Mental Health Inc

by Art Levine

  92 prescribing opiates: Mark Greenblatt et al., “Department of Veterans Affairs Takes Action Against Barbara Temeck, Jack Hetrick at Cincinnati VA,” WCPO, February 25, 2016, http://www.wcpo.com.

  92 denies any wrongdoing: Anne Saker, “Who Runs the VA Here? UC, One Official Charges,” May 13, 2016, http://www.cincinnati.com.

  92 congressman complained: Mark Greenblatt et al., “Records: Dirty and Broken Surgical Tools, Holes in Sterile Wrappers Documented at Cincy VA,” WCPO, June 23, 2016, http://www.wcpo.com.

  92 threatened by the VA hospital: Al Letson, “No Choice: Failing America’s Veterans,” Reveal from The Center for Investigative Reporting, September 17, 2016, https://www.revealnews.org.

  92 high quality, safe services: Emailed statement from Paula Paige, VA Media Relations, March 10, 2017.

  93 suicide prevention plans: Patricia Kime, “VA: Veterans Suicide Must Be a Top Priority,” Military Times, February 4, 2016, http://www.military-times.com; VA, “VA Releases Report on Nation’s Largest Analysis of Veteran Suicide,” press release, August 3, 2016, https://www.va.gov/opa.

  93 Clay Hunt: U.S. House, H.R.203, Clay Hunt SAV Act, 114th Cong., (2015–2016), https://www.congress.gov.

  93 rubber-stamping: Andis Robeznieks and Matthew DoBias, “Joint Commission Under Fire: Questions Arise After Walter Reed, West Texas Scandals,” Modern Healthcare, March 12, 2007 http://www.modernhealthcare.com.

  94 once a month: Mark Brunswick, “Cut Off Veterans Struggle to Live with VA’s New Painkiller Policy,” Minneapolis Star Tribune, July 12, 2015, http://www.startribune.com.

  94 twice as likely to die: Aaron Glantz, “VA’s Opiate Overload Feeds Veterans’ Addictions, Overdose Deaths,” The Center for Investigative Reporting, September 28, 2013, http://cironline.org.

  94 $200,000 grant from Purdue Pharma: Dr. Andrew Kolodny, “Making a U-Turn, Clinical Application of Opioid Guidelines,” presentation to the American Society of Addiction Medicine, April 6, 2017, 11–14, excerpt online at https://www.scribd.com.

  94 consultant for Purdue: American-Statesman Investigative Team, “Critics Say Pharmaceutical Firms Spurred the Increase in Prescriptions for Narcotic Painkillers,” Austin American-Statesman, September 29, 2012, http://www.statesman.com/news/.

  94 25 percent drop: Emily Wax-Thibodeaux, “New Rules on Narcotic Painkillers Cause Grief for Veterans and VA,” Washington Post, February 28, 2015, https://www.washingtonpost.com.

  95 increased 55 percent: Eric Newhouse, “VA Says 68,000 Vets Addicted to Opioid Painkillers,” Psychology Today, January 23, 2017, https://www.psychologytoday.com.; Childress, “Veterans Face Greater Risks.”

  95 No one disciplined [until November2015]: Bill Glauber and Daniel Bice, “Fired Tomah VA Chief To Surrender Medical License,” Milwaukee Journal Sentinel, January 18, 2017, http://www.jsonline.com.

  95 twenty a day: VA, “VA Fact Sheet: Suicide Prevention,” July 2016, https://www.va.gov.

  95 one attempt every half hour: Wes Moore, “Coming Back With Wes Moore,” PBS, May 13, 2014, http://www.pbs.org.

  95 44 percent increase: Janet E. Kemp, “Suicide Rates in VHA Patients Through 2011 With Comparisons With Other Americans and Other Veterans Through 2010,” VHA, January 2014, http://www.mentalhealth.va.gov.

  96 one call a day: Patricia Kime, “VA Crisis Line Director Resigns, Text Messages Go Unanswered,” Military Times, June 29, 2016, http://www.militarytimes.com.

  96 busy suicide calls: “VA Defends Work to Fix Troubled Veteran Suicide Hotline,” Associated Press, April 4, 2017, https://www.mprnews.org/story.

