Generational Wartime Behavioral Health Crises: Part One of a Preliminary Analysis

As the USA enters into its 12th year of war, the persistent drum beat of negative news headlines of unmet mental health and social needs of veterans fuels public perception of a twenty-first century military behavioral health crisis. For many Americans, the status quo harkens back to previous wartime crises. Wartime mental health crises continue to happen, despite the personal and financial consequences. This paper address this crisis by carefully tracking the critical decisions that lead to the current situation. This is the first of a two-part preliminary analysis of generational wartime behavioral health crises. We first define wartime mental health crises and how current and past conditions qualify as such a crisis. Next, we point out that there is a continual underestimate of war and post-wartime behavioral health needs. We then provide an extensive review of official military records, government investigations, and news media reports; a compelling evidence of a major crisis in the twenty-first century. In the final section of the paper, we discuss the themes that emerged from the review that both confirm the generational failure to learn fundamental war trauma lessons.     

Exploring Options Including Class Action to Transform Military Mental Healthcare and End the Generational Cycle of Preventable Wartime Behavioral Health Crises

This article examines three major options for transforming military mental healthcare in order to end the pattern of self-inflicted and largely preventable wartime behavioral health crises plaguing American veterans, their families, and broader society since the turn of the twentieth century. Evidence is provided that the first option of maintaining the status quo consisting of internal incremental changes has proven largely ineffectual in addressing the broader issues responsible for perpetuating wartime crises. The second option describes necessary transformative changes required to end the cycle of mental health neglect and preventable crises. However, there are no signs that responsible government agencies are inclined to compel the military to overhaul its system. Lastly, we offer a legal analysis for an unprecedented class action against the Department of Defense to effect change. After reviewing the history of tort law and the US military’s immunity from the Feres Doctrine, we examine legal precedents both domestic and aboard. Legal strategies are described in detail from a landmark class action by British soldiers against the Ministry of Defense (MoD) or Multiple Claimants v. MoD (2003) who sued for failure to properly identify and treat predictable war stress injury like post-traumatic stress disorder. The successful claims from individual military plaintiffs have been instrumental in compelling the MoD to implement necessary reforms of its mental health services and possibly end their cycle of neglect and preventable wartime crises. If successful, the proposed American class action will establish a critical precedent to elevate the importance of mental healthcare on equal footing with physical medicine both within and outside of the military.     

Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part III

The first and second articles in this 3-part series discussed systematic issues related to multiple standardization problems and their compounding impact on the state and federal disability systems. In addition, the lack of standardization negatively influencing the behavioral health (BH) training and treatment processes may have the potential to cause harm not only to the individual receiving professional care but also to the clinician providing the treatment. In the final article of the series, I make recommendations for systemic changes for the field as well as for potentially revising previous models toward moving the Behavioral Health treatment and disability systems into more of a biopsychosocial approach. However, conclusions emphasize that successful implementation of recommendations and models require the involvement of all of the stakeholders in promoting better outcomes and in facilitating individuals; return to the workplace.     

Those Who Hesitate Are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part I

There are multiple factors that impede the implementation of standards into the behavioral health (BH) treatment and disability processes. The combination of physical and psychological conditions as well as the influence of psychosocial issues has consistently been identified as having negative effects on treatment and treatment outcomes. Further, the wide-spread lack of standardization causes a multitude of problems throughout both BH processes. The focus of this first article in a three-part series will examine the explosion of behavioral health claims and the major factors, such as comorbid physical conditions and psychosocial issues, associated with these types of claims. In addition, the overarching theme of lack of standardization will begin to be explored in regard to the problematic definition of disability, communication difficulties between treating professionals and disability insurers and agencies as well as the introduction of bias into the BH treatment and disability processes.     

Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part II

In the first article of this three-part series, an overview of systematic problems related to behavioral health (BH) treatment and disability was discussed. In this second article of the series, I discuss a number of factors that contribute to the lack of standardization regarding the work of all professionals in the area, including those in the BH field, which serve to introduce imprecision into the BH treatment and disability determination processes. From how professionals are trained and continuing to those who are providing clinical treatment, it is essential to understand how the lack of standardization impacts the treatment itself as well as treatment outcomes. This lack of standardization contributes to poorly identified mental health (MH) conditions, no identification of psychosocial issues, and an overreliance on subjective information, including professional clinical opinion, which leads to poorly defensible professional decision-making as well as poorer outcomes in treatment. In this litigious age, it is not sufficient to employ clinical opinion alone as the basis for treatment decisions. The more sophisticated professional recognizes the importance that one's assessment and treatment decisions may later be questioned in court or in a disability determination hearing. The importance of standardization and utilizing the current scientific standards has become imperative in today's professional evaluation and treatment in the area.     

