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Military Psychiatric-Care Overhaul Urged

By Ann Scott Tyson and Christopher Lee
Washington Post Staff Writers


Top officials in the Bush administration and on Capitol Hill said yesterday that the federal government must move quickly to revamp the nation's system for identifying and caring for military personnel with the invisible wounds of mental illness.

Acting Army Secretary Pete Geren visited Walter Reed Army Medical Center yesterday and discussed mental-health issues, including treatment for patients with post-traumatic stress disorder (PTSD) on Ward 53, according to an Army spokesman.



"We have realized there are shortfalls, and we've been going about fixing it," said Col. Dan Baggio, noting that the Army has conducted four mental-health surveys of soldiers in Iraq and Afghanistan.

Geren, whose Senate confirmation hearing is scheduled for today, regularly visits Walter Reed. The previous Army secretary, Francis J. Harvey, resigned after Washington Post articles published in February revealed poor living conditions and bureaucratic obstacles for wounded soldiers at Walter Reed. Over the past two days, The Post has published stories detailing the bureaucratic and health difficulties of troops returning home with PTSD.

Defense Secretary Robert M. Gates "is very concerned that we're doing everything possible for the wounded warriors as they return, not just the physical wounds but the psychological trauma," said Pentagon spokesman Bryan Whitman.

The Army is hiring 200 more psychiatrists, psychologists and social workers to help soldiers with mental-health problems, and next month it will launch an educational program on stress for all soldiers and commanders, said Maj. Gen. Gale S. Pollock, the acting surgeon general of the Army.

The Army is also expanding a pilot program at Fort Bragg to offer behavioral-health treatment at primary-care facilities to reduce the stigma for soldiers seeking care, Pollock said.

"The tragic cases of combat stress discussed in the Washington Post June 17-18 are powerful and concerning to the U.S. Army," Pollock said in a statement. She emphasized that the Army is continuing to address the problems of soldiers with PTSD, including placing hundreds of mental-health specialists on the battlefield in Iraq and Afghanistan to counsel soldiers with combat stress.

Pollock cited efforts such as post-deployment health assessments, begun in 1998. Based on a 2004 study by Walter Reed researchers, the Army added a second screening for soldiers a few months after their return to catch problems that are not quickly apparent, such as PTSD.

Veterans Affairs Secretary Jim Nicholson on Sunday telephoned former Army Spec. Jeans Cruz of New York, who was profiled in the Post series.

Cruz, who helped capture Saddam Hussein, has been plagued by anxiety and nightmarish images of dead Iraqi children since returning home. Yet VA has denied his claim for compensation, ruling that his psychological problems existed before he joined the Army and that he had not proved that he saw combat.

"The secretary did call on Sunday, and there is an immediate review of that case going on," said Lisette Mondello, a VA spokeswoman.
According to Cruz, VA officials told him that a records search yesterday had confirmed that his Army Commendation Medal With Valor -- awarded for his help in catching the Iraqi leader -- had been left off his records. Cruz said he was told that his application for disability compensation would be reopened and expedited.

VA officials said they are aware of the growing PTSD problem. Last week, for instance, Nicholson directed the department's 153 medical centers to extend their hours to ensure that veterans can reach VA's more than 9,000 mental-health professionals when they need them.


This month, William F. Feeley, VA's deputy undersecretary for health, directed top department officials to implement new mental-health initiatives by Aug. 1, including a requirement that all veterans asking for mental-health or substance-abuse care be evaluated within 24 hours.

"The VA takes its role as the leader in mental health in this country very seriously," Mondello said.

Lawmakers in Congress also noted the PTSD crisis.

"Certainly you need a whole new attitude from the top leadership on mental health," said Rep. Bob Filner (D-Calif.), chairman of the House Committee on Veterans' Affairs. Military leaders "have got to say, 'It's okay to admit this and get treated for it. It's not going to affect your promotions.' "

Sen. Daniel K. Akaka (D-Hawaii), chairman of the Senate Committee on Veterans' Affairs, said the committee is scheduled to consider legislation next week that would extend automatic health-care coverage for combat veterans to five years, up from two, so they can receive treatment for mental illnesses that can take years to surface.

A congressionally mandated Pentagon mental-health task force issued a report with 90 recommendations on Friday, and Rep. John M. McHugh (R-N.Y.), who was involved in establishing the panel, said he is hopeful that the Pentagon "will use the task force findings to straighten this ship up and do a better job."

Rep. Susan A. Davis (D-Calif.), a member of the House Armed Services Committee, said she is encouraged that the Pentagon report called for overhauling the system of care for mentally wounded service members. "They seem to take the issue for what it is, which is a need to transform the way we respond," said Davis, who has introduced legislation to create two Defense Department centers dedicated to understanding and treating military mental health.