BY DENNIS CAMIRE

The Veterans Affairs Department seems to have a widespread indifference toward veterans with mental illness, Sen. Daniel Akaka and other Senate Democrats said Wednesday.

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 email 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 email, 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 system-wide problems within VA's mental health system."

Akaka has asked the VA to review and revise their 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 email 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 email to my staff on March 20 to stress the importance of an accurate diagnosis," she said.

In her email, 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 or have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

Disability compensation for PTSD would cost the VA millions of dollars more than the suggested alternative diagnosis.

"In retrospect, I realize I did not adequately convey my message appropriately," Perez said Wednesday. "But my intent was unequivocally to improve the quality of care that our veterans received."

Michael J. Kussman, VA undersecretary for health, said Perez's email, as characterized in reports, does not reflect the policies or conduct of the VA health care system.

"The email has been taken out of context, though we certainly agree that it could have been more artfully drafted," Kussman told the committee.

Sen. Jon Tester, D-Mont., a committee member, said he "didn't buy" Perez's explanation.

"She sent out an email telling folks not to worry about real diagnoses but to diagnosis people with this adjustment disorder," he said. "I just think that is criminal. If people are going to get the help they need in a timely manner, we need to do the best diagnosis we can."

After the hearing, Melanie Sloan, executive director of Citizens for Responsibility and Ethics in Washington, said there is widespread misdiagnosis of veterans with PTSD to cut costs.

"It is unconscionable that administrators like Norma Perez and those higher up the food chain are instituting a process by which our service members are lied to on a regular basis," she said.

Jon Soltz, an Iraq war veteran and chairman of VoteVets.org, said the problem is serious.

"Veterans clearly are having problems getting diagnoses with PTSD, and even when they are diagnosed, cannot get approved for disability claims," he said. "This is shameful treatment of the men and women who fought for our nation in war."

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Contact Dennis Camire at dcamire@gns.gannett.com

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