Army reviewing traumatic stress diagnostic practices

The U.S. Army has started a system-wide review to ensure its mental healthcare facilities are not engaging in the "unacceptable" practice of considering treatment costs in making a diagnosis, Army Secretary John McHugh told a U.S. Senate hearing on Wednesday.

Lieutenant General Patricia Horoho, the Army surgeon general, initiated the review in response to the discovery that hundreds of soldiers being treated for post-traumatic stress disorder had their diagnoses reversed after being seen by psychiatrists at the Madigan Army Medical Center in Washington State.

The medical center is located at Joint Base Lewis McChord, the home base of Staff Sergeant Robert Bales, who is suspected of killing 16 people, including nine children, in a shooting rampage in Afghanistan this month.

Bales was on his fourth deployment to a war zone in the past 10 years. His civilian lawyer told Reuters last week that PTSD would likely be part of the defense.

PTSD is a huge issue for the Defense Department. A recent Army study estimated as many as 20 percent of the more than two million U.S. troops who served in Iraq and Afghanistan could suffer from post-traumatic stress disorder. Cost of care could range between $4 billion and $6.2 billion, it said.

The Army is looking at whether doctors at the medical center were influenced by the cost of PTSD diagnosis in terms of pensions and other benefits. One psychiatrist said the cost to taxpayers was $1.5 million over the lifetime of a soldier on medical retirement, the Seattle Times reported.

What causes PTSD? Living through or seeing something that's upsetting and dangerous can cause PTSD. This can include:

- Being a victim of or seeing violence
- The death or serious illness of a loved one
- War or combat
- Car accidents and plane crashes
- Hurricanes, tornadoes, and fires
- Violent crimes, like a robbery or shooting.

There are many other things that can cause PTSD. Talk to your doctor if you are troubled by something that happened to you or someone you care about.

The review being carried out by the Army inspector general aims to ensure that standardized diagnostic procedures are followed by all psychiatrists "and equally important that fiscal considerations are not in any way a part of the evaluations," McHugh said. "It's simply unacceptable."

Facts About PTSD - PTSD can affect anyone at any age. - Millions of Americans get PTSD every year. - Many war veterans have had PTSD. - Women tend to get PTSD more often than men. - PTSD can be treated. You can feel better.

Referring to Bales, Representative Bill Pascrell, founder of a U.S. congressional task force on brain injuries, told reporters he wanted to "cradle this soldier in our arms" while condemning his actions until it could be determined what happened to him and whether he was properly tested and treated.