PTSD Treatment for Camp Lejeune Marines Returning From Combat

Jan 14, 2013

We talk to officials with the Naval Hospital at Camp Lejuene about the treatment and interventional services they provide to Marines and Sailors returning from combat.

This Tuesday was the 11th anniversary of the September 11th attacks.  9/11 ceremonies were held across eastern North Carolina to remember the thousands that were lost in terrorist attacks on the World Trade Center, the Pentagon, and in Shanksville, Pennsylvania.  This Tuesday, at Lejeune Memorial Gardens in Jacksonville, a couple hundred people turned out for the Patriot Day observance. 

"God of love, we place in your arms the thousands of innocent lives that were lost on that unforgettable morning of September 11th, 2001."

The crowd sat in silence as the stories of people who were aboard the planes hijacked on September 11th were read. There were also stories of first responders and people who worked in the Pentagon and World Trade Center that were killed on September 11th. 

"On their second wedding anniversary, Jermaine told Helen that the World Trade Center had brought them together. When the plane hit the World Trade Center, Helen tried to call Jermaine unsuccessfully.  Instead, she reached her brother, crying.  By telephone, he did his best to hold her hand."

At 8:46, the ceremony paused to observe a national moment of silence.

"At this moment on September 11th, 2001, the first hi-jacked plane crashed into the north tower of the World Trade Center."

Sirens broke the silence symbolic of the law enforcement, fire and emergency responders who died that tragic day. The ceremony also focused on remembering those who paid the ultimate price defending their country in the war on terror.

"At this very moment, brave members of our military are risking their lives for our freedom.  To all of these brave men and women, as well as to their families, we say thank you and God Bless you."

Eleven years later, we are still fighting the war.  However, US troops withdrew from Iraq in December 2011 and combat operations in Afghanistan are expected to come to an end by the middle of next year.  With more military service members returning home, there has been an alarming increase in service member suicides.

According to the United States Marine and Family Programs Suicide Prevention Program, there have been 32 suicides in the first seven months of 2012.  At the current rate, 2012 could be the highest in the past decade.  In July, eight Marines took their lives, making it the highest monthly total this year.  The US Army reported 26 active-duty soldiers committed suicide in July.  August’s figures have not yet been released.

Whether its relationship problems, financial struggles, combat related post-traumatic stress, or repeated deployments, there are many things to consider when trying to identify what would cause someone to take their life.  Board certified psychiatrist in the mental health department at Naval Hospital Camp Lejeune Dr. Victor Barnes says the symptoms of post-traumatic stress are debilitating if left untreated.

“they continue to affect your life, you start to avoid certain places or sounds or things or events in order to decrease the amount of symptoms and they become all involving and basically someone becomes isolated and they’re not able to do or perform their duties because they’re dealing with this severe level of anxiety.”

Camp Lejeune’s Naval Hospital serves marines and sailors and active duty family members and retirees.  Mental health services provided include care for post-traumatic stress, behavioral health, and traumatic brain injury among others.   About 50 percent of the patients that receive treatment at the mental health clinic have post-traumatic stress.  Dr. Barnes says combat related post-traumatic stress isn’t the main cause of suicides, but says it’s just one more variable to consider.

“when you look at combat versus not combat statistics, it seems that about 50 percent, about 50 to 50 percent combat to non-combat suicide attempters and completers, its about 50/50.  So it’s not one or the other, increasing some post-traumatic stress due to combat doesn’t mean it will increase your risk of attempting suicide.”

In an effort to prevent post combat related suicides, Director of mental health at Camp Lejeune’s Naval Hospital, Dr. Sawsan Ghurani says early detection of post-traumatic stress symptoms is key. 

“When they first come back from deployment, they go thru the post deployment testing, and if they’re picked up with PTSD or PTS symptoms, they’re referred to our services, either mental health and/or to substance abuse.  So we really try to capture all of them, however, those test…we can only rely on what the patient tells us.”

Since symptoms of post-traumatic stress can take time to develop, Dr. Ghurani says a companion program is in place for providers reach out to marines and sailors one to two months after returning from deployment.

“they mingle with the Marines to see if anyone has any questions or concerns, and generally people feel more comfortable being able to come up and talk to them. And that way, we can try to capture some of the people that are having problems but just don’t want to step forward and come get help.”

Camp Lejeune’s Naval Hospital also uses the buddy system called ACT to monitor a person’s attitude, behavior and levels of stress.  ACT stands for Ask, Care, Treat.

“Ask point blank, it’s important to ask them… are you thinking about hurting yourself, are you thinking about suicide. Over the years, people have had concerns that if you bring up the topic of suicide, it will increase their risk that they will attempt.  However, that is completely false. You can ask. And then care for them, watch over them until you can get them to care.  And of course treatment.  Get them to treatment. “

The Naval Hospital at Camp Lejeune also provides walk- in service where patients can receive one-on-one treatment.  There’s also acupuncture and art therapy, as well as group therapies.  September is Suicide Prevention Month, and providers in the mental health department recently went through suicide training.  As health care providers seek to put an end to the rising suicide rates among the military, there are some groundbreaking developments on the science front.  There is research currently underway at Indiana University to study how a nasal spray could be used to help prevent suicides among the military and civilians.  Indiana University of Medicine professor and researcher Dr. Michael Kubek.

“When this TRH or Thyrotrophin releasing hormone, which is a neuropeptide is given to patients who either intravenously in the cerebral spinal fluid, it had a profound effect on their behavioral response in major depressive disorders in patients with suicide ideation.”

The problem is getting TRH to cross the blood-brain barrier, which prevents substances in blood from injuring the brain. The United States Army awarded Dr. Kubek a three-year grant to study how to get TRH safely into the brain.  He hopes the nasal spray will become available in three years. 

There are more immediate things you can do… if you or someone you know is suffering from post-traumatic stress, the Department of Veterans Affairs has a hotline you can call. The number is 1-800-273-8255.  You can also make an appointment at the Naval Hospital at Camp Lejeune.  Jared Brumbaugh, Public Radio East.