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The Nation

Psych exams urged for vets

Mandatory mental health screenings prior to discharge are needed, VA doctors tell Mullen in L.A.

September 21, 2008|Peter Spiegel | Times Staff Writer

Senior physicians with the veterans health system in Los Angeles told the top U.S. military officer Saturday that the Pentagon needs to overhaul the way it discharges troops because hundreds are leaving the armed forces with undiagnosed combat-related mental health problems.

Several of the physicians, including the system's chief of staff and its top psychiatrist, advocated mandatory mental health screenings for all service members who retire after serving in war zones.

The doctors said that because of the stigma attached to combat stress disorders, few troops acknowledge or seek help for psychological problems while in the military, meaning most remain undiagnosed until they run into family or work problems in the civilian world. Combat stress disorders become more difficult to treat the longer they remain undiagnosed.

"We need to make it a gradual discharge process with milestones, whether it's six months or a year, whatever it takes," said Dr. Robert Rubin, chief of mental health at the Veterans Administration healthcare system for Greater Los Angeles. "The stigma goes away if they have no choice but to go for the exams."

The doctors and administrators made the recommendation during an hourlong meeting with Navy Adm. Michael G. Mullen, chairman of the Joint Chiefs of Staff, who visited the VA hospital in West Los Angeles during a five-day visit to his hometown.

Since his appointment as Joint Chiefs chairman nearly a year ago, Mullen has stepped up scrutiny of the military healthcare system, saying the Pentagon must improve the way it takes care of troops returning from Iraq and Afghanistan with physical and mental ailments.

As part of that effort, he has ordered a senior officer on his staff to pull together recommendations to make the Pentagon's hand-over of veterans to the VA health system easier and less bureaucratic.

At the VA hospital on Saturday, Mullen said one of his overriding concerns was that the Defense Department loses track of war veterans once they leave the military and is therefore unable to follow their mental and physical health.

"These people who are so precious to us, we don't have much contact with them anymore," Mullen said. "We have to figure out a way to have a system that is integrated, to know where everybody is, so we can rest comfortably that those who have sacrificed so much are taken care of."

But he also warned that it would take legal changes by Congress to overhaul the military discharge process, a fact that could make requiring mental health screenings difficult.

Mullen noted that the Israeli military requires commanders of active-duty units to take care of all wounded veterans who ever served in their regiments, as well as the families of those killed.

The Joint Chiefs chairman is halfway through a weeklong trip to Texas and California, during which he is scheduled to make several stops at mental health facilities for war veterans.

On Thursday, Mullen visited a pilot clinic the Army has set up at Ft. Bliss, Texas, where soldiers with severe post-traumatic stress disorders are aggressively treated by traditional counselors and with holistic therapies such as acupuncture, biofeedback and meditation. He is scheduled to visit a Los Angeles program for homeless veterans Monday.

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peter.spiegel@latimes.com

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