  96 As many as half: Terri Tanielen et al., “Invisible Wounds: Mental Health and Cognitive Care Needs of America’s Returning Veterans,” RAND, 2008, http://www.rand.org.

  97 75,000 veterans killed themselves: VA, “Suicide Prevention Fact Sheet,” August 3, 2016, https://www.va.gov.

  97 better than no treatment: VA, “Suicide Among Veterans and Other Americans 2001–2014,” Data Report, August 3, 2016, http://www.mentalhealth.va.gov.

  97 twelve times higher: Alan Zarembo, “Suicide Rate of Female Military Veterans Is Called ‘Staggering,’” Los Angeles Times, June 8, 2015, http://www.latimes.com.

  98 disturbing trends: American-Statesman Investigative Team, “Prescription Drug Abuse, Overdoses Haunt Veterans Seeking Relief From Physical, Mental Pain,” Austin American-Statesman, September 30, 2012, http://www.statesman.com.

  98 four hundred active-duty soldiers: Baughman, “Soldiers of the Iraq/Afghanistan Era Dead.”

  98 accidental prescription drug overdoses: Amy S. B. Bohnert, “Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths,” JAMA 205, no. 13 (2011): 1315–1321, http://jamanetwork.com.

  98 follow-up research showed: Amy Bohnert et al., “Risk of Death From Accidental Overdose Associated With Psychiatric and Substance Use Disorders,” American Journal of Psychiatry 169, no. 1 (January 2012): 64–70, https://www.ncbi.nlm.nih.gov.

  98 psychiatric drug overdoses: Rose Rudd et al. “Increases in Drug and Opioid-Involved Overdose Deaths—United States, 2010–2015,” Morbidity and Mortality Weekly Report 65, no. 50–51 (December 30, 2016): 1445– 52, https://www.cdc.gov/mmwr.

  98 272 percent increase: Glantz, “VA’s Opiate Overload.”

  99 shot up 4,100 percent: John Ramsey, “Painkiller Epidemic Especially Pronounced Near Fort Bragg,” Fayetteville Observer, July 14, 2013, online at http://www.wral.com.

  99 increased nearly 500 percent: Nicola Davis, “US Heroin Use Has Increased Almost Fivefold in a Decade, Study Shows,” Guardian, March 29, 2917, https://www.theguardian.com.

  99 manufacturers hid those risks: Peter Loftus, “Pfizer Settles Neurontin Wrongful-Death Suit” Wall Street Journal, April 5, 2010, https://www.wsj.com; Katie Thomas and Michael Schmidt, “Glaxo Agrees to Pay $3 Billion in Fraud Settlement,” New York Times, July 2, 2012, http://www.nytimes.com.

  99 competing “meta-analysis”: Scott Stossel, “Should We Still Listen to Prozac? Peter D. Kramer Jumps Back Into the Antidepressant Debate,” New York Times, July 7, 2016, https://www.nytimes.com; F. Hieronymus et al., “Consistent Superiority of Selective Serotonin Reuptake Inhibitors Over Placebo…,” Molecular Psychiatry, 21 (2016): 523–530, http://www.nature.com.

  99 marshaled in books: See, for instance, Irving Kirsch, The Emperor’s New Drugs: Exploding the Antidepressant Myth, (New York: Basic Books, 2011).

  100 70 percent of patients: Khalid Saad Al-Harbi, “Treatment-Resistant Depression: Therapeutic Trends, Challenges, and Future Directions,” Patient Preference and Adherence 6 (May 1, 2012): 369–88, https://www.ncbi.nlm.nih.gov; Institute for Quality and Efficiency in Health Care, “Depression: How Effective Are Antidepressants?” Informed Health Online, January 12, 2017, https://www.ncbi.nlm.nih.gov.

  100 eleven times: Sarah Boseley, “Seroxat Study Under-Reported Harmful Effects on Young People, Say Scientists,” Guardian, September 16, 2015, https://www.theguardian.com.

  100 suicidal behavior and aggression: T. Sharma et al. “Suicidality and Aggression During Antidepressant Treatment: Systematic Review and Meta-Analyses Based on Clinical Study Reports,” BMJ 352 (2016): i65, https://www.ncbi.nlm.nih.gov/pubmed/26819231.

