Female Veterans Suffering From PTSD Not Getting Needed Care – CNN
February 5, 2010I Served My Country…and Wound Up Living in My Car – MarieClaire.com
January 24, 2010
After a downward spiral into homelessness and drug addiction, here’s how I dug myself out.
By Jennifer Crane, as told to Lynn Harris
Study seeks to locate, help women veterans: Post-traumatic stress disorder is its focus – Albuquerque Journal
January 20, 2010Jan. 18–An unintended consequence of allowing women in the U.S. military to serve in combat has led a local psychologist to launch a four-year, $1 million research project centered on women with post-traumatic stress disorder, or PTSD.
The bad news is that about 22 percent of female veterans serving in Iraq and Afghanistan develop PTSD, compared with 15 percent of combat veterans in general.
Even worse, said Diane T. Castillo, a psychologist with the New Mexico Veterans Affairs Health Care System, between 80 percent and 90 percent of the women veterans being treated at the local VA clinic list sexual trauma as the source of their PTSD. That’s 10 times higher than the number of women who attribute their PTSD to combat trauma alone. About 20 percent report sexual trauma and at least one other source of trauma as causes of their PTSD.
With more than 20 years of research and a renewed, war-induced focus on posttraumatic stress disorder, medical practitioners are in near unanimous agreement about how to best treat the debilitating effects of PTSD.
The focus now, Castillo said, is finding the most efficient way of providing proven PTSD treatments to the burgeoning number of soldiers, Marines, airmen and sailors returning from the wars in Iraq and Afghanistan.
Castillo, coordinator for the Women’s Stress Disorder Treatment Team at the New Mexico VA Health Care System, an adjunct assistant professor in UNM’s Psychiatry Department and an associate professor in UNM’s Psychology Department, has been treating PTSD patients for more than 20 years.
Post-traumatic stress disorder is a severe anxiety disorder that produces psychological symptoms that can occur after a person experiences a traumatic event. Symptoms can include flashbacks, nightmares, depression, anxiety, edginess, substance abuse and a plethora of other conditions, and can surface years after the event that caused it.
PTSD was not a medically recognized disorder until 1980, five years after the United States ended its involvement in Vietnam, Castillo said. Before that, it was generally referred to as “shell shock” or “battle fatigue” and was often misdiagnosed.
As U.S. military personnel began returning from combat tours in Iraq and Afghanistan, PTSD became increasingly common, Castillo said.
Being in the military not only increases the chances of having experiences that can lead to PTSD, but it also can complicate recovery.
“If I’m a civilian woman and I get raped, I can quit my job, I can move to another state, I can go live with my family. I have lots of options,” Castillo said. “If I’m in the military and I get raped … my options are more limited, and the trauma can be compounded.”
Since the VA’s Women’s Stress Disorder Treatment Team program was initiated in 1995, about 400 women veterans have received treatment for PTSD, Castillo said, including nurses who served in Vietnam.
Women’s study
Since April 2008, Castillo has led a four-year, $1 million study focusing on women veterans dealing with PTSD and three psychotherapies for treating it: prolonged exposure therapy, cognitive processing therapy and skills therapy.
“What we know … is that the two most effective treatments for PTSD are prolonged exposure therapy and cognitive processing therapy,” Castillo said.
Although exposure therapy has been very successful in treating PTSD when delivered one-on-one between the therapist and the patient, its efficacy in a group setting is largely undetermined.
One goal of Castillo’s study is to determine which of those therapies work best in a small-group setting for women veterans dealing with PTSD who served in Iraq or Afghanistan.
“The study’s secondary goal is to see how these therapies work in combination, and in different orders,” Castillo said.
In exposure therapy, the women talk repeatedly and in growing detail about the trauma that triggered their PTSD. In cognitive therapy, they talk about how their thoughts are altered as a result of the trauma. In skills therapy they learn assertiveness and relaxation techniques that help them cope successfully with the trauma they experienced.
If it’s determined that the therapies are effective in small groups, more people dealing with PTSD can be treated sooner, in less time and at a lower cost, Castillo said.
With such tight parameters, Castillo said, she’s having trouble finding study participants, even though they receive free PTSD treatment and can receive a stipend of up to $270.
“Doing research on groups is much harder than doing research on individuals,” she said. “If one person drops out you’re down to two, and if one of them drops out you no longer have a group.”
