Showing posts with label Norma J. Perez. Show all posts
Showing posts with label Norma J. Perez. Show all posts

Saturday, January 31, 2009

IG report:No harm done on infamous PTSD email.

Why am I having a hard time believing this report? How do they know for sure this email did not change the outcome for veterans? Personality Disorder discharges were supposed to be appropriate too. Remember them? Diagnosing troops with PTSD as having the pre-existing condition of personality disorder made sure the government had no responsibility in the fact they were having flashbacks and nightmares along with the rest of the symptoms of PTSD. I really wonder how many of them had TBI on top of it but were cut loose by the DOD. As of now, no on knows what happened to the over 22,000 this happened to or if they ever received any justice, or ever will. Now the Inspector General report says the email sent had no bearing on the diagnosis of our veterans. This is really hard to swallow.

Inspector General Releases Investigation on VA Staffer's Email ...
Hawaii Reporter - Kailua,HI,USA
Chairman Akaka remains concerned that VA is overburdened and underfunded
By Jesse Broder Van Dyke, 1/29/2009 9:06:10 AM
WASHINGTON, D.C. – U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, commented today on a new VA Inspector General (IG) report into an email sent by a VA psychologist last year that appeared to discourage health care staff from diagnosing veterans with post-traumatic stress disorder (PTSD).
The IG investigation, requested by Akaka and released today, found that while the email was poorly written and inappropriate, it did not result in a change in diagnoses at that VA facility.
“I appreciate the IG’s investigation into this matter. It is fortunate that the actions of a single health professional did not result in an artificial decline in the number of veterans diagnosed with PTSD. I remain concerned that VA’s health care system is overburdened and underfunded as the needs of veterans grow greater and more complicated. I will continue to work towards making VA funding more timely, predictable, and robust,” Akaka said.
Chairman Akaka requested the IG’s investigation when the email was brought to light last year. He held a hearing on systemic indifference to invisible wounds on June 4, 2008.
The VA IG report is available here. VAO report
Jesse Broder Van Dyke is a spokesperson for U.S. Sen. Daniel Akaka

Tuesday, June 24, 2008

Mental Health.net takes on Perez email

When it's used to address the need for further testing then it's an appropriate diagnosis. But if it's used for political purposes - like to save the VA from having to pay out money to a disabled veteran - then that amounts to malpractice.



Mental Health Web Site Addresses Differences in Diagnosis of Adjustment Disorder and PTSD in Veterans Mental Health
MentalHelp.Net addresses the controversial email from Dr. Norma Perez and urges better care for soldiers at VA Hospitals.

(PRWEB) June 24, 2008 -- On March 20th Dr. Norma Perez, mental health specialist and coordinator of her hospital's Post-Traumatic Stress Disorder (PTSD) clinical team, sent a startling email to her staff.

"Given that we are having more and more compensation seeking veterans," she wrote. "I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder."

click post title for more

Tuesday, June 17, 2008

When it comes to PTSD help heal it or get out of the way!

One more case of "but"

Military Update: Treating mental combat wounds
BY TOM PHILPOTT Daily Press
June 16, 2008

Rep. Bob Filner, chairman of the House Veterans Affairs Committee, alleged on Wednesday that Bush administration officials were continuing to downplay the mental trauma and brain injuries suffered by veterans of the wars in Iraq and Afghanistan.

Filner, D-Calif., said an April RAND Corp. study — "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery" — justified a 10-fold jump in the U.S. casualty count, compared with the figure of 33,000 American dead and wounded used by the Pentagon.

RAND researchers extrapolated from a survey they conducted of 1,965 vets to conclude that nearly 300,000 service members and vets of Iraq and Afghanistan were suffering from post-traumatic stress disorder — PTSD — or major depression. Filner told the pair of researchers, who summarized their findings for his committee, that their work probably understated the problem.

"I personally think these are low estimates, just from my own studies," Filner said. "But if you take even the 300,000, (it's) 10 times the official casualty statistics from the Pentagon. Shouldn't this 300,000 be included?"

Lisa H. Jaycox, a senior behavioral scientist and clinical psychologist who co-directed the RAND study, embraced Filner's argument.

"Well, they are (suffering) an injury condition resulting from combat deployment, and so it's a different kind of casualty," Jaycox said, "but, yes, they are very important numbers."