  100 clearly benefit: Joan Raymond, “‘Black Box’ Warning on Antidepressants Raised Suicide Attempts,” NBC News, April 19, 2013, http://www.nbcnews.com.

  100 justifying their use: Zhai Yun Tan, “Depression Treatment Often Doesn’t Go to Those Most in Need,” NPR, August 29, 2016, http://www.npr.org.

  100 thirty-year high: Sabrina Tavernise, “U.S. Suicide Rate Surges to a 30-Year High,” New York Times, April 22, 2016, https://www.nytimes.com.

  101 never had major depression: Yoichiro Takayanagi et al., “Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample,” Journal of Clinical Psychiatry 76, no. 1 (2015): 40–44, http://www.psychiatrist.com.

  101 one out of every 100 patients: David Healy et al., “Antidepressants and Violence: Problems
at the Interface of Medicine and Law,” PLOS Medici 3, no. 9 (2006): 1478–1487, http://journals.plos.org.

  101 lawsuits have sharply dropped: Jeff Swiatek, “‘Black Box’ Warning on Antidepressants Vastly Reduced Lawsuits Against Eli Lilly, Others,” IndyStar–USA Today, August 24, 2014, http://www.indystar.com.

  101 clinically depressed: Katinka Blackford Newman, The Pill That Steals Lives, http://www.thepillthatsteals.com/; Katinka Blackford Newman, “‘Depression Pills Made Me Unfit to Be a Mother,’” Daily Mail, July 4, 2016, http://www.dailymail.co.uk.

  102 omit “major depression”: Mark Brunswick, “The VA Incorrectly Reports Suicide Data and Does a Poor Job of Tracking Vets at Risk, GAO Finds,” Minneapolis Star Tribune, January 5, 2015, http://www.startribune.com/.

  102 veterans shooting themselves: Kristina Rebelo, “Veteran Kills Himself in Parking Lot of VA Hospital on Long Island,” New York Times, August 24, 2016, https://www.nytimes.com.

  102 undercounted by the VA: Kevin Graman, “VA Center Wasn’t Aware of Many Veteran Suicides,” Spokane Spokesman-Review, August 9, 2009, http://www.spokesman.com.

  102 missing in most VA hospitals: Jeanette Steele, “Veteran Suicides: What Might Have Saved Them?” San Diego Union-Tribune, February 4, 2016, http://www.sandiegouniontribune.com.

  102 under the watch of the hospital director: Cristina Corbin, “Arizona VA Boss Accused of Covering Up Veterans’ Deaths Linked to Previous Scandal,” Fox News, April 24, 2014, http://www.foxnews.com; Dennis Wagner, “Arizona Suicides a Tragic Cost of Broken System,” Arizona Republic, August 24, 2014, http://www.azcentral.com.

  103 Less than a third: Veterans for Common Sense v. Shinseki, United States Court of Appeals, Ninth Circuit, no. 08-16728, May 10, 2011, http://caselaw.findlaw.com.

  103 1,400 veterans died: Jamie Reno, “Court Rejects Iraq and Afghanistan Veterans’ Demand for Better VA Care,” Daily Beast, May 9, 2012, http://www.thedailybeast.com.

  103 far back as 2005: Ron Zapata, “VA Hit With Massive Class Action,” Law 360, July 23, 2007, https://www.law360.com.

  103 unchecked incompetence: Carol Williams, “Court Orders Major Overhaul of VA’s Mental Health System,” Los Angeles Times, May 11, 2011, http://articles.latimes.com.

  104 new law in 2008: Peter Katel, “Caring for Veterans: Does the VA Adequately Serve Wounded Vets?” CQ Researcher, April 23, 2010, http://library.cqpress.com.

  104 suicide prevention specialist: “Evaluation of Suicide Prevention Program Implementation in VHA Facilities, Jan–June, 2009,” September 22, 2009, https://www.va.gov.

  104 malingerers: Tara McKelvey, “God, the Army, and PTSD: Is Religion an Obstacle to Treatment?” Boston Review, November/December 2009, http://bostonreview.net.

