I
noticed the incidental coincidence of these two news items:  

• href="http://www.latimes.com/news/science/la-me-zuska24may24,1,6736477.story?coll=la-news-science">Joseph
  Zuska, 93; Navy doctor developed treatment for alcoholism
• href="http://www.npr.org/templates/story/story.php?storyId=10374760">Gaps
  in Mental Care Persist for Fort Carson Soldiers

The
first item is an obituary for a Navy physician; the second is a NPR
news item in which they follow up on the changes that took place at a
particular military base, after an earlier news article exposed
undesirable practices in the treatment of military personnel with PTSD.

I did not know who Dr. Zuska was.  It turns out he was a bit
of a maverick:

Joseph
Zuska, 93; Navy doctor developed treatment for alcoholism
By Jocelyn Y. Stewart, Times Staff Writer
May 24, 2007

Inside a rusted Quonset hut at the Long Beach Naval
Station, Dr. Joseph J. Zuska operated a clandestine program, treating
sailors for an illness that in the eyes of the Navy did not exist.

It was the mid-1960s, a time when alcoholism and its accompanying
behavior were treated as violations of Navy policy, punishable by time
in the brig. Yet the atmosphere on base and at sea encouraged heavy
drinking. The abiding image of the drunk sailor was a reality for many.

After a conversation with a retired Navy commander who was also a
recovering alcoholic, Zuska began treating the illness as a medical
problem. His underground program, the first in the history of the armed
forces, eventually earned national acclaim, providing a model for other
branches of the military and private industry.

Zuska died May 17 at Los Alamitos Medical Center of complications from
kidney failure and other illnesses, his son, John Zuska, said. He was
93…

It seems odd these days to think of a “clandestine” military program
that was intended to help people.   It is even more strange to
think that it would have been necessary to keep it a secret.  

face="Helvetica, Arial, sans-serif">“The brass was alarmed
for two reasons: According to policy there were no alcoholics in the
Navy at that time, hence there was no need for a treatment policy; and
there were quite a few alcoholic admirals and generals on active duty
in the Pentagon,” Pursch wrote in a 1987 column for The Times…

The article goes on to review the history of the program, how it
eventually became a mainstream program.  Indeed, it became the
template for effective substance abuse treatment nationwide.
 Did this result in an improved attitude throughout the
military, with regard to mental health?  At first, it seemed
promising:

face="Helvetica, Arial, sans-serif">In 1967 the Pentagon
gave Zuska approval for the first official Alcohol Rehabilitation
Center, and by 1971, 70% of 900 patient admissions showed “demonstrated
improvement.”

In the 1980s the Navy’s surgeon general sent doctors to Long Beach to
learn from the program. The Navy eventually opened 33 rehabilitation
centers around the world. ..

In fact, mental health and substance abuse treatment overlap, but are
really two distinct communities with two distinct traditions.
 Progress in one area does not necessarily result in progress
in the other.  

In late 2006, NPR began snooping into the practices at Fort Carson,
with regard to mental health treatment.  
href="http://www.npr.org/templates/story/story.php?storyId=6576505">

face="Helvetica, Arial, sans-serif"> href="http://www.npr.org/templates/story/story.php?storyId=6576505">Soldiers
Say Army Ignores, Punishes Mental Anguish
by Daniel Zwerdling

All Things Considered, December 4, 2006 · Army studies show
that at least 20 percent to 25 percent of the soldiers who have served
in Iraq display symptoms of serious mental-health problems, including
depression, substance abuse and post-traumatic stress disorder (PTSD).
Administration officials say there are extensive programs to heal
soldiers both at home and in Iraq.

But an NPR investigation at Colorado’s Ft. Carson has found that even
those who feel desperate can have trouble getting the help they need.
In fact, evidence suggests that officers at Ft. Carson punish soldiers
who need help, and even kick them out of the Army…

After the story was broadcast, the Pentagon opened an investigation.
 They started a training program to “make sure” that
commanders were educated about PTSD and that reforms were instituted.
 The outcome?
href="http://www.npr.org/templates/story/story.php?storyId=10374760">

face="Helvetica, Arial, sans-serif"> href="http://www.npr.org/templates/story/story.php?storyId=10374760">Gaps
in Mental Care Persist for Fort Carson Soldiers
by Daniel Zwerdling

All Things Considered, May 24, 2007 · Six months ago, an NPR
investigation found that leaders at Fort Carson, Colo., were punishing
some soldiers who returned from war with serious mental health problems
— and were preventing them from getting the treatment they
needed. In some cases, officers kicked the soldiers out of the Army.

Those stories sparked ongoing investigations of the post, including one
by a bipartisan group of U.S. senators and another by Pentagon
officials…

But during a recent return trip to Fort Carson to see whether
conditions for troubled soldiers had improved, the most significant
changes appeared to be rhetorical.

More troubling is that independent mental health specialists who work
with troops told NPR that Fort Carson’s heralded new training course
might even make things worse…

You can go to the NPR site to listen to the full story.  But
be forewarned, it is depressing.  I listened to snippets from
the training program.  Although it is well-intentioned, it is
not effective.  

Notice that the report did not examine the attitude of the health care
personnel in the military; it did not even examine the entire system.
 They just looked at the leadership in one particular base.
 So I don’t want to imply that the problems are pervasive
throughout all components of the military.