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Reintegrating veterans into civilian life has become a battle between antiquated health care models and politically derived incentives. On Tuesday at AEI, two panels of military veterans and mental health and disability experts convened to reorient military policy and health care toward their ultimate goal: ensuring the well-being of America's veterans.
Dan Gade of the US Military Academy introduced the issue of perverse incentives with the reminder that increasing disability compensation encourages veterans to leave the workforce. He elaborated that over-compensation actually feeds identity loss, making transition into civilian life more challenging. Rich McNally of Harvard University expressed concern over disability-identification problems — for example, the fact that misclassification of normal emotional response to combat experience as compromised mental health contributes to over-compensation. Kyle Greenberg added an economic perspective, illustrating how higher application rates for PTSD benefits may arise from preexisting high unemployment conditions.
The second panel homed in on flaws in military clinical care. David Eisler of Columbia University drew from his own experience with post-service transition, stressing that purposefully seeking identity outside of the military is key to successful reintegration. Stephen Xenakis of MindCare Solutions emphasized that current models for disability identification are outdated and thus drastically out of step with the advanced medicine at our disposal, causing much over-diagnosis of PTSD and ultimately hampering the pursuit of alternative vocational identities. AEI's own Sally Satel closed with suggestions for future use of treatment-first models, which would refocus financial aid toward top-notch clinical treatment before diagnosis. Satel emphasized that diagnosis, especially when premature, should not be a long-term metric for employability.
A fundamental principle in both health care and policy design is “do no harm.” Yet many of the government’s well-intended policies to help wounded warriors — in particular, those suffering from posttraumatic stress disorder — create incentives that actually interfere with their recovery.
In this conference, veterans of the Iraq and Afghanistan wars, mental health and disability experts, and an economist will discuss current hurdles to rehabilitation and suggest alternatives that could more effectively expedite the reintegration of veterans into their families, communities, and workplaces.
If you are unable to attend, we welcome you to watch the event live on this page. Full video will be posted within 24 hours.
Thomas Donnelly, AEI
Panel I: Perverse incentives and their effects
Daniel Gade, US Military Academy
Kyle Greenberg, Massachusetts Institute of Technology
Richard J. McNally, Harvard University
Gary J. Schmitt, AEI
Panel II: Correcting a flawed system
David Eisler, Columbia University
Sally Satel, AEI
Stephen Xenakis, MindCare Solutions
Thomas Donnelly, AEI
For more information, please contact Kelly Funderburk at [email protected], 202.862.5920.
For media inquiries, please contact [email protected], 202.862.5829.
Thomas Donnelly is a defense and security policy analyst and codirector of the Marilyn Ware Center for Security Studies at AEI. He is the coauthor, with Frederick W. Kagan, of “Lessons for a Long War: How America Can Win on New Battlefields” (AEI Press, 2010). Among his recent books are “Ground Truth: The Future of U.S. Land Power” (AEI Press, 2008), also coauthored with Frederick W. Kagan; “Of Men and Materiel: The Crisis in Military Resources” (AEI Press, 2007), coedited with Gary J. Schmitt; “The Military We Need” (AEI Press, 2005); and “Operation Iraqi Freedom: A Strategic Assessment” (AEI Press, 2004). From 1995 to 1999, he was policy group director and a professional staff member for the US House of Representatives Committee on Armed Services. Donnelly also served as a member of the US-China Economic and Security Review Commission. He is a former editor of Armed Forces Journal, Army Times, and Defense News.
David Eisler is a program manager for Words After War, a literary nonprofit based in New York City. He is also a veteran of the US Army, having served in Germany, Iraq, and Afghanistan. His writing has been published in The New York Times At War blog, The Daily Beast, the Journal of International Affairs, and Military Review.
Daniel Gade is an assistant professor of political science at the US Military Academy and has served in Korea, Kuwait, and Iraq. During his combat service, he was wounded in action twice and decorated for valor. Despite losing his right leg in combat, he continued on active duty and served as a policy adviser to President George W. Bush from 2007 to 2008. His research interests are concentrated mainly in veterans policy, and he participates in several nonprofit organizations that serve veterans. Gade is also the Ironman 70.3 2010 World Champion (Wheelchair 1 category), winner in his category at Ironman Arizona 2010, and competitor in the Race Across America 2012 cycling race.
