi Polar disorder and traumatic brain disorder which are all considered a part of “The iron triangle”. This is how Dr. Manohar categorized how our troops are being affected.  There is no escape in terms of access to care within this triangle, and the only way out is through the “trap door” which is substance abuse. He spoke very highly of health professionals that do work hard to provide proper care but there are so many patients that the number of those benefiting is small. Active members of the military are being minimally treated for these disorders and sent straight back into the line of duty where they are unfit to make crucial decisions.

In the beginning of September, I attended Stand Down which is an annual event hosted to provide different types of medical and necessary services to homeless veterans. Organized by the VA, this was an eye opening event to see thousands of men and women who served for our freedom, who are living below poverty level with medical problems, and lack to basic needs such as food and clothing. Dr. Manohar reflected on this event as he spoke with me. He said that Stand Down is a huge example of the flaws in the system when it comes to supporting our military and veterans and how there is a huge need for mainstreamed care. Most of these individuals suffer from drug and alcohol addiction which was ignited by the trauma from serving in war and lack of treatment availability.

 Another frightening fact was that from 2005-2007, the army discharged about 1,000 soldiers a year for having a personality disorder. In most of these cases, the “personality disorder” was brought upon symptoms caused by PTSD. Many patients were being wrongfully diagnosed which led to Defense Department changed its policy and began requiring a top-level review of each case. After that, the annual number of personality disorder cases dropped by 75 percent. Only 260 soldiers were discharged on those grounds in 2009. At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD twice as many as two years before. Currently, The Army inspector general is conducting a system-wide review of mental health facilities to determine whether psychiatrists overturned diagnoses of post-traumatic stress disorder to save money, a move that comes as the case of a U.S. soldier suspected of killing 16 Afghan civilians has brought fresh attention to the strains of war.

Suicide is also a huge factor in these new reviews among armed service organizations. Soldier suicides have been on the rise since 2004, a trend that has been paralleled by increases in mental illness. In 2008, suicide rates among soldiers surpassed civilian rates that were adjusted for characteristics of a military population.  I will end this post with saying Dr. Manohar’s passion on this topic is astounding and it was something that has been on my mind since I left his office. It is difficult to try and sum up all of the details associated with this topic into one blog post. I have definitely only touched upon some of what I learned briefly and I understand it is somewhat sensitive with our current status overseas but I encourage you to learn more.