Veterans protest the gutting of West L.A. PTSD therapy groups

https://www.latimes.com/local/lanow/la-me-ptsd-group-shutdown-20181229-story.html

“It is important that we maintain a host of treatment options for our veterans suffering from PTSD,” he said.

The secretary of Veterans Affairs, Robert Wilkie, responded that the group therapy program was being “rebranded,” not ended. But he also questioned the effectiveness of group therapy for veterans with PTSD.

“Despite the popularity and long history of support groups as routine care for veterans with PTSD and trauma exposure, there is no strong evidence that this modality is an effective treatment,” Wilkie said in a letter to Lieu.

The outcry comes at a difficult moment for the veterans agency, which is experimenting with privatizing mental healthcare while also grappling with staffing shortages and a suicide crisis — 20 former service members a day take their own lives.

Several former clinicians have complained to the VA about an exodus of as many as 50 psychologists and psychiatrists from the Greater Los Angeles VA Health Care System, which includes the Sepulveda and West L.A. campuses.

The VA says PTSD affects 8% of veterans. The agency initially relied on medication to treat the condition, but now is turning to short-term, evidence-based therapies, including cognitive processing, prolonged exposure and eye movement desensitization and reprocessing.

Cognitive processing helps veterans recast negative thoughts about their trauma. Prolonged exposure guides veterans into reliving traumatic events to diminish their fear and anguish, and eye movement desensitization and reprocessing helps veterans recall their trauma while focusing on external motion or sound.

Each therapy course generally runs for three months. Martin said VA officials made it clear they like evidence-based treatment because it’s short and saves money. VA leaders called the therapy groups “social clubs” and said veterans who need more support should take each other’s phone numbers, Martin said.

Evidence-based therapies can be tough on veterans, who may have spent years trying to forget the very memories that the sessions dredge up. In his letter, Lieu said only 50% to 60% of veterans complete evidence-based therapies.

Peter Erdos, 35, said he tried medication and evidence-based therapies with minimal success after his return from Iraq.

“Medication is something that the VA was OK with me being on for the rest of my life,” said Erdos, a member of the combat veterans group. “Coming back in my 20s and hearing that was just soul-crushing. What worked for me was camaraderie with the guys.”

Research on the effectiveness of group therapy to treat combat veterans with PTSD is inconclusive. Carl Castro, director of USC’s Center for Innovation and Research on Veterans & Military Families, said the VA should have studied the groups before squeezing them out.

“The VA has gobs of money to do research,” Castro said. “It was a unilateral decision and goes against patient-centered therapy.”

“For a lot of veterans involved in group therapy, just the fact they’re engaging in it is therapeutic for them,” said Paul Brown, adjutant of the American Legion, Department of California. “If it makes a difference in even one veteran’s life, we’re going to push to have it continued.“

Members of the PTSD combat support group have continued meeting in a room they rent at a Westside senior center. Martin is volunteering to facilitate.

Before a gathering last month, a dozen veterans described the group as a lifeline. The men are black and white, former officers and draftees, and at least one attended West Point. Some spent years battling alcoholism or substance abuse. Some worked as lawyers, company executives or architects.

Several said they had PTSD symptoms — anger, anxiety, depression — for decades before seeking treatment.

“It only took me 47 years,” said Steven Goldstein, 71, a U.S. Army infantry veteran who served in Vietnam. “I had no joy in my life.”

Randy Kline said he was drafted out of Inglewood in 1967 “to participate in crimes against humanity“ — a moral injury that experts increasingly consider to be as damaging as a gunshot wound or other combat trauma.
Veterans Peter Erdos, from left, Dov Simens and Steven Goldstein walk outside Building 256 at the West Los Angeles Healthcare Center. Veterans accuse the VA of dismantling psychological services and PTSD groups at the Greater L.A. campuses.
Veterans Peter Erdos, from left, Dov Simens and Steven Goldstein walk outside Building 256 at the West Los Angeles Healthcare Center. Veterans accuse the VA of dismantling psychological services and PTSD groups at the Greater L.A. campuses. (Wally Skalij / Los Angeles Times)

Arnold Hudson said that as a black man from South Los Angeles, he saw no future as a convicted draft dodger. So he reluctantly answered the call to Vietnam, where he saw his friend “incinerated before my eyes.”

AHudson said the group gave him his life back after years of drug addiction.

“I’m 69 years old and I lost a whole lot of life,” he said. “When they announced we were disbanding I thought, why in the world is the government who vowed to take care of us cutting us off at the knees?”

The veterans said they want to return to the VA campus, where the next person home from Afghanistan or Iraq could wander in and find the support that only comes from shared experience.

“We’re a band of brothers. We have a duty to all vets,” Simens said. “We’re just asking for a 400- to 500-square-foot room, for two hours, once a week.”

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