As of Jan. 1, 16 women are in the study and two groups have completed treatment and are in the follow-up phase.
“The thing we always run into with our clinic is that people don’t see women as veterans,” Castillo said. “If you’re a man walking into an emergency room, they’ll usually ask you if you’re a veteran. If you say yes, they send you here to the VA. But if you’re a woman, they might not ask if you’re a veteran.” That decreases the likelihood that women veterans will know about the women’s PTSD clinic, or the study.
“The bad news is that trauma happens,” Castillo said. “The good news is, we have therapies that are really, really effective.” Women Veterans PTSD Study
Who qualifies? Veteran and active-duty military women diagnosed with PTSD who served after 9/11.
What’s involved? Women will be assigned to a 16-week group or a 16-week minimal attention/wait list, depending on their needs.
The groups, composed of three women led by a therapist, meet weekly for 90 minutes for 16 weeks. Wait-list participants meet individually with a therapist every other week for a total of four, 60-minute face-to-face sessions and four telephone contacts. Afterward, they can join a group.
What do participants get? Besides free treatment, group participants will have three follow-up interviews. Wait-list participants will have one follow-up interview. Participants are paid $75 for their initial interview, and $65 for followup interviews.
How many women are needed? The study needs 74 participants, but will recruit about 108 to compensate for drop-outs. It isn’t limited to combat veterans.
Who can I talk to about the study? Call the Women’s Stress Disorder Treatment Team program at 265-1711.
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Copyright (c) 2010, Albuquerque Journal, N.M.
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Despite prevention efforts, U.S. military suicides rise – Politics AP – MiamiHerald.com
January 19, 2010By HALIMAH ABDULLAH
McClatchy Newspapers
WASHINGTON — Eight years of war in Afghanistan and Iraq have etched indelible scars on the psyches of many of the nation’s service members, and the U.S. military is losing a battle to stem an epidemic of suicides in its ranks.
Despite calls by top Pentagon officials for a sea change in attitudes about mental health, millions of dollars in new suicide-prevention programming and thousands of hours spent helping soldiers suffering from what often are euphemistically dubbed “invisible wounds,” the military is losing ground.
The Department of Defense Friday reported that there were 160 reported active-duty Army suicides in 2009, up from 140 in 2008. Of these, 114 have been confirmed, while the manner of death in the remaining 46 remains to be determined.
“There’s no question that 2009 was a painful year for the Army when it came to suicides,” said Col. Christopher Philbrick, the deputy director of the Army Suicide Prevention Task Force, in a statement, despite what he called “wide-ranging measures last year to confront the problem.”
While the military’s suicide rate is comparable to civilian rates, the increase last year is alarming because the armed services traditionally had lower suicide rates than the general population did.
“I look at the numbers of each service, and that rate has gone up at the same rate across the services,” Adm. Mike Mullen, the chairman of the Joint Chiefs of Staff, told a gathering of military mental health professionals and advocates last week. “This isn’t just a ground force problem.”
Some of the suicides are young men, fresh from deployments and haunted by memories, who shoot themselves after they return from their second or third tours in Iraq or Afghanistan, or when romantic relationships turn sour, sometimes due to long separations or post-traumatic stress.
Others are career officers who quietly nurse addictions to drugs or alcohol and finally decide to silence their ghosts.
An increasing number are female soldiers, who rarely committed suicide before but now are killing themselves at a much higher rate.
“There does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I’m just hard pressed to believe that’s not the case,” Mullen said.
The emotional wounds are so deep and the suicide rates are so high that top Pentagon officials broke a generations-long code of silence on the topic and have started speaking publicly and vehemently about the effects of mental illness.
At Fort Benning, Ga., which defense experts say ranks among the top installations for effective mental health screening, retired Brigade Command Sgt. Maj. Samuel Rhodes’ speech to troops about how he considered suicide after serving for 30 months in Iraq encouraged other soldiers to come forward.
The military’s shift in attitudes about mental health was evident during last week’s joint Departments of Defense and Veterans Affairs suicide prevention conference, where uniformed attendees spoke openly about the stigma of seeking mental health care, the need for policy changes that will make help easier to get and the importance of supporting the families of troops suffering from mental illness.
“It’s a joint DOD and VA conference, that alone says an awful lot about where we used to be and where we are now,” Mullen said.
