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Under Pressure from Sen. Murray, Panetta Announces Military-Wide Review of Behavioral and Mental Health Diagnoses Since 2001

Jun 13 2012

Panetta to Murray: "I am not satisfied either"; "still huge gaps" in how departments diagnose PTSD and other conditions; announces that all branches of military will undergo major review of diagnoses

(Washington, D.C.) – Today, under questioning from Senator Patty Murray, Chairman of the Senate Veterans’ Affairs Committee, Defense Secretary Leon Panetta announced that he has ordered the heads of every branch of the U.S. military to review diagnoses for the invisible wounds of war going back to 2001. The Secretary’s announcement comes after Murray worked to spur a similar review by the Army which arose from hundreds of soldiers being misdiagnosed and in many cases accused of faking the symptoms of PTSD at Madigan Army Medical Center in Washington state.

“The Pentagon and the VA are losing the battle on mental and behavioral health conditions,” Murray told the Secretary at today’s hearing. Murray also noted that the Army has already begun a system-wide review saying “This is not just an Army disability evaluation system.  This is a joint DOD and VA program covering all of the services. Why has the Department not taken the lead in evaluating and making improvements to this system?”

“What I've asked is the other service chiefs to implement the same approach that the Army's taken” Secretary Panetta responded. “…I’m not satisfied either. We're doing everything we can to try to build a better system between the Pentagon, the Department of Defense and VA. But there are still huge gaps in terms of the differences in terms of how they approach these cases and how they diagnose the cases and how they deal with them, and frankly, that's a whole area we have to do much better on.”

Secretary Panetta indicated that the Pentagon-wide review will be led by the Undersecretary for Personnel and Readiness. At the hearing Senator Murray also highlighted the impact that mental health care shortcomings are having pointing to statistics that show that military suicides are outpacing combat deaths.

A full transcript of the exchange between Senator Murray and Secretary Panetta at today’s hearing of the Senate Appropriations Committee follows:

MURRAY: Mr. Secretary, I want to continue the thought process of Senator Murkowski. I, too, am very alarmed by the suicide rate of our service members and our veterans. New analysis is showing us that every day in 2012 one of our service members committed suicide and you just commented on outpacing combat deaths. In our veteran population, we know a veteran commits suicide every 80 minutes. Every 80 minutes.

Now, I think we can agree on two things. First of all, our service members and their families have risen to the challenge. They've done everything that their countries asked of them throughout the wars in Iraq and Afghanistan, we're all eternally grateful.

Secondly, the Pentagon and the V.A. are losing the battle on mental and behavioral health conditions that are confronting a lot of our service members, loved ones, and as we just talked about is resulting on such extreme things as suicide.

Secretary Panetta our service members and veterans can't get needed treatment access to needed resource without correct diagnosis. This has been a problem for soldiers in my home state of Washington. At Madigan to date, over 100 soldiers and counting have had their correct PTSD diagnosis restored after being told they were exaggerating their symptoms, lying, and accused of shirking their duties.

So understandably, a lot of our service members trust and confidence in the disability evaluation system has been seriously shaken in the wake of these events. As you know, I have continually raised concerns about the consistency and accuracy of behavioral health evaluations and diagnosis within the entire disability evaluation system, and have offered my recommendations on how to improve the system. And as you also know the Army has taken some critically important steps forward and beginning to address these concerns.

Secretary McHugh has announced a sweeping, comprehensive Army wide review of behavioral diagnosis back to 2001 to correct the errors of the past and to make sure the service members get the care and services that they need and that they deserve.

But I wanted to ask you today, but this is not just an Army disability evaluation system. This is a joint Department of Defense and V.A. program covers all of the services.

So I wanted to ask you why the department has not taken the lead in evaluating in taking the lead to the entire system?

PANETTA: Senator, we are. What I've asked is the other service chiefs to implement the same approach that the Army's taken here...

MURRAY: To go back and go back to 2001 and review all cases?

PANETTA: That's correct.

MURRAY: Throughout the entire system?

PANETTA: That's correct.

MURRAY: OK, so they are all following the Army's lead and we are told the evaluation and the progress of that. Who is heading that up?

PANETTA: Our undersecretary for personnel and for health care. That's the individual that you need to...

MURRAY: I would very much like to be kept inform as all of our members of Congress would. I think this needs to be transparent and clear. We need to make sure that people are accessing the system, getting back if they need it and the only way to get that is to be clear, open and honest with everyone.

