VA Staffer Discourages PTSD Diagnoses

The article and blogs demonstrate the danger of mixing psychiatry and politics. Read Goodwin and Guze's seminal book "Psychiatric Diagnosis" to understand the early problems of such mixtures, including the sadly humorous political path of the PMS diagnosis.

Also described in this book is a "heretical view" endorsed by those who laid the foundation for American descriptive psychiatry:

"In our view there are only about a dozen diagnostic entities in adult psychiatry that have been sufficiently studied to be useful."

As of the printing of DSM-IV, PTSD was not one of those diagnoses.

Further, American psychiatry struggles presently with a pseudo-plague of overdiagnosed bipolar disorder, with powerful, published research emerging to this effect. Why?

The psychiatric profession and money make for a messy mix.
*** In most settings, reimbursement REQUIRES diagnosis, thus everyone who sees a psychiatrist gets one.
*** Patients won't return unless a medication is prescribed.
*** Psychiatrists are paid much more per minute for short visits than for long visits, thus they now tend to see 20-25 patients per day. Careful diagnosis cannot occur with such a schedule.

Bankrupting the American taxpayer for politically motivated diagnoses is reprehensible and disrespectful to those who actually need disability benefits. Flagellating a president with fallible psychiatric diagnostic processes is useless.

I saw nothing wrong with Dr. Perez's statements. I merely heard her to be endorsing mindful diagnosis. Since when do we castigate a clinician for being careful? Would this same discussion be occurring if she were talking about cancer? "Given that cancer has serious implications, I'd like to suggest that you refrain from giving a diagnosis of cancer straight out ..."

McCain McBush wrote:

Republicans aren’t doing so well lately. Gosh, what could it be? Besides:...

Interesting portrayal of the cross-party consistency of political creatures. Politicians are politicians, be they Democrats or Republicans, with politics being a "functional niche" for psychopathic personalities.

However, it has minimal bearing on the topic in this thread.

Citizens can complain to Norma Perez "boss" Olin E. Teague Veterans Medical Center and ask the V.A. Hospital Director, Mr. Bruce Gordon, why Norma Perez, hasn't been fired yet.
She's shocked and awed the Vets with a paltry apology and "oops" ONLY after her email has been revealed.
For some odd reason the families dealing with the damaged goods manufactured by the GOP's profit margin wars and vets who committed suicide thanks to her policies.... didn't FEEL for her sad words of apology.
One can call Norma Perez at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Texas. and tell her what your think of her lies to protect the GOP's moral vacany, maltreatment of veterans, and her deliberate orders to re-name symptoms of PTSD to avoid care and expense of damaged goods manufactured for the GOP
An alternative contact is at extension 42306 for Mr. Gordon, Hospital Director or her own extension 4286 to share your compassion directly to Norma Perez.

This typical compassionate Christian Nation woman should be hauled before a Congressional Joint Armed Services Committee hearing and questioned about her lack of medical ethics and her failure to "support our troops" and their ordained vitims who are dying for our OIL CEO profit margins and GOP's campaign donors

Why dignify Ms. Perez with the title Dr.? "Psychologist" suddenly disappeared from her e-mail properties within the VA. She may in fact have no credentials at all.

Get your heads out of your asses. The biggest scandal here is that a disgruntled social worker at the Temple V.A. "leaked" an e-mail in violation of policy. The heart of the memo is that there is not enough resources to do a "correct" diagnosis of PTSD. How about you folks putting your energy into finding the good that is being done. The vets of WWII came back never "expecting" hand outs and got on with their lives. If you look at the percentage of "users" per capita the "greatest" generation used only 5% of their rightful medical allocations. Quite your bitchin you cry baby liberals. Get a life and quit being leaches. Follow the example of the WWII bunch. Those were real men.

Armando munyez wrote:

Get your heads out of your asses.
1. The biggest scandal here is that a disgruntled social worker at the Temple V.A. "leaked" an e-mail in violation of policy.
2. The heart of the memo is that there is not enough resources to do a "correct" diagnosis of PTSD.
How about you folks putting your energy into finding the good that is being done.
3. The vets of WWII came back never "expecting" hand outs and got on with their lives. If you look at the percentage of "users" per capita the "greatest" generation used only 5% of their rightful medical allocations. Quite your bitchin you cry baby liberals. Get a life and quit being leaches. Follow the example of the WWII bunch. Those were real men.

1. I doubt very seriously that the social worker was disgruntled. It is Dept of VA policy to report any VA staff member when they are practicing or behaving in contradiction to VA policies and mistreating veteran clients.

It is also against VA, APA, and NASW policies for anyone to suggest or practice in misdiagnosing clients. The end result is endangering the client(s).

2. Actually clinicians can complete an accurate diagnosis for PTSD through a psychosocial assessment interview with the veteran and do so every day throughout the Dept of Veterans Affairs.

