Aug 14

Standardized Guidelines for Diagnosis and Treatment of PTSD Coming for the Army, Police Officers Next?

Last week, the Army, along with the VA and the DoD, announced that they are in the process of standardizing the diagnosis and treatment process for soldiers with PTSD. It’s an unfortunate reality that those who do the most good for society, firemen and women, soldiers, nurses, and of course, police officers, are some of the most likely individuals to acquire this painful disorder. The real tragedy however, is that not only do they have to suffer with anxiety, depression, flashbacks, and a whole other host of psychological issues associated with PTSD, but that they are often made to feel ashamed among their colleagues and supervisors. This neglectful and sometimes abusive attitude towards these officers in need, has to change. Due to this undeniable trend, police and fire departments all over the country need to follow the Army, DoD and VA’s example, and begin to create standard guidelines for the diagnosis and treatment of PTSD. Hopefully soon, these departments will have a very well-constructed and informed template to follow.

The announcement of the standardization comes after the July 13th release of the Institute for Medicine’s report entitled “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment.” The report was very critical of the current methods, and came to the conclusion that the DoD and the VA had a long way to go in the effective treatment of PTSD, and in tracking the results of the treatment.

“DOD and VA offer many programs for PTSD, but treatment isn’t reaching everyone who needs it, and the departments aren’t tracking which treatments are being used or evaluating how well they work in the long term,” Chairmen of the committee and Chair of the Department of Epidemiology at Columbia, University, Sandro Galea said.  “In addition, DOD has no information on the effectiveness of its programs to prevent PTSD.”

With a report that read like a call to action for the DoD and the VA, it’s no surprise this announcement about the standardization of diagnosis and treatment of PTSD in soldiers came when it did. Interestingly enough, in April of this year, Army Medical Command Policy Memo 12-035 addressed many of the issues named by the I of M.

“The majority of service members with PTSD do not seek treatment, and many who do seek treatment drop out before they can benefit,” reads the memo. “There are many reasons for this, including stigma, other barriers to care, and negative perceptions of mental health care. Lack of trust in military behavioral health professionals has been identified as one important predictor of service members not utilizing services. Therefore, it is critical that Army behavioral health professionals do everything they can to advocate for and provide care in a patient-centered manner that reassures patients that they will not be judged and that their primary concerns will be addressed.”

Standardizing the diagnosis and treatment process, is theoretically going to make the process more trustworthy in the eyes of the soldiers. It’s great that the VA and DoD are making steps towards increasing the access to treatment, and diagnosis, but not all of the issues named by the I of M were addressed. Neither the announcement nor the memo mentions the tracking of these procedures, which is a cause for concern. Hopefully, once the guidelines are completed, they’ll include some method for tracking success rates of treatment. More important than tracking the success however, is to change to culture within these institutions, to be more accepting, and make sure that every person who’s afflicted with the disorder gets the help that they need.

Police officers and soldiers suffer additional stress from trauma, because they are looked to for strength and bravery.

“The police socialization process molds him/her into a myth of indestructibility. The effect of trauma on this myth is devastating” according to Jenn Andrus in “Psychotherapy Interventions II” at Appalachian State University.

A traumatic event at work can alter a police officer’s ability to perform duties associated with their work, and personal lives, dramatically. These individuals who are looked upon to keep communities safe, have to come to terms with the fact that they too, are vulnerable. This in itself can be a devastating realization. Couple that with the stress that is already commonly associated with anyone who goes through a traumatic event, and you have a sometimes deadly combination.

The 147 police suicides in 2011, should be enough evidence, that better mental health care for our officers is direly needed. It’s an especially prevalent number when you consider the fact that we the number of officers lost in the line of duty was 164. That means we are losing almost as many officers to their own anguish, as we are to the dangers associated with the said profession. While it may be difficult to to prevent violent crime and losing officers in the line of duty, preventing suicide should be much easier. There are proven methods for the diagnosis and treatment of depression. Depression is often caused by PTSD, and it seems reasonable to assume that with better diagnosis and treatment of PTSD, we could prevent severe depression, and eventually suicide. Kudos to the DoD and VA for moving forward in the way we treat our civil servants. Hopefully standardization of the process will put more faith in the system, and eventually lead to less stigma, and more soldiers seeking treatment. We can only hope that police departments will take note, and follow suit.


Emily Manke is an Outreach Coordinator for www.criminaljusticeschoolinfo.com and occasionally blogs for Legal Justice News.