Coming In From The Cold
Twenty five years ago, Dec 26, 1992 to be exact I left Canada to “Enforce Famine Relief” in Somalia, life would never be “normal” again. Twenty years ago Dec 27, 1997 to be exact I was medically released from the military with injuries that today remain unhealed. What followed my release, I initially described as gross incompetence. I often related it to a lack of knowledge and expertise on the part of the “experts” in the medical health field. PTSD was a new problem for Canada and we were ill prepared to handle it. Today Twenty five years later, not much has changed by way of medical treatment for the malady of veterans. A presentation from a study done at McMaster University Department of Psychiatry and Behavioural Neurosciences on PTSD was done back in 2010. Shifting through all the data and presentation’s information a few very glaring facts started becoming clear.
According to this study (which is a peer reviewed and fact based study) 50% of all PTSD studied is chronic, of that 50% effective reduction of symptoms only occurs in 11-36% of those studied, a combination of prescription medication and therapies producing the higher percentage numbers of improvement amongst those studied. Also noted is that of this 11-36%, 50% of them are non compliant with taking prescription medication and or therapies within 2-3 years due to drug interactions and side effects. That leaves roughly 15-18% finding any significant relief from medical treatment of PTSD long term. Or more simply put 82-85% of PTSD sufferers are found to not have any significant reduction of symptoms for any significant length of time through medical treatment. Not very encouraging is it. Imagine my shock when at the end of the presentation it was suggest that the most productive solution offered was to find better measures to keep patients in therapy and on their medications longer.
Back in the summer of 1998, I sat down with the Surgeon General of Canada along with Psychiatrist Dr Robert Oxlade, my roll was as a patient advocate. I had had severe reactions to improper medication which cost me my family and career. Dr Oxlade wanted a longer in-patient program to properly evaluate PTSD without medicating the patient prior to treatment for evaluation. He rightly felt that medicating at the family practitioners level before clinical diagnosis was problematic because once medicated the initial symptoms had been altered and any diagnosis is based on a medicated and altered state of mind. He also felt that SSRI anti depressants were contra indicated for PTSD (one of these is what I reacted to). In addition to this he was responsible for introducing me to the now hot topic of Mefloquin Toxicity and how it mimics PTSD (another story). Following our presentation we were thanked and left with the clear impression that the Surgeon General at the time (who had just receive 3 million in funding for an outpatient treatment program) felt that the military then was on the right track for PTSD treatment. Fast forward almost 20 years and little has changed.
Remember that study from 2010, 2 years ago the Veterans House team did a presentation to the current Surgeon General and his staff on our concept for peer supported healing. For the record this presentation went a lot different than the first and we were well received. We left challenging each other on our assumptions and with a mutual respect for what we were trying to accomplish. The Surgeon Generals comment forced us to rewrite our entire business plan and for the better. We learnt a lot from this encounter. Likewise we were able to challenge the Surgeon General and his staff on the medical community’s failure to address the physical trauma occurring in the brain due to Cortisol release from PTSD. Today’s treatment protocols treat only the symptoms of PTSD not the physical trauma to the brain, despite the medical community’s acknowledgment of the physical trauma to the brain.
Another admission from this meeting was the stark realization that medical practitioners see the McMaster study as problematic. Everyone at the table at the second meeting was in full knowledge of the study and although none would call the study flawed, they did refer to it as problematic. In fact it is problematic, as it shows rather clearly that practitioners who have invested hundreds and thousands of dollars into treatment modalities are so invested in the modality itself, that they fail to recognize that it does not serve the best interest of their PTSD client and rather than admitting that and seeking a better solution, they conclude that better efforts be made to keep patients in a treatment protocol that is relatively ineffective. This is often justified by the position that any reduction in the symptoms of PTSD is improvement.
Veterans House is looking to provide insight on this very problem by researching and providing direct feed back to practitioners in real time with our partners. Not on the medical treatment, or ignoring its value either, but rather on peer supported healing. Every trauma victim must at sometime rehabilitate from their trauma or remain crippled and PTSD has as much physical basis of injury as any other trauma. A stroke victim must re-learn how to walk, talk and communicate effectively. A hockey player with a concussion is often back on the ice scoring goals at the top of their game within 6 months to a year. Isn’t it time we taught PTSD trauma victims how to retrain and relearn the skills they possessed prior to the physical trauma injury of PTSD in a safe environment that isn’t a lock up or mental health ward that has a proven history of up to 85% inefficiency at promoting recovery?