  104 openly critical: Erica Goode, “Suicide’s Rising Toll: After Combat, Victims of an Inner War,” New York Times, August 1, 2009, http://www.nytimes.com.

  105 “personality disorder”: James Dao, “Branding a Soldier with ‘Personality Disorder,’” New York Times, February 24, 2012, http://www.nytimes.com.

  105 shady diagnostic practices: “U.S. Military Illegally Discharging Veterans with Personality Disorder, Report Says,” Denver Post, March 22, 2012, http://www.denverpost.com.

  105 “Other Than Honorable”: Umar Moulta-Ali and Sidath Viranga Panangala, “Veterans’ Benefits: The Impact of Military Discharges on Basic Eligibility,” Congressional Research Service, R43928, March 6, 2015, https://fas.org.

  105 6 percent: Veterans Legal Clinic (Harvard Law School), “Underserved: How the VA Wrongfully Excludes Veterans With Bad Paper,” Swords to Plowshares and National Veterans Legal Services Program, March 2016, https://www.swords-to-plowshares.org.

  106 twice the rate: Veterans Legal Clinic, “Underserved.”

  106 300,000 jobless veterans: American Public Health Association, “Removing Barriers to Mental Health Services for Veterans,” November 18, 2014, https://www.apha.org.

  106 $4.5 billion in medical care: Chris Coughlin, “Money Saved at Misdiagnosed Vets’ Expense,” Courthouse News Service, December 30, 2011, http://www.courthousenews.com.

  106 to just under 100,000: VA, “VA Claims Backlog Now Under 100,000—Lowest in Department History…,” VAntage Point, August 24, 2015, http://www.blogs.va.gov.

  106 480,000 appeals: Interview with Gerald Manar, October 2016; Statement of Manar, Veterans of Foreign Wars, House Subcommittee on Disability and Memorial Affairs, Veterans’ Dilemma: Navigating the Appeal System for Veterans Claims, January 22, 2015, https://veterans.house.gov.

  107 stuck in file drawers: “Whistleblowers: Veterans Cheated Out of Benefits,” CBS News, February 25, 2015, http://www.cbsnews.com.

  107 massive failures: Benjamin Krause, “OSC Busts Oakland VA Regional Office 14,000 Claim Blunder,” DisabledVeterans.org, October 14, 2016, http://www.disabledveterans.org.

  107 returned to their high-ranking posts: Bryant Jordan, “Judge Overturns Demotion of Second VA Official Accused in Job Scam,” Military.com, February 1, 2016, http://www.military.com.

  108 boondoggle: Lee Romney, “Veterans Choice Didn’t Ease Health Care Woes, Especially in Alaska,” from The Center for Investigative Reporting, September 15, 2016, https://www.revealnews.org.

  108 rush schedule: Quill Lawrence, “For Doctors and Patients, ‘Veterans Choice’ Often Means Long Waits,” NPR, June 6, 2016, http://www.npr.org.

  110 legislative: Steve Walsh, “How Congress and the VA Left Many Veterans Without a ‘Choice,’” NPR, May 17, 2016, http://www.npr.org.

  110 “high-performing network”: David Shulkin, “Beyond the VA Crisis: Becoming a High-Performance Network,” New England Journal of Medicine 374 (2016): 1003–1005, http://www.nejm.org.

  111 bothered to warn: No warning regarding quetiapine [the chemical name for Seroquel] or Seroquel cardiac risk has yet been issued by the VA Center for Medication Safety, as of April 1, 2017, https://www.pbm.va.gov.

  Chapter 5: A Marine’s Descent Into PTSD Hell

  113 decided to join the Marines: Most of the personal material in the chapters on Andrew White, Shirley White and Stan White is derived from extensive phone and in-person interviews with Stan and Shirley White, starting in March 2010.

  114 experiences intrusive thoughts: All medical record quotes come from confidential “Progress Notes” from Huntington VAMC, VISTA Electronic Medical Documentation, March 01, 2007–February 12, 2008, with permission of Stan and Shirley White. Some documents related to Andrew White can be viewed at mentalhealthinc.net or at the author’s scribd.com account.

  114 were burned to death: Ellen Knickmeyer, “Demise of a Hard-Fighting Squad,” Washington Post, May 12, 2005, http://www.washingtonpost.com.

