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Office of Public and Intergovernmental Affairs

Remarks by Former Deputy Secretary W. Scott Gould

David Lynch Foundation
Washington, DC
May 3, 2012

Thank you, John, for that kind introduction.

My thanks to all of you for inviting me to your National Summit on Transcendental Meditation and PTSD. I'm pleased to see several of my VA colleagues here today—Raul Perea-Henze, Ms. Jan Kemp, Dr. Alex Ommaya, Dr. Sonja Batten.

Your summit is particularly timely as alternative forms of medicine for patients with Post-Traumatic Stress are gaining acceptance, increasing in popularity, and augmenting current healthcare solutions.

It wasn't that long ago—within the lifetimes of many of us in the room this afternoon—when combat- or other trauma-related stresses defied diagnosis, much less proper and timely treatment. Pablum advice like, "Shake it off, you'll be fine," only trivialized deeply rooted pain that stigmatized and ate away at the lives of too many Veterans.

We may never know the number of soldiers and Veterans, stricken by stress, who the system in its ignorance failed to recognize—or acknowledge. After nearly a decade of war, there is a renewed and growing awareness about the consequence of combat, the urgent need to attend to the invisible wounds of war, and our obligation to care for those whom we have sent in harm's way.

I think it is fair to say we are adopting a more informed vision of the many mental stressors that affect our warriors and Veterans on and off the battlefield. Today, we know that many Veterans suffer from Post Traumatic Stress; we know their symptoms and their pain are real. We know that there are proven treatments that can provide hope, relief, and healing. And we are humbled by what we don't know about how to prevent and treat PTSD. But, as evidenced by your attendance here, and by the work you have been doing, you are bringing awareness to the problem and new approaches to deal with it.

I'd like to share some highlights of our efforts at VA. We are working hard to raise awareness about PTSD, provide world class mental health treatment, and seek out new and better ways to prevent and treat PTSD.

The scale of our effort is substantial.

  • Over 20,500 mental health providers treat 1.3 million Veterans, supported by a budget of about $5.8 billion annually.

  • VA uses state-of-the-art Clinical Practice Guidelines for PTSD Care, developed collaboratively with the Department of Defense.

  • We employ an integrated mental health strategy that includes help for families in order to provide continuity of care as servicemembers move from active duty to Veteran status.

  • We screen 100-percent of our servicemembers and encourage treatment through our "Make-the-Connection" campaign, which helps Veterans of all eras learn how other Veterans have benefited from treatment and urges them to seek care and help for themselves.

  • We cooperate with a range of organizations whose dedicated volunteers provide additional options and complementary services.

  • Of course, we all have to combat the factors that make it harder for Veterans to get care, including:

  • Our own culture of "I'm O.K., I can handle this …"

  • Incentives to withhold in the work environment—"If I admit I need help, I'll lose my next promotion."

  • Shielding from friends and family—"He's O.K., just a bad day."

A key factor is the capacity to admit you need help and take the difficult step to reach out. But the fact remains that even when we do get people into treatment, not everyone responds to the treatments that currently offer the most likelihood of benefit. And so we have to learn to recognize, relieve, and cure PTSD in Veteran patients in new ways.

To this end, VA calls on a proud tradition of mental health research and development that has produced effective treatments for PTSD. Among these are cognitive processing and prolonged exposure therapy as well as leading edge clinical care that has been extended to include many alternative and complementary medicine treatments, including meditation.

Last year, VA completed two evidence reviews which screened 1776 articles and selected seven randomized clinical trials for review. The conclusion was that the current evidence on meditation and PTSD needs enhancement.

We know that meditation has been used in treatment of PTSD and we are anxious to identify its benefits and to determine if there are any potential risks for Veterans in its use with this condition. To develop our understanding of the effectiveness of meditation, we grouped meditation into broad categories—mantric repetition, mindfulness, and transcendental meditation—and then set about to carefully study all three kinds of meditation.

As a result, VA supported three clinical trials and nine evaluation projects to study the effectiveness of meditation on PTSD. These projects have begun and we are looking forward to the results across all three types of meditation.

One recently published VA-supported clinical trial on mantra meditation showed that it was helpful in reducing PTSD symptoms, such as hyper-arousal, compared to a control group.

Our meditation field projects have been well received by our Veterans so far, and we anticipate being able to recruit even more Veterans to participate over the next few months. We have also been working collaboratively with NIH and DoD on future research opportunities in this area.

With your help, our understanding of the effectiveness of meditation on PTSD will grow, joining a range of potential therapeutic approaches. What we once imagined as a new care paradigm may find its proven and rightful place in practical applications to the benefit of our Veterans—providing even better care that is safe, effective, and evidence-based.

VA continues to encourage its researchers to explore new areas of treatment for PTSD, including meditation, and we intend to make available additional R&D funding in the future to make this possible.

Thank you for your invitation today to bring attention to the potential that meditation can have on PTSD, and to VA's commitment to expanding our understanding of how to prevent and relieve PTSD with evidence-based studies.

This summit will shed more light on the studies that have been performed, the areas of promise, and the opportunities for future study. Congratulations to the David Lynch Foundation for all you are doing to address the mental health needs of our Veterans.