What Vets Want at the End of Life Is Very Different From What Civilians Want
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VA Adds Mental Health Clinicians
Trauma Fuels HIV Epidemic Among Women
Veterans with PTSD at Risk of Prescription Opioid Abuse
Women Veterans Suffer from PTSD at Same Rate as Men
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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"state-of-health":{"type":"authors","id":"8344","meta":{"index":"authors_1591205172","id":"8344","found":true},"name":"State of Health","firstName":"State of Health","lastName":null,"slug":"state-of-health","email":"stateofhealth@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":null,"avatar":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"stateofhealth","roles":["editor"]}],"headData":{"title":"State of Health | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/state-of-health"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_361907":{"type":"posts","id":"stateofhealth_361907","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361907","score":null,"sort":[1510218031000]},"guestAuthors":[],"slug":"what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","title":"What Vets Want at the End of Life Is Very Different From What Civilians Want","publishDate":1510218031,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n","blocks":[],"excerpt":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","status":"publish","parent":0,"modified":1510279371,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":817},"headData":{"title":"What Vets Want at the End of Life Is Very Different From What Civilians Want | KQED","description":"Honor and respect can be much more important for dying vets than being comfortable or free of pain.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Vets Want at the End of Life Is Very Different From What Civilians Want","datePublished":"2017-11-09T09:00:31.000Z","dateModified":"2017-11-10T02:02:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361907 https://ww2.kqed.org/stateofhealth/?p=361907","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/11/09/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want/","disqusTitle":"What Vets Want at the End of Life Is Very Different From What Civilians Want","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2017/11/DemboskyVetsEndofLife.mp3","path":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A lot of Ron Fleming’s fellow soldiers spent the last five decades trying to forget what they saw and did in Vietnam. Now 74, Fleming has spent most of that time trying to hold on to it. He has never been as proud as he was when he was 21.\u003c/p>\n\u003cp>“I take issue with those who say we lost. We didn’t lose that war,” he said, sitting on the edge of his hospital bed at the \u003ca href=\"https://www.sanfrancisco.va.gov/\" target=\"_blank\" rel=\"noopener\">San Francisco VA medical center\u003c/a>. “Everywhere I went, we literally kicked the crap out of them.”\u003c/p>\n\u003cp>Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive, sometimes 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching one himself.\u003c/p>\n\u003cp>“You see, at 21, you’re bulletproof,” he said. “Dying wasn’t on the agenda.”\u003c/p>\n\u003cp>But now, it is. Fleming has congestive heart failure, arthritis and breathing problems. He often lands in the VA hospital with asthma attacks, and the palliative care team visits him regularly. He thinks about death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I wish it’d get off its ass and come on me. I’m sick of this crap,” he said, as his heart rate monitor ticked up. “You see, dying’s the easy part. Living is what’s hard.”\u003c/p>\n\u003cp>Fleming has had trouble holding down a job since he got back from the war. He had a girl he lived with for 10 years, but they never married, never had kids. He lives alone in Oakland now. He says he angers easily and is always hypervigilant. About 10 years ago, he was diagnosed with PTSD. More than anything, he says, he suffers from a \"rotten outlook\" on life.\u003c/p>\n\u003cp>“Sometimes I think that now I’m being paid back for all the men I killed,” he said. “I killed a lot of them. More than I can count.”\u003c/p>\n\u003cp>Unlike Fleming, some Vietnam vets don’t find out they have PTSD until they have just months or weeks left to live. Symptoms of terminal illnesses, like pain or breathlessness, can trigger flashbacks, making vets feel as threatened as they did on the battlefield.\u003c/p>\n\u003cp>“The war memories start coming back, they start having nightmares,” said \u003ca href=\"https://profiles.stanford.edu/vj-periyakoil\" target=\"_blank\" rel=\"noopener\">VJ Periyakoil\u003c/a>, a palliative care physician at the VA in Palo Alto. She says opioid medications, like morphine and oxycodone, that are often used for treating pain and breathlessness can make PTSD symptoms worse.\u003c/p>\n\u003cp>“The side effect of those medications, they make you fuzzyheaded,” she said. “Your defenses that you use to cope with the PTSD, which might help repress a lot of the difficult memories, that coping strategy starts to come apart.”\u003c/p>\n\u003cp>She has had patients tell her: “I would much rather tolerate the physical pain, the cancer pain, than take opioids and my defenses crumble.”\u003c/p>\n\u003cp>Some vets see their pain or PTSD as retribution for their work in the line of duty.\u003c/p>\n\u003cp>“Sometimes I’ve had patients refuse medications that might ease their experiences because they feel that they deserve to suffer,” Periyakoil said. “This is redemptive.”\u003c/p>\n\u003cp>The best thing to do in these situations can be to stand down, she said. With weeks left to live, there isn’t enough time to resolve the mental anguish, and staff have to let patients set the pace and tone for their care.\u003c/p>\n\u003cp>But doctors and nurses, just like soldiers, hate doing nothing.\u003c/p>\n\u003cp>“We talk about the moral distress that \u003cem>we \u003c/em>have sometimes about really knowing that we’re doing the right thing for this individual, so that we can be present for \u003cem>their \u003c/em>suffering, the way \u003cem>they\u003c/em> need to do it,” said Patrice Villars, a hospice nurse at the San Francisco VA.\u003c/p>\n\u003cp>For Ron Fleming, death is still likely a couple of years out. His doctors have been begging him, gently, to consider mental health counseling or antidepressants. But he has refused.\u003c/p>\n\u003cp>“I don’t want to take psychiatric drugs. The vets call them the happy pills,” he said. “I don’t want any of those, because they change you. I don’t want to change.”\u003c/p>\n\u003cp>He’s not sure if he deserves to be happy.\u003c/p>\n\u003cp>“That I don’t know,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>His pain is what connects him to the past. Fleming was awarded 18 air medals for acts of meritorious achievement and heroism. The loss and grief he experienced in Vietnam are woven into the same memories of victory and glory. He doesn’t want treatment that might make that go away.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361907/what-vets-want-at-the-end-of-life-is-very-different-from-what-civilians-want","authors":["3205"],"categories":["stateofhealth_3012","stateofhealth_1"],"tags":["stateofhealth_2847","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_2656","stateofhealth_3194","stateofhealth_136","stateofhealth_3193"],"featImg":"stateofhealth_361951","label":"stateofhealth"},"stateofhealth_13923":{"type":"posts","id":"stateofhealth_13923","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"13923","score":null,"sort":[1375135275000]},"guestAuthors":[],"slug":"a-daughter-struggles-to-make-sense-of-ptsd","title":"A Daughter Struggles to Make Sense of PTSD","publishDate":1375135275,"format":"aside","headTitle":"Vital Signs | State of Health | KQED News","labelTerm":{"term":2363,"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_13927\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13927\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS5740_Caitlin-Bryant.margo-scr-620x452.jpg\" alt=\"A commemorative Army dog tag similar to the one worn by Caitlin's father, was designed by her aunt and passed out at Richard Bryants' funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">A commemorative Army dog tag similar to the one worn by Caitlin's father, was designed by her aunt and passed out at Richard Bryants' funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Twenty-one-year old Caitlin Bryant lost her father, Richard Lewis Bryant, to a heart attack in 2008. But she and her brother Mitchell had grown up watching him battle a war within himself after returning from serving in Vietnam. As part of our first-person series \u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>, Caitlin Bryant describes what her family's life was like, living with her father's illness.