Interesting. It’s the first time I’ve heard of a Trump pushing for anything beneficial.
5
Funny, antipsychotic medications are also not "evidence based" for the treatment of PTSD, but plenty of the veterans I see who are receiving PTSD treatment at our VA are being prescribed them...
5
There needs to more research before investing in dogs as “treatment”. Anecdotes are not sufficient nor scientific proof. For example, how do we know whether service animals don’t just increase long term avoidance instead of curing PTSD like CPT or PE can in a shorter time? What if service animals cause increased social isolation and dependence? What about canine assisted therapy, rather than service dogs? Is the money spent on training the dogs efficient or cost effective? What disorders should be covered or not covered? PTSD is multifaceted and not perfectly understood yet. We need more information instead of biased advocacy.
2
@Aaron Michelson these veterans require treatment now, not in some poorly-defined future when we will have "more information." The astronomic suicide rate in veterans with PTSD is no secret. Clearly the VA needs to be doing more to offer effective treatment and also psychosocial support. Instead, PTSD patients in the VA system frequently end up on inappropriate cocktails of medications, carelessly handled. In my region, these patients not infrequently do poorly, and end up being shunted by the VA into the civilian involuntary mental health system, where we get to clean up the mess the VA has made-- for free, since the VA refuses to reimburse our system for their veterans' care. Oh, and it's impossible to coordinate care on these patients since no one at the VA returns phone calls. Do not pretend the VA is interested in providing "evidence-based medicine." As far as I can tell they are mostly interested in looking for ways to save money on the care of complex, high risk patients who deserve better than this.
5
How often does one hear, “Thank you for your service” to all veterans, especially those who return to civilian life injured?
Talk is cheap, especially amongst politicians. I’m reminded of how difficult and time consuming it was for 9/11 first responders to receive help from the federal government.
Thanks for your service? Well, do the right thing!
9
If the VA is so concerned about utilizing evidence based services, why are the veterans not offered EMDR therapy? It is specifically for dealing with trauma and has amazing results in a relatively short amount of time, if done correctly by someone licensed to conduct it.
6
So one thing that is making this a tricky discussion is the assumption that a service animal is treatment for a disability, it is not. It is trained to perform a specific task to provide a person equal access to the public. It can be a part of a treatment plan to help mitigate disability symptoms.But sometimes it is you still need to seek out other medical interventions , like therapy! Find therapeutic techniques that work for vets and look at a multi faceted approach to treatment might actually improve long term symptoms of psychiatric disabilities.
7
Thank you for pointing out that this whole discussion involves complexity! People are individuals, and what works in one case may not work in another. “Evidence-based medicine” is another term that seemingly offers definitive proof about treatments, but is fraught with its own murkiness and bias as you dive into how it actually works. Research methods in this area are mostly built around positivist thinking (it is or is not.) That the VA wants to evaluate PTSD treatment like those for cardiovascular disease shows how the “evidence-based” paradigm falls short in serving the real, complex needs of vets with mental and emotional scars. Given the constant pressure to appear like it is doing right by vets AND saving money, it is no wonder that the VA wants to stay far away from this kind of complexity in decision making.
2
Many people have risked their lives and severed for our country, unfortunately one in five veterans acquire post traumatic stress disorder, also known as PTSD. PTSD is a mental health condition following a traumatic event where it leaves a person with symptoms including flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. One way people with this condition can reduce these symptoms is using a service dog. The V.A. has been conducting research on the effectiveness of service dogs, however the process has been slow in gaining any data. Also, the V.A. is preventing any new service dogs programs from occurring until their internal research is complete. Furthermore, the Department of Veteran Affairs has the study being conducted has had many complications, which include poorly trained animals with health problems or aggressive behavior. “In addition, contractors had discouraged participants from reporting problems with their dogs to the V.A., which tainted the findings early on in the study.” As a result the V.A. redesigned the study that paused research for two years, which hinders the progression of the data. Even though research has not yet proven that dogs can cure PTSD, the V.A. should pay for Veterans service dogs to comfort them in return for their service.
