[Congressional Record (Bound Edition), Volume 152 (2006), Part 5]
[House]
[Pages 6931-6932]
[From the U.S. Government Publishing Office, www.gpo.gov]




             MENTAL HEALTH SERVICES FOR RETURNING VETERANS

  (Mr. MICHAUD asked and was given permission to address the House for 
1 minute.)
  Mr. MICHAUD. Mr. Speaker, the Department of Veterans Affairs has 
underestimated the need for mental health services for returning 
veterans.
  The Kansas City Star recently reported that the number of troops back 
this year from Iraq and Afghanistan who will seek care far post-
traumatic stress disorder from the VA will be five times higher than 
the VA projected.
  Earlier this year the VA reported that it anticipated 2,900 new PTSD 
cases from returning veterans for fiscal year 2006. But in just 3 
months, in fiscal year 2006, VA had already seen 4,700 new cases of 
possible PTSD.
  I am very concerned that the VA will not have the staff and programs 
to help the new combat veterans and to meet the need of veterans from 
past wars. VA may be forced to ration care. This is wrong. This issue 
needs to be addressed.
  Mr. Speaker, I ask that the article of David Goldstein from the April 
30 issue of the Kansas City Star be inserted in the Record.

              [From the Kansas City Star, April 30, 2006]

     Number of Troops Needing Help Threatens to Overwhelm Veterans 
                             Administration

                          (By David Goldstein)

       Washington.--The number of troops back this year from Iraq 
     and Afghanistan with post-traumatic stress disorder could be 
     five times higher than the Department of Veterans Affairs 
     predicted.
       Instead of 2,900 new cases that it reported in February to 
     a veterans advocate in Congress, the increase could be 15,000 
     or more, according to the VA.
       At the Kansas City VA Medical Center, only nine vets from 
     current combat were diagnosed with PTSD in 2004.
       Last year, it was 58. In just the first three months of 
     fiscal 2006, the hospital saw 72.
       ``It's absolutely incredible,'' said Kathy Lee, at the 
     Missouri Veterans of Foreign Wars.
       A former Army nurse in Vietnam who works at the hospital, 
     Lee said, ``Every single Iraq vet who comes in, I give them a 
     list and say, `How many of these (PTSD) symptoms do you 
     have?' It's almost nine out of 10.''
       A top VA mental health official said it was difficult to 
     predict the number of new PTSD cases because of unknown 
     factors like the troop discharge rate and how many veterans 
     will use the VA.

[[Page 6932]]