\u003c/em>\u003c/p>\n\u003cp>My dad suffered really badly from PTSD -– post-traumatic stress disorder. And that was due to the traumatic things that he had seen in the war and he never really sought proper treatment.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital.”\u003c/aside>\n\u003cp>He just never seemed comfortable. He never seemed at peace. He always seemed like he was trying to relax and he could never fully relax.\u003c/p>\n\u003cp>He started doing a lot of drugs –- specifically speed -– to kind of alter his reality and see a different side of things from the war.\u003c/p>\n\u003cp>He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital in Loma Linda.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They put him in the psychiatric unit of the hospital for a week. He kind of just tried to laugh it off and play it off with me and Mitchell saying, “Do you really think I belong with these crazy people here?” You know like, “Ha, ha ha.”\u003c!--more-->\u003c/p>\n\u003cp>It was really hard for us. We were really confused. And we knew how much my dad loved us, but we didn’t know that it still wouldn’t be enough for him to not want to go.\u003c/p>\n\u003cp>He tried to tell us that Mitchell and I were all that was keeping him alive. And I really believed him until that had happened. And he still tried saying even after that, you know, “I’m so sorry that this happened and I know now more than ever that you and Mitchell are my sole reasons to stay alive and to try and make it right in this world.”\u003c/p>\n\u003cp>But he was struggling. He never got the help that he needed.\u003c/p>\n\u003cp>My dad passed away about four years after that suicide attempt. His body was still messed up. It was more damaged than I think he realized or if he did know then he never shared with us.\u003c/p>\n\u003cp>But he knew. He told my Aunt Sue the very last Christmas we shared with him –- so in 2007 -– he told my Aunt Sue that he thought this Christmas was going to be his last Christmas. And he was absolutely right.\u003c/p>\n\u003cp>The following April of 2008 is when he had the heart attack. And I miss him every single day.\u003c/p>\n\u003cp>But the thing that makes me angry is that I don’t get to have my dad there when I walk down the aisle one day. I don’t get to have my dad there when I have my firstborn one day. And that’s the only thing that really makes me angry. Everything else I have made sense with and I have understood. And I’ve appreciated everything that’s come my way since then.\u003c/p>\n\u003cp>But the only thing I can get mad about now is him not being there in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was reported by Gina Scialabba\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"My dad suffered really badly from PTSD -– post-traumatic stress disorder. And that was due to the traumatic things that he had seen in the war and he never really sought proper treatment.\r\n\r\nHe just never seemed comfortable. He never seemed at peace. He always seemed like he was trying to relax and he could never fully relax.","status":"publish","parent":0,"modified":1392158913,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":649},"headData":{"title":"A Daughter Struggles to Make Sense of PTSD | KQED","description":"My dad suffered really badly from PTSD -– post-traumatic stress disorder. And that was due to the traumatic things that he had seen in the war and he never really sought proper treatment.\r\n\r\nHe just never seemed comfortable. He never seemed at peace. He always seemed like he was trying to relax and he could never fully relax.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Daughter Struggles to Make Sense of PTSD","datePublished":"2013-07-29T22:01:15.000Z","dateModified":"2014-02-11T22:48:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"13923 http://blogs.kqed.org/stateofhealth/?p=13923","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/07/29/a-daughter-struggles-to-make-sense-of-ptsd/","disqusTitle":"A Daughter Struggles to Make Sense of PTSD","path":"/stateofhealth/13923/a-daughter-struggles-to-make-sense-of-ptsd","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13927\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13927\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/RS5740_Caitlin-Bryant.margo-scr-620x452.jpg\" alt=\"A commemorative Army dog tag similar to the one worn by Caitlin's father, was designed by her aunt and passed out at Richard Bryants' funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)\" width=\"620\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">A commemorative Army dog tag similar to the one worn by Caitlin's father, was designed by her aunt and passed out at Richard Bryants' funeral service. Caitlin recently had a tattoo artist replicate one on her foot. (Photo by: Margarita Brichkova)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Twenty-one-year old Caitlin Bryant lost her father, Richard Lewis Bryant, to a heart attack in 2008. But she and her brother Mitchell had grown up watching him battle a war within himself after returning from serving in Vietnam. As part of our first-person series \u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>, Caitlin Bryant describes what her family's life was like, living with her father's illness.\u003c/em>\u003c/p>\n\u003cp>My dad suffered really badly from PTSD -– post-traumatic stress disorder. And that was due to the traumatic things that he had seen in the war and he never really sought proper treatment.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital.”\u003c/aside>\n\u003cp>He just never seemed comfortable. He never seemed at peace. He always seemed like he was trying to relax and he could never fully relax.\u003c/p>\n\u003cp>He started doing a lot of drugs –- specifically speed -– to kind of alter his reality and see a different side of things from the war.\u003c/p>\n\u003cp>He tried committing suicide when I was 11 years old. And we saw it as a huge cry for help because he did it in the parking lot of the VA hospital in Loma Linda.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They put him in the psychiatric unit of the hospital for a week. He kind of just tried to laugh it off and play it off with me and Mitchell saying, “Do you really think I belong with these crazy people here?” You know like, “Ha, ha ha.”\u003c!--more-->\u003c/p>\n\u003cp>It was really hard for us. We were really confused. And we knew how much my dad loved us, but we didn’t know that it still wouldn’t be enough for him to not want to go.\u003c/p>\n\u003cp>He tried to tell us that Mitchell and I were all that was keeping him alive. And I really believed him until that had happened. And he still tried saying even after that, you know, “I’m so sorry that this happened and I know now more than ever that you and Mitchell are my sole reasons to stay alive and to try and make it right in this world.”\u003c/p>\n\u003cp>But he was struggling. He never got the help that he needed.\u003c/p>\n\u003cp>My dad passed away about four years after that suicide attempt. His body was still messed up. It was more damaged than I think he realized or if he did know then he never shared with us.\u003c/p>\n\u003cp>But he knew. He told my Aunt Sue the very last Christmas we shared with him –- so in 2007 -– he told my Aunt Sue that he thought this Christmas was going to be his last Christmas. And he was absolutely right.\u003c/p>\n\u003cp>The following April of 2008 is when he had the heart attack. And I miss him every single day.\u003c/p>\n\u003cp>But the thing that makes me angry is that I don’t get to have my dad there when I walk down the aisle one day. I don’t get to have my dad there when I have my firstborn one day. And that’s the only thing that really makes me angry. Everything else I have made sense with and I have understood. And I’ve appreciated everything that’s come my way since then.\u003c/p>\n\u003cp>But the only thing I can get mad about now is him not being there in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was reported by Gina Scialabba\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/13923/a-daughter-struggles-to-make-sense-of-ptsd","authors":["8344"],"series":["stateofhealth_2363"],"categories":["stateofhealth_11"],"tags":["stateofhealth_136","stateofhealth_461","stateofhealth_2373"],"featImg":"stateofhealth_13927","label":"stateofhealth_2363"},"stateofhealth_6180":{"type":"posts","id":"stateofhealth_6180","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"6180","score":null,"sort":[1340037259000]},"guestAuthors":[],"slug":"ptsd-among-californias-middle-eastern-refugees","title":"PTSD Among Middle Eastern Refugees in California","publishDate":1340037259,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_6195\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1.jpg\">\u003cimg class=\"size-medium wp-image-6195\" title=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1-300x200.jpg\" alt=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Iranians protest in San Francisco. (Steve Rhodes: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California has resettled more \u003ca href=\"http://www.acf.hhs.gov/programs/orr/data/refugee_arrival_data.htm\" target=\"_blank\">Middle Eastern refugees\u003c/a> over the past decade than any other state in the U.S. In Northern California, Santa Clara County is a resettlement hub for Middle Eastern refugees -- more than 1,300 have moved there since 2006. The majority of these refugees are from Iran and Iraq, and many carry memories of past trauma with them.