The Corpus Callosum

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.  

The fundamental problem is that there are some people who insist on
making moral value judgments about virtually everything, and those
judgments influence everything they do.  They are not going to
change those value judgments, no matter what training program is
imposed.

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.

  

Comments

  1. #1 daedalus2u
    May 26, 2007

    If you are looking for the bottle neck, look at the top of the bottle.

  2. #2 rosy8230
    August 15, 2008

    Force mental health nurses provide care for patients in an environment differing from most civilian hospital settings. On an in-patient unit, which consists mainly of active duty military patients, there is a strong emphasis placed on evaluating the ability of the patient to perform their military duty. Society’s negative attitudes toward mental illness are often even more evident within the military environment toward active duty personnel needing mental health care.
    =============================================================
    rosy
    Colorado Drug Treatment

  3. #3 rosy8230
    August 15, 2008

    Military Force provide care for patients in an environment differing from most civilian hospital settings. On an in-patient unit, which consists mainly of active duty military patients, there is a strong emphasis placed on evaluating the ability of the patient to perform their military duty. Society’s negative attitudes toward mental illness are often even more evident within the military environment toward active duty personnel needing mental health care.
    =============================================================
    rosy
    Colorado Drug Treatment

  4. #4 Karmath
    August 17, 2008

    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.
    —————-
    Karmath

    Hawaii Drug Treatment

  5. #5 mukesh
    April 21, 2009

    The impact a political-legal environment can have on business can cause so many craters so as to make that business look like the moon. It was a political-legal environment that gave birth to the corporate personhood doctrine and that gave rise to the corporate world we live in today. Political-legal environments can only hope to regulate markets, and market regulations will most certainly have profound impacts on business organizations. An example of the kind of bone headed impact a political-legal environment can have on a business one need look no further than American auto makers, the electric car and California. For whatever reasons, several of the auto manufacturers in the United States began developing electric cars which they leased to satisfied customers. Then, California decided it would be a good idea to mandate to American auto makers that if they expected to sell their cars in California they would have to invent some new technology reducing carbon dioxide. Presumably, California expected to see an increase of electric cars being sold by auto makers. What happened is quite the opposite and the auto makers took a hard look at their electric car program, uncertain how to market a “clean vehicle” without admitting the piston engine vehicles are dirty, realizing that much of the profit from a piston engine vehicle comes with the replacement of parts and not so with electric cars and finally, realizing that a State, not even the State of California can make them build technology they don’t have, nor can any state even make them keep building the technology they do have, and so, the auto makers killed their own electric car program and this was the impact of a political-legal environment.
    ————
    mukesh
    Colorado Drug Treatment Centers – Colorado Drug Treatment Centers

  6. #6 rajan
    April 21, 2009

    Mental health can be socially constructed and socially defined; that is, different professions, communities, societies and cultures have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions are appropriate.Thus, different professionals will have different cultural and religious backgrounds and experiences, which may impact the methodology applied during treatment.
    Many mental health professionals are beginning to, or already understand, the importance of competency in religious diversity and spirituality. The American Psychological Association explicitly states that religion must be respected. Education in spiritual and religious matters is also required by the American Psychiatric Association.
    ——–
    rajan
    Colorado Drug Treatment Centers – Colorado Drug Treatment Center

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