Tuesday, June 26, 2012

Barry, the one trick trick




Something that hasn't been mentioned in the pie fight over Barack Obama's infamous (D-Punjab) memo: The mainly agricultural Punjab region does not appear to be a major factor in the concerns over outsourcing to which Obama and Clinton have both, at various times, payed demagogic lip service. If we're talking economics it's all about Karnataka, or maybe Andhra Pradesh. Can we just state the obvious? Neither Clinton nor Obama has a clue about Punjab, and the reason Clinton made her original getting-elected-in-Punjab wisecrack and Obama used it to smear her is that they're both thinking of Daddy Warbucks' lethal manservant.
That's just the tip of what the two candidates don't know. Kerry Howley puts some perspective on the matter by noting that Obama should be apologizing not only for putting down Indian Americans but for pandering to anti-trade buffoons


Starting with legal and with proposed legislation in the US.  Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee.  This evening, she took the Senate floor to introduce and advocate for a new mental health bill.
Senator Patty Murray:  Mardam President, last February in my office in Seattle I sat down with an Iraq and Afghanistan war veteran named Stephen Davis and his wife Kim.
Stephen and Kim were there to talk to me about their experience since he returned home and about the invisible wounds of war that they were struggling with together -- every single day. 
At the meeting, Kim did most of the talking.  She told me about the nightmares.  She told me about the lack of sleep. She talked about confusion and the anxiety that was now a constant in their lives.
But it was the way that she summed up her experience since Stephen returned home that struck me hardest.
She said that her husband still hadn't returned home.
She said that the husband she had been married to for nearly two decades -- although sitting directly next to her -- was still not back from war.
And you know what, despite the fact that we often refer to these wounds as invisible -- you could see it.
When it came time for Stephen to describe his experiences he shook as he explained how difficult the transition home has been for him, for his wife, and for their family. 
Now Madam President, the Davis family's story is no different than what thousands of other families have faced.
But their story does have a tragic and frustrating twist.
You see, Sergeant Davis knew when he returned home that he had a problem with post traumatic stress -- and he was courageous enough to reach out for help.
He sought care and was diagnosed with PTSD.
But just a few months later -- after a visit to Madigan Army Medical Base in my home state of Washington -- he was told something that shocked and appalled him and his wife.
After a 10 minute meeting and a written questionnaire -- Sergeant Davis was told that he was exaggerating his symptoms and that he didn't have PTSD.
He was told -- in effect -- that despite serving in two war zones, despite being involved in three separate IED incidents, and despite his repeated deployments, he was making it all up. 
He was then sent home with a diagnosis for adjustment disorder and told that his disability rating would be lowered and that the benefits that he and his family would receive would ultimately be diminished.
Now, Madam President, if this sounds like an isolated, shocking incident -- here is something that you'll find more shocking. 
And that's that Sergeant Davis was one of literally hundreds of patients at this Army hospital that was told the exact same thing.
Soldiers who had been diagnosed with PTSD -- not just once -- but several times -- had their diagnoses taken away.
In many instances these soldiers were told that they were embellishing or even outright lying about their symptoms.
In fact, so many soldiers were being accused of making up their symptoms by doctors at this hospital that I began to get letters and phone calls into my office.
Soon after documents came to light showing that the doctors diagnosing these soldiers were being encouraged to consider not just the best diagnosis for these patients but also the cost of care.
These revelations have led to a series of internal investigations that are still under way today.
But even more importantly, they have led to these soldiers being reevaluated and to date hundreds of soldiers -- including Sergeant Davis -- have had their proper PTSD diagnoses restored. 
Now, Madam President, this too, could be viewed as an isolated incident.
And in fact, when I first raised concerns that the problems we saw at Madigan could be happening at other bases across the country -- that's exactly what I was told.
But I knew better.
I remembered back to this Slaon.com article that ran a few years back.
In that article a doctor from Fort Carson in Colorado talked about how he was "under a lot of pressure to not diagnose PTSD."
It also went on to quote a former Army psychologist named David Rudd who said, "Each diagnosis is an acknowledgment that psychiatric casualties are a huge price tag of war. It is easiest to dismiss these casualties because you can't see the wounds.  If they change the diagnosis they can dismiss you at a substantially decreased rate."
I also had my own staff launch an investigation into how the military and the VA were diagnosing mental health conditions at other bases around the country.
And I was troubled by what they found.
It became clear there were other cases where doctors accused soldiers of exaggerating symptoms without any documentation of appropriate interview techniques.
They encountered inadequate VA medical examinations -- especially in relation to Traumatic Brain Injury.
And they found that many VA rating decisions contained errors, which in some cases impacted the level of benefits the veteran should have received.
Now, Madam President, to their credit the Army didn't run and hide as the questions about other bases continued to mount.
In fact they took two important steps.
First, in April they issued a new policy for diagnosing PTSD that criticized the methods being used at Madigan and pointed out to health officials throughout their system that it was unlikely that soldiers were faking symptoms.
Then, in May the Army went further and announced that they would review all mental health diagnoses across the country dating back to 2001.
This in turn led to Secretary Panetta to announce just last week that all branches of the military would undergo a similar review.
Now, Madam President, without question, these are historic steps in our efforts to right a decade of inconsistencies in how the invisible wounds of war have been evaluated.
Servicemembers, veterans, and their families should never have had to wade through an unending bureaucratic process.