The three-hour hearing also included testimony from retired Navy Rear Adm. Patrick W. Dunne, assistant secretary for policy and planning for the Veterans Benefits Administration.

At the same hearing, Michael L. Dominguez — principal deputy undersecretary of defense for personnel and readiness — said RAND gathered solid data from its survey but drew the wrong conclusions. The study, Dominguez said, "did not, and cannot, definitively say that there are 300,000 cases of clinically diagnosed cases" of PTSD or depression among vets who served in the two theaters.

Filner angrily interrupted him, telling Dominguez that RAND didn't say it showed 300,000 clinically diagnosed cases of PTSD or depression.

"It was an extrapolation to the possibility" of 300,000 cases, Filner said.

With more than 1.6 million U.S. service members having served in Iraq or Afghanistan, Dominguez said, a finding that 300,000 vets "have experienced some kind of mental health stress is very consistent with our data. And those people do need to be discovered (and) to get help."
go here for more
http://www.dailypress.com/news/local/military/dp-local_milupdatenew_0616jun16,0,6743686.story



Over 30 years ago, when people who got into this before I did, there was very little known about PTSD and it had just received that title because Vietnam Veterans fought for it. Five years later, I got into this because of my husband. By then a lot more was known. One of the things was that there were 500,000 with PTSD and this came from a study funded by the DAV. This study was published in 1978 before most of the people being quoted as "experts" today were even born. This is not a new illness. This is not a changing illness because humans are pretty much still made up of all the same parts of their original design.

At the NAMI convention in Orlando this weekend, we heard a lot about a lot of people suffering. A great deal of the people attending were consumers, otherwise known as patients and their families. They sat in the conference rooms right next to people who have working on helping them ranging from simple advocates like me all the way up to psychiatrists and psychologist. Why would people like us get together for 4 days of talking? Simply to provide understanding, knowledge and support to keep trying to fight for all of them. I heard a lot of heartbreak from some of the families dealing with PTSD in their own families.

Every time there was a denial of what is going on, people got up and walked out of the room. Frankly I was wondering why some of them were there are all at the head of the room instead of sitting in back and listening. No one is such an expert they have nothing to learn about this. This is why having conferences is so important for anyone living with or working in mental health needs to participate in events like this whenever and wherever possible.

Throughout the years I've come up on many articles trying to diminish the magnitude of the suffering. Whenever this happened the only question in my mind was focused on why anyone would try to do this instead of listening, learning and being quiet until they knew the answers.

While I post about medications taken totally out of the report I read, I never discuss medication when helping veterans other than to tell them they may need it, to stop self-medicating and to talk to their doctor if they feel like their medication is not working. I have very little to offer on this subject because I am not a doctor and I just don't have enough knowledge to know I am helping instead of harming with the limited knowledge I do have on this subject. In other words, a little knowledge can do a lot of harm so I keep my mouth shut on this and won't step over the line using guess work.

Why can't "experts" do the same when it comes to PTSD? If they are experts with other issues, then they should stay where they are, focus on what they know and stop pretending to be experts on what they know very little about. Why can't they except history for what it is and stop trying to stand in the way of new data drawn from history? The numbers from the Rand Study did not shock me or surprise me at all because all I had to do was pay attention in the first place to the data from Vietnam veterans to know the Rand Study is a lot closer to reality than the VA and DOD numbers are. One more thing jumping out from all of this is the fact the VA and the DAV are jumping around like their hair is on fire trying to cope with all of this. If the numbers are only about 30,000, they would be fully capable of dealing with them otherwise. They are not so inept that 30,000 would totally overwhelm them.

Just open your eyes and know what real is and what an illusion is. If you don't know what the hell you are talking about then go sit in the back of the room and open your ears as well as your mind. Otherwise, you are standing in the way of healing and that is not helping!

The following are in response to some of the things I heard during the conference which caused me to walk out of the room.

FACT: Dr. Katz did conceal the numbers of suicides and attempted suicides. The emails did not just suddenly show up on Senator Akaka's desk. The Katz emails were discovered because of the law suit brought about by Veterans for Common Sense and Veterans United for Truth. The emails were what he sent because he was trying to cover up the data CBS found with their own research work. The emails were about harmful conditions attempting to be covered up after we already saw too many suicides.