\u003c/p>\n\u003cp>Twenty-four year old Iraqi refugee Jasmine said she definitely brought her past memories with her to California. Jasmine (not her real name) and her family fled Iraq in 2006 after insurgents killed her father in a drive-by shooting. She said they escaped to Syria, then resettled in San Jose three years later.\u003c/p>\n\u003cp>\"You left your home. You left the place that you belong to. Your people who loved there,\" Jasmine said. \"Sometimes I feel like everything for me after Iraq is different: the roads, the air, the dust. I know back home. The dust of back home. I know the air of back home.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal ... Like people killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/aside>\n\u003cp>Jasmine said she was in survival mode in Iraq and experienced a delayed reaction to the stress of war. But when she did land in America, depression hit Jasmine hard.\u003c/p>\n\u003cp>\u003c!--more-->\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal,\" Jasmine told me. \"Like dead people in the street. People killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After two years in the U.S. Jasmine was diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/\" target=\"_blank\">post-traumatic stress disorder\u003c/a>, or PTSD. Now she's getting counseling at \u003ca title=\"http://cst.aaci.org/\" href=\"http://cst.aaci.org/\" target=\"_blank\">Centers for Survivors of Torture\u003c/a> (CST) in San Jose. But Jasmine said most of her Iraqi peers shy away from treatment because Iraqi culture, like many others, often considers mental health problems shameful.\u003c/p>\n\u003cp>Jasmine said therapy has given her tools to help her avoid reliving traumatic moments -- a common symptom of PTSD. She says even though she can’t forget her past, she is learning how to deal with it through various activities, like doing crafts. \"Especially like when I’m over-thinking I go to crochet,\" she said.\u003c/p>\n\u003cp>Though many Middle Eastern refugees are Iraqis who have fled war-related violence, in the past decade the largest number of Middle Eastern refugees in California are actually from Iran. More than 15,000 Iranian refugees have moved to California since 2006. Many Iranians suffer religious and political persecution. And they face many of the same social and cultural taboos about seeking mental health care as Iraqi refugees.\u003c/p>\n\u003cp>Azin Izadifar, a 45-year-old Iranian refugee, came to the U.S. in 2009 seeking asylum. She had been arrested for participating in secret meetings during \u003ca title=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" href=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" target=\"_blank\">Iran’s 1979 revolution\u003c/a>, and spent the next three years being tortured in Iran’s notorious \u003ca title=\"http://en.wikipedia.org/wiki/Evin_Prison\" href=\"http://en.wikipedia.org/wiki/Evin_Prison\" target=\"_blank\">Evin Prison\u003c/a>. She continued to have run-ins with the Iranian government after her release, so she eventually sought asylum in the U.S. She said even though she was in America and felt safe, life was difficult. She said her nightmares about her time in Evin Prison followed her to San Jose.\u003c/p>\n\u003cp>“It had become so normal for me that I couldn't even understand that there was a problem there –- I had a sleep disorder. And it could be related to the trauma I had in prison,” said Izadifar. \"Then I realize, 'OK, that's a sign of PTSD.'\"\u003c/p>\n\u003cp>Izadifar eventually saw a therapist and was indeed diagnosed with PTSD. She said she sees the same PTSD symptoms in many newly arrived Iranian refugees -- even among people who were never imprisoned. But most of them, she said, aren’t seeking therapy.\u003c/p>\n\u003cp>“There’s a tendency in our culture to underestimate that and say, ‘Okay, that was past. Now we are in a free society. We have to live our lives. We have to buy a car and get a job and just be normal.'”\u003c/p>\n\u003cp>Izadifar and Jasmine are not alone. Most refugees have been exposed to violence and trauma unheard of in the west. In the U.S., seeing a counselor is more widely accepted, but many in the refugee community would never think that way, said \u003ca href=\"http://www.sharrockmft.com/\" target=\"_blank\">Sally Sharrock\u003c/a>, a former therapist with Centers for Survivors of Torture. She said refugees more likely to go to first ask a family member or a physician for help.\u003c/p>\n\u003cp>As part of a federal refugee package, people are entitled to medical \u003cem>and\u003c/em> mental health care. Sharrock’s job was to get people into counseling and to keep them coming back after their first session. She said her sessions often began with practical support. “A lot of people are really actually more interested in being able to find a job and support their family and find good housing before they’re ready for any kind of psychological supportive services or therapy.”\u003c/p>\n\u003cp>To keep refugees coming back, Sharrock said she avoided using terms that might be associated with a mental illness, like “depression,” or “anxiety.” She said she’s found that one term seems to work across the board -- \"stress.\"\u003c/p>\n\u003cp>“Often times we find the word 'stress' works for people,” Sharrock said. “I may then ask them how they’ve been affected by stress, how they’ve been coping with it in their own culture up until now. And our conversation will kind of progress from there.”\u003c/p>\n\u003cp>Izadifar, the Iranian refugee, said the therapy at CST helped her finds tools to work through her healing process. She said she's now writing a memoir as a form of therapy. Izadifar said it's not hard to pull up those memories, because the wounds of trauma never fully disappear.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The wound will always be there, but there's a difference between a wound that has not healed –- that has not been exposed to the sun -- to a wound that's been healed and now you see a scar. It's different. The wound will be there, but you’re not as sensitive, it's not as painful.”\u003c/p>\n\n","blocks":[],"excerpt":"California has resettled more Middle Eastern refugees over the past decade than any other state in the country. In Northern California, Santa Clara County in the South Bay is a resettlement hub for Middle Eastern refugees – more than 1,300 moved there since 2006. The majority of this refugees come from Iran and Iraq. And many carry traumatizing memories with them to the U.S.","status":"publish","parent":0,"modified":1340038096,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":1082},"headData":{"title":"PTSD Among Middle Eastern Refugees in California | KQED","description":"California has resettled more Middle Eastern refugees over the past decade than any other state in the country. In Northern California, Santa Clara County in the South Bay is a resettlement hub for Middle Eastern refugees – more than 1,300 moved there since 2006. The majority of this refugees come from Iran and Iraq. And many carry traumatizing memories with them to the U.S.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"PTSD Among Middle Eastern Refugees in California","datePublished":"2012-06-18T16:34:19.000Z","dateModified":"2012-06-18T16:48:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"6180 http://blogs.kqed.org/stateofhealth/?p=6180","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/06/18/ptsd-among-californias-middle-eastern-refugees/","disqusTitle":"PTSD Among Middle Eastern Refugees in California","path":"/stateofhealth/6180/ptsd-among-californias-middle-eastern-refugees","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6195\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1.jpg\">\u003cimg class=\"size-medium wp-image-6195\" title=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/iran-protest1-300x200.jpg\" alt=\"Iranians protest in San Francisco. (Steve Rhodes: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Iranians protest in San Francisco. (Steve Rhodes: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>California has resettled more \u003ca href=\"http://www.acf.hhs.gov/programs/orr/data/refugee_arrival_data.htm\" target=\"_blank\">Middle Eastern refugees\u003c/a> over the past decade than any other state in the U.S. In Northern California, Santa Clara County is a resettlement hub for Middle Eastern refugees -- more than 1,300 have moved there since 2006. The majority of these refugees are from Iran and Iraq, and many carry memories of past trauma with them.