University

04/12/2010

Special courts for veterans? No thanks.

It’s simple arithmetic:  more and more veterans are showing signs of post-traumatic stress disorder(PTSD) and traumatic brain injury (TBI), as more and more soldiers are coming home from war.  This adds up to tragedy.  More veterans are getting into trouble after they return home, and many of them are in the nation’s prison system. 

A recent study suggested that six percent of new inmates in the Texas prison system are recently returning veterans, and now that state is trying a new approach to address the problem:  special courts for veterans. 

Modeled on “drug courts” that offer drug users social services and mental health treatment instead of jail time, the veterans courts – which are either operating or ramping up in six Texas counties – would try to identify veterans whose crimes can be traced to combat stress or the attempt to cope with it, and offer them social and mental health services and treatment for addictions instead of jail time.

Saybrook psychologists who have worked frequently with soldiers say they appreciate what Texas is trying to do, but are skeptical about the idea. 

Psychology faculty member Alan Vaughan is both a psychologist who’s worked with deployed veterans overseas and an attorney.  He says additional mental health resources for current soldiers and veterans are “necessary,” but that the special courts may quickly run into ethical/legal problems.  “The rationale for this new judicial approach is that ‘special consideration is given because they have served the country,’” he says.  “Active service men and women and veterans certainly deserve this new mode of support and much more. However, it strikes me that the 14th Amendment of the U.S. Constitution affords ‘equal protection’ to all U.S. citizens under the law. Many U.S. citizens suffer from PTSD and substance abuse, if not traumatic brain injury, caused by the history of terror and trauma from racism, poverty, domestic violence, immigration etc.  I think these citizens of the United States should also be entitled to court diversion programs, mandated treatment, and to have any criminal record expunged upon successful completion of the treatment programs.”

That need is huge, he points out.  “The jails are over populated with people who have mental disorders and substance abuse problems. They are being warehoused with little or no treatment at enormous expense to tax payers.”  The notions that only veterans are entitled to better treatment as a matter of course seems compassionate at first glance, but is indefensible upon a hard look. It’s also a bit of a dodge:  don’t soldiers deserve quality mental health care while they’re still in the military?

“The danger presented here by the Texas special county courts is creating ‘special classes of citizens’ who receive ‘special treatment,’” Vaughan says.  “I think the government should provide treatment for service men and women before they are discharged from the military. I also hope more mental health treatment will become available to the larger citizenship through reform in the health care laws, as we move toward a national health plan.”  
 
Stanley Krippner, co-author of Haunted by Combat, agrees that the prospect of special veterans courts is ethically dubious, but he is just as concerned that they won’t be effective either.  “At first glance, these specialized courts appear to be well-meaning because they take into consideration the special problems faced by war veterans with PTSD and/or traumatic brain injury,” he says. “But there are several problems that complicate these simplistic attempts to deal with these issues.”

First, Krippner says, “There is an assumption that the link between combat injuries (both physical and psychological) and criminal activity is clear-cut and well established. But it is not. Each case is unique, and a simple cause-and-effect scenario is difficult to pin down, both from a legal and a medical perspective.”

Second, he wonders, “What expertise do judges have in making these decisions?”  While many of the judges will be veterans themselves, that empathy doesn’t necessarily translate into effective therapy – or legal decisions. “These are issues few of them ever heard discussed by their law school professors.,” Krippner says.  “They will depend upon the testimony of mental health professionals, many of whom hold divergent points of view and some of whom have had no supervised training in the diagnosis of PTSD or traumatic brain injury.”

Finally, he wonders where the money for effective treatments will come from – a fair worry, given that Texas law has authorized the courts to exist, but provided them no extra funding.  “These humane alternatives to jail terms will be expensive.  Who will pay for the therapists?” he asks.  “One recent study indicates that about 20% of U.S. psychotherapists have had the necessary training to deal effectively with clients with PTSD. And a minority of rehabilitationists know how to handle patients with combat-incurred traumatic brain injury.”

The result may be a well meaning, compassionate, attempt to give veterans better care that fails to do so – at a cost to our legal system.  Potentially the worst of both worlds.

Veterans, Krippner and Vaughan agree, deserve better – and so does everyone.

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Posted at 02:30 PM in

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