FACT: Norma Perez email about not doing a diagnosis of PTSD, was what it was. No it was not a poor choice of words because of what she followed up this with and mentioned cost cutting and how they "didn't have time" to do a thorough diagnosis. This email did not suddenly show up but was discovered because of a Freedom Of Information Act filed by CREW and VoteVets.

While we are reading horrible stories about suicides and suffering of our troops and veterans, we would not be reading them if they were not happening. This is obvious! How could any of the service organizations be taking on the VA and the DOD if there were not problems that enabled them to be taken on? The DOD and the VA heads will defend everything they are doing no matter what harm is being done as long as they can get away with it. It's all as simple as that. If they were just simply mistaken on what they did, then why were they not willing to correct the harm done and leave it at that instead of defending what they did and their right to keep doing it?

Folks, this is really simple. If there is damage being done and no one is addressing it, the damage will continue and nothing will be fixed. We will keep reading more and more stories about suffering instead of less and less. This blog alone has over 2,000 posts on it and I doubt there are two hundred good stories on it. That's really sad when you consider that PTSD has been known for over 30 years and reported in humans since King David's time.




You can read more about NAMI here.
NAMI: National Alliance on Mental Illness
The mission of the National Alliance for the Mentally Ill is "to eradicate mental illness and improve the quality of life

Wednesday, June 11, 2008

Veteran's Administration cover up of PTSD

Veteran's Administration cover up of PTSD
Tuesday, June 10, 2008 5:58 PM
By Vic Lee
SAN FRANCISCO, CA (KGO) -- There is new evidence suggesting the Veteran's Administration is covering-up sub-standard mental health care given to vets. There's evidence a federal judge in San Francisco accepted on Tuesday, even though the case has already been tried.

There was email was written in March by Norma Perez, Ph.D., a V.A. psychologist who coordinates post-traumatic stress disorder cases.

She wrote, "Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of adjustment disorder."

The email was discovered by accident through a Freedom of Information request by a veterans group.

"It is a very damning email. Cut off the money, disguise them with adjustment disorders so they don't get V.A. benefits," said Gordon Erspamer, a Veterans Groups' Lawyer.

Attorneys for Veteran's groups suing the V.A. say the email supports their case that the dept has failed to diagnose and treat PTSD and other mental health problems.

Their lawsuit asks the court to force the V.A. to treat veterans who show signs of PTSD and are at risk of suicide.

The V.A. says the email's author admits it was poorly worded and has no bearing on the lawsuit.

"I think she made it clear she had mistakes. The secretary has disciplined her and also said she doesn't reflect any V.A. policies," said Kerri Childress, a Veterans Administration spokesperson.

This is the second email that the veterans say the V.A. has tried to conceal from the public.
go here for more
http://abclocal.go.com/kgo/story?section=news/local&id=6197910

Sunday, June 8, 2008

Perez says "poorly worded" email, not poor service

VA Says E-mail Was “Poorly Worded”
Veterans Affairs Psychologist Claims E-mail Appearing to Encourage VA Staff To Misdiagnose PTSD Was Out Of Context

June 4, 2008
CBS) This story was written by CBS News producer Pia Malbran for cbsnews.com.

A Veterans Affairs psychologist claims an e-mail, in which she appears to encourage VA staff to misdiagnose post traumatic stress disorder, has been taken out-of-context.

“I sent an e-mail to my staff on March 20 to stress the importance of an accurate diagnosis,” Norma J. Perez told the Senate Committee on Veterans’ Affairs Wednesday during a hearing in Washington, DC.

Perez’s internal e-mail was leaked to the media last month by two veteran watchdog groups. As the coordinator of the PTSD clinic at a VA hospital in Texas, Perez sent a message titled “Suggestion” to her mental health staff. She wrote: “given that we are having more and more compensation seeking veterans, I'd like to suggest you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder…”

Lawmakers are concerned that Perez appeared to be more interested in the cost of treatment rather than the appropriate diagnosis. A veteran diagnosed with adjustment disorder will not receive as much compensation as one diagnosed with PTSD.

“Any suggestion that we would not diagnose a condition, any condition is unacceptable,” said Dr. Michael Kussman, the VA's Under Secretary for Health, who testified alongside Perez.

