Army misdiagnosed and kicked out thousands of mentally ill vets

http://hereandnow.wbur.org/2015/12/09/discharged-soldiers-mental-health

Previous investigations revealed how the VA was underprepared to meet the medical needs of the War on Terror vets, and the backlog for mental health care was horrendous.

Not sure if it's related, but a new study found that the Army systematically under-diagnosed soldiers with "adjustment disorder" rather than PTSD/depression (a vague classification from the Vietnam era that suggests a soldier is *temporarily* experiencing poor emotional/behavioral symptoms after a deployment). The former implied that the soldier was unable to perform his/her duties stateside and should be dishonorably discharged (i.e. it's the soldier's fault). However, if they were diagnosed with PTSD/depression, that is considered a debilitation due to their military service (i.e. it's the war's fault), which is an honorable discharge that guarantees lifetime free medical care for themselves, spouse, and kids (equivalent to losing a leg or an eye).

That Vietnam vets site above suggested that the military "saved" $12B on medical/disability payments for Vietnam vets who were misdiagnosed.

In many cases, suffering vets got both civilian and Army psych evals. The civilian diagnosis was depression, but the Army diagnosis disagreed (even after reviewing the civilian diagnosis). It's possible that the civilian doctors were sometime wrong, but not to the tune of two thousand independent cases.

Since 2009, the Army has also kicked out 22,000 vets for various misconduct. But when a soldier has PTSD/depression, that increases the likelihood that they will fall into a misconduct situation (dereliction of duties, fighting, substance abuse, etc.). So we're not sure how many of the 22K were misdiagnosed, but I would bet it's at least a third. There is now a Congressional inquiry about this issue due to NPR's reporting.

You can't get a mortgage unless you can prove that you can afford it. We shouldn't go to war unless we can prove that we need to, we are likely to win, and our gov't can and will handle the costs.

Memorial Day reminder

As our leaders, media, and propagandists try to guilt trip us into remembering and appreciating veterans this season (they bled so we can BBQ - which is just a silly claim all around), let's also remember how stupid some of our leaders were in getting us into and mismanaging certain wars. Many paid the ultimate price for the mistakes of a few. Each year when the president lays a wreath at the Tomb of the Unknown Soldier, they should also burn a past leader in effigy (plenty to choose from: Nixon, Bush, Cheney, Westmoreland, Custer, MacArthur, etc.).

In the vain pursuit of glory, power, legacy, etc., they eagerly put pen to paper (with little care about consequences and how to care for the wounded after the war), and changed the fates of millions of families - usually for the worse. At least in the olden days, the "best and brightest" would offer their sons to the military as noblesse oblige and expectations of their class. But with the advent of industrialized warfare where anyone could be killed suddenly (and en masse) by flying hot metal, all that changed. And with global capitalism, the powerful could grow their empires commercially, making physical conquest (and all its risks) obsolete. The 1% sent their kids to the Ivy League as the future champions of industry/politics, and the poor did the fighting and dying instead.

http://www.kqed.org/a/forum/R201505051000

"My younger brother, a Vietnam vet, recently died. He was haunted to the end by memories of what he witnessed in the war and of "well-meaning" friends and relatives who called him a baby killer when he returned.
Now, my grandson is fighting to recover from PTSD, hearing loss, and memories of what he witnessed during 3 tours in Iraq.
Will it never end?"

The staggering social costs of gun violence in the US

This was a good interview about a Mother Jones article on the indirect costs of US gun violence: http://www.kqed.org/a/forum/R201504300930

The author's team performed an established economic analysis to estimate the total costs of gun violence - not just the direct costs of law enf., ER visit, and justice/penal system processing, but also lost productivity and diminished quality of life from long-term disability, incarceration, and death (affecting not just the victim but their family, workplace, and community). The article estimates that of the ~30K gun murders each year, on average it costs America $500K each. Add to that the ~80K cases/year of serious injuries from guns, and the total price tag is over $200B/year. That is 1/3 the value of Apple's stock, and more than US medicine spends on obesity each year. It's freaking huge.

