[The sad flip side of our ability to save injured troops who would have died in previous wars along with the high concussion sources of injuries now is a sad business. People after WW1 would speak of shell shock of those who survived nearby shells bursting by their trenches. It is time to get our guys out of this pointless line of fire. Ed Kent}

http://www.nytimes.com/2007/07/04/us/04vets.html?_r=1&oref=slogin

Screening for Brain Injury Is Set for Illinois Veterans
By LIBBY SANDER
Published: July 4, 2007

CHICAGO, July 3 — Frustrated with the federal government’s response to the mental health needs of soldiers, Illinois officials announced on Tuesday that members of the state’s National Guard would be routinely screened for traumatic brain injuries after serving in Iraq or Afghanistan.

Tammy Duckworth, state veterans director, says the program hopes to identify mild brain injuries.

The mandatory program, which appears to be the first in the nation, will also offer the screening to other veterans in the state and will include a 24-hour hot line providing psychological counseling to veterans of all military branches. The program is expected to cost $10.5 million a year.

“It’s been shown that the federal government simply was not prepared to deal with the number of war injured coming home from Iraq and Afghanistan,” said Tammy Duckworth, the director of the Illinois Department of Veterans Affairs and a former Blackhawk helicopter pilot who lost both legs on active duty in Iraq.

“This is a way that we in Illinois can react much more quickly,” Ms. Duckworth said at a news conference with Gov. Rod R. Blagojevich, a Democrat.

There are currently 1,100 members of the Illinois Army National Guard serving, or preparing to serve, in Iraq or Afghanistan.

Traumatic brain injuries afflict 14 percent to 20 percent of military service members, according to the Defense and Veterans Brain Injury Center, a federally financed program. The injuries, which are often caused by roadside bombs in Iraq and Afghanistan, are believed to be more common among soldiers who have served in those conflicts, the center estimates.

Veterans hospitals screen patients, including those who have served in the National Guard, for traumatic brain injuries and post-traumatic stress disorder, said Maureen Dyman, a spokeswoman for Hines Veterans Affairs Hospital in Chicago. Anybody who registers for first-time care must take part in the screening, Ms. Dyman said.

Ms. Duckworth said one goal of the new state program is to catch the milder form of brain injuries in National Guard veterans who show no other sign of injury and who would have no reason to seek care at a hospital. The program is mandatory only for National Guard members because the state has no authority over the military branches.

“It is obvious to everybody there is a need for more psychological care for our service members,” said Ms. Duckworth, a Democrat, who ran unsuccessfully for Congress last year.

Severe and even some moderate traumatic brain injuries are usually obvious and easy to detect, said Dr. Felise S. Zollman, medical director of the brain injury program at the Rehabilitation Institute of Chicago, which will help the state carry out the new program. But mild brain injuries often go undetected, with their symptoms of irritability, headaches, dizziness and a foggy feeling in the head, Dr. Zollman said.

The mandatory screening would consist of a written questionnaire, an assessment by a medical professional, and a professional interpretation of the results, Dr. Zollman said. Service members believed to show symptoms of a brain injury would be referred for assessment and further treatment at a veterans’ center.

“This is really good news for veterans,” said Paul Sullivan, the executive director of Veterans for Common Sense in Washington, who served in the Army in the Persian Gulf war. “It’s limited in scope, but the State of Illinois is absolutely doing the right thing.”

It makes sense for states to take on the responsibility for the screening, Mr. Sullivan said.

“It’s much easier for the state to do this, because they only have tens of thousands — and in the larger states, hundreds of thousands — of new war veterans to deal with,” Mr. Sullivan said. “In contrast, the federal government has 1.6 million service members from the Iraq and Afghanistan wars to try to screen.”

About half of the $10.5 million cost of the Illinois program would come from the current state budget, Mr. Blagojevich said, and the remainder is expected to be allocated in next year’s budget. The Legislature has been struggling to pass a budget for weeks, and on Thursday it will begin a special session that Mr. Blagojevich said would last “however long it takes” to pass an approved budget.

“Maybe I always see the glass as half full, but I can’t imagine why we wouldn’t get the money,” he said.

The Army, in the battery of tests it conducts on returning soldiers, looks generally for traumatic brain injuries, known as T.B.I., but the screening does not focus specifically on them, officials said.

“As the war has gone on and we realize that T.B.I. is one of the significant injuries of the war, we have put more initiatives in place to screen, diagnose and treat T.B.I.,” said Col. Elspeth C. Ritchie, the psychiatry consultant to the Army surgeon general.

Soldiers returning from active duty undergo health assessments as well as reassessments three months to six months later, Colonel Ritchie said.

“A war is just if there is no alternative, and the resort to arms is legitimate if they represent your last hope.” (Livy cited by Machiavelli)

Ed Kent 212-665-8535 (voice mail only) [blind copies]
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