In the early years of the wars in Iraq and Afghanistan, the various branches had been roundly criticized for failing to adequately address post-traumatic stress disorder, or PTSD, and other psychiatric problems. Responding to that criticism, leaders made progress in diagnosing and treating such illnesses among service members.
But Thursday’s attack at Ft. Hood — as well as two other recent incidents in which military personnel allegedly turned guns on their own — indicates an intractable problem not easily overcome.
In last week’s incident, Army psychiatrist Maj. Nidal Malik Hasan allegedly fired repeatedly at colleagues on the Texas base, killing 13 and wounding more than 30, before being felled by civilian base police officers. Hasan, who was about to be deployed to Afghanistan, is now hospitalized.
The fact that the suspect is a psychiatrist “is a one-in-a-billion case,” said Floyd Meshad, who served as a psychiatric social worker in the Vietnam War and is president of the National Veterans Foundation in Los Angeles. “But it does red-flag a lot of questions.”
Those questions include whether, even today, military personnel can easily obtain mental health services.
The factors that may have led to Hasan’s alleged actions are not yet clear. What is clear is that no one is immune to mental health problems: Doctors have slightly higher suicide rates than does the general population.
“Psychiatrists can have emotional difficulties too. We are humans like everyone else,” said Dr. William Callahan, a psychiatrist in Aliso Viejo who served as a flight surgeon in the 1991 Persian Gulf War. “It’s a shocking reminder of how much we need to do to get people access and better treatment.”
Military leaders acknowledge rampant psychiatric problems in their midst. According to the Army, the suicide rate among soldiers in Iraq is five times that seen in the Persian Gulf War and 11% higher than during Vietnam. The Army reported 133 suicides in 2008, the most ever. In January of this year, the 24 suicides reported by the Army outnumbered U.S. combat-related deaths in Iraq and Afghanistan.
The Marine Corps also reported an increase in suicides in 2008, to 41. The Army and Marine Corps have provided most of the troops in the two wars.
In April 2008, researchers at the Rand Corp. published a study showing that almost 20% of personnel returning from Iraq and Afghanistan reported PTSD or depression. Just over half of those had sought treatment.
“I think the military fully understands the magnitude of this problem,” said Dahr Jamail, a journalist and author of a new book, “The Will to Resist: Soldiers Who Refuse to Fight in Iraq and Afghanistan.”
“This issue of redeploying people repeatedly is a massive crisis,” Jamail said. “It’s creating a point of collapse in the military.”
In fact, Jamail said, he is surprised that violent incidents aren’t more frequent.
The wars in Iraq and Afghanistan have generated an array of mental and behavioral problems, experts say. Besides PTSD, a high rate of traumatic brain injury has contributed to cognitive and psychiatric symptoms. The wars have been long and, without a national draft in place, many troops have been subject to repeat deployment. The nature of the conflicts — fighting insurgents who mingle among civilians — is considered an additional, constant source of stress.
Military violence has been a problem in recent years. An Army sergeant has been accused of killing two superiors at a base south of Baghdad last year. And in May, an Army sergeant allegedly opened fire in a stress clinic on a base in Baghdad, killing five fellow soldiers.
The symptoms of mental health problems can include anxiety, depression, hyper-vigilance, insomnia, nightmares, emotional numbness, cognitive difficulties and intrusive thoughts. Some troops report feelings of guilt or sorrow that they cannot overcome. Others begin to abuse alcohol or drugs. Loneliness, divorce and domestic violence are common.
Service personnel have traditionally been reluctant to seek counseling because doing so might go on their records, said Meshad, who teaches mental health workers about compassion fatigue — a gradual erosion of compassion for one’s patients and apathy about their plight.
“We have a system that has a Catch-22, and it’s time the military faced it,” he said. “These soldiers would like to see a therapist. But there must be a way where it can be confidential.”
