PTSD name change heartens advocates

Change from ‘disorder’ to ‘injury’ welcomed, but coverage a concern.

The scrutiny arrives before the American Psychiatric Association updates a widely used diagnostic and mental health manual for the first time since 2000, The Washington Post reported. The debate gained momentum this week at a public hearing in Philadelphia during the association’s annual meeting.

Among mental health professionals and veterans, a possible name switch had cautious support to destigmaztize the illness mixed with concern about the impact a name change might have on service-connected disability claims and health insurance coverage.

Name change may cause more to seek help

“It’s honesty in advertising,” David Kaplan, chief professional officer of the American Counseling Association in Arlington, Va., said in an interview with the Dayton Daily News. “Post traumatic stress disorder is often defined as a normal reaction to an abnormal series of events. ... If it’s a normal reaction, than why use the word disorder.”

Terrifying events, such as war or other traumatic incidents, can trigger severe anxiety, flashbacks, or nightmares that can last years in the most serious cases, according to the Mayo Clinic.

Heidi Kraft, a former Navy clinical psychologist who treated Marines in combat in Iraq, said what it’s called isn’t as important as encouraging those who have the stress illness to get counseling. “I just don’t think it’s about the words as much as it is seeking help,” said Kraft, a resident of San Diego, Calif., and author of “Rule Number Two: Lessons I Learned in a Combat Hospital.”

Culture changing to accept treatment

The warrior mindset has a culture that has discouraged treatment in the past, although that resistance has started to fade, Kraft said in an interview. “This has been a long haul of a culture that hasn’t had a lot of tolerance for anything but emotional perfection, and there needed to be a shift in the way we think about combat trauma and its treatment.”

Whatever the mental health condition is called, the need is apparently prevalent. The Dayton Veterans Affairs Medical Center reported between 2,800 to 3,000 veterans sought treatment for PTSD in the year between October 2010 and September 2011. Nationwide, the VA treated 1.3 million veterans for a mental health care need last year.

A push to destigmatize the illness could mean health insurance companies or service disability claims could be treated differently than they are today, observers said. Changing disorder to injury “might help in terms of stigma, but it might hurt in terms of disability (claims),” said Larry C. James, a retired Army psychologist and dean of Wright State University School of Professional Psychology in Fairborn.

“People are so afraid, particularly military personnel, to seek treatment because they don’t want to be labeled with a disorder,” said Col. Kathy Platoni, an Army Reserve psychologist who has a private practice in Centerville.

A VA official declined to comment on how the agency might view defining post-tramautic stress as an injury instead of a disorder. The federal agency instead pointed to boosting mental health staff ranks to meet demand as veterans return from wars in Iraq and Afghanistan.

The VA has increased the mental health budget 39 percent since 2009, according to Mark Ballesteros, an agency spokesman in Washington, D.C. The number of veterans seeking treatment has risen 35 percent, while the number of mental health staff rose 41 percent since 2007, he added.

‘We’re still not doing enough’

Miami Valley congressional lawmakers took no stand on a name change, but advocated mental health assistance to those who need it. Raising awareness of post-traumatic stress is critical to removing the stigma, U.S. Rep. Steve Austria, R-Beavercreek, said in an email. “I intend to work with the Department of Defense and the Department of Veteran Affairs to ensure that any classification change to PTS does not limit access or benefits.”

U.S. Rep. Mike Turner, R-Centerville, said in a written response no matter how authorities reclassify post-traumatic stress “our service members who have been impacted deserve the full care they need to begin their recovery.”

Lauren Kulik, a spokeswoman for U.S. Sen. Sherrod Brown, D-Ohio, said, “Regardless of what we call post-traumatic stress disorder, we’re still not doing enough.”

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