Military suicides, particularly among Veterans, show no signs of abating. Despite recent efforts by Secretary of Shulkin of the Department of Veterans Affairs (“the VA”), the “silent wounds of war” follow our Veterans into civilian life.
In a most informative report published by CNN, Veteran suicides account for roughly 20% of all suicides in the United States.
SFTT has reported on this disturbing trend for several years, but little has been done to curb Veteran suicides. Our analysis of this dreadful situation – covered amply in previous articles – may be summarized as follows :
1. PTSD and TBI are the Smoking Guns of Veteran Suicide
Veterans with complex PTSD or PTSD and TBI are more than 25 times more likely to commit suicide than their veteran peers, according the National Center for Biotechnology Information (“NCBI”).
2. The VA is Currently Not Able to Effectively Treat Veterans with PTSD
Like the NFL’s denial of culpability, the VA continues to insist that Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”) help reverse the trends of PTSD and TBI. This is patently untrue as described in more detail below.
The VA’s top-tier Specialized Intensive PTSD treatment Programs (“SIPPs”) failed to achieve clinically significant improvement in PTSD symptoms after an average 46-day program of treatment at an average cost of $23,578 per veteran. Average change in PCL-M scores was 5.7 points and “most program graduates met the criteria for clinically significant PTSD after discharge….” according to Institute of Medicine of the National Academies or IOM 2014 study, p.100.
“However, the outcomes from RCTs suggest that only a minority of veterans can be expected to lose their PTSD diagnosis as a result of getting CPT or PE, arguable administered in an ideal fashion…” (p.49) 2/3s retain PTSD diagnosis.
“In the RCTs conducted to date, with one exception, mean symptom scores at the end of treatment or at the latest follow-up (when available) indicated that PTSD symptoms were still substantial .” (p.49)
“Attaining high end-state functioning may be the exception rather than the rule.” (p.49)
The VA continues to treat the symptoms of PTSD and TBI with potentially lethal prescription drugs rather than use other proven therapy programs. In fact, many current programs (i.e. cannabis) funded by the VA focus on treating symptoms rather than the underlying causes of PTSD and TBI.
3. The VA has Shown Little Inclination to Understand the Causes of PTSD
The “evidence-based” treatments currently deployed by the VA and DOD have little actual evidence supporting their efficacy in treating combat trauma and the existing evidence shows these treatments are generally ineffective.
The IOD concluded in 2014 that “[N]either department [DoD and VA] knows whether it is providing effective, appropriate, or adequate care for PTSD.
The VA insists that this is not the case, but many other studies have reached similar conclusion regarding the standard therapies used by the VA.
Specifically, in randomized controlled trials of “evidence-based” treatments in military PTSD “. . . mean post-treatment scores for CPT and prolonged exposure therapy remained at or above clinical criteria for PTSD, and approximately two-thirds of patients receiving CPT or prolonged exposure retained their diagnosis after treatment. Symptom remission was rare.” (Steenkamp, et. al., p. 489)
4. SFTT has Assembled a World Class Medical Task Force to Identify and Deploy Effective Treatment for TBI and PTSD
Despite overwhelming evidence to the contrary, the VA continues to march to a drummer of its own choice insisting that Veterans are receiving the best care possible. As SFTT will demonstrate in the next couple of weeks, support for Veterans diagnosed with PTSD (and their supportive families) is abysmal.
Veterans recognize the limitations of the VA and are seeking alternative therapy programs. SFTT has assembled a world class Medical Task Force to identify promising new technologies and recommend proven treatment programs.
While some of these therapy programs have been around for years with proven success stories, others are more experimental in nature. There is no “silver bullet” and each Veteran may respond differently to a specific program. Nevertheless, it seems far better than the hype rather than substance of VA programs.
Veterans and those who serve our country need a helping hand.