\u003c/p>\n\u003cp>Twenty-four year old Iraqi refugee Jasmine said she definitely brought her past memories with her to California. Jasmine (not her real name) and her family fled Iraq in 2006 after insurgents killed her father in a drive-by shooting. She said they escaped to Syria, then resettled in San Jose three years later.\u003c/p>\n\u003cp>\"You left your home. You left the place that you belong to. Your people who loved there,\" Jasmine said. \"Sometimes I feel like everything for me after Iraq is different: the roads, the air, the dust. I know back home. The dust of back home. I know the air of back home.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal ... Like people killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/aside>\n\u003cp>Jasmine said she was in survival mode in Iraq and experienced a delayed reaction to the stress of war. But when she did land in America, depression hit Jasmine hard.\u003c/p>\n\u003cp>\u003c!--more-->\"What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal,\" Jasmine told me. \"Like dead people in the street. People killed in front of your eye. I don’t believe I’m going to forget them.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After two years in the U.S. Jasmine was diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/\" target=\"_blank\">post-traumatic stress disorder\u003c/a>, or PTSD. Now she's getting counseling at \u003ca title=\"http://cst.aaci.org/\" href=\"http://cst.aaci.org/\" target=\"_blank\">Centers for Survivors of Torture\u003c/a> (CST) in San Jose. But Jasmine said most of her Iraqi peers shy away from treatment because Iraqi culture, like many others, often considers mental health problems shameful.\u003c/p>\n\u003cp>Jasmine said therapy has given her tools to help her avoid reliving traumatic moments -- a common symptom of PTSD. She says even though she can’t forget her past, she is learning how to deal with it through various activities, like doing crafts. \"Especially like when I’m over-thinking I go to crochet,\" she said.\u003c/p>\n\u003cp>Though many Middle Eastern refugees are Iraqis who have fled war-related violence, in the past decade the largest number of Middle Eastern refugees in California are actually from Iran. More than 15,000 Iranian refugees have moved to California since 2006. Many Iranians suffer religious and political persecution. And they face many of the same social and cultural taboos about seeking mental health care as Iraqi refugees.\u003c/p>\n\u003cp>Azin Izadifar, a 45-year-old Iranian refugee, came to the U.S. in 2009 seeking asylum. She had been arrested for participating in secret meetings during \u003ca title=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" href=\"http://en.wikipedia.org/wiki/Iranian_Revolution\" target=\"_blank\">Iran’s 1979 revolution\u003c/a>, and spent the next three years being tortured in Iran’s notorious \u003ca title=\"http://en.wikipedia.org/wiki/Evin_Prison\" href=\"http://en.wikipedia.org/wiki/Evin_Prison\" target=\"_blank\">Evin Prison\u003c/a>. She continued to have run-ins with the Iranian government after her release, so she eventually sought asylum in the U.S. She said even though she was in America and felt safe, life was difficult. She said her nightmares about her time in Evin Prison followed her to San Jose.\u003c/p>\n\u003cp>“It had become so normal for me that I couldn't even understand that there was a problem there –- I had a sleep disorder. And it could be related to the trauma I had in prison,” said Izadifar. \"Then I realize, 'OK, that's a sign of PTSD.'\"\u003c/p>\n\u003cp>Izadifar eventually saw a therapist and was indeed diagnosed with PTSD. She said she sees the same PTSD symptoms in many newly arrived Iranian refugees -- even among people who were never imprisoned. But most of them, she said, aren’t seeking therapy.\u003c/p>\n\u003cp>“There’s a tendency in our culture to underestimate that and say, ‘Okay, that was past. Now we are in a free society. We have to live our lives. We have to buy a car and get a job and just be normal.'”\u003c/p>\n\u003cp>Izadifar and Jasmine are not alone. Most refugees have been exposed to violence and trauma unheard of in the west. In the U.S., seeing a counselor is more widely accepted, but many in the refugee community would never think that way, said \u003ca href=\"http://www.sharrockmft.com/\" target=\"_blank\">Sally Sharrock\u003c/a>, a former therapist with Centers for Survivors of Torture. She said refugees more likely to go to first ask a family member or a physician for help.\u003c/p>\n\u003cp>As part of a federal refugee package, people are entitled to medical \u003cem>and\u003c/em> mental health care. Sharrock’s job was to get people into counseling and to keep them coming back after their first session. She said her sessions often began with practical support. “A lot of people are really actually more interested in being able to find a job and support their family and find good housing before they’re ready for any kind of psychological supportive services or therapy.”\u003c/p>\n\u003cp>To keep refugees coming back, Sharrock said she avoided using terms that might be associated with a mental illness, like “depression,” or “anxiety.” She said she’s found that one term seems to work across the board -- \"stress.\"\u003c/p>\n\u003cp>“Often times we find the word 'stress' works for people,” Sharrock said. “I may then ask them how they’ve been affected by stress, how they’ve been coping with it in their own culture up until now. And our conversation will kind of progress from there.”\u003c/p>\n\u003cp>Izadifar, the Iranian refugee, said the therapy at CST helped her finds tools to work through her healing process. She said she's now writing a memoir as a form of therapy. Izadifar said it's not hard to pull up those memories, because the wounds of trauma never fully disappear.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The wound will always be there, but there's a difference between a wound that has not healed –- that has not been exposed to the sun -- to a wound that's been healed and now you see a scar. It's different. The wound will be there, but you’re not as sensitive, it's not as painful.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/6180/ptsd-among-californias-middle-eastern-refugees","authors":["46"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_68","stateofhealth_136"],"label":"stateofhealth"},"stateofhealth_5294":{"type":"posts","id":"stateofhealth_5294","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"5294","score":null,"sort":[1334957052000]},"guestAuthors":[],"slug":"va-adds-mental-health-clinicians","title":"VA Adds Mental Health Clinicians","publishDate":1334957052,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1334957767,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":695},"headData":{"title":"VA Adds Mental Health Clinicians | KQED","description":"The Department of Veterans Affairs has announced that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"VA Adds Mental Health Clinicians","datePublished":"2012-04-20T21:24:12.000Z","dateModified":"2012-04-20T21:36:07.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"5294 http://blogs.kqed.org/stateofhealth/?p=5294","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/04/20/va-adds-mental-health-clinicians/","disqusTitle":"VA Adds Mental Health Clinicians","path":"/stateofhealth/5294/va-adds-mental-health-clinicians","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/5294/va-adds-mental-health-clinicians","authors":["234"],"categories":["stateofhealth_14"],"tags":["stateofhealth_68","stateofhealth_136","stateofhealth_137"],"label":"stateofhealth"},"stateofhealth_3892":{"type":"posts","id":"stateofhealth_3892","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"3892","score":null,"sort":[1332262653000]},"guestAuthors":[],"slug":"trauma-fuels-hiv-epidemic-among-women","title":"Trauma Fuels HIV Epidemic Among Women","publishDate":1332262653,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_3911\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Rhodessa-Cassandra-Eddy.jpg\">\u003cimg class=\"size-medium wp-image-3911 \" title=\"UCSF helped create a theater workshop for HIV-positive women suffering from trauma (From left to right: Cassandra Steptoe, Edward Machtinger & Rhodessa Jones. Photo courtesy of UCSF).\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Rhodessa-Cassandra-Eddy-300x199.jpg\" alt=\"UCSF helped create a theater workshop for HIV-positive women suffering from trauma (From left to right: Cassandra Steptoe, Edward Machtinger & Rhodessa Jones. Photo courtesy of UCSF).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF helped create a theater workshop for HIV-positive women suffering from PTSD and other forms of trauma. From left to right: theater participant Cassandra Steptoe, UCSF Professor Edward Machtinger & Rhodessa Jones of the theater group Cultural Odyssey. (Photo: UCSF).