Recently, military leaders have made strides in addressing the mental health crisis. In 2007, the Defense Department established the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury to promote prevention and treatment.
The department also recently launched a program called Real Warriors to fight the stigma surrounding mental health issues and promote treatment. In July, the Army provided $500 million for the largest study ever on suicide and mental health issues among military personnel and last month announced it would begin emotional-resilience training to prepare troops for the psychological duress of service.
“The military is doing more and more to address emotions,” Callahan said. “They are becoming more focused and precise in realizing they have got to prepare people emotionally for war.”
Some say military mental health providers, possibly including Hasan, carry heavy workloads as a result.
“They are horribly burned out,” said Aaron Glantz, author of the 2009 book “The War Comes Home: Washington’s Battle Against America’s Veterans.”
Military psychiatrists can face especially frustrating circumstances because they may recommend releasing a soldier from active duty or redeployment because of mental health problems, only to be overridden by a commanding officer, Glantz said.
In 2007, a soldier at Ft. Hood told mental health services that he was suicidal, but he was nonetheless ordered to redeploy.
“His commanding officer said, ‘I don’t care, I want you redeployed anyway,’ ” Glantz said. “He walked into a field and killed himself. Imagine if you’re the psychiatrist in that situation. All of these psychiatrists are experiencing this.”
November 9th, 2009 By Ian Birrell, The Independent Racism was rife in the playgrounds of my youth. It seems incredible looking back, but if someone would not share their sweets or lend a few pennies to a friend in need of crisps, they might be mocked as “Jews”. Or even “Yids”. Sometimes, children would go so far as to rub their noses in a “Shylock” gesture to emphasise the point. It must have been hellish for the handful of Jewish pupils. Thankfully, as we grew older and began to learn the brutal history of anti-Semitism, the taunts dried up. Today, such behaviour is stamped upon. A lexicon of loathsome words has been driven underground as we make faltering steps forward towards a more tolerant society. Sticks and stones break bones, but words wound. This explains why there are such howls of outrage when a low-rent celebrity makes a joke about “Pakis”, or when a newspaper columnist delivers a diatribe against homosexuals. Casual racism, crude stereotyping and abuse towards a minority is not just offensive, but corrosive. So why is it acceptable against people with disabilities? When did they become such a forgotten minority that they ceased to matter in the battle against bigotry? A group so exiled still from mainstream society that it has become acceptable to fling around hateful words such as “retard” and “spazz” without a murmur of disquiet. Not just in the playground, where these words and many more like them are commonplace, but online, in the office, in the home and in Hollywood. This week, we had two of the hottest young actors, Robert Pattinson and Kristen Stewart, describe rumours of their romance as “so retarded”. Last month, Guy Ritchie used the same word to describe his former wife. Previously, it was Lindsay Lohan, Courtney Love, Russell Brand and Britney Spears. Imagine how their careers would have nose-dived if they used language offensive to gay or black people. Go on to YouTube and look at all the videos of people dancing “like a retard”. Or go on to MySpace and find an oh-so-funny gallery entitled “Adopt Your Own Retard”. Or go on to any one of dozens of internet sites and laugh at the jokes about “retards”. Or go on to the most popular political blogs and see the word bandied around as a term of abuse; one left-leaning site failed to spot the irony of a rant about “homophobic, racist retards” in a recent posting on the BNP. It is not just the new media polluted by such unthinking contempt. Listen to radio phone-in shows. Or watch the film Tropic Thunder, which uses “retard” or “retarded”17 times and makes gags about actors going the “full retard”. Or check out the Black Eyed Peas song “Let’s Get Retarded” with its chorus “Everybody, Everybody, Let’s get into it, Get stupid, Get retarded”. This from a band whose main creative force was one of the most influential figures behind the mobilisation of support for the election of Barack Obama as President of the United States. But then, even the first black president makes derogatory jokes about the disabled, while a leading French politician yesterday used autism as a form of political abuse against the Tories, and a supposedly-liberal newspaper splashed it across its front page without comment. In