Returning troops put strain on VA

 

WASHINGTON, May 3 (UPI) – U.S. troops returning from Afghanistan are providing a challenge for veterans-affairs organizations straining to meet the needs of veterans, analysts said.

There are currently 91,000 troops in Afghanistan and 23,000 will return to the United States by the end of the summer, MSNBC reported Thursday. The rest will be home by December 2014.

Ray Kelley, legislative director for the Veterans of Foreign Wars, says the agency is going to need more funding.

“You can’t have more people coming into the system needing care and flat line the service,” Kelly told MSNBC. “It’s not that we can cross our fingers — we have to insist that budgets continue to grow.”

President Obama has proposed $140.3 billion to the U.S. Department of Veterans Affairs for the next fiscal year, and the VA estimates about $53 billion would go towards medical care.

Last year, the VA provided specialty mental health services to 1.3 million veterans.

“It’s going to be a question of capacity,” Lawrence J. Korb, a senior fellow for the Center for American Progress, told MSNBC. “Do they have enough doctors and people?”

Read more: http://www.upi.com/Top_News/US/2012/05/03/Returning-troops-put-strain-on-VA/UPI-74091336044242/#ixzz1tvoi7KBN

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VA mental health hiring is flawed, critic says

 

From the Army Times

By Patricia Kime – Staff writer

A representative of a major mental health organization blasted the Veterans Affairs Department for failing to hire therapists whom he says could ease VA staffing shortages and eliminate prolonged waiting periods for veterans in need of care.

David Kaplan, chief professional officer for the American Counseling Association, said Wednesday that VA has ignored licensed professional counselors, or LPCs, in its efforts to fill mental health vacancies in its medical system.

Requirements for LPC licensure vary from state to state, but in general, they are masters degree-level professionals with education and clinical experience in psychotherapy treatment and counseling.

“There’s an unconscionable crisis going on now with mental health treatment for those who have served our country, and the really sorry thing about this is it doesn’t have to be,” Kaplan said.

VA has 1,500 vacancies for mental health staff. It announced in April it plans to hire an additional 1,600 professionals.

But with a nationwide shortage of trained mental health workers, the department will be hard-pressed to fill its staffing needs without recruiting LPCs, Kaplan said.

“Each day, as these vacancies and positions remain unfilled, men and women continue to struggle with thoughts of suicide and post-traumatic stress disorder,” he said.

The critique comes on the heels of a scathing VA inspector general’s report released last month showing that officials inflated success rates in providing timely mental health services for veterans.

According to the IG, VA reported in 2011 that 95 percent of new patients seeking mental health services received full evaluations for care within the department’s required 14-day window, when the figure actually was closer to 50 percent.

Average wait time, the IG found, was 50 days.

Five days after VA’s April 19 announcement that it planned to hire 1,600 nurses, psychiatrists, psychologists and social workers to bolster its mental health staff, officials said marriage and family therapists and LPCs, also known as licensed professional mental health counselors, are included in the hiring effort.

“The addition of these two mental health professions is an important part of VA’s mission to expand access to mental health services,” VA Secretary Eric Shinseki said in a release.

But Kaplan worries the announcement is simply paying lip service to Congress, which passed the Veterans Benefit Health Care and Information Technology Act in 2006 to require VA to draft qualification standards for LPCs and hire them.

Kaplan noted that in the past 14 weeks, VA has advertised jobs for nearly 400 licensed clinical social workers but just eight LPCs.

“VA doesn’t get it,” he said. “They are more focused on getting veterans in the system than they are on providing the service.”

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Army Will Reshape Training, With Lessons From Special Forces

From the NYTIMES.com

By 
Published: May 2, 2012

WASHINGTON — The Army is reshaping the way many soldiers are trained and deployed, with some conventional units to be placed officially under Special Operations commanders and others assigned to regions of the world viewed as emerging security risks, like Africa.

Win Mcnamee/Getty Images

Gen. Ray Odierno is overseeing changes in the training and deployment of soldiers.

The pending changes reflect an effort by the Army’s top officer, Gen. Ray Odierno, to institutionalize many of the successful tactics adopted ad hoc in Afghanistan and Iraq. As the Army shrinks by 80,000 troops over the next five years, General Odierno is seeking ways to assure that it is prepared for a broader set of missions, including in hot spots around the world where few soldiers have deployed in the past.