And because of the outcry from veterans and servicemembers alike the Pentagon now has an extraordinary opportunity to go back and correct the mistakes of the past.
But Madam President . . . we still need to make sure these mistakes are not repeated.
We still need to fundamentally change a system that Secretary Panetta admitted to me has "huge gaps" in it.
And that is why I am here today.
Madam President, today I have introduced the Mental Health ACCESS Act of 2012.
It is a bill that seeks to make improvements to ensure that those who have served have access to consistent, quality behavioral health care.
It is a bill that strengthens oversight of military mental health care.
And improves the Integrated Disability Evaluation System we rely on.
Now Madam President, as anyone who understands these issues knows well this isn't any easy task.
The mental health care, suicide prevention, and counseling programs we provide our service members are spread out through the Department of Defense and VA.
Too often they are tangled in a web of bureaucracy.
And frankly too often this makes them difficult to address in legislation.
So what I did in crafting this bill is I identified critical changes that need to be made at both DoD and VA and set up a checklist of legislative changes needed to do just that.
Some provisions in this bill will likely be addressed in my Veterans Committee others will need to be addressed through Defense bills and work with the Chairs of other committees.
But all of these provisions are critical and today I wanted to share some of the most important ones. 
Madam President, high atop the list of changes this bill makes it addressing military suicides -- which was we all know is an epidemic that now outpaces combat deaths.
My bill would require the Pentagon to create comprehensive, standardized suicide prevention programs. 
It would also require the Department to better oversee mental health care for servicemembers.
Second, my bill would expand eligibility for a variety of VA mental health services to family members.
This will help families -- and spouses like Kim -- who I spoke about earlier -- cope with the stresses of deployments and help strengthen the support network that is critical to servicemembers returing from deployment.
Third, my bill will improve training and education for our health care providers.
Often times our servicemembers seek out help from chaplains, medics, and others who may be unprepared to offer counseling.  This bill would help prepare them through continuing education programs.
Fourth, my bill would create more peer to peer counseling opportunities.
It would do this by requiring VA to offer peer support services at all medical centers and by supporting opportunities to train vets to provide peer services.
And finally, this bill will require VA to establish accurate and reliable measures for mental health services.
This will help ensure the VA understands the problem they face so that veterans can get into the care we know they can provide.
Madam President, all of these are critical steps at a pivotal time.
Because the truth is -- right now -- the Department of Defense and the VA are losing the battle against the mental and behavioral wounds of these wars.
To see that you don't need to look any further than the tragic fact that already this year over 150 active duty servicemembers have taken their own lives.
Or the fact that one veteran commits suicide every 80 minutes.
And while there are a number of factors that contribute to these suicides including repeated deployments, a lack of employment security, isolation in their communities, and difficulty transitioning back to their families.
Not having access to quality and timely mental health care is vital.
When our veterans can't get the care they need they often self medicate.
When they wait endlessly for a proper diagnoses they often lose hope.
Last year at this time, I held a hearing on the mental health disability system that this bill seeks to strengthen and heard two stories that illustrate this despair.
Andrea Sawyer, the wife of Army Sergeant Lloyd Sawyer testified about how her husband -- an Iraq veteran -- spent years searching for care.
Together they hit barriers and red tape so often that at one point he held a knife to his throat in front of both her and an Army psychiatrist before being talked out of it.
Later in the same hearing, Daniel Williams an Iraq combat veteran testified about how his struggle to find care led him to stick a gun in his mouth while his wife begged him to stop -- only to see his gun misfire.
Madam President these are the stories that define this problem.
These are the men and women who we must be there for.
They are those who have served and sacrificed and done everything we have asked of them.
They have left their families and homes, several multiple times, and protected our nation's interests at home and abroad.
Madam President, this bill will help make a difference.
But we need to make changes now.
Today, I am asking members of the Senate from both sides of the aisle to join me in this effort.
We owe our veterans a medical evaluation system that treats them fairly, that gives them the proper diagnosis, and that provides access to the mental health care they have earned and deserved.
Thank you.
Her office noted the speech in a press release which also noted:
(Washington, D.C.) – As it becomes increasingly clear that the Pentagon and VA are losing the battle on mental and behavioral health conditions that are confronting so many of our servicemembers and veterans, Senator Murray gave a speech on the Senate floor to introduce her new servicemembers and veterans mental health legislation, the Mental Health ACCESS Act of 2012. Her speech also comes as the Pentagon begins a comprehensive military-wide review, which Senator Murray urged Secretary Panetta to conduct on diagnoses for the invisible wounds of war dating back to 2001.  The misdiagnosis of behavioral health conditions has been a constant problem for soldiers at Madigan Army Medical Center in Tacoma, Washington, where to date over 100 soldiers and counting have had their correct PTSD diagnosis restored following reevaluation.
The Mental Health ACCESS Act of 2012 would require the Department of Defense to create a comprehensive, standardized suicide prevention program; expand eligibility for a variety of Department of Veterans Affairs mental health services to family members; strengthen oversight of DoD Mental Health Care and the Integrated Disability Evaluation System; improve training and education for our health care providers; create more peer-to-peer counseling opportunities; and require VA to establish accurate and reliable measures for mental health services. More about Senator Murray's bill HERE.


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