America, the fightback has begun. The Special Olympics has launched a campaign to drive the word “retard” into disuse, asking people to pledge never to use the word. Many of the pledges are from children such as Samantha, who has a sister with special needs. “All my life I have heard people saying the r-word. It makes me really upset. No one understands how hurtful it is until you have someone close to you being called that.” As the parent of a child with profound mental and physical disabilities, I share Samantha’s view. It is deeply upsetting to hear words once used to describe my daughter thrown around as a casual insult. But far worse than my own bruised sensitivities, language reflects how we view the world, reinforcing the exclusion of people with disabilities from the rest of society. When people with physical disabilities are figures of fun and mental incapacity is a term of insult, is it any wonder my daughter gets unpleasant stares wherever she goes? Is it any wonder parents complain over the appearance of a children’s television presenter missing part of one arm? Or a major fashion chain insists that a similarly-disabled worker is hidden out of sight of customers? Or that a college allows classmates to hold a vote to ban a student with Down’s syndrome from a barbecue party, as happened this summer? People should bear in mind that barely one in six disabled people are born with their disability, and the number of people with disabilities is rising. Despite this, there is so little interaction with disabled people that a recent survey by Scope discovered a majority of Britons believe most people see them as inferior people. Given this scarcely-believable finding, it is unsurprising that people with disabilities find it so much harder to get jobs, are far more likely to live in poverty, will be paid less and bullied more if they do find work and, increasingly, are victims of hate crime. Six weeks ago, Britain was engulfed in outrage over the terrible story of Fiona Pilkington, who killed herself and her disabled daughter after years of hostility from her neighbours. But the reality is that disabled people are regularly mocked, taunted, harassed, hurt and humiliated, with the most vulnerable – those with mental disability – suffering the worst. There are even cases of torture and disembowelment, of a woman urinated on and filmed as she lay dying in a doorway. Hate crime is the most extreme articulation of the prejudice that disabled people endure on a daily basis. Its roots lie in contempt, fertilised by misguided feelings of superiority. So will anything really change while retard is an acceptable term of abuse, and autism is used to denigrate political rivals? “We are giving people permission to say and do hateful things,” said John Knight, director of policy and campaigns at Leonard Cheshire Disability, who himself had to endure screams of “spastic” from two aggressive men in the street just a fortnight ago. “And it’s getting worse. If we don’t address low-level abuse, we let people think it’s acceptable, allowing it to proliferate and become mainstream.” An investigation into crime against the disabled revealed that nearly two-thirds of people with mental health problems had been abused in the street in the previous two years, with about a quarter suffering sexual harassment or physical assault. But only 141 disabled hate crimes were successfully prosecuted in a year, compared with 778 homophobic cases and 6,689 racial cases. The Home Office does not even bother collecting statistics on disability hate crime, unlike racially or religious-based offences. We are retreating in the fight to offer respect and inclusion to more than one million of our fellow citizens. John Bangs, head of education at the National Union of Teachers, admitted to me that the promotion of disabled rights had fallen back in the past decade while schools concentrated on racism and homophobia. And as the struggle for inclusion in society gets harder, the stares get more pronounced, the insults more widely heard, the harassment worse – and more and more people with disabilities will abandon their personal battles and withdraw to their ghettos. Is this really what we want? Or should we at the very least start to mind our language?Op Ed: Words can Cause Terrible Damage
Woman Shatters Stereotypes, Shares Experience with Down Syndrome
November 6th, 2009
By Leah Boyd, Daily Press & Argus
Nineteen years ago, doctors told parents Mike and LuAnn Loy they should consider institutionalizing their newborn daughter diagnosed with Down syndrome.
Today, the proud parents feel so grateful because they didn’t listen.
“We just felt that Abby deserved the chance to explore her potential just like our other children,” LuAnn Loy said. “I just didn’t want to put limitations on her. We were prepared to accept less, but not expect less.”