The initiatives are a recognition that the role and clout of Special Operations forces are certain to grow over coming years. Faced with impending budget cuts and  public exhaustion with large overseas deployments, the military will focus on working with partner nations to increase their ability to deal with security threats within their borders. The goal is to limit the footprint of most new overseas deployments.

Senior Pentagon policy makers briefed on the plans say they are fully in keeping with the new military strategy announced early this year by Defense Secretary Leon E. Panetta and Gen. Martin E. Dempsey, the chairman of the Joint Chiefs of Staff.

Creating new sets of formal relationships between Army general-purpose units and the Special Operations Command would be a significant change in Army culture. For more than a generation, the large, conventional Army and the small, secretive commando community viewed each other from a distance, and with distrust. Armor and infantry units trained and operated separately from counterterrorism and counterinsurgency teams.

The attacks of Sept. 11, 2001, changed that. The demands of combining high-end conventional combat and counterinsurgency missions for complementary and overlapping operations in Afghanistan and Iraq pushed conventional and Special Operations forces together. General Odierno, who now serves as Army chief of staff, oversaw many of those tactical initiatives.

He was a division commander in northern Iraq when Saddam Hussein was captured there in a mission that combined mechanized infantry units and the elite counterterrorism force. And during his tours as the No. 2 and then the top commander in Iraq, he integrated conventional and Special Operations missions on a daily basis.

Under the emerging plans, conventional Army units would train alongside Special Operations units, and would deploy with them, under their command, on overseas missions.

Other units would remain in the conventional force, but would be told in advance that their deployments would focus on parts of the world, like Africa, that do not currently have Army units assigned to them. This would allow officers and soldiers to develop regional expertise.

General Odierno foreshadowed his planning in an essay published last week in Foreign Affairs, in which he wrote that “the Army will need to preserve and enhance its relationship with joint Special Operations forces.”

“The evolution of this partnership over the past decade has been extraordinary, and the ties can become even stronger as we continue to develop new operational concepts, enhance our training and invest in new capabilities,” he wrote.

On the effort to prepare Army units with a regional focus, General Odierno wrote, “We must align our forces, both active and reserve, with regional commands to the greatest extent possible.”

The military’s global combatant commanders would guide whether the units focused on high-end combat skills, disaster relief or training missions to improve the capability of militaries within partner nations. “Regional alignment will also help inform the language training, cultural training and even the equipment that units receive,” General Odierno wrote.

The first unit to be designated for this new regional orientation will be a full brigade that will train for missions in support of the military’s Africa Command, Army and Pentagon officials said.

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New VA hires to include marriage therapists, professional counselors

 

From Stars and Striples by Leo Shane

WASHINGTON – The 1,900 new mental health staffers to be added to the Department of Veterans Affairs workforce in coming months will include two new types of specialists: marriage and family therapists, and licensed professional mental health counselors.

That’s worth noting because for years those professionals and therapists have been largely shut out of the VA system, which they say only hurts veterans’ health care. Their complaints stem from local VA facilities’ preference to hire licensed social workers in lieu of developing new standards for other specialists.

Now, VA officials say, new therapists and counselors will help provide mental health diagnostic and psychosocial treatment services for veterans and their families. In a statement, VA officials said the goal of the new move is to provide “a complete range of services” to deal with veterans’ problems and “help keep families together.

The department has developed new qualification requirements for those new hires, including new professional standards boards to review employment opportunities and promotion opportunities for those hires.

But a handful of therapists and counselors who reached out to Stars and Stripes after the announcement said they’re still hesitant to welcome the news as a true change in philosophy from the department, at least until they see how the hiring process progresses.

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Times: VA hospitals improve performance by changing rules

Just another case of VA cooking the books to make things look better. Don’t let them get away with it. Tampa Bay Business Journal Date: Monday, April 30, 2012, 6:20am EDT

An investigation by the Tampa Bay Timesindicates that the region’s two veterans hospitals are quietly changing their procedures to make their wait times look less daunting. The U.S. Department of Veterans Affairs    denies the paper’s accusations.