Perez told the Committee that there is “no relationship whatsoever” between the VA’s disability process and the treatment clinics. As to why she mentioned “compensation” in her e-mail, Perez said she just wanted to emphasize consistent diagnoses.
go here for more
http://www.cbsnews.com/stories/2008/06/04/cbsnews_investigates/main4154924.shtml


Pure Bull!
In her e-mail, Perez cited a growing number of veterans seeking compensation when she suggested her staff "refrain from giving a diagnosis of PTSD straight out" and consider a lesser diagnosis of adjustment disorder. "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

http://woundedtimes.blogspot.com/2008/06/norma-perez-to-ptsd-veterans-no-time.html

Norma Perez to PTSD veterans: No time for you!

VA e-mail reflects indifference to mentally-ill troops, Akaka says
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By Dennis Camire
Advertiser Washington Bureau

WASHINGTON — The Veterans Affairs Department seems to have a widespread indifference toward veterans with mental illness, U.S. Sen. Daniel K. Akaka and other Senate Democrats said yesterday.


Their comments came after the Senate Veterans Affairs Committee, which Akaka chairs, heard a VA psychologist deny she was trying to save money when she suggested in an e-mail to her staff that they use other mental illness diagnoses for veterans who may have post-traumatic stress disorder.

"This incident was both disturbing and disappointing," Akaka said. "It reinforced fears among many veterans that the VA's mental health system is not meeting all their needs."

The e-mail, written by Norma Perez, a former PTSD program coordinator for the VA medical center in Temple, Texas, followed another problem where VA officials tried to suppress data on veteran suicides, Akaka said.

"Together, these incidents suggest a possible trend — widespread indifference to the invisible wounds of war," Akaka said. "We are concerned about systemwide problems within VA's mental health system."

Akaka has asked the VA to review and revise its PTSD treatment and compensation guidelines and provide complete data on veterans' suicides. He also has requested a VA inspector general's investigation of the Temple VA medical center.

Perez told the committee that her e-mail was meant to remind her staff that war stress could also cause adjustment disorder, which is a diagnosis less serious than PTSD.

"I sent an e-mail to my staff on March 20 to stress the importance of an accurate diagnosis," she said.

In her e-mail, Perez cited a growing number of veterans seeking compensation when she suggested her staff "refrain from giving a diagnosis of PTSD straight out" and consider a lesser diagnosis of adjustment disorder. "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD," Perez wrote.
go here for more
http://www.honoluluadvertiser.com/apps/pbcs.dll/article?AID=/20080605/NEWS08/806050348/1001/LOCALNEWSFRONT


This is a quote from the Critical Incident Stress Management (CISM) manual, Assisting Individuals in Crisis George Everly Jr. Ph.D. F.A.P.M. John Hopkins University and Loyola College

"Posttraumatic Stress Disorder (PTSD): a pathognomonic variation of post-traumatic stress. It is characterized by 3 symptom clusters: intrusive memories of the event, stress arousal symptoms, numbing, and avoidance reactions. Symptoms must persist for a minimum of 30 days and must cause significant distress and/or dysfunction. Psychosomatic symptoms may develop as a result of PTSD."


In other words, if symptoms last more than 30 days, it's PTSD. If people who train for CISM can understand this with just two days of training, how can a "professional" not know this and find no time to diagnose the veterans correctly?

Just hearing the view that Perez thought it was ok to tell staff that they don't have time for the veterans sent shutters down the spine of every veteran in this country!

VA Law Suit Update, Judge orders hearing over Perez email

June 8, Lawsuit Update:
VCS & VUFT Case Mentioned in NY Times

Daniel Frosch
New York Times

Jun 07, 2008

June 7, 2008 - A federal judge presiding over a lawsuit alleging mistreatment of veterans has ordered a hearing regarding new evidence in the case.

The judge, Samuel Conti of Federal District Court in San Francisco, ordered the hearing, scheduled for Tuesday, after the emergence of an internal e-mail message that appears to urge Veterans Affairs clinicians to avoid making a diagnosis of post-traumatic stress disorder to save money.

The message was written by a V.A. psychologist in Texas, but it did not surface until after the trial concluded in April, prompting the plaintiffs to request that the case be reopened. “It’s part of a systemic pattern where there’s a divergence between the pristine world of the V.A.’s central office and what goes on around the country,” said Gordon Erspamer, a lawyer for the plaintiffs.