  115 came so suddenly: Julie Robinson, “The Cost of War: One Son’s Life Was Claimed in Combat; Another by the Trauma That Followed It,” Charleston Gazette-Mail, March 16, 2008, online at http://veteransforcommonsense.org.

  115 nineteen different: Douglas Kennedy, “Powerful Psychiatric Drugs Harmful to Veterans?” Fox News, May 27, 2013, Online at http://www.cchr.pt.

  116 promoted Seroquel’s off-label use: Martha Rosenberg, “Are Veterans Being Given Deadly Cocktails to Treat PTSD?” Alternet, http://www.alternet.org.

  116 early stages: Brian C. Lund, “Declining Benzodiazepine Use in Veterans With Posttraumatic Stress Disorder,” Journal of Clinical Psychiatry 73, no. 3 (March 2012): 292–296, https://www.ncbi.nlm.nih.gov.

  116 more than 770: Matthew Perrone, “Questions Loom Over Drug Given to Sleepless Vets,” Associated Press, August 30, 2010, online at http://www.nbcnews.com.

  116 growth in antipsychotic use: “Medicating the Military: Use of Psychiatric Drugs Has Spiked; Concerns Surface About Suicide, Other Dangers,” Military Times, March 29, 2013, http://www.militarytimes.com.

  117 “higher risk of becoming fear-conditioned”: Email correspondence with Dr. Richard Friedman, May 2017; Friedman, “Why Are We Drugging Our Soldiers,” New York Times, April 21, 2012, http://www.nytimes.com; Friedman, “Wa
rs on Drugs,” New York Times, April 6, 2013, http://www.nytimes.com.

  117 five times more likely to have PTSD: Alan Zarembo, “Pentagon Study Links Prescription Stimulants to Military PTSD Risk,” Los Angeles Times, November 19, 2015, http://www.latimes.com/science.

  117 second-largest drug expenditure: Perrone, “Questions Loom Over Drug.”

  117 lost its patent protection: Martha Rosenberg, “Controversial Drug Receives Military Restrictions and FDA Warnings as Its Patent Expires,” Truthout, June 27, 2012, http://www.truth-out.org.

  117 damning 2011 Journal: John Krystal et al., “Adjunctive Risperidone Treatment for Antidepressant-Resistant Symptoms of Chronic Military Service–Related PTSD,” JAMA 306, no. 5 (August 3, 2011): 493–502, http://jamanetwork.com.

  117 payouts of over $1 billion: Duff Wilson, “AstraZeneca Settles Most Seroquel Suits,” New York Times, July 28, 2011, https://prescriptions.blogs.nytimes.com.

  117 nearly 800,000: “VA Data Spread Sheet FY 2011–FY 2015 Atypicals,” 3, https://www.scribd.com/document/342907650.

  117 found “dead in bed”: Baughman, “Soldiers of the Iraq/Afghanistan Era Dead.”

  118 needed a waiver: “DoD Cracks Down on Off-Label Drug Use,” Military Times, March 29, 2013, http://www.militarytimes.com.

  118 long after his death: See medical literature search at PubMed, for “quetiapine” and “monotherapy,” https://www.ncbi.nlm.nih.gov; “Seroquel for Insomnia: A Risky Off-Label Treatment,” Mental Health Daily, May 23, 2015, online at http://mentalhealthdaily.com.

  119 various sleazy strategies: DOJ, “AstraZeneca Seroquel Settlement Agreement.”

  119 alleged illegal sales techniques: DOJ, “AstraZeneca to Pay $520 Million.”

  119 whistleblower: Ed Silverman, “Texas AG Lawsuit Claims AstraZeneca Improperly Marketed Seroquel,” Wall Street Journal, October 10, 2014, http://blogs.wsj.com.

  119 official guidelines: VA and DoD, “VA/DoD Clinical Practice Guidelines for the Management of Post-Traumatic Stress,” 2004, https://www.healthquality.va.gov/.

  120 in-depth scrutiny: John Nardo, “Seroquel 1: Introduction of an Atypical…,” 1Boring Old Man, 12-Part Series, February 8, 2011, http://1boringoldman.com.