[Congressional Record Volume 158, Number 96 (Monday, June 25, 2012)]
[Senate]
[Pages S4461-S4463]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. MURRAY:
  S. 3340. A bill to improve and enhance the programs and activities of 
the Department of Defense and the Department of Veterans Affairs 
regarding suicide prevention and resilience and behavioral health 
disorders for members of the Armed Forces and veterans, and for other 
purposes; to the Committee on Veterans' Affairs.
  Mrs. MURRAY. Madam President, last February, in my office in Seattle, 
I sat down with an Iraq and Afghanistan war veteran named Stephen Davis 
and his wife Kim. Stephen and Kim were there to talk to me about their 
experiences since he returned home and about the invisible wounds of 
war they were struggling with together every single day.
  At the meeting Kim did most of the talking. She told me about the 
nightmares. She told me about the lack of sleep. She talked about the 
confusion and the anxiety that was now a constant in their lives. But 
it was the way she summed up her experience since Stephen returned home 
that struck me hardest.
  She said her husband still hadn't returned home. She said the husband 
she had been married to for nearly two decades--although he was sitting 
directly next to her--was still not back from the war.
  Do you know what. Despite the fact that we often refer to these 
wounds as invisible, you could see it. When it came time for Stephen to 
describe to me his experiences, he shook as he explained how difficult 
the transition

[[Page S4462]]

home has been for him, his wife, and for their family.
  The Davis family's story is no different than what thousands of other 
families have faced. But their story does have a tragic and frustrating 
twist. You see, Sergeant Davis knew when he returned home that he had a 
problem with post-traumatic stress, and he was courageous enough to 
reach out for help. He sought care and he was diagnosed with PTSD.
  But just a few months later, after a visit to Madigan Army Medical 
Base in my State of Washington, he was told something that shocked and 
appalled him and his wife. After just a 10-minute meeting and a written 
questionnaire, Sergeant Davis was told he was exaggerating his symptoms 
and he didn't have PTSD. He was told, in effect, that despite serving 
in two war zones, despite being involved in three separate IED 
incidents, and despite his repeated deployments, he was making it all 
up.
  He was then sent home with a diagnosis of adjustment disorder and 
told his disability rating would be lowered and that the benefits he 
and his family would receive would ultimately be diminished. If this 
sounds like an isolated, shocking incident, here is something you will 
find even more shocking. Sergeant Davis was one of literally hundreds 
of patients at that Army hospital who were told the exact same thing.
  Soldiers who had been diagnosed with PTSD--not just once but several 
times--had their diagnosis taken away. In many instances these soldiers 
were told they were embellishing or even outright lying about their 
symptoms. In fact, so many soldiers were being accused of making up 
symptoms by doctors at that hospital I began to get letters and phone 
calls from them to my office.
  Soon after that, documents came to light showing that the doctors 
diagnosing these soldiers were being encouraged to consider not just 
the best diagnosis for their patients but also the cost of care. These 
revelations have led to a series of internal investigations that are 
still underway today. Even more important, they have led to these 
soldiers now, thankfully, being reevaluated, and today hundreds of 
these soldiers, including Sergeant Davis, have had their proper PTSD 
diagnosis restored.
  This, too, could be viewed as an isolated incident. In fact, when I 
first raised concerns, the problems we saw at Madigan could be 
happening at other bases across the country, that is exactly what I was 
told--it was an isolated incident at one base, at one hospital. But I 
knew better.
  I remembered back to this Salon article that ran a few years ago. In 
that article, a doctor from Fort Carson in Colorado talked about how he 
was ``under a lot of pressure to not diagnose PTSD.''
  It went on to quote a former Army psychologist named David Rudd, who 
said:

       Each diagnosis is an acknowledgement that psychiatric 
     casualties are a huge price tag of this war. It is easiest to 
     dismiss these casualties because you can't see the wounds. If 
     they change the diagnosis, they can dismiss you at a 
     substantially decreased rate.