With one of the highest suicide rates in the Army, Fort Campbell, a sprawling installation on the Kentucky-Tennessee border that’s home to the elite 101st Airborne Division, illustrates the severity of the problem.
“Our issues here at Fort Campbell identically mirror the issues mirroring the Army as a whole. The demographics are almost exactly: white males 18-29 who commit suicide (using handguns),” said Joe Varney, the Fort Campbell suicide prevention program manager.
In 2007, Fort Campbell created a suicide task force after nine soldiers committed suicide, three during the first few weeks of October, and 101st Airborne’s commander, Maj. Gen. Jeffrey Schloesser, reached out to soldiers and their families.
“As our soldiers fight terrorism, the sacrifices asked of them and their families have increased significantly,” Schloesser said in a letter to troops. “Regrettably, under such circumstances, it is natural for our people to feel the stress of these demands and to be overwhelmed at times. Tragically, these pressures too often end in suicide.”
The following year, Fort Campbell’s suicide rate jumped to 12.
The base hired a suicide-prevention program manager and dispatched staffers to study trends, increased awareness training for troops and boosted the number of mental health professionals available to soldiers while in combat and after they return. Army officials say those efforts could prove useful service-wide.
Last year, Fort Campbell held a three-day “suicide stand-down,” and top officials pleaded with soldiers to get mental help if they needed it and assured them that seeking such help wasn’t a sign of weakness and wouldn’t affect their careers.
The number of suicides increased to 14 in 2009.
“It’s been discouraging to say the least,” Varney said.
Stemming the rise in suicides will take more than conferences, task forces, training and studies, said Col. Elspeth Ritchie, the director of behavioral health for the Office of the Army Surgeon General. The military also will have to grapple with the easy availability of handguns, a topic that’s sure to be unpopular, she said.
“It’s amazing to me when you see Fort Campbell, which is at the top of suicide lists. They have a beautiful gun shop in the middle of the (Post Exchange),” Ritchie said. “I’m troubled by what I see as a mixed message.”
Some soldiers who receive counseling are still committing suicide, and many think – with good reason, given previous military policies and attitudes about mental health – that seeking treatment could ruin careers, she said.
“We cannot change stigma until we change policies that contribute to stigma,” Ritchie said. “In many ways we talk out of both sides of our mouths.”
The Obama administration, at the behest of a small bipartisan congressional group, is reviewing a long-standing unofficial policy that bars the president from sending condolence letters to the families of servicemen and women who commit suicide.
Family members of soldiers who’ve committed suicide said that changing the policy would go a long way toward removing the stigma because the military already provides a full military burial for soldiers who commit suicide.
“That policy reflects the heartlessness to those who served. They’ve been inflicted with hidden wounds, but it doesn’t mean they’re any less lethal,” said Kevin Lucey, of Belchertown, Mass., whose son Jeffrey, a 23-year-old Marine, hanged himself less than a year after he returned from Iraq. The government settled with the family for $350,000.
ON THE WEB
The Defense Department December suicide report: http://www.defense.gov/releases/release.aspx?releaseid=13242
Defense Department 2008 Survey of Health Related Behaviors Among Active Duty Military Personnel: http://www.tricare.mil/2008HealthBehaviors.pdf
Women’s Scars of War « MIAPBLOG.us
January 19, 2010women’s scars of war
Zen Hernandez, 12, proudly wears a “My Mommy Wears Combat Boots” shirt while posing with his momBy Jessica Yadegaran
Contra Costa TimesWhen retired Army Staff Sgt. June Moss returned from Iraq, she had to explain to her children why she couldn’t hug them. Any embrace longer than two seconds made her skin feel like it was on fire.
“When I got back, my kids were really clingy,” Moss says. “They wanted affection. But, what do you say to a child?”
At night, sleep never came. Instead, Moss baked cupcakes until dawn. At playgrounds, surrounded by the noise and chaos of crowds, Moss felt like her chest was going to explode. Worse, she was afraid she’d hurt someone.
“I wasn’t the same person when I came home,” says Moss, who returned from Iraq in August 2003 and now lives in East Palo Alto. “I was different. I was cold.”
When imagining a struggling war veteran, it’s likely few people picture a young woman such as Moss, who was eventually diagnosed with post-traumatic stress disorder. But women make up 15 percent of active-duty military members, and the Department of Veterans Affairs estimates that by the end of 2020, women will represent 10 percent of the nation’s veteran population.
