The Corpus Callosum

suppose this is good, although it is too little too late.  It
would be a lot better to prevent these casualties in the first place.

plans to hire more psychiatrists

PAULINE JELINEK, Associated Press Writer

WASHINGTON – Overwhelmed by the number of soldiers returning from war
with mental problems, the Army is planning to hire at least 25 percent
more psychiatrists, psychologists and social workers.

A contract finalized this week but not yet announced calls for spending
$33 million to add about 200 mental health professionals to help
soldiers with post-traumatic stress disorder and other mental health
needs, officials told The Associated Press on Thursday.

“As the war has gone on, PTSD and other psychological effects of war
have increased,” said Col. Elspeth Ritchie, psychiatry consultant to
the Army surgeon general.

“The number of (mental health workers) that was adequate for a
peacetime military is not adequate for a nation that’s been at war,”
she said in an interview.

The new hiring, which she said could begin immediately, is part of a
wider plan of action the Army has laid out to improve health care to
wounded or ill veterans and their families. It also comes as the
Defense Department completes a wider mental health study —
the latest in a series over recent months that has found services for
troops have been inadequate…

go on to say that 15 to 20 percent of returning soldiers have features
of PTSD.  They say nothing about the “contractors,” who are
probably on their own.  

Is 200 providers enough for the number of patients they are talking

quick back of the envelope calculation: 150,000 soldiers*0.2=30,000
mental health casualties.  They don’t say what
percentage of that 200 would be psychiatrists vs. nonmedical
therapists.  Let’s say they hire 20 psychiatrists.
 That would be 30,000/20=1,500.  One psychiatrist for
each 1,500 casualties.  I suppose that could work.  

But try to go out and find 20 psychiatrists who are expert, or at least
competent to treat PTSD, and are willing to work for what you are
offering, and who are willing to have anything to do with the military.
 It could be done, but it will take a while.  I’d bet
it would take the rest of the year just to get the first ones on board.

The people you’d want to hire are people who are already busy.
 Even if you could lure them away, a physician can’t just
close a practice and leave at a moment’s notice.  You have to
recruit them, interview them, check their credentials, make an offer,
wait while they talk it over with their families, get them to accept
the offer, then they have to give their existing patients at least a
month’s notice, close up their existing practice, probably move to some
new location.  

And the longer people go without proper treatment, the worse the
problems get. (Not always, but often.)


  1. #1 Drugmonkey
    June 15, 2007

    No problem. The solution is just a short trip away…

  2. #2 Ian
    June 15, 2007

    I was in a different armies medical corps, and along time ago to boot. However, based on my (1980’s) knowledge of CSR/PTSD treatment, I think I see a couple of flaws in the logic here.

    I’ll whole-heartedly agree with your last “And the longer people go without proper treatment, the worse the problems get”, But I don’t think the solution will be found by throwing more “mental health professional” at the problem.

    The analogy I would make with this example is having a soldier step on a mine and the rest of his section do nothing because there are such great orthopedic surgeons available back home. It may seem a bit “Illich” but, in my time and place, when the community (line officers and NCOs) caused a problem they were expected to step up and fix the problem.

    Very few of the private/corporal soldiers that I served with were incapable of learning at a graduate level (all of us were completing undergrad courses at the time)and many of us did complete graduate degrees in the social services/health care/education.

    Would it be unreasonable to think that this “don’t teach them to fish, just give them fish” has more to do with professional turf guarding/dependence building than the delivery of best care/outcome?

  3. #3 Greg P
    June 16, 2007

    The track record of government, VA and other, this administration and others, is to carefully plan programs at considerable expense for the planning process, then underfund and implement them poorly.

    While there is in this generation a change in heart in regard to PTSD, mainly manifested by an acknowledgment that it exists, one has to suspect there is a lingering sentiment in higher ups that still goes back to the time of Patton, when mental problems in soldiers were treated with derision.

  4. #4 Midwife with a Knife
    June 18, 2007

    I think that it could be tough for some psychiatrists to treat combat related mental injuries like PTSD with the knowlege that the goal of treatment is to get the soldier back to their unit, back to the fighting, and back to what it was that traumatized them in the first place.

  5. #5 ashraf
    August 21, 2008

    this is great news for the soldiers.Am not surprised at the government spending these bucks for their soldiers.

    Washington Drug Treatment

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