3. It's quite apparent that you know nothing about the WWII veterans and what they're experiencing. It's a fact you know nothing about the project that DOD and the Washington politicians had conducted on when they funneled all the "Shell Shocked" veterans after that war into one location and had an army of medical personnel evaluate them, which resulted in finding out more about PTSD!

Cheers

My Opinion_El Paso_TX wrote:

<quoted text>
2. Actually clinicians can complete an accurate diagnosis for PTSD through a psychosocial assessment interview with the veteran and do so every day throughout the Dept of Veterans Affairs.

The elephant in the living room of psychiatric diagnosis is the degree to which diagnosis is founded upon self-reported symptoms. Such data are inherently suspect when dollars are attached.

There is no diagnostic test for PTSD. The validity of the diagnosis depends entirely upon the validity of the data provided by the person being evaluated.

One interview may be sufficient to raise the diagnostic consideration of PTSD. However, one interview should rarely be considered sufficient for a definitive diagnosis, especially when disability benefits are at stake.

Too quickly diagnosing PTSD misallocates limited resources away from those who actually need them the most. No matter how good the intentions of a VA clinician, the taxpayer's pocket has its limits.

pragmaticus wrote:

<quoted text>
1. The elephant in the living room of psychiatric diagnosis is the degree to which diagnosis is founded upon self-reported symptoms. Such data are inherently suspect when dollars are attached.

2. There is no diagnostic test for PTSD. The validity of the diagnosis depends entirely upon the validity of the data provided by the person being evaluated.

3. One interview may be sufficient to raise the diagnostic consideration of PTSD. However, one interview should rarely be considered sufficient for a definitive diagnosis, especially when disability benefits are at stake.

4. Too quickly diagnosing PTSD misallocates limited resources away from those who actually need them the most.

5. No matter how good the intentions of a VA clinician, the taxpayer's pocket has its limits.

1. Pragmaticus, could you plaese exlain more on what you mean and believe where dollars are attached to data related to diagnoses?

2. There is the MMPI-2 which consists of 567 questions which accurately determines dianoses for PTSD along with other mental health issus.

The DSM-IV is also an excellent criteria for determing mental health diagnoses.

3. The psychosocial interview on the average takes more than one session. Researchers have been able to develop several software programs with the appropriate questions in order to speeding up the process and thus, saving money for the client.

I've utilized two of those software programs in order to compare their results to my psychosocial assessments and found them to be very accurate.

4. I do agree that psychosocial interviews/intakes need to be thorough and accurate. In the past I have found VA clients who were misdiagnosed. But, as in any profession, there are good ones and then there are not so good ones.

This is where I have encourage clients to contact the various state licensing boards to report the individual.

Actually in refference to those with intense menatl health issues in comparison to those with less intense issues are appropriately scheduled by clinicians within the Dept of VA and other agencies. The more intense clients are seen more times on a regular schedule in comparison to scheuling less sessions or futher apart for the clients with lesser issues.

But, to be fair, any veteran suffering mental health issues has the right to treatment and health care.

5. It's all too easy for the tax payer to criticize the Dept of VA and providing health care to our veterans who have served our country, while putting their lives on the line every day.

The US government is actually spending more money in providing services to "ILLEGAL IMMIGRANTS" than they are providing to the Dept of VA.

Most tax payers who are veterans and or have family members in the military services of the US are not complaining about taking care of our returning veterans.

But, than most tax payers who complain don't take the time in contacting their political representitives with their concerns. And many of them haven't walked in the paths that our service men/women have walked.

Cheers

adjustment disorder vs post traumatic stress disorder. Sounds like the same republican wash crap similar to the IRS unpublicized fine print that screws the American taxpayers out of their proper rebate amounts they were prommised.

You can thank your buddy Bush for ruining our military personnel, remember the Texas monkey that you voted for?... so don't complain when in the years to come that these mentally damaged exmillitants commit acts of violence against the public.

Bill Hargett wrote:

adjustment disorder vs post traumatic stress disorder. Sounds like the same republican wash crap similar to the IRS unpublicized fine print that screws the American taxpayers out of their proper rebate amounts they were prommised.
You can thank your buddy Bush for ruining our military personnel, remember the Texas monkey that you voted for?... so don't complain when in the years to come that these mentally damaged exmillitants commit acts of violence against the public.

Yes, Bush did this all by himself. Guess the Senate and the Congress were out to lunch during that time. After all, you voted some of those senators and congressmen/woemen into office yourself.

Cheers

Not a Scientologist: Not the psychiatrist statements:

http://www.youtube.com/watch...

http://www.youtube.com/watch...

HumanSpirit wrote:

Not a Scientologist: Not the psychiatrist statements:
http://www.youtube.com/watch...
http://www.youtube.com/watch...