       But Laurent Lehmann, associate chief consultant for mental 
     health, disaster, post-deployment and post-traumatic stress 
     disorder, acknowledged that 2,900 new cases ``would be an 
     underestimate.'' He said the VA hoped recent increases in 
     funds and new programs ``would catch'' unanticipated cases.
       ``Are we ahead of the curve?'' Lehmann said. ``That's the 
     question I don't think I can answer except to say we're going 
     to be monitoring our heads off on this.''
       John Baugh, who attends a PTSD support group at the Kansas 
     City VA Medical Center, said many soldiers still in combat 
     zones are suffering from the disorder.
       ``They think that the numbers are high right now,'' said 
     Baugh, 31, a former driver for an Army construction battalion 
     in Iraq. ``Wait until those guys get out and try to start 
     functioning in the civilian world. There's going to be hell 
     to pay.''
       The miscalculation on PTSD echoes last year's 
     underestimation by the Bush administration of how many Iraq 
     and Afghanistan veterans would need medical treatment. It had 
     underfunded VA health care by $1 billion, despite assurances 
     to Congress that the department had enough money.
       Congress subsequently added $1.5 billion to the VA's 
     budget, but money problems still loom.
       ``They're going to be short and they're going to be playing 
     catch-up,'' Cathy Wiblemo, deputy director for health care at 
     the American Legion, said of the VA's PTSD treatment. 
     ``They're not going to have the money, and the waiting list 
     will grow.''
       PTSD is an anxiety disorder that can follow combat or other 
     traumatic experiences. Symptoms include survivor's guilt, 
     flashbacks, nightmares, depression and irritability. It can 
     lead to drug abuse and even suicide.
       The war in Iraq presents a higher PTSD risk than other 
     wars, said Robert Ursano of the Department of Psychiatry at 
     the Uniformed Services University of the Health Sciences.
       ``Since it's a terrorist war, one could be under attack in 
     any spot,'' he said. ``There is an enduring sense of a lack 
     of safety.''
       Among the half million veterans who have served in Iraq or 
     Afghanistan, more than 144,000 have gone to the VA for health 
     care. Nearly a third have been diagnosed with mental 
     disorders, with nearly half of those PTSD, according to the 
     VA.
       The White House asked for $80.6 billion in 2007 for the VA, 
     including $3.2 billion for mental health programs. But Rep. 
     Michael Michaud, a Maine Democrat on the House Committee on 
     Veterans Affairs, said the VA would need more, sooner.
       ``What's going to happen is unless we give added resources, 
     they're going to have to start rationing care,'' Michaud 
     said. ``It's going to have to start pitting veterans against 
     veterans.''
       Jeff Schrade, a spokesman for Sen. Larry Craig, an Idaho 
     Republican and chairman of the Senate Veterans Affairs 
     Committee, said Craig was unhappy over the VA's botched 
     estimates on health care last year.
       Congress now requires quarterly budget reports, which 
     Schrade said show that VA's budgeting appears to be on track.
       ``What concerns us is they're seeing a lot more patients 
     than they anticipated,'' he said.
       The VA's contradictory estimates on PTSD surfaced in 
     February. Prior to a Capitol Hill budget hearing, the agency 
     replied to written questions from Rep. Lane Evans of 
     Illinois, ranking Democrat on the House VA panel.
       Asked about the need for mental health services, the VA 
     told Evans that it expected to see 2,900 new cases in fiscal 
     2006, which began Oct. 1 and ends Sept. 30.
       A week later, the agency issued its latest quarterly report 
     on use of the VA by Iraq and Afghanistan veterans.
       The numbers indicated it had diagnosed 4,711 possible cases 
     just from October through December--more in the first three 
     months than it told Evans to expect over the entire fiscal 
     year.
       VA spokesman Jim Benson said the estimate of 2,900 cases 
     was based on earlier data. The latest quarterly numbers were 
     still in the draft stage at the time of the hearing, he said, 
     and VA officials stuck with the earlier data because trying 
     to explain ``would be more challenging and perhaps more 
     confusing.''
       ``The reason they felt it was OK to do that was that, 
     although the numbers are increasing'' due to more troops 
     being discharged and seeking help, Benson said, ``the rate of 
     PTSD is staying relatively constant.''
       But critics said that even if the annual PTSD rate was 
     constant, the number of cases was rising nonetheless.
       ``They continue to downplay the severity and the real size 
     of the problem,'' said Paul Rieckhoff, executive director of 
     the Iraq and Afghanistan Veterans of America and a platoon 
     leader during the war.
       VA officials also had at the time of the February budget 
     hearing a report from the department's Special Committee on 
     Post-Traumatic Stress Disorder. It warned that the VA was 
     unable handle services to new combat veterans as well as 
     survivors of past wars, saying: ``We can't do both jobs at 
     once within current resources.''
       Most of the PTSD cases the VA sees involve veterans from 
     earlier conflicts, primarily Vietnam.
       Baugh of Kansas City won't talk much about his Iraq 
     deployment because it triggers bad memories. But when he 
     returned home in 2004, he couldn't escape them.
       ``I was jumpy, angry, irritated, sleeping one, two hours a 
     night,'' Baugh said. ``I was totally worn out. I'd drink and 
     drink and drink just to shut the memories down and the 
     nightmares. ``
       His wife pushed him to get help. Baugh said he'll ``jump 
     through the ceiling'' if she drops a frying pan. The 
     clattering of kids skateboarding down his street sounds just 
     like ``gunfire in the distance: kack-kack-kack-kack.''
       Joshua Lansdale knows about nightmares and noises, too. A 
     23-year-old veteran from Kansas City, North, he spent 11 
     months in the Sunni Triangle as a firefighter and emergency 
     medical technician with the Army Reserve's 487th Engineer 
     Detachment.
       ``It was a pretty hot zone,'' he said. ``We took a lot of 
     mortar fire, IEDs, car bombs, saw a lot of helicopter crashes 
     and worked the UN embassy bombing. I dragged a lot of people 
     out of burning buildings, cars, motorcycle wrecks and 
     explosions.''
       Back home, Lansdale was diagnosed with PTSD and joined a 
     support group at the VA hospital. He predicted that returning 
     troops would overrun the VA.
       ``A third of all soldiers are seeking help,'' he said. ``Do 
     we have the capability of treating all those soldiers? I 
     don't think we do.''

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