Will re-naming Post Traumatic-Stress Disorder (PTSD) to Post-Traumatic Stress Injury (PTSI) help to reduce patient stigma?According to Matthew Friedman, MD, PhD, the answer is no.
In our last post, I talked about whether or not we should drop the “disorder” from PTSD. Now, let’s get into the discussion the American Psychiatric Association is having.
In 2011, then-Army Vice Chief of Staff Peter Chiarelli made a motion to the American Psychiatric Association asking them to modify the name of Post Traumatic Stress Disorder.
Chiarelli claimed that labeling the condition as a “disorder” creates the stigma that there is something wrong with the soldier as an individual, and acts as an obstacle by preventing them from getting the care they need.
Dr. Friedman, however, believes that simply changing the name without changing anything else would not accomplish anything. He suggests that we instead shift our focus to how the U.S. military handles soldiers who have been traumatized.
As an example, he highlights the fact that the Pentagon does not consider solders with PTSD for the Purple Heart, an unfortunate occurrence that he considers more damaging than the name itself could ever be.
Alternatively, Friedman suggested that following the Canadian model for treating veterans suffering from psychological trauma may be a better solution. He argues that the Canadian model exhibits successful approaches in helping military personnel to “acknowledge their PTSD, [and] to reduce stigma for seeking help.”
The Canadian military coined the term OSI or “Operational Stress Injury,” which pertains to a range of persistent psychological difficulties resulting from service, including PTSD. They also funded counseling centers for veterans and started an education campaign to raise awareness about mental health.
There was one facet of the Canadian plan that I found particularly touching – they consider soldiers with OSI eligible for the Sacrifice Award, the equivalent of the U.S. Purple Heart.
Friedman believes that the Canadian model is “brilliant” because it allows us to have it both ways; in his mind, the stigma is addressed effectively without altering the diagnostic label itself.
Chiarelli countered by pointing out that the Canadian military was forced to invent the term “Operational Stress Injury” because it accepts the guidelines of the American Psychological Association.
Because the new Canadian term only extends to troops, it may be confusing and damaging to soldiers after they leave the military. Chiarelli described a hypothetical example of this issue as, “I left the Army and it was Operational Stress Injury, but now I’m a veteran and it’s Post-Traumatic Stress Disorder?”
Is the Canadian model the next step for how the U.S. military deals with PTSD?
Would you like to learn more about how to overcome treatment barriers with combat veterans?
NICABM is offering a comprehensive training program, the Rethinking Trauma webinar series, which will cover treatments for soldiers as well as the newest mind-body approaches to healing trauma.
Have you had patients who viewed the labeling of PTSD as a stigma discouraging them from seeking treatment? Please leave a comment below.