Rowan and Berger Op-Ed Piece on VA Home-based Care System

Use of VA Mental Health Services by Vietnam Vets On The Rise

A study by investigators at the West Haven VAMC indicates that the number of veterans who used VA mental healthcare rose by almost 120% from 1997 to 2010, an annual growth rate of 9.0%.  A prior study had examined trends thru 2005.  The new findings indicate that the rate of growth in a variety of indicators has increased since then, especially for veterans with PTSD.  For example, annual growth in the number of veterans with PTSD who received treatment was 12.6% between 1997 and 2005 and 14.8% between 2005 and 2010.  Although the number of OEF/OIF veterans with PTSD who received treatment rose sharply after 2005—125%— growth among Vietnam veterans was 36.9%, indicating that need continued to increase in this cohort, which accounted for over 50% of veterans treated for PTSD across all years. The average number of visits per year had decreased from 24.5 in 1997 to 9.8 in 2006 but increased to 14.8 by 2010.  By multiplying the number of veterans by the number of visits, the investigators estimated that total visits by PTSD patients increased by 1.6% annually in 1997-2005 and 19.6% in 2005-2010.  The authors speculate that the rise in the number of veterans treated for PTSD and the continued increase among Vietnam veterans could be due to increased symptoms, expansion of VA services, and, for those approaching retirement, reductions in the availability of mental health services outside the VA.  Read the entire article here: http://www.ptsd.va.gov/professional/articles/article-pdf/id38463.pdf

Greater Risks for Veterans with PTSD Who Use Opioids

Given the comorbidity of PTSD and pain, it may not be surprising to see higher frequency of opioid prescribing in veterans with PTSD.  What is surprising, however, is findings from a study led by researchers at the San Diego VA showed an elevated rate of opioid prescriptions among veterans with PTSD who do not have comorbid pain. The researchers used administrative data for 291,205 OEF/OIF veterans who entered into VA care between 2005 through 2008.  Regardless of whether comorbid pain was present, veterans with PTSD were over four times more likely to get an opioid (12.4% received a prescription) relative to veterans without a mental health diagnosis (2.7% received a prescription); veterans with other mental health diagnoses were 2.5 times more likely. Veterans with a drug use disorder and comorbid PTSD were most likely to receive opioids (RR = 4.19).  Among veterans prescribed opioids, those with PTSD took higher doses for longer periods and had a higher prevalence of adverse clinical outcomes compared with veterans with a mental health diagnosis other than PTSD or no mental health diagnosis.  Adverse outcomes included alcohol-, opioid- , and non-opioid drug-related overdose, as well as self-inflicted injuries. This study highlights the importance of clinician and patient education about the risks of opioids. The findings also suggest use of lower risk non-pharmacological approaches to pain management, particularly for veterans with comorbid substance use disorders.

VVA Veteran to AVVA Members

The AVVA National Board of Directors is pleased to announce that the VVA VETERAN magazine will, once again, be available to those AVVA members where there is no VVA member living at the same address. 

If a copy of the Veteran is not currently being sent to your home, and you wish to receive it, please email the following information to avvaveteranmagazine@aol.com :

• Membership name  
  
• Membership number
  
• Current mailing address
  
• State and VVA Chapter affiliation (if one) or State and at-large

Each member must submit an individual request.  No group request will be honored.  Multiple mailings to the same address will not be honored.  Delinquent membership renewal will result in the cancellation of the magazine.

If the member has no email access, a request can be made by calling the National Membership Chair at 717-259-5716. 

James Ansley's Story

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National Guard Association Hosts Bataan Survivors

On April 24, the National Guard Association hosted seven survivors of the Bataan death march (aka "The Battling Bastards of Bataan") at a  luncheon in Washington, D.C. sponsored by the Asia Policy Point. The seven included  former Illinois National Guardsmen, Dr. Lester Tenney; Army veterans Joseph Alexander, Ben Steele, and Roland Towery;  Marine veteran Donald Versaw; and Olivia Rosen, the widow of Colonel Melvin Rosen, USMA  1940. The survivors recounted the little known ghastly treatment of the 12,000 American POWs who were ordered to surrender to the Japanese in the Philippines on May 6, 1942 after defending the Bataan peninsula and the island of Corregidor for four months without any resupply of rations, war materiel or reinforcing troops that, according to the veterans, were promised to them by General Douglas MacArthur, 12 days before he evacuated Corregidor on March 12 for the safety of Australia.  Serving on Bataan from the National Guard were the 192nd Tank Battalion (Kentucky, Ohio, Illinois, Wisconsin), the 194th Tank Battalion (Minnesota, Missouri, California); and the 200th Coast Artillery (New Mexico). Thousands of the 12,000 POWs were National Guardsmen.
 
Only 1,700 of the 12,000 would survive their capture. The 12,000 were not treated as POWs in observance of the Geneva Conventions but as "captives" by a culture that dishonored surrender.  Dr. Tenney noted that 40% of Americans prisoners captured in the Pacific died in captivity.  This compares to a 1% fatality rate among US prisoners held during WW 11 by the Germans who did observe the Geneva Convention for US POWs.  As told by the five, after surrendering they were forced to march 90 miles in four days in jungle heat without water or food facing instant death by beheading or bayoneting by their Japanese captors if they faltered or merely smiled.  Dr. Tenney told how, once encamped , 200-300 prisoners daily died from the effects of the march.   Despite their surrender, Dr. Tenney believes the Bataan defenders contributed to the Allies victory in the pacific by holding the Japanese off for four months that allowed time for the U.S. to regroup and organize an effective  counteroffensive.

Many of the POWs were later transported to Japan in unmarked "hell ships" that were subject to attack by American submarines and aircraft resulting in the death of thousands from friendly fire.  Many of those lucky enough to survive the hell ship passage like Dr. Tenney,  were sentenced for the duration of the war to serve as slave laborers for Japanese industry to whom they were sold and in whose custody they were subject to restricted rations and beatings for failing to bow to Japanese soldiers or  their civilian overseers. The survivors are still waiting for a public apology from well-known Japanese companies still operating today, who benefited from their slave labor.  Dr. Tenney  remarked that "accepting responsibility is a prerequisite to forgiveness". The mantra of the seven is "to forgive but not forget". 

VVA's special advisor, Carl Tuvin attended the luncheon and spoke with Dr. Tenney about his experiences after the war.  When he returned home, Dr. Tenney went to school to become a teacher, using the GI Bill.  He was told that he needed a masters degree to qualify, so he commuted between San Diego and LA to work on his Master's .  At one point he thought that he had completed all his courses,  but was told that he needed a foreign language.  Faculty asked him if he spoke a foreign language, and he said Japanese. They asked where did you learn it, and he answered "In the POW camp, from the guards and the coal miners I worked with in the mines."  Dr. Tenney received a grade of A.