And though military and congressional policy says women can’t participate in direct ground combat, women carry guns, and use them. They drive Humvees hit by improvised explosive devices. They interrogate, and witness bloodshed. But for women, there is a major difference. They come home to a society that for the most part doesn’t understand — or accept — that they’re serving in the line of fire.
As a result, the feelings of isolation can be even more overwhelming, especially since a woman is often one of few in her unit, says Natara Garovoy, program director of the Women’s Prevention, Outreach and Education Center for the VA Palo Alto Health Care System.
Fear of assault
Complicating matters, some female soldiers live in fear of being attacked by one of their own. In 2008, the VA reported that one in five women screened for military sexual trauma had been sexually harassed or assaulted by a fellow soldier.
Moss did little alone, whether it was burning confidential papers or taking out the trash. But she still feared for her safety, especially at night. “You already feared for your life,” Moss says, “but the thought of a soldier attacking another soldier?”
The mother of two spent eight months in 2003 as a light-wheel vehicle mechanic with the Third Infantry Division. As she drove through bustling marketplaces, often under aerial or ground fire, she clutched the steering wheel, scanning for suicide bombers. To get through those drives, she prayed.
“I was calling to God really heavily,” Moss says. “I was scared for my life every day, not knowing if I was going to come home to my children and what loss they would have to bear. So I just had to have my wits about me and believe in my training.”
Back at the base, Moss struggled with her identity. She was a soldier, wife to a soldier (her now ex-husband, who was also in the Army), her family’s primary caregiver and a mechanic. Still, she tried to blend in, especially since she was the only woman in her unit. She cut her hair short. She wore boxer shorts and big T-shirts to hide her figure. She tried to be overly tough and stand up for herself, she says, particularly when male soldiers made off-color remarks or unwanted gestures.
“You just have to know when to say, ‘Stop. I don’t appreciate that,’ ” Moss says.
Reconciling identity is among the biggest issues Tia Christopher sees in her work with female veterans. As the women veterans coordinator for Swords to Plowshares’ Iraq and Afghanistan Veterans Project, Christopher helps homeless and low-income women obtain medical care, housing and job training upon returning from war.
“So many of my female clients who were in Iraq put up with things, even injuries, because they don’t want to be that girl (who complains),” she says. “They soldier on and silently bear that burden. But you can lose a certain amount of your femininity.”
On the upside, the military has recognized and is beginning to rectify the lack of postwar support for women. Historically, female veterans have had a hard time gaining access to services because facilities aren’t welcoming or because they didn’t know the VA served them, says Garovoy, a clinical psychologist. Due to the increase of women in the military — 20 percent of new recruits are female — programs tailored for women are increasing. Still, there are barriers. Even diagnosing post-traumatic stress disorder is a major issue.
“Because women serving in Iraq are often performing duties not in their job title, and because of the nature of the warfare, they are coming back with symptoms of the disorder and having to deal with the burden of proof,” Christopher says.
Returning to the states, Moss, then 32, was at first misdiagnosed. Had she been a man, the diagnosis might have been swifter, Moss says.
“They probably thought, ‘Oh you’re a woman. You must have depression,’ ” she says.
Many don’t seek help
Treatment is equally challenging. “If you’re the only woman in a support group, you might not feel comfortable and are less likely to go back,” Christopher says. At groups for women dealing with post-traumatic stress disorder, the focus is often on sexual trauma, which further alienates those who are there for combat-related traumas, Christopher adds.
Sgt. Myrna Hernandez, of Concord, wasn’t diagnosed with post-traumatic stress disorder for years. She didn’t seek help because she didn’t want to admit something was wrong. When Hernandez, who served as maintenance support for Pittsburg’s 870th Military Police Company, returned from Iraq in 2004, her mood was sour. She was anti-social, she says, and turned to drinking. On good nights, she got three hours of sleep.
She was also nervous about reuniting with her 6-year-old son, Zen. Hernandez had two opportunities to come home — including vacation time while she was in Iraq — but she chose to stay away.
“It was pretty rough,” recalls Hernandez, who was 26 at the time and one of six women in her company. “But I thought it would be too difficult for him to see me and have to say goodbye again.”
Meanwhile, at the base, Hernandez was dealing with more difficulties. She was one of three women who accused their commanding captain, Leo Merck, of peering beneath a shower wall and snapping nude photographs of them at Abu Ghraib. In a deal to avoid a court-martial, Merck resigned from the National Guard in November 2003. In May 2004, Hernandez told the Bay Area News Group that she saw Merck taking the photos.