Too bad the Scientologists are a yellow-journalistic Xenuphilic cult. This dissolves any credibility that could otherwise be given to their efforts to critique psychiatry.

Psychiatry needs critique, and should do a better job of self-examination. For years it held its psychoanalytic nose high, until descriptive psychiatrists cleaned house with needed observational pragmatism. Psychiatry slowly cheered to outgrow the religious monopoly held by Freudian disciples. Now a new breed of biological psychiatrists hold up sneering noses at the presbyanalytic guard, forgetting in the process to actually listen to their human patients. Instead, psychiatric practices are now churning humanoid widgets through assembly line, CPT and DSM coded schedules.

House cleaning ain't over yet, and should never cease.

My Opinion_El Paso_TX wrote:

<quoted text>
1. Pragmaticus, could you plaese exlain more on what you mean and believe where dollars are attached to data related to diagnoses?
2. There is the MMPI-2 which consists of 567 questions which accurately determines dianoses for PTSD along with other mental health issus.
The DSM-IV is also an excellent criteria for determing mental health diagnoses.

1. Diagnoses are the gateway to remuneration, for the doctor, and a patient seeking disability. No diagnosis, no money.
2. MMPI is not an instrument for making DSM diagnoses.

***

Read Goodwin and Guze's "Psychiatric Diagnosis, 5th edition," especially the forewords. These now deceased authors represent the "founding fathers" of modern American descriptive psychiatry, and their perceptions of the limits of psychiatric diagnostic validity are eye-opening.

***

Add up a disability pension some day, multiplying it over the expected life span of a beneficiary. Remember that you and I are paying for this out of our own hard-won paychecks. Then contemplate how carefully disability should be determined.

(Side note: I've found that if you pay a man to be sick, he'll never get well.)

pragmaticus wrote:

<quoted text>
Too bad the Scientologists are a yellow-journalistic Xenuphilic cult. This dissolves any credibility that could otherwise be given to their efforts to critique psychiatry.
Psychiatry needs critique, and should do a better job of self-examination. For years it held its psychoanalytic nose high, until descriptive psychiatrists cleaned house with needed observational pragmatism. Psychiatry slowly cheered to outgrow the religious monopoly held by Freudian disciples. Now a new breed of biological psychiatrists hold up sneering noses at the presbyanalytic guard, forgetting in the process to actually listen to their human patients. Instead, psychiatric practices are now churning humanoid widgets through assembly line, CPT and DSM coded schedules.
House cleaning ain't over yet, and should never cease.

Why do you discount those psychiatrists that made a statement and aren't members of Scientology?

HumanSpirit wrote:

<quoted text>
Why do you discount those psychiatrists that made a statement and aren't members of Scientology?

For your answer, read what I've written.

pragmaticus wrote:

<quoted text>
Too bad the Scientologists are a yellow-journalistic Xenuphilic cult. This dissolves any credibility that could otherwise be given to their efforts to critique psychiatry.
Psychiatry needs critique, and should do a better job of self-examination. For years it held its psychoanalytic nose high, until descriptive psychiatrists cleaned house with needed observational pragmatism. Psychiatry slowly cheered to outgrow the religious monopoly held by Freudian disciples. Now a new breed of biological psychiatrists hold up sneering noses at the presbyanalytic guard, forgetting in the process to actually listen to their human patients. Instead, psychiatric practices are now churning humanoid widgets through assembly line, CPT and DSM coded schedules.
House cleaning ain't over yet, and should never cease.

Amen

pragmaticus wrote:

<quoted text>
1. Diagnoses are the gateway to remuneration, for the doctor, and a patient seeking disability. No diagnosis, no money.
2. MMPI is not an instrument for making DSM diagnoses.
***
3. Read Goodwin and Guze's "Psychiatric Diagnosis, 5th edition," especially the forewords. These now deceased authors represent the "founding fathers" of modern American descriptive psychiatry, and their perceptions of the limits of psychiatric diagnostic validity are eye-opening.
***
4. Add up a disability pension some day, multiplying it over the expected life span of a beneficiary. Remember that you and I are paying for this out of our own hard-won paychecks. Then contemplate how carefully disability should be determined.
(Side note: I've found that if you pay a man to be sick, he'll never get well.)

1. I understand where you're coming from here and for many that has been the outcome. But, not all clients are seeking just the money. And many clinicians are focusing on the therapy first and formost.

2. The MMPI is a tool just as the DSM-IV and other tests are in assessing the on going effects of the individual.

3. I will definitelly check out these two authors. Thanks for sharing this information. It's refreshing in interacting with you and sharing thoughts and experiences in our field.

4. I have no problem paying taxes in order to help society. I do aggree that this has gotten out of hand and it's due to many who are involved in the disability process.