3
It is important to be much clearer about the distinction between SERVICE dogs and EMOTIONAL SUPPORT animals. The public needs good research on the costs and relative values of trained support dogs as well as untrained on-line "certified" companion alligators, squirrels, peacocks, cats and puppies. The abuse of ESAs in housing and travel, allowed with nothing but anecdotal evidence and heartwarming stories, is inflicted on all of us who travel or who have neighbors every day. Let's get reliable evidence and base our mental health diagnosis and treatment on that. Puppies are cuddly. We love our pets. That's not enough to force miniature ponies into the apartment above us.
7
An impatient psychiatric stay can run to six figures, a dog in the thousands at most. It shows that government doesn’t understand “orders of magnitude”. Scary.
11
The PTSD dogs I have met were primarily trained by their owners (with supervision). They were not bred for the job; it is nothing like being a guide dog; a lot of dogs, even mixed breeds, if trained early could do the job. The training took less than 6 months. So, I don't get the 25K price tag. Military dogs should not be conflated with vet service dogs, as they are incredibly expensive to keep on the job and must be isolated from other animals due to their high value.
Another point not mentioned: their owners are usually disabled per the ADA, so you need a good reason to prevent their use. Owners agree to keep them very clean, healthy, and under control. They are a joy to be around, unlike the few fake service dogs I have encountered.
Also, dogs allow some vets to return to work and to stop taking expensive and work-incompatible drugs. Do you want someone who operates machinery on these meds rather than bringing a dog to work?
All in all, many vets will just get these dogs whether the VA pays for them. They can deduct some dog expenses due to their disability.
7
The Armed Forces of the United States already has an extensive training program for dogs that will have special skills. They rely on these dogs in life and death situations. A fair study would seem to be to separate a small portion of these breeders and trainers to create psychiatric service dogs who would then meet the standards of proper training to study their effects. Why not let them expand their program and train dogs for physical needs as well. Why not use the resources we have?
15
Once again we see how every serviceman is described as a hero when they are able-bodied to serve, then when in need of help the government is prepared to treat them as a cheat. Current VA attitudes and policies about PTSD are a continuation of their attitude and policies about Agent Orange.
25
@Svante Aarhenius
As a VA physician, I couldn’t disagree more with your comment. The VA has more experience diagnosing and treating PTSD than any private hospital in the country, and has been funding evidence-based therapies (both inpatient and outpatient) for PTSD for decades. I agree with others that we should be exploring other therapies, both evidence-based (EMDR) and anecdotal (service animals, ketamine etc). Unlike Agent Orange exposure, where correlation and causation are almost impossible to untangle, PTSD has validated screening tools and treatments that the VA is fully funding. A much better parallel to Agent Orange in our OIF vets is burn pit exposure- I think it’ll take decades of research to know the full effects of that and the VA is reluctant to make someone service connected for it without better data.
5
Evidence based medicine is the gold standard. I like dogs, I have a dog, she's my best buddy, but I don't impose her on other people by taking her into stores, restaurants, or actually out in public much except when she goes jogging early morning with my wife.
PTSD is real, and I support fully funding all veterans care forever. Veterans are owed. What I don't support is anecdotal medicine. No aroma therapy, no chi gung, no acupuncture, no service dogs except for the blind.
7
@somsai Pretty cruel of you to say this. You sound like a very close-minded person who doesn't know anyone who is disabled!
Many people benefit from service dogs including those with multiple sclerosis like me. What you're really saying is you're not willing to accept the disabled's needs for service dogs, whether their disabilities are mental or physical, and don't respect the concept of accommodating the disabled wherever they need to go.
It's the law in this country and if you don't want to "impose" your dog on someone else, then don't! If you don't have a disability, and don't use a service dog then why would you bring your dog to stores, to the bank, to a restaurant, etc. in the first place?
We are talking about the VA and THEIR research, not standard psychological/physiological/mental health studies that show patients do benefit from having a pet, not only for PTSD but for hypertension and other illnesses.