\u003c/figcaption>\u003c/figure>\n\u003cp>Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/19049353\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/19049353\" target=\"_blank\">more likely to be at risk for HIV\u003c/a>.\u003c/p>\n\u003cp>Now two new studies published in the journal \u003ca title=\"http://www.springerlink.com/content/n164716853x285h7/\" href=\"http://www.springerlink.com/content/n164716853x285h7/\" target=\"_blank\">AIDS and Behavior\u003c/a> show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.\u003c/p>\n\u003cp>In the first study researchers at U.C. San Francisco and Harvard Medical School looked at nearly 6,000 HIV-positive women. They found HIV-positive women were twice as likely to experience violence from their partner and five times more likely to suffer from PTSD than the national average.\u003c/p>\n\u003cp>In the second smaller study of 113 HIV-positive women, researchers reported that women experiencing ongoing trauma were about four times more likely both to have unsafe sex \u003cem>and\u003c/em> to fail taking antiretroviral medications correctly.\u003c/p>\n\u003cp>That combination of skipping medication and unsafe sex leads to alarming public health consequences, says lead author Edward Machtinger, who directs UCSF's \u003ca title=\"http://www.whp.ucsf.edu/\" href=\"http://www.whp.ucsf.edu/\" target=\"_blank\">Women’s HIV Program\u003c/a>. He said if a woman isn't taking HIV medications properly, she is more infectious.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV.\"\u003c/aside>\n\u003cp>\"And if that person is having unprotected sex with HIV-negative partners,\" Machtinger told me, \"that is a situation that predisposes further transmission more than any other. The conclusion that we come to is that trauma fuels all aspects of the HIV epidemic among women.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->Machtinger said the key to curbing this epidemic is to address the trauma, not just the illness. \"Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV, along with blood tests and HIV medication adherence.\"\u003c/p>\n\u003cp>Machtinger says the Women's HIV Program (WHP) has turned to an innovative approach to intervention--theater. In a unique collaboration between the WHP and the San Francisco group \u003ca title=\"http://culturalodyssey.org/v2/season/winter10/\" href=\"http://culturalodyssey.org/v2/season/winter10/\" target=\"_blank\">Cultural Odyssey\u003c/a>, HIV-positive women go through a year-long workshop. At the end of the year, the women disclose their HIV status publicly in a performance called \u003ca title=\"http://culturalodyssey.org/v2/season/winter10/\" href=\"http://culturalodyssey.org/v2/season/winter10/\" target=\"_blank\">Dancing with the Clown of Love\u003c/a>.\u003c/p>\n\u003cp>\"None were completely out about their diagnosis prior to participating, and now all of them are out publicly - to their families, and friends and entire community,\" said Machtinger. \"The women who participated described it as transformative.\"\u003c/p>\n\u003cp>Cassandra Steptoe is one of those women. Steptoe was diagnosed with HIV in 1987, a time when she was working as a prostitute to support her own heroin and cocaine addictions, as well as her then-husband's addiction. She didn't reveal that she was HIV-positive for almost two decades. Steptoe says she was frequently beaten, both by her husband and her clients.\u003c/p>\n\u003cp>\"At that point I felt that my life was useless,\" said Steptoe. \"I didn’t have no hope. Because 1987, when I was diagnosed, there was a lot of people dying in the circle of men and women that I would hang around with. They was dying. And so I just waited around, wanting to die and wondering when I was gonna die. But in the process I was still shooting dope, I was still selling my body, I didn’t care about life, period. I lived in a dark world.\"\u003c/p>\n\u003cp>Steptoe lived on the streets for much of the next two decades. Then in 2001 she was sent to a drug treatment center in San Francisco. That's where she met Machtinger, and was introduced to the HIV-positive women's theater workshop. In the workshop, HIV-positive women like Steptoe write and perform their traumatic personal stories, under the guidance of Cultural Odyssey's Rhodessa Jones.\u003c/p>\n\u003cp>\"Rodessa has a way of having us write our feelings about our past out -- the dark places that we wouldn’t go into and we wouldn’t talk about,\" Steptoe said. \"But because of the safety and trust in this group, I was able to go deeper into my past and write about some things that I didn’t tell nobody. And that freed me a lot about my past.\"\u003c/p>\n\u003cp>Steptoe did her first series of live performances in 2010. She said she now takes all her antiretroviral medications, and works with other HIV-positive women in the community to overcome the shame associated with the virus. \"There’s no reason to feel shame. It’s not a crime to be HIV-positive--it’s a health condition. And you know what? We not alone. We in this together. Let’s have safe sex. We don’t need to keep spreading it. Let’s be open about this.\"\u003c/p>\n\u003cp>\u003cem>Watch Cassandra Steptoe's performance about her HIV status.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>http://www.youtube.com/watch?v=2mw7zZqOCJM&feature=youtu.be\u003c/p>\n\n","blocks":[],"excerpt":"Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are more likely to be at risk for HIV.\r\n\r\nNow two new studies published in the journal AIDS and Behavior show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.","status":"publish","parent":0,"modified":1342213657,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":881},"headData":{"title":"Trauma Fuels HIV Epidemic Among Women | KQED","description":"Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are more likely to be at risk for HIV.\r\n\r\nNow two new studies published in the journal AIDS and Behavior show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Trauma Fuels HIV Epidemic Among Women","datePublished":"2012-03-20T16:57:33.000Z","dateModified":"2012-07-13T21:07:37.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3892 http://blogs.kqed.org/stateofhealth/?p=3892","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/","disqusTitle":"Trauma Fuels HIV Epidemic Among Women","path":"/stateofhealth/3892/trauma-fuels-hiv-epidemic-among-women","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3911\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Rhodessa-Cassandra-Eddy.jpg\">\u003cimg class=\"size-medium wp-image-3911 \" title=\"UCSF helped create a theater workshop for HIV-positive women suffering from trauma (From left to right: Cassandra Steptoe, Edward Machtinger & Rhodessa Jones. Photo courtesy of UCSF).\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/Rhodessa-Cassandra-Eddy-300x199.jpg\" alt=\"UCSF helped create a theater workshop for HIV-positive women suffering from trauma (From left to right: Cassandra Steptoe, Edward Machtinger & Rhodessa Jones. Photo courtesy of UCSF).\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCSF helped create a theater workshop for HIV-positive women suffering from PTSD and other forms of trauma. From left to right: theater participant Cassandra Steptoe, UCSF Professor Edward Machtinger & Rhodessa Jones of the theater group Cultural Odyssey. (Photo: UCSF).\u003c/figcaption>\u003c/figure>\n\u003cp>Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/19049353\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/19049353\" target=\"_blank\">more likely to be at risk for HIV\u003c/a>.\u003c/p>\n\u003cp>Now two new studies published in the journal \u003ca title=\"http://www.springerlink.com/content/n164716853x285h7/\" href=\"http://www.springerlink.com/content/n164716853x285h7/\" target=\"_blank\">AIDS and Behavior\u003c/a> show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.\u003c/p>\n\u003cp>In the first study researchers at U.C. San Francisco and Harvard Medical School looked at nearly 6,000 HIV-positive women. They found HIV-positive women were twice as likely to experience violence from their partner and five times more likely to suffer from PTSD than the national average.\u003c/p>\n\u003cp>In the second smaller study of 113 HIV-positive women, researchers reported that women experiencing ongoing trauma were about four times more likely both to have unsafe sex \u003cem>and\u003c/em> to fail taking antiretroviral medications correctly.\u003c/p>\n\u003cp>That combination of skipping medication and unsafe sex leads to alarming public health consequences, says lead author Edward Machtinger, who directs UCSF's \u003ca title=\"http://www.whp.ucsf.edu/\" href=\"http://www.whp.ucsf.edu/\" target=\"_blank\">Women’s HIV Program\u003c/a>. He said if a woman isn't taking HIV medications properly, she is more infectious.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV.\"\u003c/aside>\n\u003cp>\"And if that person is having unprotected sex with HIV-negative partners,\" Machtinger told me, \"that is a situation that predisposes further transmission more than any other. The conclusion that we come to is that trauma fuels all aspects of the HIV epidemic among women.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->Machtinger said the key to curbing this epidemic is to address the trauma, not just the illness. \"Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV, along with blood tests and HIV medication adherence.\"\u003c/p>\n\u003cp>Machtinger says the Women's HIV Program (WHP) has turned to an innovative approach to intervention--theater. In a unique collaboration between the WHP and the San Francisco group \u003ca title=\"http://culturalodyssey.org/v2/season/winter10/\" href=\"http://culturalodyssey.org/v2/season/winter10/\" target=\"_blank\">Cultural Odyssey\u003c/a>, HIV-positive women go through a year-long workshop. At the end of the year, the women disclose their HIV status publicly in a performance called \u003ca title=\"http://culturalodyssey.org/v2/season/winter10/\" href=\"http://culturalodyssey.org/v2/season/winter10/\" target=\"_blank\">Dancing with the Clown of Love\u003c/a>.\u003c/p>\n\u003cp>\"None were completely out about their diagnosis prior to participating, and now all of them are out publicly - to their families, and friends and entire community,\" said Machtinger. \"The women who participated described it as transformative.\"\u003c/p>\n\u003cp>Cassandra Steptoe is one of those women. Steptoe was diagnosed with HIV in 1987, a time when she was working as a prostitute to support her own heroin and cocaine addictions, as well as her then-husband's addiction. She didn't reveal that she was HIV-positive for almost two decades. Steptoe says she was frequently beaten, both by her husband and her clients.\u003c/p>\n\u003cp>\"At that point I felt that my life was useless,\" said Steptoe. \"I didn’t have no hope. Because 1987, when I was diagnosed, there was a lot of people dying in the circle of men and women that I would hang around with. They was dying. And so I just waited around, wanting to die and wondering when I was gonna die. But in the process I was still shooting dope, I was still selling my body, I didn’t care about life, period. I lived in a dark world.\"\u003c/p>\n\u003cp>Steptoe lived on the streets for much of the next two decades. Then in 2001 she was sent to a drug treatment center in San Francisco. That's where she met Machtinger, and was introduced to the HIV-positive women's theater workshop. In the workshop, HIV-positive women like Steptoe write and perform their traumatic personal stories, under the guidance of Cultural Odyssey's Rhodessa Jones.\u003c/p>\n\u003cp>\"Rodessa has a way of having us write our feelings about our past out -- the dark places that we wouldn’t go into and we wouldn’t talk about,\" Steptoe said. \"But because of the safety and trust in this group, I was able to go deeper into my past and write about some things that I didn’t tell nobody. And that freed me a lot about my past.\"\u003c/p>\n\u003cp>Steptoe did her first series of live performances in 2010. She said she now takes all her antiretroviral medications, and works with other HIV-positive women in the community to overcome the shame associated with the virus. \"There’s no reason to feel shame. It’s not a crime to be HIV-positive--it’s a health condition. And you know what? We not alone. We in this together. Let’s have safe sex. We don’t need to keep spreading it. Let’s be open about this.\"\u003c/p>\n\u003cp>\u003cem>Watch Cassandra Steptoe's performance about her HIV status.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/2mw7zZqOCJM'\n title='//www.youtube.com/embed/2mw7zZqOCJM'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/3892/trauma-fuels-hiv-epidemic-among-women","authors":["46"],"categories":["stateofhealth_14"],"tags":["stateofhealth_313","stateofhealth_136"],"label":"stateofhealth"},"stateofhealth_3507":{"type":"posts","id":"stateofhealth_3507","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"3507","score":null,"sort":[1331132404000]},"guestAuthors":[],"slug":"veterans-with-ptsd-at-risk-of-prescription-opioid-abuse","title":"Veterans with PTSD at Risk of Prescription Opioid Abuse","publishDate":1331132404,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_3555\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611.jpg\">\u003cimg class=\"size-medium wp-image-3555\" title=\"Veterans with PTSD are more likely to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterans with PTSD are more likely than other vets to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Across the country, there's been a greater understanding of \u003ca title=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" href=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" target=\"_blank\">treating pain\u003c/a>. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, \u003ca title=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">prescription opioid abuse, overdose and death\u003c/a> has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\u003c/p>\n\u003cp>But little has been known about mental health disorders and the prescribing of opioids to veterans. Researchers at the San Francisco Veterans Affairs Medical Center and UCSF set out to address this question and found that veterans with mental health problems were more likely to be prescribed opioid drugs than veterans without mental health issues.\u003c!--more-->\u003c/p>\n\u003cp>The study, published Tuesday in the \u003ca title=\"http://jama.ama-assn.org/content/307/9/940.short\" href=\"http://jama.ama-assn.org/content/307/9/940.short\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, reviewed information from more than 140,000 Iraq and Afghanistan war veterans who were diagnosed with pain. Veterans without mental health problems were prescribed opioids much less frequently--about 6.5 percent of them received these prescriptions. That rate went up to 11.7 percent in veterans with a mental health diagnosis. And the rate was highest--17.8 percent--for veterans with Post-Traumatic Stress Disorder (PTSD).\u003c/p>\n\u003cp>The study also showed that all veterans that were prescribed opioids had a higher risk of misusing their prescription opioid by either over-dosing, having drug-related accidents, hurting oneself, or other things that would cause them to end up in the Emergency Room. That risk was the greatest among those with PTSD.\u003c/p>\n\u003cp>Lead author \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" target=\"_blank\">Karen Seal\u003c/a> is a physician at the San Francisco Veterans Affairs Medical Center and a professor at UCSF. She says the study results are troubling. \"The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Seal says there were clear patterns in the data showing that Veterans Affairs (VA) patients with PTSD were more at risk for being on higher doses of opioids, and for longer periods of time. PTSD patients also had a higher risk of being prescribed two or more opioids simultaneously, and were more likely to get early refills on medications. She says getting early refills is a good indication that veterans may be abusing drugs by taking more than prescribed.\u003c/p>\n\u003cp>Seal says the VA often offers alternatives to opioid pain medication first, such as anti-inflammatory drugs, physical therapy, complementary alternative medicine, and various relaxation techniques. She says in her own practice, she's found that when she approaches her patients about alternatives to opioid prescriptions, many patients say they would rather avoid the opioids and try these alternative therapies first.\u003c/p>\n\u003cp>\"They particularly like going to physical therapy,\" Seal said. \"And actually trying -- usually for the first time -- modalities like acupuncture, chiropractory, relaxation, and even in some case psychotherapy that's really meant to address their pain and PTSD, or other mental health problems, simultaneously.\"\u003c/p>\n\u003cp>But Seal cautions that these alternative methods don't\u003cem> \u003c/em>always work. Some patients require opioid medication to relieve their pain. \"In those cases you would still prescribe [opioids] to relieve pain and suffering, but you would do so in a way that you are assessing for risk, and you are monitoring their use of the medication.\"\u003c/p>\n\u003cp>In the study, the authors note that the VA has guidelines that \"urge caution in opioid prescribing\" in people with substance abuse issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs issued a written statement in response to the study saying it \"agrees with the recommendation that VA continue to build upon its current approach to treating patients who have both pain and PTSD. This includes expanding \u003ca title=\"http://www.va.gov/primarycare/pcmh/\" href=\"http://www.va.gov/primarycare/pcmh/\" target=\"_blank\">Patient Aligned Care Teams\u003c/a> (PACTs) that align primary care physicians with nurses, mental health providers, pharmacists and social workers. VA is committed to ensuring Veterans receive the quality care and benefits they have earned.