Legion testifies on treating military sexual trauma

The Department of Veterans Affairs (VA) has recently expanded its outpatient programs for women veterans suffering from the effects of military sexual trauma (MST), including post-traumatic stress disorder (PTSD). Nevertheless, The American Legion has advised Congress that VA needs to provide more inpatient programs for such treatment.

The Legion made its recommendation, along with several others, in written testimony submitted for the record at a July 19 hearing by the House Veterans’ Affairs Subcommittee on Health, "Safety for Survivors: Care and Treatment for Military Sexual Trauma."

According to VA, about one in five women and 1 in 100 men have reported to their health-care provider that they have experienced sexual trauma while in the military.

VA provides treatment programs for veterans suffering from PTSD to address the mental anguish associated with MST. The problem is that VA doesn’t have a separate program to work with patients whose PTSD is a result of sexual trauma. This is a problem because VA’s PTSD therapy is a co-ed treatment program that groups male and female patients together. Trying to address sexual trauma issues in a co-ed setting, in many cases, further exacerbates symptoms and, in some cases, discourages patients from remaining in the program.

Some women victims have reported to The American Legion that VA’s co-ed residential treatment program is not conducive to their recovery, and that there is not enough separation from men for women to feel confident that they will not be victimized again, even if sleeping areas are separate.

Nationwide, The American Legion has more 2,600 accredited service officers, which enables the Legion to receive real-time feedback of what is transpiring in the field. One Legion service officer reported that one of his clients, a woman veteran receiving treatment for MST-related PTSD, was further traumatized while in the co-ed inpatient facility when one of the male patients reached for a TV remote control that was sitting in her lap. This incident illustrates the intensity of the issues faced by victims of MST, and the Legion fears that co-ed treatment may only serve to exacerbate these issues in many, if not, most cases.

VA has only seven residential PTSD treatment programs in the United States fully dedicated to women veterans. The American Legion believes that the co-ed approach needs to be reconsidered, given the complications associated with this particular issue, and that there should be an expansion of inpatient women veteran treatment programs in order to address the issues unique to sexual trauma and PTSD victims.

During The American Legion’s System Worth Saving site visit to the Coatesville (Pa.) VA Medical Center, its team was briefed on a program that the Legion believes to be a model for women veterans. Called the Power Program, it is a residential dual-diagnosis unit that provides inpatient and residential treatment to eligible women veterans with substance abuse disorders, mental health problems and homelessness struggles.

The program’s mission is to prepare women veterans for lifestyles that support continued recovery of mind, body and spirit. Patients come from as far away as Denver to enroll in the program, and women veterans who participate say they receive excellent care and would recommend the program to other women veterans.

PTSD and sexual trauma are major problems facing women veterans, and the Legion recognizes that outpatient programs have received funding and support and have enjoyed recent expansion. Nevertheless, women veteran inpatient programs are still lacking and women have to leave the local facility or region – and their families – to receive care in a VA facility that is far away.

The Legion believes it is important to remember that sexual trauma is not an issue that only affects women. According to surveys of 14 VA medical facilities conducted by the Legion in the first half of 2013, nearly half of those being treated for MST were men. According to VA, while it is true that MST proportionally affects more women than men "because of the disproportionate ratio of men to women in the military, there are actually only slightly fewer men seen in VA that have experienced MST than there are women." This fact is often overlooked in the discussion of this issue. The Legion believes that the issues faced by all veterans should be considered and addressed, regardless of gender.

At The American Legion’s 2012 national convention in Indianapolis, its voting membership passed Resolution No. 295, "Military Sexual Trauma (MST)." The resolution urges VA to use MST counselors "to oversee the screening and treatment referral process, and to continue universal screening of all veterans for a history of MST."

This does not address the lack of facilities, but the Legion believes that a counselor at each facility will go a long way toward ensuring that this issue gets the recognition it deserves, and that veterans receive the care they deserve. Furthermore, universal screening recognizes that sexual trauma does not pertain to women only, and helps to reduce any stigma that may be associated with MST.

In October 2008, the Government Accountability Office released a report, "Additional Efforts Needed to Ensure Compliance with Personality Disorder Separation Requirements," which found that the Department of Defense was not doing enough to ensure that servicemembers being separated for various personality disorders were unjustly being denied recognition of symptoms from traumatic brain injury, PTSD and/or MST that may have led to their discharge. Those who have these kinds of injuries as a result of their service may be denied VA healthcare related to these injuries.

At its May 2013 National Executive Committee meetings, The American Legion passed Resolution No. 26, "Mischaracterization of Discharges for Servicemembers with Traumatic Brain Injury and Post Traumatic Stress Disorder and Military Sexual Trauma." Outlined in it is a short history of less-than- honorable discharges that have been used to deny veterans benefits. Unfortunately, discharges that result from personality disorder diagnoses deny veterans any recourse toward receiving treatment they may be entitled to, if their conditions are found to be service-connected.

The American Legion is extremely concerned that a great many veterans who experience MST while in the service are being denied health care in the VA system. The character of the discharge resulting from the incident in service paradoxically prevents them from accessing care from the VA. The Legion believes this circumstance must be changed.

The American Legion called upon the subcommittee to direct VA to carefully review all claims for PTSD that indicate the possibility of sexual assault while on active or reserve duty to ensure that veterans are not denied the care they need and deserve.