Psyche, Science, and Society

Mental Health professionals’ letter asks Michelle Obama to investigate diagnostic abuse of veterans

May 18th, 2009

I recently published an article — Diagnostic abuse of veterans and the dilemmas of health professional ethics — [based on reporting by Mark Benjamin and Michael de Yoanna in Salon] on Army pressures for mental health clinicians to not diagnose post traumatic stress disorder [PTSD] in returning soldiers. A group of approximately 130 psychologists and mental health professionals responded to my article by writing Michelle Obama and asking her to look into these charges. Here is their letter:

May 12, 2009

First Lady
Michelle Obama
The White House
1600 Pennsylvania Avenue NW
Washington, D.C.

Dear First Lady,

We are a group of mental health professionals who hope to reach you about an issue concerning the treatment of our veterans.  We are grateful that you have taken an interest in the well-being of veterans and their families, recognizing the weight of responsibility and trauma they may carry during and after service to our country.

In writing we want to call your attention to a concern that official pressures may be interfering with returning soldiers receiving appropriate treatment.  A recent series in Salon by Mark Benjamin and Michael de Yoanna (latest May 5, 2009), reports pressure placed on mental health professionals to under-diagnose Post Traumatic Stress Disorder (PTSD) in returning combat veterans regardless of the clinical reality.  A number of our colleagues who work with veterans have relayed similar experiences of pressure to misdiagnose.

One consequence of this apparent misdiagnosis is that the men and women who served our country do not receive appropriate Veterans’ benefits when their diagnoses do not correctly attribute their emotional problems to their combat experiences. Instead, their problems are attributed either to less severe “anxiety disorders” or to preexisting “personality disorders.”  In addition to potential loss of benefits to which combat veterans are due, misdiagnoses can result in inappropriate treatment and in the veteran being held responsible for part or all of the cost of treatment for conditions caused by combat experience.

As mental health professionals, we are deeply disturbed that pressure is being put upon colleagues to give incorrect diagnoses for reasons antithetical to the best interests of our patients.  Those who suffer serious disorders in the service of our country deserve better.  They deserve the best treatment available.  We are also concerned that this pressure may undermine the ethical foundation upon which the mental health professions are based.

We have included an essay by Dr. Stephen Soldz, co-founder of the Coalition for an Ethical APA and Steering Committee Member of Psychologists for Social Responsibility, which we believe sheds important light on this subject.

We ask you to look into this matter and related issues concerning the mental health treatment of our soldiers and veterans.  We are willing to assist you in any ways we can in this endeavor.

With respect and regards,

Alice Lowe Shaw, Ph.D.
President-Elect Section IX, Division 39
Psychoanalysis and Social Responsibility

Stephen Soldz, Ph.D.
Director, Center for Research, Evaluation and Program Development
Boston Graduate School of Psychoanalysis

Psychologists for Social Responsibility (PsySR), organizational endorsement
700+ members

Thomas Rosbrow, Ph.D.
Psychoanalytic Institute of Northern California (PINC)
San Francisco

Marilyn S. Jacobs, Ph.D., ABPP
David Geffen School of Medicine at UCLA
Dept. of Psychiatry and Biobehavioral Sciences
Los Angeles

Melanie Suchet, Ph.D.
Stephen A. Mitchell Center for Relational Studies
New York City

Lynne Layton, Ph.D.
Harvard Medical School
Cambridge, Massachusetts

Katie Gentile, Ph.D.
Women’s Center Director
John Jay College of Criminal Justice
New York City

Karen Rosica, Psy.D.
Denver, Colorado

Richard Reichbart, Ph.D.
Institute for Psychoanalytic Training and Research (IPTAR)
Ridgewood, N.J.

Rachael Peltz, Ph.D.
PINC
San Francisco

Elizabeth Hirky, Ph.D.
Senior Psychologist
Bellevue Hospital Center
New York City

Julie Gerhardt, Ph.D.
PINC
San Francisco

Ruth Fallenbaum, Ph.D.
Berkeley,  California

Nina K. Thomas, Ph.D., ABPP
NYU Postdoctoral Program in Psychotherapy and Psychoanalysis
New York City