\"\u003c/p>\n\n","blocks":[],"excerpt":"Across the country, there's been a greater understanding of treating pain. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, prescription opioid abuse, overdose and death has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\r\n","status":"publish","parent":0,"modified":1332471588,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":720},"headData":{"title":"Veterans with PTSD at Risk of Prescription Opioid Abuse | KQED","description":"Across the country, there's been a greater understanding of treating pain. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, prescription opioid abuse, overdose and death has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Veterans with PTSD at Risk of Prescription Opioid Abuse","datePublished":"2012-03-07T15:00:04.000Z","dateModified":"2012-03-23T02:59:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3507 http://blogs.kqed.org/stateofhealth/?p=3507","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/07/veterans-with-ptsd-at-risk-of-prescription-opioid-abuse/","disqusTitle":"Veterans with PTSD at Risk of Prescription Opioid Abuse","path":"/stateofhealth/3507/veterans-with-ptsd-at-risk-of-prescription-opioid-abuse","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3555\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611.jpg\">\u003cimg class=\"size-medium wp-image-3555\" title=\"Veterans with PTSD are more likely to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/PillsGenericGetty060611-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Veterans with PTSD are more likely than other vets to be prescribed opioid drugs for pain relief. (Photo: Jupiter Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Across the country, there's been a greater understanding of \u003ca title=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" href=\"http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx\" target=\"_blank\">treating pain\u003c/a>. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, \u003ca title=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">prescription opioid abuse, overdose and death\u003c/a> has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.\u003c/p>\n\u003cp>But little has been known about mental health disorders and the prescribing of opioids to veterans. Researchers at the San Francisco Veterans Affairs Medical Center and UCSF set out to address this question and found that veterans with mental health problems were more likely to be prescribed opioid drugs than veterans without mental health issues.\u003c!--more-->\u003c/p>\n\u003cp>The study, published Tuesday in the \u003ca title=\"http://jama.ama-assn.org/content/307/9/940.short\" href=\"http://jama.ama-assn.org/content/307/9/940.short\" target=\"_blank\">Journal of the American Medical Association\u003c/a>, reviewed information from more than 140,000 Iraq and Afghanistan war veterans who were diagnosed with pain. Veterans without mental health problems were prescribed opioids much less frequently--about 6.5 percent of them received these prescriptions. That rate went up to 11.7 percent in veterans with a mental health diagnosis. And the rate was highest--17.8 percent--for veterans with Post-Traumatic Stress Disorder (PTSD).\u003c/p>\n\u003cp>The study also showed that all veterans that were prescribed opioids had a higher risk of misusing their prescription opioid by either over-dosing, having drug-related accidents, hurting oneself, or other things that would cause them to end up in the Emergency Room. That risk was the greatest among those with PTSD.\u003c/p>\n\u003cp>Lead author \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4802489\" target=\"_blank\">Karen Seal\u003c/a> is a physician at the San Francisco Veterans Affairs Medical Center and a professor at UCSF. She says the study results are troubling. \"The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Seal says there were clear patterns in the data showing that Veterans Affairs (VA) patients with PTSD were more at risk for being on higher doses of opioids, and for longer periods of time. PTSD patients also had a higher risk of being prescribed two or more opioids simultaneously, and were more likely to get early refills on medications. She says getting early refills is a good indication that veterans may be abusing drugs by taking more than prescribed.\u003c/p>\n\u003cp>Seal says the VA often offers alternatives to opioid pain medication first, such as anti-inflammatory drugs, physical therapy, complementary alternative medicine, and various relaxation techniques. She says in her own practice, she's found that when she approaches her patients about alternatives to opioid prescriptions, many patients say they would rather avoid the opioids and try these alternative therapies first.\u003c/p>\n\u003cp>\"They particularly like going to physical therapy,\" Seal said. \"And actually trying -- usually for the first time -- modalities like acupuncture, chiropractory, relaxation, and even in some case psychotherapy that's really meant to address their pain and PTSD, or other mental health problems, simultaneously.\"\u003c/p>\n\u003cp>But Seal cautions that these alternative methods don't\u003cem> \u003c/em>always work. Some patients require opioid medication to relieve their pain. \"In those cases you would still prescribe [opioids] to relieve pain and suffering, but you would do so in a way that you are assessing for risk, and you are monitoring their use of the medication.\"\u003c/p>\n\u003cp>In the study, the authors note that the VA has guidelines that \"urge caution in opioid prescribing\" in people with substance abuse issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs issued a written statement in response to the study saying it \"agrees with the recommendation that VA continue to build upon its current approach to treating patients who have both pain and PTSD. This includes expanding \u003ca title=\"http://www.va.gov/primarycare/pcmh/\" href=\"http://www.va.gov/primarycare/pcmh/\" target=\"_blank\">Patient Aligned Care Teams\u003c/a> (PACTs) that align primary care physicians with nurses, mental health providers, pharmacists and social workers. VA is committed to ensuring Veterans receive the quality care and benefits they have earned.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/3507/veterans-with-ptsd-at-risk-of-prescription-opioid-abuse","authors":["46"],"categories":["stateofhealth_14"],"tags":["stateofhealth_68","stateofhealth_136","stateofhealth_137"],"featImg":"stateofhealth_3555","label":"stateofhealth"},"stateofhealth_2178":{"type":"posts","id":"stateofhealth_2178","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"2178","score":null,"sort":[1326757727000]},"guestAuthors":[],"slug":"women-veterans-suffer-from-ptsd-at-same-rate-as-men","title":"Women Veterans Suffer from PTSD at Same Rate as Men","publishDate":1326757727,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_2232\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/FemaleVetsPTSD_011612.jpg\">\u003cimg class=\"size-medium wp-image-2232\" title=\"For Some Returning US Troops, PTSD Is The New Battlefield\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/FemaleVetsPTSD_011612-300x192.jpg\" alt=\"Post Traumatic Stress Disorder is a major issues for female soldiers returning from the wars in Iraq and Afghanistan. (Chris Hondros: Getty Images)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Post Traumatic Stress Disorder is a major issue for female soldiers returning from the wars in Iraq and Afghanistan. (Chris Hondros: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The number of women in the military has doubled in the past decade. According to the Pentagon, about 10 percent of the 2.2 million troops who served in Iraq and Afghanistan have been women.\u003c/p>\n\u003cp>These women are more likely to be in the line of fire than those serving in previous wars -- and that means they're also at a higher risk of having depression, Post-Traumatic Stress Disorder (PTSD) and other mental health problems. Researchers at the University of California San Francisco and the San Francisco VA Medical Center (SFVAMC) wanted to see if\u003cem> gender\u003c/em> played a role in mental health outcomes after soldiers were exposed to combat-related trauma. In a recent \u003ca href=\"http://www.whijournal.com/article/S1049-3867%2811%2900174-5/abstract\" target=\"_blank\">study\u003c/a>, researchers looked at 7,251 veteran responses to different kinds of combat exposure: witnessing killing, sexual trauma, killing in war, and injury. They found that\u003ca href=\"http://www.whijournal.com/article/S1049-3867%2811%2900174-5/abstract\" target=\"_blank\"> PTSD rates are the same among male and female vets\u003c/a> of the Afghanistan and Iraq wars, with about 18 percent of both groups screening positive for the disorder.