You don't support a lot of things, and saying acupuncture is only anecdotal medicine is like saying Chinese medicine is a farce. Live outside your own intellectual borders and learn some things...
20
I am so sick of fake support animals. and so sick of people saying they have ptsd so casually.
9
@nancydrew You definitely could use an emotional support animal!
52
@nancydrew
Yes, some people throw around a casual PTSD self-diagnosis and some have “fake support animals.” This article is about neither. This article is about real PTSD sufferers who had served our country and paid an awful price, and for whom real service dogs can provide real relief.
I’m so sick of callous, non-sequitur comments on articles that should invoke a compassionate and measured response instead.
63
@Sam Lyons I heartily agree. I also do not trust the VA in their assessment. And all the years of research and millions spent for what? If vets who have benefited from trained dogs say they help a great deal, what more do you need other than setting the best training practices in place. It is like insurance companies deciding what your treatment will be rather than the doctors. I hate how our vets are treated. And I hate the few very rich people who make millions and billions off our many needless wars and then not even bothering to pay the soldiers well or see that they are well taken care of if they get out alive. The manufacturers of war equipment pay huge bribes to politicians in congress to have all these wars, they can bribe them a little more to help the suffering of the fodder they needed to implement their money making plans.
10
My nephew, Brian Anderson, a veteran of the Iraq-Afghanistan wars, has suffered from PTSD for a long time. His service dog, Hero, has been just that, a hero. This lovely dog has helped him cope with the stress that Brian has had to live with since his return to civilian life. Brian has also been a leader in promoting alternative form of treatment for our veterans. It’s high time the VA moves its shoes towards helping these men and women!
43
The problem is that The VA went about and conducted their study with complete ignorance of not understanding the proper canine selection process, the matching/pairing techniques and training theories, while just randomly choosing unproven and ineffective "fly-by-night" organizations that because of an unregulated industry adheres to zero common proven strategies and standards. So that's the problem....Here is the answer, that is "Evidence Based Medicine": Canine Assisted Therapeutic Intervention.(tm)
Review studies from numerous higher institutions of learning like Cornell University and Bergin College of Canine Studies, just to name a few. Go visit,study, observe and connect with authentic service dog organizations like ECAD, NEADS and Paws for Purple Hearts but more importantly engage with Veterans that have been matched with highly trained service dogs that exhibit the proper temperament and intelligence to perform tasks without hesitation in order to assist with intervention techniques that mitigate symptoms when they occur.
If the major concern is funding the mentioned grants then that argument holds no weight because some organizations like Paws For Purple Hearts provide trained service dogs at no cost to the veteran with a documented disability that involves Mobility Impairment, PTSD and MST and they (PPH) receives no government funding.
The VA should commit to become good shepherds to the flock they promised to protect!
The Solution: "PAWS NOT PILLS!"
30
PTSD is not unique to veterans. There are many treatments for PTSD, all of which require much hard work from the affected person. The person (victim is not the correct word - it implies helplessness) must not only participate in the treatment but come to accept that terrible things happen to people in this world, and that you must move forward and do painful, anxiety-provoking things in order to get better and live in this world.
If use of service dogs does not prove efficacious in treatment studies, the VA should not pay for them. Psychiatric service dogs seem to be mostly comfort animals, not treatment. I think the VA is right.
Having vets with PTSD train dogs themselves, like prisoners do, could be very helpful to them. Building self- esteem and confidence through dog training and other immersive activities that create successes and get your mind off yourself can help you re-integrate with the world. When you start to feel that you are a worthwhile person and can manage your symptoms and be valuable to others, you are getting better. That’s treatment.
7
@KathyGail
Yes you are correct. If you see my comment below I agree 100%.
@KathyGail You have conflated 2 very different things. Prisoners raise and socialize puppies for their first year, teach them basic obedience skills. Service dog training is done by professionals. It take up to 2 years. It is intensive, training for precise skills needed by a handler for precise deficits. It is virtually impossible to train one's own psychiatric service dog because one would have to teach it during episodes when you cannot function.