I agree that disability needs to be appropriately screened and better deteremined, especially with veterans by the Dept of VA. I'll provide three examples that I have personally observed:

Veteran #1:
---Recieves a retiment chack for 30 years in military.
---Recieves a retirement check from teaching.
---Is 100% SC and recieves a disablity check from VA.

This veteran utilizes the military hospital. How much money is enough for this individual.

This wasn't what the VA SC disability program was originally designed for and now it's gotten out of control.

Veteran #2:

---Recieves a check for being retired military.
---Recieves a check for being 100% SC and Unemployable.

This veteran is a vet organization SO (service officer) who helps veterans in applying for VA SC disability(s) monday throug friday.

This veteran completed an AA degree and was offered a teaching position by the school. So, why didn't VA make the rational decision in helping this veteran in accepting another type of work? Because the system has gotten out of control.

Veteran #3:
---Recieves a check for being retired military.
---Recieves a check for being VA SC for disability.

This veteran continues to work as they utilized their GI Bill and Vocational Rehab for going to school, earning a BSW and MSW.

This veteran works with veterans and their families.

(Side note: I've found that if you pay a man to be sick, he'll never get well.)

That is the case with many individuals, mostly due to the fact that this system has gotton out of control.

But, it's not the case with many more out there who continue working because they in fact did utilize the therapy provided to them in order to change their lives and continue in being successful in life. Veteran #3 is an example of this along with many more veterans.

The entire disability system and the social services needs a complete overhaul in order to better utilize the monies involved. We also need to quit providing social services to illegal immigrants. That may sound harsh, but we owe our priorities to legal citizens first and formost.

Cheers Pragmaticus

pragmaticus wrote:

<quoted text>
For your answer, read what I've written.

Check and Check Mate!!!

My Opinion_El Paso_TX wrote:

... That is the case with many individuals, mostly due to the fact that this system has gotton out of control.
But, it's not the case with many more out there who continue working because they in fact did utilize the therapy provided to them in order to change their lives and continue in being successful in life.

Your examples trouble me.
When a veteran functions that well, he should no longer receive a disability pension. He's no longer disabled!
I think some see disability checks to be a sort of apology by society for having put veterans in harm's way.
If so, then all veterans should receive such apologetic checks ... and a guilt-ridden segment of society can bankrupt the nation.
I very much hope that wise stewardship will prevail. Too many people climbing in a boat will sink it.

pragmaticus wrote:

<quoted text>
Your examples trouble me.
When a veteran functions that well, he should no longer receive a disability pension. He's no longer disabled!
I think some see disability checks to be a sort of apology by society for having put veterans in harm's way.
If so, then all veterans should receive such apologetic checks ... and a guilt-ridden segment of society can bankrupt the nation.
I very much hope that wise stewardship will prevail. Too many people climbing in a boat will sink it.

I do understand where you coming from here. And Yes, maybe the system needs to be over hauled completely.

For a veteran to be treated at the Dept of VA, they have to meed certain criterias. And if they are not service connected (SC) for disabilities, they have to pay copayments for their medications and services.

When they get SC for any disability then they are no longer required to pay the copayments.

When I refer that one who is SC and still works, doesn't mean that they are making the salary of a CEO. The majority who are SC and still working in many cases are just barely making ends meet.

What many don't understand is that the military reitred veterans who are SC are actually paying for their own SC disability(s). For every dollar they receive from SC disability, the dollar comes from their retirement checks.

What is killing this system is that we're receiving so many more new veterans from the current two war zones and it's over loading the system more than Washington had expected.

Another main problem is what we can relate to in our profession. We continue to evaluate what services are needed for the clients and we continue to restartigize our programs.

Washington and the Congress more often than not continue leaving programs and policies in place to the point of stagnation and that more often than not blows up in their face.

But, I believe that many here are not looking at the whole picture related to their concerns about the money spent in the care of veterans and the money related to SC for disabilities.

1. Look at the amount of money that Washington is spending on the two war zones. Granted that there is a reason for this one. But, in every war contractors made more money than they actually should have.

2. Look at the money that Washington and the fifty states are spending for the care of illegal immigration.

3. Look at the money that Washington gives to other countries, especially Mexico.

The policies that were set into place were for the veterans and their disabilities. Yes, it has gotten out of control to a point, but that is from the policies set in place. As much as some veterans are getting too much in my opinion, the majority of veterans are just barely making ends meets.

Sorry if I offend anyone here, but my support goes to the veterans first! I've been there and done that in Vietnam and Desert Storm, so I know what they did in earning their SC for disabilities. Reason why I choose to work with them in all capicities.

Numbers #2 and #3 are what need changing first. We need to begin taking care of US citizens first and foremost.

Cheers Everyone