KRCC Western Skies
program for October 20, 2005, reveals that Ft. Carson is openly OPPOSED to mental health services offered to soldiers suffering PTSD that are not coordinated through the Army
The October 20 Western Skies (KRCC) program opens the door on the Ft. Carson Chief of Psychiatry, yet another player in the smear campaign against the organizers of the pro bono mental health services alliance,
Operation Just One. Here we get a glimpse of the source of Mayor Lionel Rivera's politicization of health care for soldiers.
Eric Whitney is getting into some good reporting here.
October 20, 2005SOLDIERS' MENTAL HEALTH - PART 1Eric Whitney talks to local Army officials about recent allegations that Fort Carson isn't providing sufficient mental health resources to soldiers returning from combat. [LISTEN] [TRANSCRIPT]SOLDIERS' MENTAL HEALTH - PART 2Continuing the discussion of mental health in the military, Eric Whitney talks to the psychiatric consultant to the Surgeon General of the Army. [LISTEN] [TRANSCRIPT]EXPANDED CONTENT--> You can read the New England Journal of Medicine article on post-combat mental health by clicking here.The basis of
Mayor Lionel Rivera's flip-flop in retracting his support for Operation Just One, becomes more apparent in light of recent comments by
Colonel Steven Knorr, Chief of Psychiatry at Ft. Carson's Evan's Hospital to Eric Whitney of KRCC's Western Skies news radio program for, in which Knorr states that he is opposed to such community outreach efforts, providing services to PTSD (post-traumatic stress disorder) survivors, unless they are coordinated by the Army. Of course, this is just another smokescreen. That's not the true reason for Col. Knorr's opposition.
Colonel Knorr first denies that Ft. Carson needs any community help in meeting the mental health care requirements of its soldiers:
COL. KNORR: I don't have commanders coming to me complaining that their soldiers aren't getting treatment, aren't getting seen. They're not complaining, I haven't had one complaint that...Well, I don't get basically any significant complaints that my soldier's not getting seen, or that the wait's too long, or things like that, that "you're not delivering mental health care here." So I'm not sure, just because people are getting press time, doesn't mean that their complaint is valid.(To Col. Knorr: Define significant. Look, you've only been there, what, one or two months?)
Steve Robinson, Director of the Army watchdog group,
National Gulf War Resource Center, which backs Operation Just One, disagrees:
STEVE ROBINSON: We identified problems at this base last year, about a year and a half ago actually. I came out here to talk with soldiers who had called me in Washington, DC, based on Congressional testimony that we gave that indicated that the Department of Defense was slow to provide mental health care to returning combat veterans. And, the numbers of the calls were so great that I actually flew out to Colorado and we went and talked to the soldiers, and they numbered in the hundreds.Colonel Steven Knorr's position also flies in the face of the prevailing view among those studying access to mental health care for post-traumatic stress disorder and related psychological problems in the Army.
Veterans with post-traumatic stress disorder are
waiting an average of 47 days to get into PTSD inpatient programs and up to a year at some outpatient facilities.On July 28, 2005, Army Surgeon General Lt. Gen. Kevin Kiley told a House Armed Services that
nearly 60 percent of soldiers returning from war are not fully aware of available treatment and counseling.A lack of access to mental health care for PTSD can lead to suicide. Former Army captain Michael John Pelkey was among the first soldiers to return from deployment in Iraq, in July 2003. His wife testified before the subcommittee that
her husband felt anxious and sought advice from military counselors, but dropped the issue after he was told several times it could take weeks or months to get an appointment. Eighteen months after his return his PTSD was identified by an outside expert. He shot himself a few days after the evaluation. Ft. Carson has seen five suicides among combat veterans of the Iraq war.
Although Western Skies' coverage in this program is focused on active Ft. Carson personnel, Operation Just One's services are provided also to veterans and families. A
GAO report revealed that the Veterans Administration has not met any of 24 recommendations related to clinical care and education made by the 1985 VA Special Committee on Post-Traumatic Stress Disorder, and that the VA does not plan to fully implement 23 of 24 recommendations until fiscal year 2007 or later. Six of seven VA medical facilities may not be able to meet an increase in demand for PTSD services.
