Transcript: Sen. Lindsey Graham’s Q&A w/ DOD & VA officials on the handling of military sexual assault, PTSD & suicides

Partial transcript of Sen. Lindsey Graham’s (R-South Carolina) Q&A on the Department of Defense and Department of Veterans Affairs handling of post traumatic stress disorders and suicides of service members who suffered military sexual assault. The hearing before the Senate Armed Services Subcommittee on Personnel was held on Feb. 26, 2014:

Sen. Lindsey Graham (R-South Carolina):
Kind of follow up on that – personality disorder would make one subject to involuntary discharge is that right, Dr. Galbreath?

Dr. Nathan W. Galbreath, Senior Executive Advisor of Department of Defense Sexual Assault Prevention and Response Office [SAPRO]:
Yes, sir.

Sen. Lindsey Graham (R-South Carolina):
And the point we’re trying to make is if you’re a victim of an assault, one of the consequences obviously would be people would be disturbed and they would show…We don’t want to cut off treatment. We don’t want anything other than an honorable discharge. We want to make sure that the person may no longer be able to serve the military but not denied treatment for what happened in the military. Is that correct?

Dr. Nathan W. Galbreath, Senior Executive Advisor of Department of Defense Sexual Assault Prevention and Response Office [SAPRO]:
That’s correct.

Sen. Lindsey Graham (R-South Carolina):
Okay. Now, having said that, personality disorder is often used as a way to separate, and we want to make sure that we don’t deny people treatment but at the same time not deny the military the ability separate somebody from a unit for a cause.

As to this charge, it makes perfect sense to me that PTSD candidates from – a person who’s been sexual assault would have a higher propensity to have post-traumatic stress syndrome simply because of the nature of the attack compared to anything else.

The one category that we left out is combat-related action. Most of the PTSD cases that I’m familiar with come from people who have been involved in a combat-related experience. And I would argue that sexual assault is every bit as traumatic, if not more, so that makes perfect sense to me that that would occur.

Now, about two things: The military system is being scrutinized and that’s fair. That’s appropriate. We have a problem. We have to admit the problem before you can fix it. The question is how to fix it. That’s what the whole debate is about.

But I want to also highlight some of the things about the military that are worth noting.

I asked a question if one of our staff members were assaulted at work. Would they be entitled to medical disability as a result of that assault? I’ve been told that’s not the case. I just want people to understand that in the workplace in the civilian world sexual assaults occur; most employers are not going to be held liable for worker compensation claims based on the criminal acts of a third party. That’s a general proposition of law.

In the military, when the assault occurs during employment, you’re treated quite differently. I think that’s a positive thing. Just realize that if somebody in your own office were assaulted – they’re federal employee – under the law that exists now all of the things available to a military member would not be available to your staff. That’s probably true in the civilian population.

So let’s focus on the fact that if you get assaulted in the military, sexually, there’s an array of benefits and counseling available to you unlike anything that I know of in the private sector, and I think that is very much appropriate because of your willingness to serve your country.

So how we make that better is the subject of the discussion, but we need to realize that our military members are not – they have access to health care, to treatment not available to the average person who goes through a similar experience in the work place, and we want to make it better. But we should be part of the fact, quite frankly, that occurs in our military. We want to make it better.

Now, about expanding treatment options. Both witnesses testified that they believe that services available in the civilian sector could supplement or greatly increase the likelihood of better outcome.

The one gentleman – the Lance Corporal – is Tricare eligible. The other lady is not. How do we deal with that dilemma? What do we do as a Congress to make sure that someone who goes through the disability evaluation process – you make a claim “This happened to me in the military. I was sexually assaulted. As a result, I’m having these problems.” Once the medical board evaluates and the VA or the Department of Defense you’re eligible for compensation based on your evaluation, this gentleman is eligible for Tricare because of his disability rating. The other lady was not. How do we correct that problem?

Dr. Susan J. McCutcheon, National Mental Health Director, Family Services, Women’s Mental Health and Military Sexual Trauma, Department of Veterans Affairs:
Senator, I certainly can’t speak to the compensation process because that falls under the Veterans Benefit Administration, but for our veterans who screen positive for military sexual trauma and every veteran who comes to the VA is screened for these experiences, these are two questions – one question addresses sexual assault that occurred while you were on active duty or active duty for training; and the second question is sexual harassment. If you answer yes to one or both of the questions, you’re considered to have screened positive for military sexual trauma.

Sen. Lindsey Graham (R-South Carolina):
Are you eligible then for civilian treatment outside the VA?

Dr. Susan J. McCutcheon, National Mental Health Director, Family Services, Women’s Mental Health and Military Sexual Trauma, Department of Veterans Affairs:
None VA care is always an option.

Sen. Lindsey Graham (R-South Carolina):
So these two witnesses, has anyone ever told them that? She’s shaking her head no. How can that be?

Dr. Susan J. McCutcheon, National Mental Health Director, Family Services, Women’s Mental Health and Military Sexual Trauma, Department of Veterans Affairs:
What we do do, Senator, is that we have an MST coordinator at every VA facility and –

Sen. Lindsey Graham (R-South Carolina):
Is part of the screening process making you aware that you’re available for treatment outside the VA?

Dr. Susan J. McCutcheon, National Mental Health Director, Family Services, Women’s Mental Health and Military Sexual Trauma, Department of Veterans Affairs:
If you’re screened positive, you’re given a referral to mental health, and we can always connect you with the MST coordinator and that person can explore options for you if for some reason there is an access issue for you – like the gentleman spoke as far as like 90 miles to get to treatment or various things.

Sen. Lindsey Graham (R-South Carolina):
Well, both of the witnesses seem to indicate that while they appreciate the services they were limited and, I understand, over-medication. Every problem you have in the military you have in the civilian world when you deal with these issues. People are afraid to report, intimidated. Defense attorneys have to do their job. The Rape Shield Law exists in the military exists in the civilian community. Some of these problems we’re never going to solve because somebody accused of a crime has a right to defend themselves, and where that right starts and stops is always subject to debate.

But both witnesses seem to be very much unaware that they were – they had access to health care outside of the traditional VA system. How can we – do you agree with that statement by me? And if so, how can we improve that?

Dr. Susan J. McCutcheon, National Mental Health Director, Family Services, Women’s Mental Health and Military Sexual Trauma, Department of Veterans Affairs:
I think in all, Senator – in all of our outreach materials, we encourage veterans to contact the MST coordinator at the facility and that person is in the perfect position to help them as far as coordinating care within the facility or applying for non-veteran care.

What we are finding, Senator, is that every year we’ve been tracking MST-related treatment is that our numbers are increasing every year, and so we are seeing more and more veterans after they have screened positive coming to the VA for services.

Sen. Lindsey Graham (R-South Carolina):
And I would just conclude – I want to end on a positive note. I appreciate the gains made and the focus and the attention. This is a very real problem for the military and I think we’re on the right track. But we can learn from these experiences. This has been a good hearing in that regard. So I really appreciate the additional scrutiny and the Congress’s interest. But for the two witnesses, I do think there’s a gap; I think the average – at least these two, if they’re representative – there seems to be a disconnect between what’s actually available to them and what they perceive to be available to them. So let’s try to fix that.

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