These dogs are not companion animals. They go into all areas of public access and do only the specific tasks needed. The most important aspect of training a service dog is choosing the dog that can handle the stresses and demands. Many flunk out mid-training due to being assessed as unable to handle it. Sure there are many fakes out there, too many dogs who are unsuited.
The VA is trying to a survey study across providers rather than choose a certified vendor and looking at the changes brought by the particular dog. That would isolate variabilities in the training and measure only the effect on the patient.
You have no idea what psychiatric illness is and no idea of how a service dog provides beneficial treatment. Perhaps you should get a puppy, raise and train it, and let it teach you compassion for others. Any pet can indeed do that.
13
According to the V.A.’s chief veterinarian, “We want people to use therapy that has proven value.”
Anyone familiar with governmental double-speak can easily translate that remark: We don't want to pay for it.
Considering the limited care and dubious quality of treatment provided to our veterans at V.A. Hospitals, I'm not surprised by their refusal to fund mental-health service animals, especially in light of the growing crisis affecting those who have served our country.
Soldiers troubled beyond the reach of another human often respond to the attentions of a devoted dog. How like the government to throw $16 million away on a “study” and ignore the solution at their feet, staring at them with melting eyes and a raised paw.
14
my pup helps tremendously with quelling my daily anxieties
i cannot fathom how this would not help these vets in need
spend less on the war machine and help our vets
19
As a physician I have often waited for new treatments to be proven effective with research. We are often excited because of anecdotes about the new treatment's effectiveness.
When the results come slowly, it usually means the treatment doesn't actually work very well.
Very effective therapies will often be released early after an interim analysis.
We should let the science work and not rely too much on the story of some guy you know.
16
@dry This is a super-valuable point. Without solid research, the issues that hampered the VA study (unqualified vendors, poorly-trained or unhealthy animals, etc.) would simply be replicated on a larger scale among the patient population at large. The result would be the waste of huge amounts of money, time and effort that might otherwise be expended on more effective treatments.
4
@dry several points.
1) As an almost rabid dog-lover and retired mathematician, I agree completely with you and Jl below but have carried out a discussion with a lawyer friend who's position is just what you decry: "Where we differ is this......the best outcomes from human understanding without studies, the emotional content which drives what some might call common sense."
2) It was disappointing the article did not mention the success rate for E.M.D.R., whatever it happens to be. Nor did it discuss how expensive the various treatments are.
3) Of course, we shouldn't be limiting treatment to vets. Whatever works well ought to be generally available. Anyone for universal health care?
4) Per Tom Ochs, "We're the cops of the world, boy, we're the cops of the world." This too needs to change, for the entire world. It'd be a lot better and cheaper to deal with the problem at the source than after the fact.
5
There are plenty of organizations out there which are pairing canines with veterans. We don't need the VA entering the program. They would most likely choke the program to death with regulations and standards that aren't really necessary.
6
Yeah, right. Dogs never bite anyone. Freedom!!!
1
@Phoenixman: I'm not following your logic. The VA is trying to decide if they will pay for PTSD service dogs. They are not trying to shut down civilian training organizations. That decision will affect the VA and those of its patients who unable or unwilling to get a dog from the "plenty of organizations out there pairing canines with veterans." No matter what the VA decides, those organizations will continue.
5
When I read articles like this and think of the chicken-hawk Republicans who sent these men into battle and now cannot manage to find the money for dogs to help them, I have to contain my anger. Somehow we have $750 billion for a military budget, but cannot do the research and spend the money for a program that could help people without drugs. Purdue is working here? The same Purdue played a giant role in the opiod crisis. Sure, give the money to a pharmaceutical company, what else is new.
14
@CarolSon
I believe it is Purdue University in Indiana, not the pharmaceutical company.
6
This highly effective proven treatment for trauma should be covered. It would save thousands in medical expenses. Just cover it
6
Even partially cover it. Of course, that would be too much like right.
2
@Char
That’s the entire point of the article... while there is anecdotal evidence that this therapy is effective, this isn’t a ‘proven therapy’ and there is no evidence that it would save money in the long run. Hence the reason a study like the one the VA is conducting is needed.