Not only can 19-year-old Abby Loy read, but she has toured the region in recent weeks to give oral presentations about Down syndrome to government and education groups. In her presentation, Abby Loy tells how the cognitive disorder has affected her life — such as causing delayed speech and coordination development — but also has not stopped her from living a happy life.
The presentation is meant to bring awareness and break stereotypes about people with Down syndrome.
“Most people don’t understand Down syndrome very well,” Abby Loy said. “Each person with Down syndrome has strengths and weaknesses.”
Abby Loy happens to have many strengths.
The recent Brighton High Schoolgraduate — who described herself as outgoing and caring — now attends Washtenaw Community College. She is studying child development and dance, which is a favorite hobby along with baby-sitting and horseback riding.
During high school, Abby Loy played clarinet in the marching band, and competed in swimming and teen beauty pageants. She has a boyfriend, Max, who accompanied her to the prom.
In 2005, Abby Loy ended up on C-SPAN during a trip to Washington, D.C., to lobby for what became the Prenatally and Post-natally Diagnosed Conditions Awareness Act signed into law last year. She met Sens. Carl Levin, D-Detroit, Debbie Stabenow, D-Lansing, and the late Ted Kennedy, D-Mass., during the trip.
Abby Loy presented all of her accomplishments during an Oct. 23 presentation to a University of Michigan class of second-year medical students. Professor Jenny Christner said the class “fell in love with Abby.” Christner said about 75 percent of her students said Abby Loy’s presentation was their favorite aspect of the class.
“She’s just adorable and really able to connect to people really well,” Christner said. “I thought it was a very powerful presentation to hear everything she has done.”
“To hear her talk about what she’s doing now in terms of her career and ongoing education was really encouraging,” Routt said.
What Abby Loy has been able to accomplish despite having a disability has not been easy. LuAnn Loy said she and her husband had to push for their daughter’s rights and and believe in her potential when no one else would.
LuAnn Loy said she refused to allow her daughter to be segregated from general-education classes and took on much of the responsibility in teaching her daughter to read.
“Individuals in the school system didn’t always agree with our vision of what Abby would be able to achieve,” LuAnn Loy said. “We had a vision of success for Abby. We weren’t sure what success would include but we encouraged her to dream.”
Abby Loy seems to be happy with the outcome.
“I feel great,” Abby Loy said. “I love my life and my journey.”
How Tech for the Disabled Is Going Mainstream
November 4th, 2009
Apple is widely celebrated for making devices as easy to use as they are elegantly designed. What customers probably don’t know is that some of these features aren’t exactly new—they evolved from software Apple created to help disabled people use PCs. Among them: the new iPhone’s voice control option, which allows users to speak to their handsets to prompt an action, such as calling Mom, or to get a spoken answer to such questions as “What song is playing?”
And “mainstreaming” tools for the disabled is spreading. Software developer Nuance Communications, for instance, invented voice command technology to help people who are unable to type on a computer. Today, the company’s algorithms are used in products ranging from Amazon.com’s latest Kindle e-reader to cars from Ford Motor. Meantime, Mattel is incorporating technology, initially intended to help paraplegics, into a soon-to-be-released game controlled by players’ brainwaves.
Other companies should consider following these trailblazers, say innovation consultants. “Companies could look at designing for accessibility as a sales opportunity. Most features that are accessible for the disabled have great value to everybody,” says Donald A. Norman, a former Apple vice-president for advanced technology who heads a joint business and engineering program at Northwestern University.
Benefits for the Blind
Mainstreaming has a long history. Thomas Edison saw his invention of the phonograph as a way to open the printed world to the blind by recording book readings. More recently, predictive-text software, the algorithms that finish words people type in search engines or e-mail, had its roots in technology geared to the disabled, according to patents filed for related programs.
