Mental Health Parity

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Dana Priest and Anne Hull continue their look at the holes in the Walter Reed safety net, this time focusing on the hospital’s almost comically inept treatment of post-traumatic stress disorder. The harrowing story is told through the experiences of Pfc. Joshua Calloway:

Wearing a rock band T-shirt, Calloway looked like any other 20-year-old on the sidewalk, but an unspeakable compulsion tore through him. He said he wanted to hatchet someone in the back of the neck.

“I want to see people that I hate die,” he said. “I want to blow their heads off. I wish I didn’t, but I do.” He made similar statements to his psychiatry team at Walter Reed.

Violence seeped into his life in a thousand ways. When he cut himself shaving, the iron smell of blood on his fingertips gave a slight euphoria. But it was the distinct horror of his sergeant’s death that was encoded in his brain. The memory made him physically sick. He would sweat and shake as if having a seizure, and sometimes he felt as if he were back in the heat and sand of Iraq.

The recognized treatment for PTSD is cognitive behavioral therapy, in which patients are encouraged to face their feared memories or situations and to change their negative perceptions. A key technique is known as prolonged exposure therapy. It involves revisiting a traumatic memory in order to process it. The idea is not to erase the memory but to prevent it from being disabling. Highly structured, one-on-one sessions over a limited time period have proved most effective, according to Edna B. Foa, a professor of psychology in psychiatry at the University of Pennsylvania, who has been contracted by the Department of Veterans Affairs to train 250 therapists who treat PTSD.

But Calloway and a dozen other soldiers from Iraq and Afghanistan interviewed by The Post described a vague regimen at Walter Reed’s outpatient psychiatric unit, Ward 53. They get a heavy dose of group sessions such as “Reflecting with Music,” “Decisions,” “Feelings Exploration” and “Art Expressions.” Calloway reported to his “Reel Reflections” class one morning for a screening of “The Devil Wears Prada.”

Surreally cruel, no? “One Flew Over the Cuckoo’s Nest” meets “Dr. Caligari”

For a more expansive view of the train wreck that is the military mental health care system (“system”), check out this heart wrenching series by the Hartford Courant.