2
Maybe we should go to the source, and stop sending young people to wars that don't need to happen. Why are our young so apparently disposable? And now Pompeo and Bolton are revving up to do it again.
29
@Tricia Valid, but not what the article or discussion is about here. Yes that's an important conversation going forward, but that doesn't mean we shouldn't advocate the best possible care for those who have already been sent to wars, regardless of whether those wars did or did not need to happen.
4
Forgo your scientific research, your lack of common sense in running a pilot program and simply watch the interactions between a veteran suffering from PTSD and their dog. It will tell you everything you need to know.
15
I am not a vet. But after my 12.5 year old died, I can tell you life sucks without him. My dog was the best part of every day, and even when life was hard, he made it better.
PETS FOR VETS!!!!!!!!
14
@Ghost, I agree, PETS FOR VETS helped me a lot. I am so over protective of my dog, and he knows me so well. Helps me to calm down, and sticks by my side all the times.
1
PTSD is very treatable through Trauma Focused CBT and TEAM CBT both with exposure. I’ve seen severe cases cured and/or provide the Veteran with antidotes to their daily suffering. However, there is a motivation issue on behalf of patients of not wanting to do the work, hard work, to get better. Treatment fails because of the patients outcome and process resistance.
Having a dog reduces symptoms and could provide help in motivation to help melt away resistance of retraining the patients brain, but dogs are not a replacement. They, by themselves are not curative, but could be an incentive to go through the entire process of evidence based therapy. To defeat PTSD one has to go through the entire therapeutic process(at times terrifying). This could be a win/win. I would greatly welcome this in my practice. I’d use the dog during the process and then, eventually, the patient would have to face fears on their own! If they use the dog for the entire process, this will backfire as the dog accommodates the PTSD symptoms, and the patients have to rely on the dogs instead of themselves. So a therapist and patient have to contract this eventual separation and reintegration with the dog in order to be cured. I’d love for the VA to try this!!!
10
"The animals were also extremely expensive." If you know of a Veteran with stability problems please have them contact The Service Dog Project in Ipswich, Massachusetts. Service Dog Project partners Vets who have stability problems with fully trained Great Danes. The cost to Vets as well as Civilians for the trained dogs = ZERO Not one cent. The requirement is that if you end up not needing the dog that it be returned the the Service Dog Project farm where it will live out it's days in comfort and love.
42
@joebrown. Great program. A pity the life expectancy of a Great Dane is only 7-8 years.
3
I am a retired VA mental health employee. Most people will not like what I am going to say. There are many fine therapies for PTSD at the VA. Many Vets do not take advantage or they routinely cancel their appointments. Check the NO Show rate at the VA. I also volunteer at the Service Dog Project In Mass. They work very hard to match a dog to the right recipient. They also say no and that gets Vets angry. They charge nothing. The whole organization is run on donations and volunteers. When I was at the VA I took vets to the shelter to volunteer. They bonded with a dog and took it home. It greatly improved their lives. The bottom line with PTSD is this, no matter what you still have to be able to go out in public and learn to deal with society, dog or no dog. Get a pet. My dog makes me feel better all the time. She is just a pet.
52
As a licensed clinical therapist I can tell you unequivocally that, yes, they help! As do therapy horses. It is ridiculous to assume that only human intervention can help someone to heal. The VA had its own issues and to disqualify this amazing group of healers (animals) is to be patently unfair.
21
@kathy
With your attitude, I'm happy to know you have retired.
9
I am disappointed that this article makes no mention of Assistance Dogs International (ADI), the accrediting body for service and guide dog training organizations. The V.A. has made the decision that it will cover some of the expenses related to a having a service dog for veterans as long as the dog was trained by an ADI accredited organization. ADI accredited organizations do not pass on the significant expense of training service dogs to their clients. Instead, they rely on individual donors, corporate sponsors, and philanthropic organizations. I would like to see a follow up article about ADI so that the public knows and understands there are professional standards and oversight in the industry that is service and guide dog training.
