Refraining from PTSD in Texas

Earlier this month an e-mail was sent by psychologist Dr. Norma Perez at Olin E. Teague Veterans’ Center in Temple, Texas to staff suggesting that they “refrain from giving a diagnosis of [post traumatic stress disorder] PTSD straight out.” Dr. Perez suggested that a diagnosis of “adjustment disorder” be given instead. This didn’t upset me at first as there are many instances of any number of conditions being over-diagnosed, and maybe Dr. Perez just wants to be accurate. As I read on, though, a couple of things jumped out at me.

First, I learned from many sources that the level of treatment for adjustment disorder is not the same as for PTSD. Adjustment disorder generally results from less intense experiences and stressors, and treatment for adjustment disorder vs. PTSD cuts costs.

Second, Dr. Perez’s e-mail states that she makes the suggestion because they have been seeing “more and more compensation seeking veterans.” Oh really? The U.S. continually sends women and men to fight wars with purposes, ethics and end dates all up for debate, and all the while the U.S. promises to care for these women and men when they return. So veterans of current and past conflicts are seeking compensation for their time served, and care for their physical and mental health needs? Wow, yeah, greedy. Watch out for those veterans, we certainly wouldn’t want to properly care for them. Did I pour that sarcasm on thick enough?

Third, and most appalling to me, Dr. Perez states in her e-mail, “Additionally, we really don’t or [sic] have time to do the extensive testing that should be done to determine PTSD.” Knowing that many limitations and shortages exist in the health care system(s), I have to acknowledge that this might be true. It’s infuriating that VA centers, or any health/medical centers, in the U.S. don’t have adequate time, staff, and/or training to properly treat its patients. I don’t advocate that anyone be diagnosed and receive subsequent treatment for a condition which they do not have, but I do advocate appropriate screening and care. Rather than asking staff to cut back on potentially correct diagnoses, then, shouldn’t Dr. Perez have admitted the inadequacy and offered suggestions on how the center administration and staff could work to provide better care for the veterans for whom they care?
Sources:
“CREW and VoteVets release email telling VA staff to ‘refrain from giving a diagnosis of PTSD straight out’” - citizens for responsibility and ethics in washington
VA psychologist to staff: don’t diagnose PTSD – Chicago Tribune, May 16, 2008
VA Stats At A Glance – U.S. Department of Veterans Affairs. National Center for Veterans Analysis and Statistics