Apple’s VoiceOver feature can be traced back to the late 1980s, says Norman, when the computer maker decided to try to embed “universal access” in its Macintosh PC line. The term is used in engineering and design circles to describe goods, from scissors to cell phones, made in such a way that people of any age or physical ability can use them. VoiceOver became a standard feature of Apple computers in 2006. When it’s activated, the Mac reads everything highlighted by the cursor, from text on a Web page to numbers in a database, in a natural-sounding voice.
While VoiceOver helped broaden Apple’s reach to the blind, it also became a mini-engine for innovation within the company. “When we created the VoiceOver idea and concept for the Mac, we also realized we could take advantage of it by mainstreaming it,” says Greg Joswiak, Apple’s vice-president for iPod and iPhone marketing.
Now the technology has made its way into the iPod Shuffle. Unlike its larger brethren, the Shuffle is too small to have a screen to display information about its music content. The latest model, introduced last March, gets around this shortcoming with software that can say what song is playing. Sales were 51% higher in the new Shuffle’s first week than they were for the previous model’s debut, says Barclays Capital analyst Benjamin Reitzes. The low $79 price undoubtedly was part of the reason. But many users raved online about the voice interface, indicating that the feature helped popularize the music player, too.
Apple added a reverse version of Voice Over to its third-generation iPhone, released in June, that enables users to tell the phone to perform functions rather than type commands
That permits hands-free use of the smartphone and makes the device functional for people with visual and other physical handicaps, as well as for motorists. “Some customers need assistive technologies, and other people want convenience,” says Joswiak. “We try to solve problems for the disabled community, then we drive the solutions into the mainstream, to let everyone take advantage of them.”
The rising demand for devices that can speak and be spoken to has been a boon for Nuance Communications. The Burlington (Mass.) company supplies voice control software for a growing number of products, from its Dragon NaturallySpeaking speech recognition software for PCs to hands-free voice dialing for phones from Nokia, Samsung, LG Electronics, and BlackBerry maker Research in Motion. Through a joint Ford-Microsoft venture called Sync, Nuance also provides voice command capabilities in top-selling GPS navigation devices, such as Garmin and TomTom, as well as in Ford, Lincoln, and Mercury vehicles.
“While the disabled aren’t a significant percentage of our users today, they are our biggest power users,” says Peter Mahoney, general manager of Nuance’s Dragon unit. “They help us push the envelope” when it comes to improving products for mass-market customers.
Other companies are borrowing technology that aids the deaf. At Google, a deaf software engineer, Ken Harrenstein, spearheaded the creation of a captioning tool for videos posted on Google’s YouTube site. His original intention was to help deaf users. But the company soon figured out the software could also help translate languages. That idea led in late 2008 to an auto-translation tool that allows people to add captions in 50 languages instantly to YouTube videos they upload, increasing the number of people who can watch and understand the clips.
Mind Control
Mattel is taking mainstreaming into the toy market. In October it plans to release Mindflex, an $80 game that borrows from technology used by severely disabled people to control electronic devices by channeling brainwaves via sensors. Mattel has licensed the toy’s brainwave-harvesting technology from a San Jose company called NeuroSky. To play, users put on a headband with sensors. By focusing their thoughts on motion, they can cause a motor to propel small plastic balls through a tabletop obstacle course. When they relax, the objects stop moving.
Mattel is betting that the technology will become the basis for a line of mind-controlled physical games like Mindflex, opening up a new category for the toy industry, says Geoff Walker, a senior marketing vice-president at the El Segundo (Calif.) company.
As pioneers boost sales by incorporating technology once confined to products for the handicapped, other companies are sure to follow. They could come out ahead, says Tim Bajarin, president of technology consultancy Creative Strategies in Campbell, Calif. “It’s smart, because there is an aging population that will need easier-to-use tech. It’s even smarter to follow Apple’s lead—and then call these features out and get people’s attention. Then it becomes a competitive advantage.”