19
@Sarah Day I am happy to read your comment. I was thinking of writing a similar one. I have a service dog from America's VetDogs, an ADI accredited organization out of Smithtown, NY. They have their own breeding program -- Labs, which have an 85% success rate, according to ADI -- professional trainers, a wonderful training facility that provides dorm rooms to individuals training with their newly assigned service dog, a professional kitchen with a professional chef for the trainees, and a fabulous administrative and support staff to help the client with all aspects of having a service dog. I just received expert instructions on how to being my service into Canada for an upcoming trip. I was even contacted by the the Nova Scotia Department of Justice, Security Programs Office advising me on how easy it is to being my ADI certified service dog into Canada. And because he comes from an ADI accredited Service Dog program, Nova Scotia is offering that my service dog be certified under the Nova Scotia Service act. Canada does it right, just like their healthcare. Why are Americans so unwilling to take advice from them? Anyway, here are three links to ADI, America's VetDogs and and the Service Dog Act: https://assistancedogsinternational.org/
https://www.vetdogs.org
https://nslegislature.ca/sites/default/files/legc/PDFs/annual%20statutes/2016%20Spring/c004.pdf
2
My husband has Parkinsons due to agent orange in Viet Nam.
He was not leaving the house so I purchased a chocolate lab puppy-Harry
Without any fancy training, Harry can open childproof medicine vials as well as plastic milk containers.
When my husband fell in the middle of the night, Harry would bark and get me.
I attached Harry to his leash, place the leash in my husband's hand. and throw a treat for Harry, stand behind my husband, and he was then upright.
Why does the va need double blind studies when they can just open their eyes?
45
@dr parodneck
But your method of care does not produce lots of billable hours for VA officials. The researchers don't get the money, the subjects don't get the money, the trainers don't get the money.
10
@dr parodneck
The dogs cost 25K each and there are millions of veterans with PTSD. That's no small investment. Furthermore, the standard for any medical therapy should be actual scientific evidence, not anecdote or simply "opening our eyes." Would you seriously argue otherwise? What if the FDA decided to waive their requirement for medical research ("it takes too long") and instead relied on heartwarming stories to make their approvals?
18
@Fiznat
For $200/month we should not be doing this?
Let's compare the "price " of psychiatric hospitalizations over 10 yrs and the life not lead for about $2,400/month.
Perhaps the AKC could partner with the VA and develop an alliance?
10
"In May, the V.A. said the findings of the study, which has cost $16 million to date, would be released to the public in 2020."
American taxpayers should not be wasting that much money on a study when they could easily be accomplished in a timely manner at our academic institutions across the country and done correctly.
21
@Jacquie
You don't seem to be aware that some of our most impactful research over the last several decades has come from the VA, ranging on topics from diabetes to cardiovascular disease to psychiatry. The VA system has some unique advantages when it comes to research of this type, not to mention a disproportionately large population of interest: patients with PTSD.
15
@Fiznat
Right. The VA hospital system actually has better outcomes for most common conditions than private hospitals.
For example, if you went to the VA with a heart attack, you would have a 9% chance of dying. If you went to a non-VA hospital with the same heart attack, you would have a 14% chance of dying. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2618816
The VA has better outcomes because of their careful research and quality improvement program, which few if any private health care systems in the country can match. The VA system is a leader in the world of medicine. They report their results at major medical conferences, and publish their research in the major medical journals. (They just published a comparison of open surgery vs. endovascular surgery for abdominal aortic aneurysms in the NEJM.)
They already partner with academic institutions. Many VA doctors have joint appointments with top academic hospitals. The VA does things that academic hospitals just couldn't do alone.
@Jacquie is apparently not aware of the VA research. Do a Pubmed search.
If instead of following this careful research, the VA just followed the latest fads of the President's sister, that would destroy the present system that works so well.
The VA saves taxpayers a fortune -- by finding out which treatments work and don't work, so they don't waste money on ineffective treatment.
10
@Norman I am ware of the VA research. I am also aware that when they team up with academic medicine they produce good research like we do here in Iowa City where the VA teams up with University of Iowa Hospitals and Clinics to do research.