Susan Gutwill, MS, LCSW
Highland Park, New Jersey

Diane Ehrensaft, Ph.D.
Oakland, CA

Brad Olson, Ph.D.
Northwestern University
Evanston, Illinois

Susan Phipps-Yonas, Ph.D., L.P.
Minneapolis, MN

Lorri Greene, Ph.D.
San Diego, CA

Ryan Hunt

Connie Evert, Ph.D.
Philadelphia

Leni de Mik, Ph.D.
Minneapolis, MN

Larry Welkowitz, Ph.D.
Keene State College,
Keene, New Hampshire

Frank Summers, Ph.D., ABPP
Northwestern University
Chicago, Il

Jeanne Wolff Bernstein, Ph.D.
Berkeley, CA

Kenneth Feiner, Ph.D.
NYC

Jancis Long, Ph.D.
President, Psychologists for Social Responsibility
Berkeley, CA

John Neafsey, Psy.D.
Chicago, Il

Thomas S. Greenspon, Ph.D.
Minneapolis, MN

Stephen Botticelli, Ph.D.
NYC

Loren Krane, Ph.D.
UCSF Dept of Psychiatry
San Francisco

Trudy Bond, Ph.D.
Toledo, OH

Armond Aserinsky, Ph.D.
North Wales, PA

Muriel Dimen, Ph.D.
NYC

Donna Bassin, Ph.D.
Secretary APA Division 39, Section IX

Ellen G. Levine, Ph.D., M.P.H.
Castro Valley, CA

Anthony J. Marsella, Ph.D.
Past President, PsySR

Polly Scarvalone, Ph.D.
NYC

Cynthia Colvin, Ph.D.
PINC
Oakland, CA

Laurel Bass Wagner, Ph.D.
Dallas, TX

Stefan R. Zicht, Psy.D.
NYC

Helene Goldberg, Ph.D.

Stephen Benson, Ph.D.
Blue Hill, ME

Maureen Murphy, MSN, Ph.D.
San Francisco

Virginia Goldner, Ph.D.

Nancy Burke, Ph.D.
Northwestern University
University Medical School
Chicago, Il

Elizabeth Hegeman, Ph.D.
Professor John Jay College of Criminal Justice
William A. White Institute
NYC

Leigh Messinides, Ph.D.
Tustin, CA

Peter Shabad, Ph.D.
Chicago

Ann B. Clarkson, Ph.D.
Portland, OR

Mary-Joan Gerson, Ph.D.

Sonia Orenstein, Ph.D.
NYC

Jill Bellinson, Ph.D.
NYC

Stephen Portuges, Ph.D.
Executive Editor, International Journal of Applied Psychoanalytic Studies
Los Angeles

Andrew Tatarsky, Ph.D.
Past president, Division on Addiction,
New York State Psychological Assn.
NYC

Susan Bodnar, Ph.D.
NYC

Todd Essig, Ph.D.
William Alanson White Institute
NYC

Sharon Brennan, Ph.D.

Christy Paliouras, Ph.D.
Astoria, NY

Maureen C. Grix, Ph.D.
The Suffolk Institute
Garden City,  NJ

Maureen O’Reilly-Landry, Ph.D.
Columbia College of Physicians and Surgeons
NYC

David Sloan-Rossiter, Ph.D.
Brookline, MA

Steven Reisner, Ph.D.
NYC

David Thurn, LMSW, PH.D.
NYC

Richard Lasky, Ph.D.
Clinical Professor of Psychology
NYU Post-Doctoral Program in Psychotherapy and Psychoanalysis
NYC

Elaine Gould, Ph.D.
New York

Susan Katz

Richard B. Gartner, Ph.D.
NYC

Eric W. Anders, Ph.D., Psy.D.
Institute of Contemporary Psychoanalysis
Oakland, CA

Linda R. Laughlin, Ph.D.

William A. MacGillivray, Ph.D., ABPP,
University of Tennessee,
Knoxville, TN

Kathryn G. White, Ph.D.
New Haven, CT

Katie L. Fitzpatrick, M.A.
University of Tennessee

Knoxville, TN

Dana Satir, M.A.
Center for Anxiety and Related Discord
Boston, MA

Kathleen W. Erickson, LCSW
(mother of an Iraq War veteran)
Knoxville, TN

Robert K. Albiston, Ph.D.
Past President, Appalacian Psychoanalytic Assn.
Knoxville, TN

Edward R. Ryan, Ph.D.
New Haven, CT

Mila R. Tecala, Lic. SW
Washington, D.C.

