By Sandra Basu
WASHINGTON — Military sexual trauma (MST) survivors told a Senate subcommittee that improvements still are needed to ensure rape victims get all the help they need in the DoD and VA healthcare systems.
“Good counselors are the stuff of legends. They are always 50 miles away,” former Army Pfc. Jessica Kenyon, who was sexually assaulted while in the military, said about the challenges that MST victims have in accessing mental health help. Moreover, she added, If they are “any good, they have a very long [waiting] list.”
MST survivors Kenyon and Marine Lance Cpl. Jeremiah Arbogast, along with DoD and VA officials, testified at a Senate subcommittee hearing about the impact of military sexual assault and its link to PTSD and suicide.
Sen. Kirsten Gillibrand (D-NY), who chaired the hearing, noted that a study of Iraq and Afghanistan veterans treated at the VA found that mental health diagnoses, PTSD, other anxiety disorders, depression and substance use disorders were much more likely among men and women who reported a history of military sexual trauma.
“Sexual assaults are obviously very traumatic events for victims — traumatic events that have long-lasting, frequently lifelong consequences, including PTSD and suicides,” she said.
In her testimony, Kenyon recounted how she was raped multiple times after joining the military in 2005 and was honorably medically discharged. Currently working to help other victims of MST, she said she feels that overmedication of MST survivors in the VHA is a problem and would like to see more treatment options available.
“It is not uncommon to hear of veterans being prescribed dozens of medications at a time,” she said.
More Resources for Male Victims
Arbogast, meanwhile, told lawmakers that, while in the service, he was drugged, rendered incapacitated and then sexually assaulted. He retired from the Marines due to MST and PTSD and now is a paraplegic after trying to kill himself with a gunshot.
He emphasized that more resources are needed in VA for male victims of sexual assault.
“The VA mental health system lags in offering male MST survivors male-specific support groups, which is badly and urgently needed,” Arbogast said.
VA and DoD officials responded that they are working to ensure that MST victims get the care they need.
DoD Principal Deputy Assistant Secretary of Defense for Health Affairs Karen Guice, MD, told lawmakers that sexual assault survivors are at increased risk for sexually-transmitted infections, depression, anxiety and PTSD. DoD has issued comprehensive guidance on medical management for survivors of sexual assault for all MHS personnel who provide or coordinate medical care for sexual assault survivors, she said.
“Included in this guidance is the requirement that the care is gender responsive, culturally competent and recovery-oriented,” she said.
At the VA, Susan McCutcheon, RN, ED, VA National Mental Health director for Family Services for Women’s Mental Health and Military Sexual Trauma, told lawmakers that every VAMC provides MST-related care for both mental health and physical health conditions and that veterans are able to receive free MST-related care, even if they are ineligible for other VA healthcare.
VA officials reported in their written testimony that in FY 2013, 93,439 veterans received MST-related care at VHA, an increase of 9.3% from FY 2012.
Margaret Bell, PhD, VA director for Education & Training for the National Military Sexual Trauma Support Team, acknowledged to lawmakers that both men and women are at increased risk for developing PTSD and other mental health issues after experiencing MST.
“FY 2012 VA medical record data indicate that PTSD and depressive disorders were the mental health diagnoses most frequently associated with MST. Other common diagnoses include other anxiety disorders, bipolar disorder, substance use disorders, and schizophrenia and psychotic disorders,” she said.
Prosecuted on Evidence Only
The issue of military sexual assault has taken on increased visibility on Capitol Hill. Last month, the Senate approved legislation that would ban the “good soldier” defense for servicemembers accused of sexual assault.
The bill “removes the ‘good soldier defense,’ so that defendants are prosecuted based on the evidence and nothing else,” one of the bill authors, Sen. Kelly Ayotte (R-NH), said in a written statement.
Another bill that was considered but ultimately did not make it out of the Senate was one sponsored by Gillibrand that would strip military commanders of their power to prosecute sexual assault cases and reassign the convening authority powers for serious crimes to an impartial military prosecutor. DoD senior leadership did not support the measure taking authority away from commanders, and the proposal also was controversial among lawmakers.
During the hearing in which Kenyon and Arbogast testified, Sen. Lindsey Graham (R-SC) made it clear he did not support the Gillebrand bill, noting that telling the commanders that “this is no longer your problem would be an absolute disaster for fixing the problem.
“From my point of view this is a problem that can never be solved if you tell a commander this is no longer your problem.”
Both Arbogast and Kenyon voiced support for Gillibrand’s bill during the hearing.
The most common age for diagnosis of schizophrenia is late teens to early 30s.
With a long history of point of care testing at both of its predecessor organizations, the Walter Reed National Military Medical Center (WRNMMC) laboratory services staff were keenly aware of the advantages of using portable testing devices to obtain rapid patient assessments.