Still, she’s not bitter.
“For most people, (the experience) would turn them against the military,” says Hernandez, who did prisoner processing and other duties similar to military police. “But I can’t let the actions of a few people ultimately change how I feel about my service.”
Today, Hernandez works as a technician in the Army Reserves. She attends support groups at the Concord Vet Center but is usually the only woman.
As President Barack Obama prepares to send more troops to Afghanistan, Hernandez braces herself for the possibility of another deployment.
“If I’m told I have to go, I will,” she says. “At the same time, it’s pretty scary. I guess knowing you have a job to do kind of overshadows that.”
Ultimately, she is proud of the contribution she and all women are making in the military. “We don’t do infantry jobs, but I think we’ve come a long way since the image of the nurse in heels,” she says.
Moss feels similar pride. Last month, after 12 years of service, she permanently retired from the military, and she works as an assistant in chaplain services for the VA Palo Alto Health Care System. She still struggles with her symptoms, but because she knows her triggers, she avoids them.
At restaurants, she sits in a corner booth that allows her an unobstructed view, should there be a sudden or loud noise. When she picks up her children up at school, she calls the school secretary to send them outside. She can’t wait in the busy parking lot with the other parents.
In the end, though, Moss measures her progress by the duration of her embraces. When her children need a hug, they can now linger in her arms for a full 10 seconds.
Women represent 15 percent of active-duty military members and 17.5 percent of National Guard and Reserves Forces.
20 percent of new military recruits are women. 38 percent of female troops are mothers.
California has 167,000 female veterans, the highest number of any state.
Women represent 220,000 of the 1.8 million troops serving in Operation Iraqi Freedom and Operation Enduring Freedom.
The average age of a female veteran is 48; average male veteran is 61.
The VA estimates that the percentage of female veterans it serves will double by the end of 2010.
Women have been volunteering in the military since the American Revolution, but it wasn”t until the 1980 census that they were asked if they had served in the U.S. Armed Forces; 1.2 million answered that they had.
“Lioness”: This 2008 documentary by Meg McLagan and Dara Summers makes public the stories of female Army support soldiers who were part of the first program in American history to send women into direct ground combat, despite congressional and military law that states women are not allowed to do so. Without the same training as their male counterparts, these young women fought in some of the bloodiest counterinsurgency battles alongside Marine combat units in Iraq and returned home with the same physical and psychological issues. http://lionessthefilm.com.
“Women of the Military”: Santa Clara-based W.J. Parolini”s recent documentary following Kate Hoit, a young U.S. Army specialist who returns home from Iraq and attempts to enlighten and educate Americans about the roles of women in the military. www.womenofthemilitary.com.
“Love My Rifle More Than You “” Young and Female in the U.S. Army” (W.W. Norton, 2005): Kayla Williams” memoir about serving as a sergeant in a military intelligence company and understanding her identity in “an ocean of testosterone.” Williams went to Iraq in 2003 and participated in signal intelligence and direction finding of enemy communication in Baghdad. She also accompanied infantry troops on missions, which isn”t common for a female soldier.
“” Jessica Yadegaran
Service Dogs Help Traumatized Veterans Heal – US News and World Report
January 4, 2010By Amanda Gardner
HealthDay Reporter
THURSDAY, Sept. 3 (HealthDay News) — Iraq war veteran Jennifer Pacanowski was unaware that she was racing dangerously down the freeway at 85 miles an hour when she felt a wet nose nudge her elbow.
The wet nose belonged to Boo, Pacanowski’s 110-pound Bull Mastiff, warning her that her anxiety levels were rising, a dangerous state given that Pacanowski has post-traumatic stress disorder (PTSD) from her experiences as a medic in the war.
Boo, who turned 1 in August, has been with Pacanowski, helping her deal with the world since last December.
“Sometimes I forget where I am and will go back to the war in Iraq. He brings me back to reality and makes me realize that I can’t run people off the road. It’s a frequent thing with PTSD to have road rage,” said Pacanowski, who returned to the United States at the end of 2004 and now lives in northeastern Pennsylvania. “He’s a comfort. I also know I’m not alone, and people can’t just sneak up on me without his knowledge.”
Read More…Service Dogs Help Traumatized Veterans Heal – US News and World Report
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