Greta H. Gustafson, LCSW
NYC

Mark S. Kane, Ph.D.
Michigan

Margaret L. White, Ph.D.
Upper Montclair, NJ

Christine A. Chapman, LCSW

Cathy S. Nelson, LISW
Ames, IA

Adrienne Harris, Ph.D.
NYC

Erika Vadopalas, LMFT
Coming Home Project
San Carlos, California

Annita Sawyer, Ph.D.
Yale Medical School
New Haven, CT

Steven H. Knoblauch, Ph.D.
NYC

Andrew M. Barclay, Ph.D.

Cathie Bird, MA, Psy.D.
Pioneer, TN

Debra Rothschild, Ph.D.
NYC

Luz Towns-Miranda, Ph.D.

NYC

Darlene DiGorio-Hevner, MA, MSW, LCSW
Ardmore, PA

Arlene Lu Steinberg, Ph.D.
Columbia University
NYU

Don Greif, Ph.D.
William Alanson White Institute
NYC

Spyros D. Orfanos, Ph.D., ABPP
Clinic Director
NYU Postdoctoral Program in Psychotherapy and Psychoanalysis
NYC

Barbara Eisold, Ph.D.
Yeshiva University
NYC

Barbara Blasdel, Ph.D.

Susan R. Greene, Ph.D.
San Francisco Center for Psychoanalysis (SFCP)

Candy Siegel, Ph.D.
Tucson, Arizona

Carolyn Ellman, Ph.D.
IPTAR, NYU Postdoctoral Program
NYC

Robert Keisner, Ph.D.
Professor of Psychology
CW Post/Long Island University
Brookville, NY

Maria T. Russo, Ph.D.
East Hampton, NY

Jerome Siller, Ph.D., ABPP
NYC

Scott W. Smith, M.A.
Doctoral Candidate
Adelphi University
New York

Martha Davis, Ph.D.
Visiting scholar, John Jay College of Criminal Justice
NYC

Stephen J. Ducat, Ph.D.
San Francisco

Debra A. Lopez, MD
Clinical Associate Professor
University of Vermont Dept of Psychiatry
Burlington, VT

Jeffrey F. Johns, MD (former Air Force Psychiatrist)
Oakland, CA

Barbara F. Marcus, Ph.D.
Yale University School of Medicine
Vice President, Board of Trustees and Faculty,
The Western New England Institute of Psychoanalysis
New Haven, CT

Sergio Rothstein, Ph.D.
NYC

Lawrence O. Brown, Ph.D.
Fellow Supervisor of Psychotherapy and Teaching Faculty
William Alanson White Institute
NYC

David G. Byrom, Ph.D.
Co-Director, Family Therapy Institute of Suffolk
Smithtown, NY

Juliet M. Ross, Psy.D.
NYC

Andrew B. Sieff, A.P.N., PMHCNS-BC
Psychiatric Clinical Nurse Specialist
Fayetteville, AR

Mildred Antonelli, Ph.D.
Institute for the Psychoanalytic Study of Subjectivity
NYC

Herbert Gingold, Ph.D.
Co-Founder of the Noir Institute
Kew Gardens, NY

Marc Pilisuk, Ph.D.
Professor Emeritus, The University of California
Professor, Saybrook Graduate School and Research Center
Berkeley, CA

Sharon L. Windwer, Psy.D.
Little Neck, NY

Bonnie J. Lipeles, Psy.D.

Margit Winkler Ph.D.
Supervising Analyst, Wm. Alanson White Institute

Lydia Seggev

Susan Lillich, Ph.D.
Williston, VT

Jules Burnstein, Ph.D.

Ronna Friend, Ph.D.
Eugene, Oregon

Cornelia St. John, MFT
Oakland, CA

Claire Hertz
Institute for Contemporary Psychotherapy
NYC

Linda Schrader, Ph.D.
Bend, OR

Jeff Kaye, Ph.D.
Clinician, Survivors International
San Francisco

Gerald Gray, LCSW
Founder, Center for Justice and Accountability
San Francisco
Co-Founder Institute for Redress and Recovery
Santa Clara University Law School

Philip Hill, Ph.D.

Latika Mangrulkar, MSW, ACSW

Jean Maria Arrigo, Ph.D.

Jonathan Wormhoudt, Ph.D.

Elliot Jurist, Ph.D.

Skye Haberman, Ph.D.

Joanie V. Connors, Ph.D.

Stephen Seligman, D.M.H.
University of California, San Francisco

Entry Filed under: Mental Health, Psychiatry, Psychology, US Troops, Veterans