\u003c/p>\n\u003cp>While both male and female vets had equal chances of having PTSD after exposure to killing, sexual trauma, or witnessing killing, women vets who were\u003cem> injured\u003c/em> were more likely to have PTSD than men.\u003c/p>\n\u003cp>The study also found that while female veterans were more likely to suffer from depression, their male counterparts were more likely to abuse alcohol.\u003c/p>\n\u003cp>\u003c!--more-->Lead author \u003ca href=\"http://psych.ucsf.edu/faculty.aspx?id=1744\" target=\"_blank\">Shira Maguen\u003c/a>, a psychologist at SFVAMC and an assistant professor of psychiatry at UCSF, said the study suggests that doctors should get a detailed assessment of specific traumatic combat experiences because \"not all types of combat may be equally experienced by men and women after they return from deployment.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Though men and women had the same rates of PTSD due to sexual trauma, 12 percent of women actually reported experiencing sexual trauma, compared to less than one percent of men. Previous studies on female veterans show that those with a history of sexual trauma are about eight times more likely to suffer from PTSD than other female veterans.\u003c/p>\n\u003cp>Still, what's surprising, said Maguen, is that there are more similarities than differences between male and female PTSD outcomes. She said the the VA needs to do more research on women's health issues, but adds that they're doing an \"excellent\" job adding women's clinics for this growing population of veterans.\u003c/p>\n\u003cp>\"At the San Francisco VA we have a one-stop-shop model where a woman veteran can come in and get medical care and mental health care and social work all in one visit. These are particular settings where women can really be evaluated. And if we have studies like this informing us what the highest risk factors are, we can really do a better job of assessing women, and hopefully that will lead to better treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was supported by the \u003ca href=\"http://www.va.gov/\" target=\"_blank\">Department of Veterans Affairs\u003c/a>, and was published electronically in the \u003ca href=\"http://www.journalofpsychiatricresearch.com/\" target=\"_blank\">Journal of Psychiatric Research\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"Researchers at the University of California San Francisco and the San Francisco VA Medical Center (SFVAMC) wanted to see if gender played a role in mental health outcomes after soldiers were exposed to combat-related trauma. In a recent study, researchers looked at 7,251 veteran responses to different kinds of combat exposure: witnessing killing, sexual trauma, killing in war, and injury. It found that PTSD rates are the same among male and female vets of the Afghanistan and Iraq wars, with about 18 percent of both groups screening positive for the disorder.","status":"publish","parent":0,"modified":1326932424,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":513},"headData":{"title":"Women Veterans Suffer from PTSD at Same Rate as Men | KQED","description":"Researchers at the University of California San Francisco and the San Francisco VA Medical Center (SFVAMC) wanted to see if gender played a role in mental health outcomes after soldiers were exposed to combat-related trauma. In a recent study, researchers looked at 7,251 veteran responses to different kinds of combat exposure: witnessing killing, sexual trauma, killing in war, and injury. It found that PTSD rates are the same among male and female vets of the Afghanistan and Iraq wars, with about 18 percent of both groups screening positive for the disorder.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Women Veterans Suffer from PTSD at Same Rate as Men","datePublished":"2012-01-16T23:48:47.000Z","dateModified":"2012-01-19T00:20:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2178 http://blogs.kqed.org/stateofhealth/?p=2178","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/01/16/women-veterans-suffer-from-ptsd-at-same-rate-as-men/","disqusTitle":"Women Veterans Suffer from PTSD at Same Rate as Men","WpOldSlug":"ptsd-among-women-in-combat","path":"/stateofhealth/2178/women-veterans-suffer-from-ptsd-at-same-rate-as-men","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2232\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/FemaleVetsPTSD_011612.jpg\">\u003cimg class=\"size-medium wp-image-2232\" title=\"For Some Returning US Troops, PTSD Is The New Battlefield\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/FemaleVetsPTSD_011612-300x192.jpg\" alt=\"Post Traumatic Stress Disorder is a major issues for female soldiers returning from the wars in Iraq and Afghanistan. (Chris Hondros: Getty Images)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Post Traumatic Stress Disorder is a major issue for female soldiers returning from the wars in Iraq and Afghanistan. (Chris Hondros: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The number of women in the military has doubled in the past decade. According to the Pentagon, about 10 percent of the 2.2 million troops who served in Iraq and Afghanistan have been women.\u003c/p>\n\u003cp>These women are more likely to be in the line of fire than those serving in previous wars -- and that means they're also at a higher risk of having depression, Post-Traumatic Stress Disorder (PTSD) and other mental health problems. Researchers at the University of California San Francisco and the San Francisco VA Medical Center (SFVAMC) wanted to see if\u003cem> gender\u003c/em> played a role in mental health outcomes after soldiers were exposed to combat-related trauma. In a recent \u003ca href=\"http://www.whijournal.com/article/S1049-3867%2811%2900174-5/abstract\" target=\"_blank\">study\u003c/a>, researchers looked at 7,251 veteran responses to different kinds of combat exposure: witnessing killing, sexual trauma, killing in war, and injury. They found that\u003ca href=\"http://www.whijournal.com/article/S1049-3867%2811%2900174-5/abstract\" target=\"_blank\"> PTSD rates are the same among male and female vets\u003c/a> of the Afghanistan and Iraq wars, with about 18 percent of both groups screening positive for the disorder.\u003c/p>\n\u003cp>While both male and female vets had equal chances of having PTSD after exposure to killing, sexual trauma, or witnessing killing, women vets who were\u003cem> injured\u003c/em> were more likely to have PTSD than men.\u003c/p>\n\u003cp>The study also found that while female veterans were more likely to suffer from depression, their male counterparts were more likely to abuse alcohol.\u003c/p>\n\u003cp>\u003c!--more-->Lead author \u003ca href=\"http://psych.ucsf.edu/faculty.aspx?id=1744\" target=\"_blank\">Shira Maguen\u003c/a>, a psychologist at SFVAMC and an assistant professor of psychiatry at UCSF, said the study suggests that doctors should get a detailed assessment of specific traumatic combat experiences because \"not all types of combat may be equally experienced by men and women after they return from deployment.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Though men and women had the same rates of PTSD due to sexual trauma, 12 percent of women actually reported experiencing sexual trauma, compared to less than one percent of men. Previous studies on female veterans show that those with a history of sexual trauma are about eight times more likely to suffer from PTSD than other female veterans.\u003c/p>\n\u003cp>Still, what's surprising, said Maguen, is that there are more similarities than differences between male and female PTSD outcomes. She said the the VA needs to do more research on women's health issues, but adds that they're doing an \"excellent\" job adding women's clinics for this growing population of veterans.\u003c/p>\n\u003cp>\"At the San Francisco VA we have a one-stop-shop model where a woman veteran can come in and get medical care and mental health care and social work all in one visit. These are particular settings where women can really be evaluated. And if we have studies like this informing us what the highest risk factors are, we can really do a better job of assessing women, and hopefully that will lead to better treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study was supported by the \u003ca href=\"http://www.va.gov/\" target=\"_blank\">Department of Veterans Affairs\u003c/a>, and was published electronically in the \u003ca href=\"http://www.journalofpsychiatricresearch.com/\" target=\"_blank\">Journal of Psychiatric Research\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/2178/women-veterans-suffer-from-ptsd-at-same-rate-as-men","authors":["46"],"categories":["stateofhealth_11"],"tags":["stateofhealth_136","stateofhealth_137"],"featImg":"stateofhealth_2232","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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