Madigan hospital expands PTSD screening for troops

As some 12,000 soldiers from three Stryker brigades return to Joint Base Lewis-McChord from war this year, Madigan Army Medical Center will temporarily expand its staff and implement new screening programs to catch mental health issues.

Hospital staff will pay special attention to 5th Brigade, 2nd Infantry Division, which has lost a reported 35 soldiers and has seen frequent combat since it deployed to southern Afghanistan last July.

"It's no surprise the Army is searching for the right answer for this: How do you take care of soldiers and families during this whole cycle?" said Col. Mark Thompson, the hospital's deputy commander for clinical services.

Before each brigade returns to Lewis-McChord, platoon leaders and platoon sergeants will complete a questionnaire on each soldier that looks for potential mental health concerns.

The questions will probe issues such as financial stability ("Are you in debt?", etc.) and ask soldiers if they've had any discussions or thoughts of committing suicide or killing another person.

The questionnaire is in addition to the Army's standard Post-Deployment Health Assessment form. Platoon leaders and sergeants are tasked with administering the questionnaire because they best know their soldiers on a personal level, Thompson said. A platoon in a Stryker brigade has about 30 soldiers.

Less than two weeks after soldiers assigned to 5th Brigade return, each will meet with a behavioral health provider for a 20-minute, one-on-one session. The provider will often be a psychologist, but some soldiers will meet with psychiatrists or social workers.

The care providers will screen for potential problems but also talk about larger wellness and resiliency issues, Thompson said.

"Some of the focus of the interview is to say, 'Here are some hurdles you might face, and here are some coping strategies,'" he said.

The 900 soldiers of I Corps who returned home last month from Baghdad have already gone through the process successfully, Thompson said.

The process should take about three weeks for an entire brigade and require about 30 health care providers, some of whom will be assigned from other Army medical facilities to Madigan on temporary duty.

Each soldier also receives briefings about other available programs. They will go through another assessment three to six months after returning home.

For soldiers of the base's other two Stryker brigades, both of which are deployed to Iraq, the meeting with the behavioral health provider will be in a group setting of about 30 soldiers, Thompson said.

It's little surprise that hospital officials will focus most intently on 5th Brigade. The unit, the first Stryker brigade deployed to Afghanistan, was sent into Kandahar and neighboring provinces to reassert American control. Ambushes and bomb attacks have been a near-daily occurrence for many of the brigade's soldiers.

"The one truly identifiable thing that triggers PTSD is combat exposure," Thompson said.

As much as 20 percent of American service members returning from Iraq and Afghanistan suffer from post-traumatic stress disorder, according to the Department of Veterans Affairs.

PTSD symptoms sometimes don't surface for weeks or months after a soldier returns home. The program could be more effective if it were pushed back to a later date after the return. But that could cut into block leave, when most of the unit takes off at the same time.

"There's a balance with folks wanting to go on block leave and deserving to go on block leave," Thompson said.

Stryker brigades have previously come home to Fort Lewis from brutal combat tours, such as the 3rd and 4th Brigades' returns from Iraq in 2008. But the current screening program differs from the past by offering two more opportunities for unit leaders to identify soldiers who might need further behavioral health support, said Dr. Joseph Etherage, Madigan's deputy chief of psychology.

"We know that soldiers, understandably eager to return home and begin leave, may at times under-report their concerns or symptoms," Etherage wrote in an e-mail.

Madigan is able to offer such programs because it's one of the Army's largest hospitals and is situated on a base with one of the largest concentrations of combat soldiers.

"It's the only place in the Army where this mix exists," Thompson said.

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Information from: The News Tribune, http://www.thenewstribune.com