2
Thank you for this article. It is difficult to understand why the VA does not follow the NIH model for contracting with academia for research. As a clinical social worker in practice and academia, the peer reviewed work as driven my use of animal assisted therapies and witnessed successful outcomes. As a mom of a daughter with a bipolar I diagnosis and PTSD, I know that she would not be alive if she did not have her service dog, a collie named Luna.
Hopefully this article will drive the service dog community to action to an agreed upon set of standards and practices.
21
It's tempting to decry VA incompetence, but that's being naive about the capability of government. Sprawling government bureaucracies simply cannot achieve difficult things (provide health care, housing, etc) effectively, equitably, on-time and on-budget. Government bureaucrats and apparatchiks are only interested in self-preservation (the only qualification needed to work in government). I'm sure everyone with a hand in the failures of the past decade are still at the VA.
NYT readers tend to equate 'small government' believers with right wing nuts. What's truly nutty is being surprised by a story of government ineffectiveness.
3
@Andy Deckman
Making each government agency completely ineffective to justify terminating them is not the right approach to creating anything efficient. Small government is an excuse to move more money into fewer hands it is not intended to help anyone...
22
It's tempting to decry VA incompetence, but that's being naive about the capability of government. Sprawling government bureaucracies simply cannot achieve difficult things (provide health care, housing, etc) effectively, equitably, on-time and on-budget. Government bureaucrats and apparatchiks are only interested in self-preservation (the only qualification needed to work in government). I'm sure everyone with a hand in the failures of the past decade are still at the VA.
NYT readers tend to equate 'small government' believers with right wing nuts. What's truly nutty is being surprised by this story of government incompetence.
Article points out the two main issues quality control of agency producing the dogs and the need for valid and reliable research. Time and money wasted because of these issues. Most important - veterans are going without needed services.
14
@Observer
Would you take a medicine that was not adequately researched or quality controlled?
5
Humane society partnership, while an intuitively appealing idea, has a potential conflict of interest. HC's mission is to find homes for dogs, while service dog program needs ONLY those dogs with proper training and temperament
3
@Observer, not all dogs are suitable to be service dogs but some could be. An acquaintance has a dog that alerts her when her sugar levels are too high. The dog was never trained and her ability was discovered by accident. I met a veteran who said his dog is trained to bring items he needs. He had physical needs but also emotional ones. He said the dog calms him when he has flashbacks. As to the critics cited in the article, animals can be a comfort to anyone, why not to veterans? As long as the animal is relatively calm and even somewhat trained to obey common commands it can be a help.
26
First, the Trump family, including inlaws and outlaws, should stay away from things associated with veterans. Their meddeling will do no good. I have been diagnosed with PTSD since 1993, but the problems associated with it started in the middle 1970s. Service dogs were not even thought of at that time. Since about 2000, I have seen hundreds of vets with PTSD who have service dogs. Service dogs cannot cure PTSD, there is, to the best of my knowledge, no effective treatment for the problem. No pills will work. Few psychologists and psychiatrists really know what the devil the problem is even though they will tell you they can help. No two cases are alike. What service animals do is provide comfort and those that are appropriately trained can tell when something is wrong and intervene in a a loving way by simply letting the veteran know that at least something cares. Dogs are sensitive, they know when something is wrong and they react to it. I don't have a service dog and never had one. When nightmares and flashbacks occur, I would have been happy for a dog to jump into my bed to let me know that he was there to help. Dogs are comforting. In 77 years, I have never lived a month without a dog and cannot envision how someone could live without one. A lick or a nudge is all I need when times are bad, they are indicative that there is something there that cares and a way of refocussing the person it trouble. Purple hearts should be given to PTSD veterans.
74
@Bill Dooley
Best letter of all. Yes, service dogs can help, and yes, like any other mental health issue, "no two cases are alike". Yes, PTSD does exist and yes, it does require treatment. Rarely can these difficult situations be managed by the patient alone.