Georg-Andreas (Andrew) Pogany, Director of Operation Just One, which is currently serving some soldier/veteran clients with free services in Colorado Springs, said in a
previous interview with Western Skies [
LISTEN] [
TRANSCRIPT]:
POGANY: We're not saying, and I have never said, that the Army is not providing services. The Army is providing services, but, soldiers are reluctant to access them. And again, that is not my information. That is data that is given out by the Department of Defense. Soldiers are reluctant, not everybody, a certain percentage, so this program is designed to give an avenue to the ones that are reluctant, because they fear stigma, they fear ridicule, they don't want their careers to be impacted by seeking treatment for mental health issues. And it's purely designed to aid the soldiers in their reintegration and return process when they come back. Ultimately what this will do is it will produce healthier soldiers. And ultimately what this means for the Army, or for Fort Carson if we want to talk about Fort Carson, is it will return healthy troops to the units. It's a force multiplier.Colorado Springs psychologist, Kaye Baron, works closely with soldiers from Ft. Carson and says that 60-70% of her clients are from the military. Baron, who is also a contract psychologist for a local government agency which evaluates military personnel for combat operational stress, said in an
article published by the American Psychological Association,
I've seen a lot of people walking around that have PTSD symptoms but who are dealing with it in other ways. They appear reluctant to get help through the military as a result of the stigma or mentality that says you have to suck it up.Steve Robinson also recently addressed
three suicides within the Tenth Special Forces Group attached to Ft. Carson, saying there appears to be
a problem in the unit -- namely a refusal to acknowledge stress and seek help.Robinson's group is affiliated with Operation Just One, which is currently serving some soldier/veteran clients with free services in Colorado Springs.
This all goes to the opening comment by Col. Steven Knorr in which he says he has no significant reports from base commanders of soldiers not getting treatment, or not getting it fast enough. He is certainly not going to hear about the soldiers that are not getting into the system because they are not aware of the help available, they are not being properly screened, or because they are staying away from the Army docs in droves.Not only is Ft. Carson's Col. Steven Knorr not supporting the initiative by over 50 Colorado Springs mental health care providers, but he says he is openly opposed to soldiers utilizing the program. While some soldiers have concerns about the stigma of seeking help for mental health conditions among peers and supervisors,
Col. Knorr told Western Skies that he has concerns about them getting that care through Operation Just One.KNORR: If a provider who is not connected with the military, not connected with the network, starts engaging in treatment, they might not know what's going on from the unit perspective, they might not be engaging with other health care providers, like a family practitioner. The majority of soldiers in deployable units have medical officers assigned to them, physicians or physicians assistants that know the soldiers, that are responsible for their medical care, not necessary personally know them, but they're responsible for the medical care. We can coordinate, we do coordinate with those other health care providers. We get information from the unit, from the soldiers' chain about how they're performing and what their issues are. I'd be worried that providers seeing somebody, in this program that's being touted, it might not work with the Army, they might not work with providers here at Evans, and that could be detrimental to the soldiers' health care, to the Army mission. They're only going to see a slice of the thing.Mayor Lionel Rivera has also taken the position that groups should not operate outside of the system. From the
Western Skies October 4 program:
WHITNEY: Mayor Rivera says he, and Colorado Springs, have always backed community-based efforts to help local soldiers. He says if health care providers in the area want to provide soldiers services for free, their efforts might be better organized through a formal relationship with a specific military installation. He mentioned a similar effort being organized by the Colorado Psychological Association with Buckley Air Force Base in Denver.Well, great! Is Col. Knorr ready to coordinate with Operation Just One? Of course not.
What Col Knorr failed to mention is that he has rebuffed attempts by Pogany and Robinson to do just that, work with Ft. Carson command.Again from the
October 4 Western Skies program:
POGANY: For two weeks I placed calls into them and I got no answers. Then the final phone call that I made to them, I got the answer that they're not interested in what it is that we're doing.This is the issue that is still not being consistently nor truthfully addressed by Col. Knorr, Ft. Carson command, or Mayor Lionel Rivera. Ft. Carson opposes participation in programs not coordinated by the base, but they refuse to meet with Pogany, or to even look at the Operation Just One program.
Col. Steven Knorr's remarks are perhaps the most outrageous and careless that have been made surrounding this issue. As Mayor Lionel Rivera has done with
his accusations that Andrew Pogany is anti-Army, Col. Knorr is now discouraging participation by Ft. Carson personnel and community veterans in the free mental health services being offered by generous caregivers in Colorado Springs for those suffering combat operational stress and PTSD. Both officials are in positions of influence over a military population, some of which are already scared to get help within the system. Col. Steven Knorr and Mayor Lionel Rivera are labeling this program as something they do not want to see the military community associating with. Soldiers who have to answer to Ft. Carson command, and veterans who may still be called back into active service, are being advised to stay away from groups that don't have affiliation with Ft. Carson. Knowing what we do about the foot soldier and military authority, do we have to guess what chilling effect their remarks will have on those who may be considering asking Operation Just One for help? It is shameful that this should come from the chief of psychiatry, who should be embracing rather than discouraging these community outreach efforts. The hippocratic oath, remember, Dr. Knorr? How disappointing that you have allowed your political function to impede the care of the soldiers in your charge.
