Thanks for your post and your service, Chuck. I too had heard that the VA was making improvements, but I know change happens way too slowly in an organization as large as the VA.

There are two particular changes that I understood were underway that I wonder if you have any new information about. The first is a crucial change that I read had been recently instututed: Vets will no longer be required to have maintained sobriety for X amount of time (days? weeks? I'm not clear on the specific time requirements) before they are allowed to access mental health and other VA services. I am appalled to think how many vets suffering from PTSD surely were turned away by the earlier policy, especially since substance abuse is an extremely common symptom of PTSD. Do you know anything about whether the VA has actually done away with this wrongheaded policy? I'm not a vet myself so I don't keep as up-to-date on these issues as you probably do.

The second question concerns something you refer to in your article - the long time it often takes PTSD symptoms to appear. I believe there was some sort of cut-off date for treatment eligibility that the VA had established in the past, meaning that if symptoms took months or years to appear, they weren't treated as service-related by the VA. A "debriefing" immediately upon return from overseas service is a good step in the right direction, but may not be enough for every vet, as symptoms differ from person to person. Are there new plans for VA outreach beyond the time of the immediate return?

I've also been disturbed to read reports of vets being denied disability benifits for PTSD by VA specialists who evaluate their condition as "pre-existing," usually with a diagnosis of a personality disorder. Again, this is appalling. If they were considered healthy enough to serve their country at the time they enlisted, these guys continue to deserve our support after they served, and the VA should not be playing self-serving games with diagnoses.

The VA sometimes has a peculiar way of "supporting the troops" and I sincerely hope there are changes for the better in the works.

Chuck: I'm glad you found my comment - I had a hard time getting back here, until I discovered that the "Search" function (up at the top of the page)really does work.

I seem to remember reading something quite a while ago about the results of the MMPI (a psychological test) commonly leading to diagnoses of personality disorder when the real problem was PTSD. I don't know if the MMPI is one of the tests used by the VA to diagnose returning vets, but it might be worth looking into.

Master's level psychotherapist responding here - ten years of treating people with trauma issues.

There's a little more to the sobriety requirement than unthinking bureaucracy. Entering therapy and getting drunk are both ways of coping with PTSD symptoms. One is quicker, easier and more fun - at first. Clinical research has shown that if you have a client with a mental health issue and a substance abuse issue, therapy goes nowhere until the substance abuse stops. People aren't going to work through painful emotions if they're pushing them away with booze or drugs.

The approved course of treatment has been to get your "dually-diagnosed" client into substance-abuse treatment. Once they have enough sober time that they can face their issues with depression, anxiety, anger, trauma, etc., you get them into therapy. It's not clear from the post above whether the VA offers that approach to vets or not.

A new model coming out these days is the 'Integrated Dual-Diagnosis Team' approach, where clients receive intensive group therapy for substance abuse and mental health issues together.
Let's hope the VA offers this soon, if they aren't already.

... and Chuck, thank you for your service on and off the field. I hope you're getting all the help and support you can use.

Chuck, recommended reading:

Dr Jonathan Shay, 'Odysseus In America' & 'Achilles In Vietnam'.

They didn't institute the 12 & 20 policy just for the hell of it. People should go to jail for what they're doing to our Iraq & Afghan combat vets with these long & recurring tours. Then, screwing them out of every form of help that they possibly can upon return.