The James A. Haley VA Medical Center in Tampa increased the amount of time a patient has to go with no appointment before they are put on a wait list from 30 to 120 days, according to the Times. This means the waiting list for outpatient appointments dropped from almost 5,000 in March to only 1,800 in April.

The VA Medical Center at Bay Pines changed its wait list time measure in 2010, according to the Times.

VA policy does not mandate a specific amount of time a veteran must wait between appointments before being put on the wait list.

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Military families and mental health: Understanding the issues and available resources

From the Milwaukee-Wisconsin Journal Sentinel

By (ARA)

Today’s service men and women are facing particularly challenging circumstances. Many soldiers have been deployed several times to the wars in Afghanistan and Iraq, often serving in prolonged combat operations. Army Secretary John McHugh recently told Congress that, for perhaps the first time in history, there are more than 50,000 soldiers in uniform who have had at least four deployments, and some have even served 10 or more. The situation is getting worse day by day. Know full updates on davidthompson200 .

The full impact of multiple deployments is still unknown. A recent study by the alcohol detox in Los Angeles reveals growing trends in a range of mental health issues, as well as prescription drug and alcohol abuse, among soldiers and veterans. A 2012 report from the U.S. Army Public Health Command found that, since the start of the Iraq War in 2003, the rate of suicide among U.S. Army soldiers has increased. This coincides with a rise in other conditions including depression, anxiety and post-traumatic stress disorder (PTSD).  hristian rehab tends to share many similarities with secular rehab. Legacy Healing Center in South Florida, for instance, goes by the same evidence-based treatment protocols as other facilities.  You can visit nican for more details. There is a difference in how these treatments are framed, however. The counselors and other staff members who treat you, share your faith and help you understand why the treatments you receive are the right choice to make, in a religious context.  Human support is an important part of any rehabilitation program, whether in the form of family support, support from friends, a group, or therapists. In Tampa drug rehab, you can count on additional support — you have the faith that you share with your fellow survivors and the therapists. For those with strong faith and spirituality, this can greatly boost confidence in a positive outcome.  It’s important to remember that faith-based rehab only works well for those who are deeply spiritual or religious. Trying faith-based rehab when you are ambivalent about religion can work against you. You may find that you aren’t able to accept what you’re asked to practice, and you may find yourself rebelling. It’s important to choose a treatment approach that you can go along with in good conscience.

“Our men and women in uniform are making the world a better place and their contributions are invaluable,” says Dr. Joseph Hullett, a Vietnam-era Marine Corp veteran and senior medical director of Clinical Strategy for OptumHealth’s behavioral health business. “But many soldiers, veterans and their families may have trouble recognizing the signs of a mental health condition or may even be afraid or embarrassed to reach out.

“A mental health condition is not a weakness and it’s nothing to be ashamed of,” says Hullett. “The good news is there is help available to support soldiers and veterans so they can enjoy a full, healthy life.” Go through https://amindforallseasons.com site for more detail about the Brain Health.

Hullett offers military families tips for recognizing a mental health condition and knowing when it may be time to seek help:

* Signs of depression: Depression often manifests itself in feelings of hopelessness, lack of interest in the things you once loved, and having trouble sleeping or sleeping too much.

* Signs of anxiety: Anxiety is marked by needless worrying, indecisiveness, difficulty concentrating, irritability and physical symptoms such as sweating, heart pounding and dizziness.

* Signs of PTSD: PTSD is not limited to combat experiences. In fact, women veterans suffer disproportionately high rates. Moreover, people suffering from PTSD often don’t talk about the traumatic events. Look for:

– Intrusive memories and nightmares – Emotional extremes – Anxiety and guilt – Unreasonable or disproportionate fear – Substance abuse

“If you or a loved one is experiencing these symptoms for more than a few days and they are interfering with work or relationships, help is available,” says Hullett. “And if the problems are severe, talk to your doctor right away.”

Hullett suggests a few resources for soldiers, veterans and their families:

* The Substance Abuse and Mental Health Services Administration “Military Families” webpage (www.samhsa.gov/militaryfamilies).

* The National Alliance on Mental Illness Veterans’ Resource Center (www.nami.org/veterans); and the National Center for PTSD of the U.S. Department of Veterans Affairs (www.ptsd.va.gov).

