Fort Carson Says Post Improving Its Treatment Of Combat Stress

Team Infidel

Forum Spin Doctor
Colorado Springs Gazette
March 26, 2007
Pg. 1
Second In A Two-Part Series
By Cary Leider Vogrin and Tom Roeder, The Gazette
Leaders at Fort Carson say they’re trying to change Army culture by leading the way in compassionate care for soldiers with war-caused mental illness.
But they admit they’ve got a long way to go to shed the stigma that only cowards suffer combat stress.
It’s been more than 60 years since Gen. George Patton slapped a soldier suffering from “battle fatigue,” sparking a controversy in the midst of World War II. But some in the Army are still stuck in the mind-set, says Maj. Gen. Robert Mixon, commander of the post.
“We’re not going to get rid of all the biases next week,” Mixon said. “But I tell everyone that bias will not be tolerated.”
The general said people under his command are getting the message, and Fort Carson is doing more than ever to treat mentally ill soldiers and return them to the battlefield. The Army gets a big assist from civilian care providers in Colorado Springs.
Critics, including mental health activist and ex-soldier Andrew Pogany, say the Army is still letting scores of soldiers slip through cracks. But even Pogany admits the Army is improving its level of care.
Since 2003, every soldier returning from Iraq or Afghanistan to Fort Carson has been screened for mental illness symptoms. Unit chaplains are also asked to identify soldiers who might have mental health difficulties.
Those soldiers are referred to the post’s 38 licensed mental health workers, who range from psychiatrists to social workers. Col. Steve Knorr, the post’s top psychiatrist, said his contingent of mental health workers has nearly doubled since the Iraq war began in 2003.
Despite national media reports that the military mental health care system is strained, the Fort Carson system is working, Knorr said.
Col. John Cho, who commands the post hospital, Evans Army Community Hospital, said the program is effective because it catches problems early and ensures that at-risk soldiers know where they can get treatment. Options include going off-post to get help from civilian doctors through the military’s Tricare insurance program.
Treatment at Fort Carson ranges from a walk-in clinic to group therapy sessions for patients with ongoing needs, Knorr said. Most soldiers who have symptoms of mental illness, including post-traumatic stress disorder, stay in the Army and return to active duty, including many who are prescribed antidepressants, which Knorr said have proven safe and effective for deployed troops.
Pogany said the Army provides too little care to soldiers and fails to tailor programs to individual needs. He also assailed waiting times for help through Tricare.
Knorr said the waiting time to see a psychiatrist at the post is two weeks, meeting Defense Department standards, which allow a month.
Civilian facilities
Fort Carson lacks facilities to hospitalize patients for psychiatric care. Cho said the post couldn’t justify the expense in light of the available civilian facilities in Colorado Springs.
“We see many active-duty service people from Fort Carson,” said Dr. Stephanie Purcell, a psychiatrist at St. Francis Behavioral Health Services. “We certainly are seeing a great deal of post-traumatic stress disorder.”
Purcell said that at any given time five or six patients in the 26-bed unit east of downtown are from the military.
The same is true at Cedar Springs Behavioral Health System, CEO Elaine Crnkovic said.
“When all this started, we saw a lot of people who were stressed about going to war,” she said. “Now we’re seeing the guys who have gone and come back — once, twice, three times — and are very anxious about going back again.”
Crnkovic said the cases at Cedar Springs have become “more complex” because of multiple traumatic wartime experiences.
“That seems to create layers and layers of the stress, so there’s more to work through,” she said.
Most soldiers at St. Francis, Purcell said, are referred there from Fort Carson and voluntarily check themselves in.
Some soldiers, though, are there on an involuntary 72-hour hold. They’ve been deemed a danger to themselves or others, perhaps because of psychosis or severe depression. Over three days, they are evaluated and could be court-ordered to stay longer.
Crnkovic and Purcell also are seeing substance abuse related to PTSD.
“Unfortunately, that is not rare. We do see many people who make an attempt to deal with their symptoms by using, for example, alcohol or other substances,” Purcell said.
Normal feelings
Brian Butler, clinical training supervisor at the Lighthouse Assessment Center, an arm of Pikes Peak Mental Health, called PTSD a “sticky diagnosis,” meaning it typically will have one or two other mental health or substance abuse issues along with it.
“It’s not an easy diagnosis to make,” he said. “There may be soldiers — a lot of soldiers — that don’t meet full-blown diagnosis for PTSD but are suffering from PTS symptoms.”
The Lighthouse is a shortterm stabilization and assessment unit.
“While they’re here, we try to do three things,” Butler said. The first, he said, is to let soldiers know it’s a place they can talk freely. Second, they are told many of their feelings are normal. Finally, they are taught about triggers and how to handle them.
“Oftentimes, soldiers feel they cannot talk about their feelings,” said Butler, who experienced post-traumatic stress symptoms after coming home from the Persian Gulf War with the 1st Infantry Division. “Or they may not know how to express themselves. We let them tell their stories. We want them to know even the bravest and courageous soldiers have all been scared, and that it’s OK to feel those things and in fact, it’s normal.”
Soldiers often complain of being uneasy in crowds, feeling anxiety behind the wheel, being easily angered or experiencing other “this is not me” feelings.
“The military is all about managing chaos and being in control when situations are chaotic,” Butler said. “You can imagine how a soldier feels when they’re feeling out of control in a situation that is normal and not chaotic.”
Purcell, of St. Francis, said there’s still much to be learned about the long-term effects of PTSD.
“I think certainly we have a long road ahead of us in terms of understanding PTSD and in terms of understanding the impact that modern warfare has on the soldier and the family unit and the progression of the soldier’s life beyond the military,” she said. “There are tremendous areas where we are just children in dealing with this field.”
Butler said there is hope for those suffering from PTSD.
“Can you cure it? No,” he said. “Can you adapt to it, treat it and resolve the symptoms? Absolutely yes.”
Report documents military needs
The American Psychological Association issued a 67-page document last month titled “The Psychological Needs of U.S. Miliary Service Members and Their Families: A Preliminary Report.”
The report says that although efforts by individual military mental health providers are laudable, the military system falls short in its ability to meet the psychological health needs of deployed personnel and their families. The report was drafted by the APA Presidential Task Force on Military Deployment Services for Youth, Families and Service Members. See the full text of the report at deploymenttaskforcereport.pdf