Senior leaders at Joint Base Lewis-McChord identified several problems Thursday that led the Army to stop using forensic psychiatry at Madigan Army Medical Center to evaluate soldiers diagnosed with post-traumatic stress disorder.
The Army announced the end of the practice Tuesday as investigations delve into whether it was used to save money by adjusting the diagnoses of soldiers being considered for medical retirement. It also announced the reinstatement of Madigan’s commander, Col. Dallas Homas, who was placed on temporary leave when the investigations began.
Maj. Gen. Richard Thomas, who leads the Army’s 20-state regional medical command headquartered at Madigan, called the cost-saving allegation “absolutely untrue.”
“Our focus is to give them the best care that we can. They deserve that. They deserve nothing less, so cost is not a factor for us,” said Thomas, who was joined by Homas and Lt. Gen. Robert Brown, Lewis-McChord’s commanding general, at a news conference outside the military hospital.
The military has launched at least three investigations into the work of the Madigan team. It has not released the results of those inquiries, and their status is unclear. A Madigan spokeswoman referred questions about the investigations to the Department of the Army, which couldn’t be reached.
About 1,700 soldiers being considered for medical retirement were evaluated by the forensics team going back to 2007, Thomas said, and 450 were brought in for interviews and testing. He couldn’t say how many had their PTSD diagnoses adjusted or how many of those adjustments were restored once concerns came to light. Earlier this year, U.S. Sen. Patty Murray said the team adjusted more than 40 percent of the initial PTSD diagnoses it reviewed.
Madigan created a team in 2008 to use forensic psychiatry to review diagnoses of soldiers recovering from injuries; it was a first-of-its-kind program in the Army. This branch of psychiatry typically is used to determine whether someone is fit to stand trial, accepts responsibility for criminal behavior or deserves commitment to a mental institution.
At Madigan, the team interviewed the soldiers, verified their deployment history and administrated a personality test to assess whether someone was exaggerating or downplaying symptoms. The Army’s top medical officer, Lt. Gen. Patricia Horoho, praised its work as an example of “best practices” three years ago when she was commanding Madigan.
But Army leaders said Thursday that the practice was not a good fit for their soldiers.
Thomas characterized the forensic methods as a “surgical instrument” that were deemed too specialized for an evaluation that a behavioral health clinician could handle.
“You don’t want to use a surgical instrument in all cases because it’s not necessary,” he said.
The team couldn’t evaluate soldiers receiving care at smaller installations in other states, so there also rose the concern over fairness and equity.
Another problem Brown noted is that soldiers might be hesitant to open up about PTSD symptoms if they know they’ll be placed under added scrutiny.
The commanding general said it’s time to move beyond the stigma that he said still exists in the Army and in society for seeking psychological help.
“The important thing is that they feel they can seek that help” whether inside or outside the Army, Brown said. “Anything that would deter them is not good.”
Homas, in his first public comments since being reinstated as Madigan commander, said he was honored and humbled to be back on the job.
“My pledge to all of you is that I will tirelessly to ensure that Madigan is delivering the finest care that we’re capable of delivering,” he said.
Brown praised Homas’ leadership and said he has the energy and drive to deliver on his promise.
“There’s nothing he did wrong. He’s the right leader,” he said. “In the whole process, folks were trying to do the right thing. There was nothing malicious in that. We were trying to do the right thing for soldiers. We’re a learning organization. Let’s move on, learn from it and get better.”
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