* The Defense Center of Excellence (DCOE) for Psychological Health’s website on military behavioral health (www.dcoe.health.mil).

* Visit www.liveandworkwell.com website to access useful resources to help military families get connected with the right support services.

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National Guard Members’ Next Battle: The Job Hunt

From NPR TOM DREISBACH and 

Before the soldiers of the 182nd Regiment of the Army National Guard came home, they were asked how many were unemployed or looking for work. The answer: about one in three.

As more soldiers return to civilian life, a civilian job may not be there waiting. Service members with the National Guard have the extra challenge of convincing employers to hire them when they may be called to active duty for a year or more. There are laws designed to protect vets from losing their jobs or promotions because of their service, but it’s hard to prove when it happens.

‘A Unique Challenge’

According to the Army, these so-called “citizen soldiers” have been mobilized more in the past decade than at any other time since the Korean War. That means for many of them, being in the National Guard has been their full-time employment. That’s changing now, and these soldiers are faced with trying to restart careers — or start one from scratch.

Michael Haynie is the executive director of the Institute for Veterans and Military Families at Syracuse University. He says soldiers today are coming home to an employment situation that’s as bad as it’s ever been.

“Our National Guard and Reserve components face a unique challenge because the model is predicated on their ability to move in and out of an employment situation as they’re activated and deactivated,” he says.

Their employment rights are protected, Haynie says, by the Uniformed Service Employment and Reemployment Rights Act, or USERRA.

“In a perfect world anyway, our Guard and Reserve members who are activated should have the ability to make a seamless transition to the jobs that they left when they were brought on active duty,” he says.

But that’s not always how it works. He says a number of issues come up with people who have to move in and out of employment.

“One: the burden of proving discrimination under USERRA falls on the individual — and it’s a high burden,” Haynie says.

The law not only allows service members to return to work – it also forbids employers from letting military service determine things like promotions or salary.

“Very often the discrimination is not necessarily explicit,” Haynie says.

Smaller Companies’ ‘Burden’

Having an employee that may be gone for a year or more can be difficult for business too. While Haynie doesn’t want to give employers excuses to discriminate, he does say the issue can be challenging, especially for smaller companies.

“To be honest, our larger companies are in a much better position to absorb some of that burden, if you will,” he says.

Companies with 50 to 100 employees, though, may not be able to replace a key supervisor or highly skilled technician, Haynie says.

“You’re not gonna find an employer that’s gonna say ‘I’m not gonna hire a veteran.’ That is illegal,” he says. “At the same time, you will hear employers talk about not necessarily targeting vets in their recruitment efforts because they’re concerned about what it might mean for their organization to bring someone into their work force that may be lost to them for a year or more if they’re called to active duty.”

Complaints On The Rise

Kenan Torrans oversees investigations of labor discrimination against veterans for the U.S. Department of Labor Veterans’ Employment and Training Service.

“Sometimes, I often find that the disputes that we encounter are the result of a lack of understanding of the law,” he says.

Torrans says the number of complaints are going up.

“We’ve been in a formal conflict now, at a state of emergency since 9/11. We’ve had 846,494 members of the Guard and Reserve that have been activated,” he says. “Currently, 70,000 are still on active duty, and more than 776,000 have come back.”

That’s more than three-quarters of a million Guard and Reserve members who’ve now returned to civilian life.

“So, if you look at those numbers, you would anticipate that the number of complaints — just by the duration and the numbers mobilized — would go up,” Torrans says.

There’s still a major disconnect, he says, between the military and the civilian population — between employers and their employees returning from war.

“Employers remain very supportive of our service members. They really are. And they want to do the right thing,” he says, “and when these disputes arise, it’s usually because they didn’t know what their obligations were.”

Staff Sgt. Mike Fitzpatrick joined the National Guard right out of college in 2010. The Guard generally requires members to attend drills at least one weekend a month, and Fitzpatrick says getting that time off can be hard. He would give his manager a schedule a year in advance, but would still get asked to work on days he needed off.

