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Army to stop using forensic psychiatrists to evaluate soldiers diagnosed with PTSD

By Hal Bernton, The Seattle Times –

SEATTLE—The Army will no longer use forensic psychiatrists to evaluate soldiers diagnosed with post-traumatic stress disorder who are under consideration for medical retirement, a change resulting from an investigation of a screening team at Madigan Army Medical Center.

“ What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system,” said Gen. Lloyd Austin, the Army’s vice chief of staff in a statement released Tuesday announcing the decision. “We learned MAMC (Madigan) 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.”

Madigan leaders launched the forensic team back in 2007, and once touted their work, involving patient interviews and a series of tests, as an example of “best practices” that could be a model for other Army medical centers.

The Madigan forensic team ended up overturning the PTSD diagnoses of more than 300 service members who likely would have qualified for pension and other benefits of medical retirement.

Their work triggered complaints from patients, some who were tagged by the team as possible malingerers. Their work also drew scrutiny from an Army Medical Command ombudsman and Sen. Patty Murray, the Washington Democrat who chairs the Senate Committee on Veterans’ Affairs.

“I’m pleased the Army has put an end to the use of forensic psychiatry and the practices that were at the core of the misdiagnosis of hundreds of soldiers,” Murray said in a statement released Tuesday. ‘” … I also hope that it encourages more service members to come forward and seek help, knowing they won’t be treated unfairly or accused of lying about their symptoms

In February, the Army Surgeon General, Lt. Gen. Patricia Horoho, announced an investigation of Madigan’s mental health screening, suspending the forensic team from its evaluation duties and putting together a new group to re-evaluate the claims of patients whose PTSD evaluations had been overturned.

The progress of the Madigan re-evaluations was not disclosed in the statement released Tuesday by the Army.

A source with knowledge of that review said the Army has completed 229 revaluations of patients screened by the forensic team, and more than 50 percent of those patients ended up receiving PTSD diagnoses.

The investigation also sparked intense controversy within Madigan, a major Army medical facility that provides care for service members, their families and retirees.

Back in February, Col. Dallas Homas, the medical center’s commander, was removed while the investigation was conducted, and that angered many of his supporters within Madigan and the broader Army who viewed him as a forceful leader who could tackle tough problems.

At the time of his removal, Homas told The Seattle Times that “I don’t feel that I or my team have done anything wrong.”

Investigators found that Homas did not exert any undue influence on Madigan doctors involved in the PTSD screening, and he has been reinstated as commander.

“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… “

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