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Army trying to improve stress detection
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WASHINGTON — Since 2003, the Army medical community has been working to establish processes that will improve the speed at which post-traumatic stress cases are diagnosed in military members, the Army’s surgeon general said recently.
As many as 30 percent of troops redeploying from Iraq and Afghanistan could develop post-traumatic stress symptoms, and early detection is key to their treatment, Army Lt. Gen. Eric B. Schoomaker said in a roundtable discussion with reporters.
“Earlier wars have taught us that you need to be very aggressive and very close to the battle when treating and diagnosing psychological impacts of deployment and combat exposure,” he said. “You can actually create more problems for the individual soldier by delaying the treatment or evacuating them out of theater.”
Some symptoms of post-traumatic stress, Schoomaker said, are avoidance of people, a sense of internal panic, intrusive thoughts and sleep problems, as well as drug and alcohol abuse.
Soon after the start of Operation Iraqi Freedom, the Army began sending mental health advisory teams to Iraq and Afghanistan to study behavioral health among troops exposed to combat, the general said.
The battlefield teams’ work enabled the military medical community to refine how behavioral and mental health issues among troops were distributed, Schoomaker said. The teams also helped to validate the mental health community’s efforts.
Initial treatment for soldiers on the spot, rather than waiting until they redeploy, has proven to restore the majority of diagnosed troops to operational performance levels, the general said. It also contributes to long-term health.
However, many troops still are returning home with post-traumatic stress, compounded by traumatic brain injuries, Schoomaker said. Until recently, service members exposed to battlefield violence or attacks had the option to seek immediate health care. But many troops, he said, weren’t coming forward for care.
“If you give the soldier the option of self-identifying, what we’ve learned the past couple of years is that soldiers won’t do that,” the general said. “How many football players are willing to come off the field [voluntarily]? Many of our soldiers and Marines are the same way. They brush themselves off, try to recover from what’s going on, and they go back into the fight.”
But now policies are in place that force soldiers to be evaluated based on certain events, Schoomaker said.
“We’re pushing our protocols aggressively down to the battlefield [level], and taking it out of the hands of the soldier and taking them out of the fight,” he said. “If we report an attack ..., then everybody within a 50-meter range of that event is going to take a knee. They don’t have a choice.”
Research and data provided by mental-health teams has helped the Army develop additional survey questions and discover other causes of post-traumatic stress, Schoomaker said.
The Army began looking harder at deployment lengths and the amount of time troops had between deployments.
“Dwell time plays a very important role,” he said. Fewer than 24 months does not allow service members enough time to restore to a baseline level of psychological health.
“Short dwell [times] between deployments were contributing to some of the problems we’re seeing,” Schoomaker said. “Before [troops] had time to reconnect with family, reconnect with their community and get back to a normal ground state, they were getting out the door again.”

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