“And then it would be a very contentious conversation with my manager,” Fitzpatrick says, “and he’d be like, ‘Well, do you really have to go?’ And it’s like, ‘Well … there could be a warrant out for my arrest if I don’t show up for the drill weekend this weekend.’ ”

Employers’ Responsibility

Soldiers looking for jobs say they can get interviews, but as soon as an employer finds out that they could be gone for weeks or even a year as part of their military service, the conversation can stop cold.

“That’s the wrong attitude,” says Sen. Patty Murray of Washington State.

As the chair of the Senate Veterans’ Affairs Committee, she recently proposed a bill to toughen up the laws protecting veterans from labor discrimination.

“We have a policy in this country that we’ve had for a very long time, that if we have men and women who are willing to protect all of us … that we will provide them the support of this country, of our businesses, of our families, of our communities, to make sure they’re not lost when they come home,” Murray says. “So … you’re an employer in the United States? This is part of your responsibility.”

‘Service Might Become A Hindrance’

Fitzpatrick got home from Afghanistan with the rest of the 182nd National Guard regiment about a month ago, and since then he’s been on leave, spending time with his new wife and their two young daughters. He says he’s proud of his military service, but he knows the job search he’s about to start might force him to make a tough choice.

“I, in thoughts of desperation, have also thought about maybe even hanging it up, because I have to think about my family and their future and my ability to provide for them,” he says. “And if the fact that my service might become a hindrance to that — that’s … a very serious thought.”

Since Fitzpatrick got back home, he and his family have been living off the military salary he got for his deployment. He knows he has to kick his job search into high gear; his military pay expires in just over a month.

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VCS ED on BBC News Hour

This weekend in addition to a Friday live interview VCS ED Patrick Bellon was featured in an interview on the BBC Newshour. This interview was only the latest round in our efforts to bring attention to the plight facing our veterans as they re-enter society. Also,featured in the interview is Yania Padilla a suicide prevention advocate and Gold Star family member.

You can listen to the entire segment here:

BBC News hour Suicide vets story S Seq

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VCS Spring Membership and Fundraising

Thank you for visiting our website.  Please feel free to look around. Perhaps you heard or saw one of our recent  interviews on NPR, the BBC or in the New York Times, regarding veterans mental health.  Were you wondering how you could help our efforts for veterans? One thing you can do is sign up to be  a member of our mailing list by clicking on the link below.

http://veteransforcommonsense.us4.list-manage.com/subscribe?u=d67c570931450f39704967a60&id=bb62661b50

Policy makers in DC always want to know how many people support Veterans for Common Sense. Strength in numbers matters a great deal in getting their attention. Your information will remain with us and will not be sold. You can also help us with our spring fund raising drive. We rely on individual donations.  We cannot keep up our fight for veterans with out your help. Join our cause and help us keep strong and  fighting into our second decade.  Thank you.

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Army warns doctors against using certain drugs in PTSD treatment

BY BOB BREWIN 04/25/2012

 From NEXTGOV.com

The Army Surgeon General’s office is backing away from its long-standing endorsement of prescribing troops multiple highly addictive psychotropic drugs for the treatment of post-traumatic stress disorder and early this month warned regional medical commanders against using tranquilizers such as Xanax and Valium to treat PTSD.

An April 10 policy memo that the Army Medical Command released regarding the diagnosis and treatment of PTSD said a class of drugs known as benzodiazepines, which include Xanax and Valium, could intensify rather than reduce combat stress symptoms and lead to addiction.

The memo, signed by Herbert Coley, civilian chief of staff of the Army Medical Command, also cautioned service clinicians against prescribingsecond-generation antipsychotic drugs, such as Seroquel and Risperidone, to combat PTSD. The drugs originally were developed to treat severe mental conditions such as schizophrenia and bipolar disorder. The memo questioned the efficacy of this drug class in PTSD treatment and cautioned against their use due to potential long-term health effects, which include heart disorders, muscle spasms and weight gain.

Throughout more than a decade of war in Afghanistan and Iraq, the military services have relied heavily on prescription drugs to help troops deal with their mental health problems during and after deployment. In a June 2010 report, the Defense Department’s Pharmacoeconomic Center said 213,972, or 20 percent of the 1.1 million active-duty troops surveyed, were taking some form of psychotropic drug — antidepressants, antipsychotics, sedative hypnotics or other controlled substances.