New developments in SPME Part 2: Analysis of ammonium nitrate-based explosives

Solid-phase microextraction (SPME) followed by gas chromatography-mass spectrometry (GC-MS) is a simple, reliable technique for the recovery and analysis of many organic explosives. However, this technique is impractical for the analysis of ammonium nitrate-type explosives due to the extreme polarity, low molecular weight, and high volatility of the amine moiety. This article describes an initial investigation of a derivatization process utilizing alkylchloroformates that converts ammonium nitrate and methylammonium nitrate into a form suitable for recovery by SPME and analysis by GC-MS.     

Behavioral Economic Analysis of Crime: A Critical Review

Behavioral economic analysis of law is about bringing recent research about behavior and choice together with classical law and economics. In this essay we assess its relevance for the theory of optimal law enforcement. It is our view that criminal law is an area where behavioral analysis has a role to play. Notwithstanding the results so far provided by the behavioral approach are somehow disappointing.     

Reconstruction of a real car-pedestrian-accident. Part 2: Modelling and simulation

A real pedestrian-car-crash was reconstructed by use of a multi-body simulation. The main aspect was the use of an individual body surface for the human body model and the car. The simulation allowed a plausible reconstruction of the accident. A good correlation of the contact-pairs in the model and the real forensic data was achieved by variation of the hypothetical szenario.     

Analysis and discrimination of electrical tapes: Part I. Adhesives

This study involved the comparative analysis and discrimination of 90 electrical tape adhesives. The objectives included the evaluation of the ability of individual techniques to discriminate samples and the assessment of the ability of the techniques combined to distinguish samples. The techniques utilized were stereomicroscopy, Fourier transform infrared spectroscopy (FTIR), pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS), and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS). Stereomicroscopy, to assess adhesive colors of black, clear/colorless, and clear adhesives with brown tint, resulted in a discrimination of 53%. FTIR analysis yielded eight distinct groups with a discrimination of 67%. Py-GC/MS analysis resulted in 16 groups with a discrimination of 83%. These analyses confirmed and further subdivided the FTIR groups. SEM/EDS resulted in five separate groups at 17% discrimination, increasing the overall discrimination to above 85%.     

Cross Border Health Care: An Analysis of Recent ECJ Rulings

Recent rulings of the European Court of Justice show a trend towards a virtual European health-care basket. Four developments underlie this trend. First, the competence of the European Union seems to mature in the field of health care. Secondly, through a variety of authorisation procedures, individual Member States can to a large extent determine the conditions for cross border care. Thirdly, recent court cases indicate that the co-ordination of cross border care increasingly becomes a EU matter. Finally, in particular border regions, more flexible procedures for cross border care are being developed. An analysis of these developments from an (economic) institutional/constitutional point of view shows that potential Pareto-improvements can be expected from recent changes. These improvements depend on the institutional/constitutional framework into which these rules and engagements are embedded. Our analysis suggests that, although the current (increasing) role for the EU seems desirable, diminishing the role that individual Member States can play is not. National authorisation procedures, local/regional arrangements and flexible rulings are mechanisms that can secure an efficient level of output and an optimal size of the jurisdiction responsible for cross border care. This leads to the following recommendations: Current authorisation procedures (which differ per Member State) have to be maintained in order to secure an optimal community size for cross border services and goods; Bilateral agreements and flexible procedures in cross border regions should be stimulated in order to adapt institutional arrangements to the demand for cross border care by (a group of) individuals. The increased competency of the EU in the field of health care can best be used to make authorisation procedures more consistent and stimulate regional cross border care arrangements.     

More Than a Glance: Investigating the Differential Efficacy of Radicalizing Graphical Cues with Right-Wing Messages

European Journal on Criminal Policy and Research - In recent years, online radicalization has received increasing attention from researchers and policymakers, for instance, by analyzing online...