But it did take the VA quite a bunch of years to even admit there was such a condition as PTSD. That was after it was listed in the DSMV-III in 1980, which was five years after the Vietnam War that began in 1955 had ended. It was three years later (1983) that Congress asked the VA to do a study. Talk about foot dragging.
Vets kill themselves at a rate of 22 PER DAY. Addiction and homelessness are beyond epidemic. But let's spend another ten years having expensive trials led by a group that really doesn't seem to get it in the first place.
9
There are many of us who support local training organizations for service dogs which are placed with people who have hearing disabilities, diseases such as diabetes or epilepsy, autism, and other needs which can be met by a well-trained service dog. It is amazing what these partnerships can accomplish.
It is incredible to me that the VA has had to "reinvent the wheel" in order to research whether service dogs can make a difference for veterans with PTSD or coping with the injuries sustained through military activity such as the veteran profiled in this article. There are hundreds of organizations with proven records which have competed for community grants and needed to show objective results of service dog requirements. A survey of these organizations would have been a better source of data for a large pilot program which in turn could have provided the specific data the VA required while not denying veterans access to a proven resource for help. In fact many veterans worked with combat dogs during active service and would be good candidates to continue working with a service dog.
Pressure from veterans, their families and legislators who are interested in the service dog project is important to make the service dog program large enough to help as many veterans as want to be helped. Perhaps all that is needed is a good reality show to bring the service dog program to the attention of the right audience.!
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@Lynda
There are significant differences in rigor between the "track records" these organizations have documented and actual peer-reviewed, controlled scientific research. The latter, of course, is the standard of evidence that is required when it comes to our medicines and therapies. The VA has to "reinvent the wheel" literally because this is not something that has been rigorously studied before.
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@Fiznat
I am not sure that the standard for service dogs is the same as the standard for medicines nor should it be. I agree that the standard may be the same for "therapies", but I doubt the "rigor" of peer review, controlled scientific research" was conducted before using dogs in combat.
The interest of those opposing the use of dogs for PTSD is primarily cost. Apparently no one connected to the current administration would be paid to provide service dogs to veterans so the dogs must meet standards much higher than combat dogs. Ironic.
The focus of the VA should be preventing suicides in veterans suffering from PTSD. If trained service dogs work with the community standards used by hundreds of organizations preparing dogs to help diabetic children and adults or people with other life-threatening diseases, the VA should be able to do several pilot programs to set up their massive peer-reviewed, controlled scientific research project collecting data unique to veterans.
While we are waiting for the conclusions of the VA research project, pay for service dogs to work with veterans as one way to prevent suicides and improve the lives of veterans.
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I recently saw an episode of "My Cat From Hell" on Animal Planet where a veteran suffering from PTSD has a cat he and his wife adopted. The veteran says his cat helps him with his PTSD. When his PTSD symptoms flare up, the man said that his cat helps him by sitting close to him and snuggling with him. If a cat can help, surely a dog can help too.
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Psychedelics have a science based proven record of treating major depression and PTSD very effectively, psilocybin and ketamine particularly. Eye movement desensitization and reprocessing (E.M.D.R.) is less evidenced based than them. Of course, not getting into horrible and unnecessary wars of choice in the first place is the ultimate idea and evidence suggests avoiding Republican administrations is the solution there.
D.A., J.D., NYC
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Very well stated. Everyone needs a dog..more than one to be exact
@ Dawn
I have more than my fair share. Anyone want a dog?
I have friends that are PTSD vets. Some use pot and some have a service dog. The only difference in the way they both help is the pot eventually wears off and the dog is always there. I have noticed how well behaved the vets dogs are at the VA hospitals. Why not listen to the thousands of vets with PTSD instead of thick headed VA bureaucrats?
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Can we be honest here? If you need anything, the current administration wants to get rid of you and the systems that support you. Not content with 70 years of union busting this administration is Intent on bankrupting the country in order to justify terminating social security, medicate and the VA. (Too bad that you paid into them and these are not the welfare queen "entitlements" the GOP is so fond of.) Looks like they will accomplish their goal by the end of August. They'll probably throw in just enough money to keep things limping along through the 2020 election cycle...
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