  Madam President, I also had my own staff launch an investigation into 
how the military and the VA were diagnosing mental health conditions at 
other bases across our country, and I was very troubled by what I 
found.
  It became clear that there were other cases where doctors accused 
soldiers of exaggerating symptoms without any documentation of 
appropriate interview techniques. They encountered inadequate VA 
medical examinations, especially in relation to traumatic brain injury. 
They found that many VA rating decisions contained errors, which in 
some cases complicated the level of benefits that veterans should have 
received.
  Now, to their credit, the Army did not run and hide as the questions 
about other bases continued to mount. In fact, they have now taken two 
important steps. First, in April, they issued a new policy for 
diagnosing PTSD that criticized the methods being used at Madigan and 
pointed out to health officials throughout the entire system that it 
was unlikely that soldiers were faking these symptoms. Then, in May, 
the Army went further and announced they would review all mental health 
diagnoses across the country dating back to 2001. That, in turn, has 
led Secretary Panetta to announce just last week that all branches of 
the military are now going to undergo a similar review.
  Without question, these are historic steps in our efforts to right a 
decade of inconsistencies in how the invisible wounds of war have been 
evaluated. Servicemembers, veterans, and their families should never 
have to wade through an unending bureaucratic process. Because of this 
outcry from veterans and servicemembers alike, the Pentagon now has an 
extraordinary opportunity to go back and correct the mistakes of the 
past.
  We have to make sure these mistakes are never repeated. We still need 
to fundamentally change a system that Secretary Panetta admitted to me 
last week has ``huge gaps'' in it.
  That is why I am here this evening. Today, I am introducing the 
Mental Health ACCESS Act of 2012. It is a bill that seeks to make 
improvements to make sure that those who have served have access to 
consistent, quality behavioral health care.
  It is a bill that strengthens oversight of military mental health 
care and improves the integrated disability evaluation system on which 
we rely. As anyone who understands these issues knows well, this is not 
an easy task. The mental health care, suicide prevention, and 
counseling programs we provide our servicemembers are spread throughout 
this entire Department of Defense and the VA. Too often they are 
entangled in a web of bureaucracy and, frankly, too often this makes 
them difficult to address in legislation.
  In crafting this bill I identified critical changes that need to be 
made at both the Department of Defense and the VA, and I set up a 
checklist of legislative changes needed to do just that. Some 
provisions in the bill will likely be addressed in my Veterans 
Committee. Others will need to be addressed through Defense bills and 
work with the chairs of those committees. But all of these provisions 
are critical, and today I want to share with you some of the most 
important ones.
  High atop the list of changes this bill makes is addressing military 
suicides which, as we all know, is an epidemic that now outpaces combat 
deaths in this country. My bill will require the Pentagon to create 
comprehensive standardized suicide prevention programs. It would also 
require the Department to better oversee mental health services for 
servicemembers.
  It will expand eligibility for a variety of VA mental health services 
to family members so we can help families and spouses to cope with the 
stress of deployment and strengthen the support network that is 
critical to servicemembers who are returning from deployment.

  Third, my bill will improve training and education for our health 
care providers. Oftentimes our servicemembers seek out help from 
chaplains, medics, or others who may be unprepared to offer counseling. 
This bill will help prepare them through continuing education programs.
  Fourth, my bill will create more peer-to-peer counseling 
opportunities. It would do it by requiring VA to offer peer support 
services at all medical centers and by supporting opportunities to 
train vets to provide peer services.
  Finally, this bill will require VA to establish accurate and reliable 
measures for mental health services. This will help ensure that the VA 
understands the problems they face so that veterans can get into the 
care we know they can provide.
  All of these are critical steps at a pivotal time, because the truth 
is, right now the Department of Defense and the VA are losing the 
battle against the mental and behavioral wounds of these wars.
  To see that, you don't need to look any farther than the tragic fact 
that already this year over 150 active-duty servicemembers have taken 
their own lives or the fact that one veteran commits suicide in this 
country every 80 minutes. And while we all know there are a number of 
factors that contribute to suicide--repeated deployments, lack of 
employment security, isolation in their communities, and difficulty 
transitioning back to their families--not having access to quality and 
timely mental health care is vital.

[[Page S4463]]

  When our veterans cannot get the care they need, they often self-
medicate. When they wait endlessly for a proper diagnosis, they lose 
hope. Last year at this time, I held a hearing in my veterans committee 
on the mental health disability system this bill seeks to strengthen, 
and I heard two stories that illustrate that despair.
  Andrea Sawyer, the wife of Army SGT Lloyd Sawyer, testified about her 
husband, who is an Iraq veteran and spent years searching for care. 
Together, they hit barriers and they hit redtape so often that at one 
point, she said, he held a knife to his throat in front of both her and 
an Army psychiatrist before being talked out of it.
  Later, in that very same hearing, Daniel Williams, an Iraq combat 
veteran, testified about how his struggle to find care led him to stick 
the gun in his mouth while his wife begged him to stop, only to see his 
gun misfire.
  Those are the stories that define this problem. These are men and 
women we must be there for. They have served and sacrificed and done 
everything this country has asked of them. They have left their 
families, left their homes. They have served multiple times and 
protected our Nation's interests at home and abroad. This bill will 
make a difference for them, but we have to make these changes now.
  Today I am asking Members of the Senate from both sides of the aisle 
to please join me in this effort. We owe our veterans a medical 
evaluation system that treats them fairly, that gives them the proper 
diagnosis, and that provides access to the mental health care they have 
earned and they deserve. We need to join together to get this 
legislation passed, and I ask every Member of the Senate to help me get 
this through. It is critical, as thousands of men and women come home 
today and thousands of them are waiting on care.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN of Ohio. Madam President, let me begin by thanking the 
chair of the Senate veterans committee for her incredible leadership on 
one of the most tragic issues of our times--the suicide rate among 
active-duty personnel in our Armed Forces, and especially among 
veterans.
  Last week I spoke to the Disabled American Veterans in Columbus. I 
hear these same issues all the time, particularly among men and women 
who are sent for their second, third, fourth, and fifth deployments. 
One veteran, active in the DAV, told me about an Ohio soldier who has 
had a seventh deployment. That is not what we should be doing, and so I 
appreciate Senator Murray's leadership.
  I am a member of that committee--the first Ohioan to ever serve on 
the veterans committee for a full term--and I am on this committee 
because of these problems. So I am thankful for the leadership we have 
on that committee and for what Senator Murray has done.
  I remember when I was presiding some years ago, and she was talking 
on the Senate Floor about her dad, who is a veteran, and I know that is 
a big part of why she does what she does.
  I thank the Senator from Washington State.

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