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Agencies dispatch health care workers

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Federal health officials are dispatching hundreds of psychiatrists, social workers and other mental health care providers to military facilities across the U.S. to treat the growing number of war veterans returning from Iraq and Afghanistan who are diagnosed with post-traumatic stress disorder.

The psychological health mission announced Wednesday by officials from the Pentagon and Department of Health and Human Services (HHS) will recruit 200 practitioners, many with military experience, including neurologists, speech pathologists and physical therapists.

Adm. Joxel Garcia, assistant secretary for health at HHS, said the effort will coordinate scientific research for the mental health care needs of veterans and improve the treatment of war-related traumas or help prevent the mental disorder, also known as PTSD.

"We are very proud that this is an effort to essentially serve not only the veterans that are coming from war, but also their families," Adm. Garcia said.

"The cavalry riding to the rescue is the public health service," Dr. S. Ward Casscells, assistant secretary of defense for health affairs, said during a press briefing.

A Rand Corp. study estimates that 830,000 veterans - 300,000 of whom served in Iraq or Afghanistan - suffer from depression or PTSD symptoms. A study released May 27 by Army Surgeon General Eric B. Schoomaker shows that the number of troops diagnosed with the illness jumped nearly 50 percent last year and that 40,000 soldiers have been identified as PTSD sufferers since 2003.

Dr. Casscells estimated that 20 percent of returning troops will "put down some symptom and then about half of those will be confirmed on further discussion to formally have PTSD."

"About half of those will feel better in a few weeks or months, and then the others we really have to work to support and get them back on their feet - make sure they're working, make sure their family understands, make sure the employer understands, make sure that their unit understands that this is not an issue of malingering, it's not an issue that will never get better, but some of them take months and months and months," he said.

Dr. Casscells said the number of health care providers needed is a high estimate that could later be cut to 100.

He said there is an assumption "that there would be a surge of people asking for mental counseling and psychological counseling" as the Pentagon's campaign progresses "to reduce the stigma of asking for help, to assure people that this won't adversely impact their career."

On Capitol Hill, the Senate Veterans' Affairs Committee questioned a Veterans Affairs official about an e-mail she sent suggesting that clinicians "refrain from giving a diagnosis of PTSD straight out" because of "more compensation-seeking veterans."

Dr. Norma Perez, mental health integration psychologist for the Central Texas Veterans Health Care System, told the panel that veterans became frustrated after an initial diagnosis of PTSD and later with a different diagnosis during a compensation and pension examination.

"Although PTSD is sometimes recognizable as early as the first few sessions, veterans often need more time to fully disclose their trauma and its impact on their lives," she said.

"This situation was made all the more confusing and stressful when a team psychiatrist correctly told them they were displaying symptoms of combat stress, but did not meet criteria for the diagnosis of PTSD," she said.

"In retrospect, I realize I did not adequately convey my message appropriately, but my only intent was to improve the quality of care our veterans received," she said.

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