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Published: Tuesday, 5/16/2006

Ensure war stress treatment

DURING the Civil War, the intense psychological stress of combat on soldiers was referred to as "Da Costa's Syndrome." By the time World War I rolled around, the malady was known as "shell shock." But it wasn't until after the Vietnam War that the problem was given sufficient attention and a clinical name.

Today, Post-Traumatic Stress Disorder, with its immobilizing angst and terrifying flashbacks, is universally recognized as a serious form of collateral damage to men and women who have served in this nation's wars.

Unfortunately, a new government report indicates that large numbers of veterans returning from duty in Afghanistan and Iraq with PTSD symptoms aren't necessarily being referred for treatment.

The Government Accountability Office, Congress's watchdog arm, looked at questionnaires filled out by 178,664 recent veterans and, using Defense Department criteria, found that 5 percent were at risk for PTSD. But only 22 percent of that group were referred for further evaluation that might lead to treatment.

The GAO found that the Pentagon "cannot provide reasonable assurance that service members who need referrals receive them." Moreover, the agency found widely varying rates of referral among the services.

Hopefully, these discrepancies are matters of procedure that can be fixed and not evidence of neglect or incompetence on the part of the Defense Department.

In a reassuring sign that the problem is being taken seriously by the government, the Department of Veterans Affairs maintains what it calls the National Center for Post-Traumatic Stress Disorder, which has its own informative Web site at www.ncptsd.va.gov. The site includes, among other resources, a clinician's guide to PTSD as it applies to the Iraq War.

The mere availability of information, however, does not ensure that returning service members either recognize they might have a problem or are given active guidance to get help. It appears that screening procedures need to be improved to make sure treatment is not just available but likely.

A generation ago, the debilitating effects of PTSD claimed thousands of Vietnam veterans before the extent of the problem was fully recognized. For the sake of those who have served their country, this same mistake must not be made again.



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