But we're not talking about this because the NRA and others make the data so hard to access. And if people do try to study it (like the CDC and Harvard School of Public Health and Obama's recent nominee for Sgn. General), the gun lobby paints them as gun-control activists with a political agenda. Conservatives want to cut waste and spending left and right (social programs, research, etc.), but somehow the military and guns are exempt?

BTW - the study also found a correlation between states with weak gun laws and higher gun violence costs per capita (LA, WY are the worst, while HI and MA are some of the best - also with stricter gun laws). It's a no-brainer to us, but the 2nd Amendment crowd clings to the myth that more guns make you safer. They might also argue - what about the economic savings from all the crimes prevented by conscientious citizens with guns? Well there's just no data to support that claim, if it's even true (which is doubtful). You're much more likely to hurt yourself or a loved one than prevent a crime with your gun.

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This is pretty heartbreaking stuff about the effects of violence on Oakland's youth:

http://ww2.kqed.org/news/2015/04/29/violence-causes-ripple-effects-for-thousands-of-oakland-students

For a kid who turned 18 this year in Oakland, he or she lived through 111 kids getting killed in that city, not to mention the trauma that caused for everyone else. At least Alameda County is deploying more mental health resources for them now - but really this is an issue that no kid should have to deal with. Especially if they're under 10, children often can't deal with the difficult emotions generated from experiencing violence, so their ability to learn is impaired and they may lash out in negative ways.

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NPR did a story based on this article and the most persuasive outcome, to me, was that there needs to be science and data applied to this stuff.  One of the guests was talking about the idea that if you even ask for data you are anti gun.  That there is this all or nothing approach.  Why wouldn't the dates show all the loves being saved if guns are great?  Couldn't we also find that, for example, people with lots of gun training have better outcomes related to fun violence?  It seems weird to assume data can only be anti gun.

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Agreed. I guess it's like climate change and cop racism issues - if one side of the argument is confident in their position, they should have no problems whatsoever with full data transparency. When you are "trying to hide something" and suppressing info, that is a tell-tale sign that your argument has a problem. Actually if those folks really love gun rights and "freedom", then they should welcome data transparency to help improve gun use and gun culture in America (like a majority of NRA members favor better background checks, but NRA leaders don't). Or do they think that everything is OK? Don't they know that the most successful (legit) companies and gov'ts in the last 50 years are obsessed with data to help them succeed and improve?

Bottom line, the gun industry/lobby's only goal is to sell more product. Gun ownership in the US (as % of households) is on a huge decline since WWII, partly driven by urbanization, less interest in hunting, and I would like to believe social progress. But the # of guns in circulation may have gone up, so someone is buying them. There are fewer gun owners now, but they own more guns (and more deadly ones) per capita. Police departments upgrade their guns more frequently, and lord knows where their used guns go (I think there are accounts of cartels/gangs using former US police firearms).

So to accomplish their goal, the gun lobby has to oppose anything that would potentially hurt sales, and of course social costs data is a big threat. And when the costs are so obvious (even without hard data), they pull the freedom and liberty card. Sure guns are destructive, but the costs are "worth it" because we have to sacrifice to keep the communists from taking our freedoms. We have to tolerate the side-effects of guns because I need to protect my family from the bad guys. And when it's poor/black people shouldering most of the costs, it's easier to ignore - until incidents like Columbine and Sandy Hook happen, which affected affluent whites and jarred the nation.

I use data to put food on the table, so I'd like to think that I have some sense of "data ethics" and best practices. When the pro-gun side decides to actually use data in their arguments, I can honestly say that they are the worst in terms of ethics and rigor. Total intellectual dishonesty (or maybe ignorance). I have not read any NRA white papers (if there are any non-laughable ones), so I am basing my judgment mostly on the sound bites you hear in the gun debate.

