Army Announces Changes To How It Evaluates PTSD at Madigan Army Medical Center

(Editor's note: This is from the Department of Defense)

Gen. Lloyd Austin, Army vice chief of staff, announced today that the United States Army has changed how it reviews cases of  Soldiers in Madigan Army Medical Center's (MAMC) disability evaluation system who have been diagnosed with PTSD.

The change comes following an exhaustive review of the hospital's disability evaluation system directed by Secretary of the Army John McHugh and Gen. Ray Odierno, Army chief of staff, after it was learned that some Soldiers diagnosed with PTSD had that finding rejected during a subsequent evaluation at MAMC.

In April, 2012, Austin designated Lt. Gen. David Perkins, commander of the Combined Arms Center at Ft. Leavenworth, KS, to serve as director of the Army's Task Force on Behavioral Health.  In that capacity, Perkins conducted a review of behavioral health policies and procedures related to the disability evaluation system at Joint Base Lewis-McChord and Western Regional Medical Command.  Perkins consulted with senior leaders, MAMC health care providers, staff, physical evaluation board liaison officers and Soldiers going through the disability evaluation system, working to gain a better understanding of the forensic psychiatric methods - used by MAMC - in the integrated disability evaluation system and provided input to inform Gen. Austin's review.

"What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system," Austin said, noting that new policies and procedures are in place to review PTSD cases.  "We learned MAMC officials acted in accordance with the standard of practice for civilian disability evaluations.  But we also learned that while the evaluation may be fair and appropriate, it's simply not optimal for the unique cases that the Army diagnoses and reviews.  We've fixed that."

The MAMC developed the forensic psychiatry service to perform a variety of functions - including completing behavioral health evaluations on Soldiers in the disability evaluation system - to make the most accurate diagnosis possible.  The forensic psychiatry service conducted a thorough review of each case, applying a strict interpretation of the diagnostic criteria found in the Diagnostic and Statistical Manual (DSM-IV-TR), the accepted national standard.

The Army determined that, while forensic psychiatric methods are appropriate under certain circumstances, they do not work well in the disability evaluation system.  As a result of this determination, the Army discontinued its use as part of the disability evaluation system.

Austin acknowledged the role of U.S. Sen. Patty Murray in bringing problems with the evaluation process to the Army's attention.

"The fact that Senator Murray's constituents brought their concerns to her regarding our evaluation process provided the impetus to look at our entire system," Austin said.  "Our health care delivery will be better for it."

Army medical leaders are conducting a series of comprehensive reviews of behavioral health processes at all medical treatment facilities, including MAMC.

The Army has extended the review of behavioral health diagnoses and evaluation processes in the disability evaluation system by establishing the Army's Task Force on Behavioral Health.  The Task Force is developing a corrective action plan to ensure diagnosis and evaluation best practices are in place Army-wide.

Austin further announced that he has reinstated Col. Dallas Homas as commander of Madigan Army Medical Center (MAMC), after determining that Homas did not inappropriately influence Post Traumatic Stress Disorder (PTSD) diagnoses.  Homas had been temporarily removed as commander while the Army reviewed the hospital's handling of PTSD cases.

"The Army takes very seriously any allegation regarding the health care of our soldiers, and the leaders who provide it," Austin said.  "My review found that Col. Homas did not exert any undue influence over PTSD diagnoses, and that he acted appropriately enforcing standard medical guidelines.  He is, therefore, being returned to duty effective immediately."

Austin also expressed confidence in Homas's leadership of MAMC, as the Army implements new practices and processes to assess Soldiers in the disability evaluation system.

"Col. Homas began his tenure at MAMC at a critical juncture, as the hospital faced a massive deficit, declining numbers of patients served, and other organizational problems," he said.  "His leadership was important to improving MAMC and I am confident that he is the leader our medical community needs to implement these new systems and ensure world class care for our Soldiers and their families."