Kyle Greenberg is a PhD candidate in economics at the Massachusetts Institute of Technology. His primary areas of research are labor eco¬nom¬ics and pub¬lic finance. Currently a captain in the US Army, Greenberg previously served tours in Iraq and Germany.
Richard J. McNally is a licensed clinical psychologist and fellow of the Association for Psychological Science. In 1984, he was appointed assistant professor in the Department of Psychology at the Rosalind Franklin University of Medicine and Science where he established the Anxiety Disorders Clinic and directed the university counseling center. He moved to the Department of Psychology at Harvard University in 1991, where he is now professor and director of clinical training. He has authored more than 360 publications, most of which concern the cognitive aspects of anxiety disorders (for example, posttraumatic stress disorder (PTSD), panic disorder, phobias, and obsessive-compulsive disorder) including “Panic Disorder: A Critical Analysis” (Guilford Press, 1994), “Remembering Trauma” (Belknap Press/Harvard University Press, 2003), and “What is Mental Illness?” (Belknap Press/Harvard University Press, 2011). McNally has conducted laboratory studies concerning cognitive functioning in adults reporting histories of childhood sexual abuse, including those reporting recovered memories of abuse. His research has been supported by the National Institute of Mental Health. He served on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV PTSD committee and specific phobia committees and as an adviser to the DSM-V anxiety disorders sub-workgroup. He is the winner of the 2005 Distinguished Scientist Award from the Society for the Science of Clinical Psychology and the 2010 Outstanding Mentor Award from the Association for Behavioral and Cognitive Therapies. McNally is on the Institute for Scientific Information’s Highly Cited list for psychology and psychiatry.
Sally Satel is a resident scholar at AEI and the staff psychiatrist at Partners in Drug Abuse and Rehabilitation Counseling. Dr. Satel was an assistant professor of psychiatry at Yale University from 1988 to 1993. From 1993 to 1994, she was a Robert Wood Johnson Health Policy Fellow with the Senate Labor and Human Resources Committee. She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. Her essays have appeared in the 2003 and 2008 editions of “Best American Science Writing.” She has testified before Congress on veterans’ mental health and disability, federal funding for mental health, and substance abuse. Dr. Satel is author of “Drug Treatment: The Case for Coercion” (AEI Press, 1999) and “PC, M.D.: How Political Correctness Is Corrupting Medicine” (Basic Books, 2001). She is the coauthor of “One Nation under Therapy” (St. Martin's Press, 2005) and “The Health Disparity Myth” (AEI Press, 2006), and editor of “When Altruism Isn’t Enough: The Case for Compensating Organ Donors” (AEI Press, 2009). She most recently coauthored “Brainwashed: The Seductive Appeal of Mindless Neuroscience” (Basic Books, 2013).
Gary J. Schmitt is codirector of the Marilyn Ware Center for Security Studies at AEI and the director of AEI's Program on American Citizenship. Schmitt is a former staff director of the US Senate Select Committee on Intelligence. He was executive director of the President's Foreign Intelligence Advisory Board during former president Ronald Reagan's second term. Schmitt's security work focuses on longer-term strategic issues that will affect America's security at home and its ability to lead abroad, while his work in the area of citizenship focuses on challenges to maintaining and sustaining a strong civic culture in America. His books include “Safety, Liberty and Islamist Terrorism: American and European Approaches to Domestic Counterterrorism” (AEI Press, 2010), “The Rise of China: Essays on the Future Competition” (Encounter Books, 2009), “Of Men and Materiel: The Crisis in Military Resources” (AEI Press, 2007), “Silent Warfare: Understanding the World of Intelligence” (Potomac Books Inc, 2002), and “U.S. Intelligence at the Crossroads: Agendas for Reform” (Brassey’s Inc, 1995).
Stephen N. Xenakis, MD, is an adult, child, and adolescent psychiatrist with many years of clinical, academic, and management experience. He retired from the US Army in 1998 at the rank of brigadier general and entered an active career in start-up medical technologies and clinical practice. He has advised the chairman of the Joint Chiefs of Staff and other senior US Department of Defense officials on psychological health and the effects of blast concussion. During his career in the Army, he pioneered the introduction of telemedicine applications, including the development of a device for electronic house-call services. He has had an active clinical and research interest in quantitative electroencephalography and is the founder of the Center for Translational Medicine, which develops treatments and conducts tests on brain-related conditions affecting soldiers and veterans. Dr. Xenakis has authored numerous medical publications and is an adjunct professor at the Uniformed Services University of Health Sciences.