Diagnostic quandaries and PTSD

In what follows, Elspeth Cameron Ritchie discusses PTSD with a degree of nuance not always seen in mainstream journalism. Ritchie notes her ambivalence over the frequency with which the diagnosis is assigned to milirary personnel, inasmuch as other disorders can go untreated as a consequence. As she writes, “This is the last in my series of posts on the ethics of treating posttraumatic stress disorder (PTSD) (the first simply outlined ethical issues for military mental-health personnel; then I wrote about the right time to send a service member back into combat; how to maintain confidentiality between a service member and the mental-health professional; and why the military’s best mental-health programs are not available to everyone in uniform).

“Now I want to discuss the good and bad consequences of automatically giving a 50% disability rating for PTSD.I hesitate to post on this, as I know that there will be folks out there who say I am ‘trying to save the Army money by screwing the vets out of what rightfully belongs to them.’”

“Know that this is not my intention: I am all for vets receiving the disability that is due them. But to automatically give 50% disability for one particular diagnosis creates a major incentive to get that diagnosis — and keep it.

I repeat: the issue for me, and many of my colleagues, is not whether the veterans deserve disability after an unrelenting 11 years of war. It is whether one diagnosis — PTSD — deserves more than schizophrenia, or bipolar disorder, or depression. And whether that automatic disability does more harm than good by discouraging patients from getting better.

This is not a new issue. Questions of fairness regarding veterans’ disability were a major issue in World War I, both in the U.K. and the U.S. And disability compensation has continued to be an issue in every war since then, especially following Vietnam.

Read more in “The Unintended Consequences of the Current PTSD Diagnosis.”

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