So I didn't know we were looking at all of the other services and I would like more information and to be informed on that as soon as possible about how that's taking place and what the timetable is and how that's going to occur.

PANETTA: I appreciate your leadership on this, Senator. I'm not satisfied either. I think the misdiagnosis that took place, what's happening in this area between -- we're doing everything we can to try to build a better system between the Pentagon, the Department of Defense and V.A. But there are still huge gaps in terms of the differences in terms of how they approach these cases and how they diagnose the cases and how they deal with them, and frankly, that's a whole area we have to do much better on.

MURRAY: You can't imagine what it's like to talk to a soldier who was told he had PTSD, his family was working with him, and then when he went to the disability evaluation system, was told he was a liar or malingerer. He was taken out of it and he went out in the civilian world not being treated. That's a horrendous offense.

You know, I chair -- I am chair of the veterans affairs committee and I held a hearing on the joint disability evaluation system, and I just have to tell you I am really troubled by what with I'm hearing.

Enrollment is continuing to climb, the number of service members cases meeting timeliness goals is unacceptably low, the amount of time it takes to provide benefits to the service member who is transitioning through the system has risen each year since we began this.

In response to these problems we heard from the Departments of Defense and Veterans Affairs together about how five years after -- five years after the Walter Reed scandal, they are just now beginning to map out business processes to find room for improvement. You know, that's just unacceptable.

The public, all of this really believed this was being taken head-on, that we were dealing with it and five years out. Unacceptable numbers we're seeing.

So I wanted to ask you what you are doing at your level to deal with this, five years into this program and we're still hearing statements from Army leaders about how the disability system is fundamentally flawed, adversarial, and, tell me what I'm going to do.

PANETTA: Let me do this. Secretary Shinseki and I have been meeting on a regular basis to try to do what we can to implement improvements and frankly, we're not satisfied either by the progress being made here. Part of it is bureaucratic. Part of it is systems and part of it is the complicated...

MURRAY: You can't imagine what it sounds like to hear that.

PANETTA: Pardon me?

MURRAY: It's bureaucratic. I mean that -- if you're in the system, that's not the word you want to hear.

PANETTA: You know, I see it every day. I'm in charge of a very big bureaucracy. And the fact is that sometimes just the bureaucratic nature of a large departments prevents it from being agile enough to respond and do what needs to be done. And so a large part of this is making sure people are willing to operate out of the box and do what needs to be done in order to improve these systems. What I would offer to you is let Secretary Shinseki and I sit down with you and walk through the steps we're taking to try to see if we can try to shake the system...

MURRAY: I really appreciate that commitment. I know you have not been there the entire five years, but I will tell you this, we've been told for five years that the DOD and V.A. are sitting down on a regular basis addressing this.

And I'm talking to soldiers that are stuck in the disability evaluation system. There are bureaucratic delays. The people that are supposed to be helping them they're training them because they've been in the system longer than the trainers that are supposed to work with them. Their families are facing you know horrendous challenges as they try to figure out what the future brings months on end.

You know people at the top are saying that this is fundamentally flawed, you want to hear who the people at the bottom who are in it are saying.


MURRAY: I totally appreciate your saying that to me today, but sitting down and talking with Secretary Shinseki is something we've been hearing for a long time. We need some recommendations and we need to move forward and we need to be a top priority out of the Pentagon as we transition now out of Afghanistan, this is not going to get more simple.

Add to that the complexities of now going back and reviewing all of these PTSD and behavioral health cases, you have people who are in the IDES (ph) system right now who are saying what's going to happen to me while you go back and review all these people? Are we putting personnel into deal with this? Or now am I going to take another back seat while we deal with that?

This is complex, it's hard. It's problematic, but it needs every single effort from top to bottom.

PANETTA: Listen, I share all of your frustrations, and my job is to make sure that we don't come here with more excuses and that we come here with action.

MURRAY: I truly appreciate that comment. I want to work with you. All my efforts are at your disposal. We do a fantastic job of training on you are men and women to go into the service. We still today have not gotten this right in making sure that we transition back home.

We have families and soldiers and Airmen and -- throughout the service who are really stuck in a process they shouldn't be stuck in. We've got to get this right and we've got it get it right now and we need every effort at it and I will sit down with you the minute we tell you you're available, but I want more than a meeting.

PANETTA: OK, I agree.