Examples:

• "Chicago has strict gun laws, but they still have plenty of gang violence and murders, so gun laws don't work!" Because we don't have borders. Thugs just have to buy a gun 30 miles away in easier places like Indiana, and then drive back to the city to shoot someone.
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• "Since the Brady Bill/Assault Weapons Ban expired, there have been fewer mass shootings, so assault weapons in the hands of 'the good guys' is an effective deterrent." Not enough sample size to assess a trend, and what defines a "mass shooting"? Public mass shootings are fortunately still pretty rare (it's much more common for someone to slaughter their family in a private residence). But Mother Jones and Harvard ran a statistical analysis to handle rare events, and they concluded that mass shootings are actually more frequent after the loosening of gun laws. Of course correlation is not causation, but it invalidates the pro-gun claim.
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• "Guns don't kill people; people kill people - address the mental health and anger issues instead." But guns kill people A LOT more effectively than a knife or bare hands. Yes there will always be a baseline level of violence and murder intent in any society, but if you restrict access to the murder tools, people won't be able to carry them out as effectively. Look at AUS/UK vs. US. Fairly similar culture, demos, etc., but we have all the guns and murders. Canada is an exception (many guns, few murders), but there will always be outliers.

Consequences of our "great success" Iraq Surge

http://www.pbs.org/wgbh/pages/frontline/woundedplatoon/view/?utm_campaign=homepage&utm_medium=proglist&utm_source=proglist

Politicians and the Pentagon love to tout the Surge as positive validation of our counter-insurgency and Middle East strategies. But this documentary describes the human costs on a particular platoon of soldiers from Fort Carson, CO, which had one of the highest kill and casualty rates in the Army. Due to the Army's desperate need for more boots on the ground, they relaxed their admission standards and granted waivers to young men with criminal records. While those men mostly served gallantly and performed similarly to non-criminal peers, they also had a higher incidence of misconduct. After their first tour (pre-Surge), the platoon returned to Fort Carson and some engaged in substance abuse, criminality, and poor performance. 15 of 42 soldiers in the platoon left the Army for various reasons, which reduced the unit's combat readiness and seniority. Their commanders asked if anyone wanted to talk about problems, and "offered" mental health services, but it was mostly lip-service and troops were scared to come forward, possibly risking harsh judgment or punishment (http://www.npr.org/templates/story/story.php?storyId=10374760). The fort was terribly under-staffed and under-trained for PTSD treatment anyway, and even needed to outsource to local doctors in town.

Despite these problems at Fort Carson and elsewhere, Washington needed more troops for the Surge in 2007, so many unfit soldiers were called up again to deploy after just one year home (the military recommends two years). Despite pending criminal investigations and evidence of PTSD/substance abuse against some, the Army broke its own rules and allowed these troubled men to return to combat. These already mentally and physically wounded men were now asked to live in forward areas outside base protections, and street fight with more intensity and at a higher frequency. Their tours were extended from 12 to 15 months midway. Morale was down and casualties were up, as well as unconfirmed reports of indiscriminate killings of non-hostile Iraqis. Complaints of PTSD rose, as did demand for battlefield mental health services. But since many of the needy soldiers now lived beyond the wire, they were inaccessible to psychiatrists, and those who got treatment were often declared "fit for duty" despite obvious warning signs. Instead, the Army prescribed a huge amount of pharmaceuticals such as anti-depressants and sleep aids like Ambien, to 20,000 soldiers in total (prior to the Iraq War, combat soldiers did not take psychological drugs due to supply logistics and inability to monitor treatment). Yet the warning labels for those drugs state, "Do not perform hazardous activities while medicated. May cause side effects such as depression, aggression, insomnia, reduced inhibitions. Take only under the close supervision of a doctor." Withdrawal from those drugs can also be severe, and due to combat constraints, soldiers would exhaust their prescriptions on the field and wonder "now what?". Soldiers also got their hands on black market Valium, pot, and other drugs.

Since the Iraq War began, 17 soldiers from Fort Carson have been charged or convicted of murder/attempted murder/manslaughter, many of whom had prior criminal records, symptoms of PTSD and TBI (traumatic brain injury), and were taking prescription or illegal drugs. 36 others have committed suicide. Fort Carson had 14,000 soldiers, so their suicide rate is 40% higher than the overall US male population (according to WHO). When asked about these matters, retired Fort Carson officer Colonel David Clark, head of the 506th Infantry (that this platoon is a part of), said, "The Surge worked. War is a dangerous thing. [There will be] psychological problems for soldiers; is that reason not to do it? You gotta do what you have to do."

Easy for him to say from behind a desk.