On Wednesday, a lawyer with the Justice Department wrote to Judge Conti contending that the e-mail message in question did not represent V.A.-wide practice or policy. Also on Wednesday, Norma Perez, the psychologist who wrote the message, told members of Congress that it was poorly worded and was meant only to suggest diagnostic options for doctors. The lawsuit was filed last year by veterans’ groups.
http://www.veteransforcommonsense.org/ArticleID/10328


Anyone who thinks this is a bad idea had better reconsider. This is what they have been hiding as the suicide rate and attempted suicide rate goes up in the VA and the DOD.

Tuesday, June 3, 2008

Norma Perez denies money factor in memo on PTSD

VA denies money a factor in PTSD diagnoses
The Associated Press - The Associated PressPosted : Tuesday Jun 3, 2008 20:42:23 EDT

WASHINGTON — A Veterans Affairs Department psychologist denies that she was trying to save money when she suggested that counselors make fewer diagnoses of post-traumatic stress disorder in injured soldiers.

Norma Perez, who helps coordinate a post-traumatic stress disorder clinical team in central Texas, indicated she might have been out of line to cite growing disability claims in her March 20 e-mail titled “Suggestion.” She said her intent was simply to remind staffers that stress symptoms could also be adjustment disorder. The less severe diagnosis could save VA millions of dollars in disability payouts.

“In retrospect, I realize I did not adequately convey my message appropriately, but my intent was unequivocally to improve the quality of care our veterans received,” Perez said in testimony prepared for delivery Wednesday before a Senate panel.

The Senate Veterans’ Affairs Committee and the VA inspector general are investigating whether there were broader VA policy motives behind the e-mail, which was obtained and disclosed last month by two watchdog groups. VA has strenuously denied that cost-cutting is a factor in its treatment decisions.
go here for more
http://www.armytimes.com/news/2008/06/ap_va_ptsd_060308/

She is the head of a team and should know what this kind of thing would do. She should know better and should know how much harm something like this has done.

Monday, May 19, 2008

VA Busted Again, as reported by a Marine

Tim King is a former U.S. Marine with twenty years of experience on the west coast as a television news producer, photojournalist, reporter and assignment editor. Today, in addition to his role as a war correspondent in Afghanistan where he spent the winter of 2006/07, this Los Angeles native serves as Salem-News.com's Executive News Editor. Salem-News.com is the nation's only truly independent high traffic news Website, affiliated only with Google News. Tim's coverage from Iraq that was set to begin in April has been delayed and may not take place until August, 2008. You can send Tim an email at this address: newsroom@salem-news.com



VA Busted Again Over Poor Diagnosis and Mistreatment of PTSD Vets
Tim King Salem-News.com
There are good people working for the VA, but its leadership keeps trying to cut wounded veterans off at the knees.

(SALEM, Ore.) - Maybe it was fate, perhaps it is what many refer to as "Murphy's Law"; either way the spirit of the Veteran's Administration reared its ugly head last week when an email in a few simple words, nearly sized up what many believe is their general policy in its treatment of combat veterans with Post Traumatic Stress Disorder.

That policy in layman's terms begins with the agency's position to do anything possible to avoid paying veterans what they deserve, and results in them pumping veterans full of hard drugs to essentially make them vegetables. They can't complain after all, when they are no longer themselves. The VA creates this scenario in tens of thousands of Americans who deserve something better.

It all came to a head last week over a simple email. That electronic message contained a VA psychologist’s direction to staff at a Texas veterans facility to withhold diagnoses of Post Traumatic Stress Disorder from soldiers returning from Afghanistan and Iraq.

The author of the email, Norma J. Perez, is the PTSD program coordinator at the Olin E. Teague Veterans’ Center in Temple, Texas. The email instructs staff to not provide the right medical diagnosis: "given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out."

This caretaker of America's injured combat veterans suggested to her staff that they "consider a diagnosis of Adjustment Disorder."

Then as if to underscore the revelation, never intended for public eyes to see, the VA's Perez wrote that the staff at the VA "really don’t ... have the time to do the extensive testing that should be done to determine PTSD."
go here for the rest

http://salem-news.com/articles/may192008/va_caught_again-5-19-08.php