The root of the deceitful, lying, evasive cover up by Mayor Lionel Rivera and Ft. Carson is their contempt for the watchdog group, National Gulf War Resource Center which steadfastly advocates for soldiers welfare, and Operation Just One, which is organized to mop up behind the Army, where it is failing to provide for the soldier. Ft. Carson brass also has a personal prejudice toward Andrew Pogany, who was a difficult PTSD case for them for almost two years. They do not want to have anything to do with him. They do not want to let us look at the weaknesses in their provision of mental health care. They do not approve of soldiers seeking care outside of the Army system, and soldiers and their families are suffering and dying from it, right here in Colorado Springs.
Yesterday, I spoke with a Colorado Springs massage therapist who is providing service for a Ft. Carson veteran of the war on Iraq who appears to suffer from PTSD. He clearly is struggling under the weight of unreleased traumatic memory related to combat. One specific incident will illuminate the severity of this man's trauma, that of shooting an 11-year-old Iraqi boy in the head. Col. Steven Knorr does not know this soldier. He was not in the Ft. Carson mental health system. He is not in the VA system. The massage therapist is working to get him a psych eval through Operation Just One. Other vet friends are hoping he will begin to attend
Vets4Vets meetings. It is the attitude of Col. Knorr and Mayor Rivera regarding participation by vets and soldiers in groups operating outside of the Army's system that is
detrimental to these soldiers.
It's the stigma, stupid.
Eight Unanswered Questions:
1. Why has Col. Steven Knorr refused to meet with Andrew Pogany and to consider working with the Operation Just One program?
2. Would Col. Steven Knorr be open to coordinating with the pro bono
group organized by the Colorado Psychological Association coordinated with Buckley, or would he rebuff it as he has Operation Just One?
3. If he would support the CPA group, is it because that group does not discuss the role afforded it, in working outside of the system, of attracting and assisting soldiers and vets afraid to go to the Army docs (i.e., because its is not being in any way critical of the current inability of the Army to adequately address combat operational stress and PTSD)?
4. Is Col. Knorr concerned that treatments being currently provided by counselors, therapists, social workers and physical therapists to clients attached to Ft. Carson, independent of the Army's doctors, are
detrimental to the soldiers' health care, to the Army mission?
5. Would Col. Knorr's department refuse to cooperate with individual mental health professionals who may contact him regarding their military clients?
6. Would his answer be different if the health professional is associated with Operation Just One?
7. Has Mayor Rivera had conversations or correspondence with Col. Knorr or Ft. Carson command regarding Operation Just One and Andrew Pogany (do Col. Knorr's lips move when Mayor Rivera is speaking)?
8. There is a growing acknowledgement at very high levels on authority of the Army's current inadequacies in meeting the mental health care needs of the soldiers and families.
Discussions in Congress are ratcheting up, as is research by the DoD and the VA. What will it take for Col. Knorr and Mayor Rivera to acknowledge the need locally and get on the right side of this issue? Will they follow the lead of Buckely brass, or will they wait until they are given the order from Washington? The health of our military community and our city is in the balance?
--Dave
Postscript:
Perhaps there is hope that the barriers to community-based pro bono mental health treatment for PTSD survivors at Ft. Carson will come down soon. In
Part 2 of the October 20 Western Skies program, Eric Whitney asks Colonel Elspeth Cameron Ritchie, the psychiatric consultant to the Army Surgeon General, if she thinks local efforts to organize civilian mental health providers into offering free mental health care for soldiers and their families are helpful:
COL. RITCHIE: I think that across the country people want to take care of our soldiers, and we really appreciate that. And we are doing, as I said, the best we can, but we also appreciate it when other people come in and have some ideas and have some thoughts. And we are happy to listen and learn from our civilian colleagues, in addition we want to teach our civilian colleagues what we're doing ourselves. A lot of people think about PTSD, post traumatic stress disorder in the context of Viet Nam as a chronic disorder, and of course now what we're seeing is people just returning from war, having been over in a nasty environment for a prolonged period of time, so I think what it is and what you're getting at here is it's not just an Army medical department issue, it's really a national issue of what is the best way to take care of soldiers, veterans and their families. WHITNEY: Colonel Ritchie, thanks for joining us.COL. RITCHIE: Thank you. Thank you, Eric Whitney, for bringing Colonel Ritchie, and a sensible perspective from the Army, into the discussion.