The Army, in a July 2010 report on suicide prevention, said one-third of all active-duty military suicides involved prescription drugs.

Mental health experts say the military’s prescription drug problem is exacerbated by a U.S. Central Command policy that dates to October 2001 and provides deploying troops with up to a 180-day supply of prescription drugs under its Central Nervous System formulary.

That formulary includes Xanax, Valium and three other benzodiazepines to treat anxiety: Ativan, Klonopin and Restoril.

The Army’s new PTSD policy makes it clear that the risk of treating combat stress with benzodiazepines outweighs the rewards: “Benzodiazepine use should be considered relatively contraindicated in combat veterans with PTSD because of the high co-morbidity of combat-related PTSD with alcohol misuse and substance use disorders (up to 50 percent co-morbidity) and potential problems with tolerance and dependence.”

Read the entire Broken Warriors series.After becoming dependent on these drugs, soldiers face enormous problems when they try to discontinue their use, the report said. “Once initiated in combat veterans, benzodiazepines can be very difficult, if not impossible to discontinue, due to significant withdrawal symptoms compounded by underlying PTSD symptoms which can only be compared to the likes of a Cymbalta withdrawal treatment or something of a similar nature,” the document said.

The Army policy memo highlighting problems with benzodiazepines for PTSD treatment dovetails with a study published in the April issue of Current Psychiatry Online by Jolene Bostwick, clinical assistant professor of pharmacy at the University of Michigan College of Pharmacy.

Bostwick wrote “benzodiazepine administration fails to prevent PTSD and may increase its incidence.” She added, “use of benzodiazepines for PTSD is associated with withdrawal symptoms, more severe symptoms after discontinuation and possible disinhibition, and may interfere with patients’ efforts to integrate trauma experiences.”

Army clinicians who prescribe Risperidone, Seroquel and other second-generation antipsychotic drugs “must clearly document their rationale concluding that the potential benefits outweigh the known risks and that informed consent has been conducted,” the policy memo said.

Seroquel has been implicated in the deaths of combat veterans and theVeterans Affairs Department reported in August 2011 that Risperidone was no more effective in PTSD treatment than a placebo. VA spent $717 million on the drug over the past decade. The military has spent $74 million over the past 10 years on Risperidone, a spokeswoman for the Defense Logistics Agency said.

An Army doctor who declined to be identified told Nextgov “these long-overdue policy changes are welcome, but they will further shift the mental health care of soldiers to an already overstressed VA and will result in the separation of many mentally stressed volunteers, who just months earlier had been counseled to steel themselves for a career of perpetual deployment and had been willing to sacrifice the best years of their lives to do so.”

This long-serving Army clinician said, “the nation needs to take a long, hard look at what delayed the institution of these policies, and why the priorities of our Army medical leaders have too often favored the manpower needs of the Army rather than the mental health of its soldiers.”

Dr. Grace Jackson, a former Navy psychiatrist who resigned her commission in 2002 “because I did not want to be a pill pusher” said the new Army policy shows “they are finally admitting to some problems associated with at least one class of psychiatric medication.” But, Jackson said, the Army policy does not address problems with other classes of prescription drugs, including antidepressants and selective serotonin re-uptake inhibitors (SSRIs), such as Prozac, in the treatment of PTSD. Clinical studies, Jackson said, have shown these drugs to be no better than placebos — but far more dangerous in the treatment of PTSD.

The Army also has ignored the role antipsychotic drugs play in the “sudden death” of troops diagnosed with traumatic brain injury due toundiagnosed endocrine abnormalities Jackson said.

The use of antipsychotic drugs to treat troops with TBI can cause changes in growth and thyroid hormones, which can in turn trigger a variety of cardiac-related events that could result in sudden deaths, Jackson said.

Though the Army has adopted a new policy on the use of benzodiazepines, Jackson said the Defense Department overall is still wedded to a policy of using drugs to treat mental problems even when scientific evidence “demonstrates poor risk-benefit ratios.”

The Army policy memo encouraged clinicians to look beyond drugs to treat PTSD and suggested a range of alternative therapies, including yoga, biofeedback, acupuncture and massage.

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