Stigma remains barrier to PTSD treatment among vets.(ADULT PSYCHIATRY)

NEW YORK -- Stigma surrounding mental illness continues to complicate treatment for veterans with symptoms of posttraumatic stress disorder, experts say.

The stigma exists not just in the military culture but mainly as an issue among young men, M. David Rudd, Ph.D., chair of the department of psychology at Texas Tech University in Lubbock, said at a panel discussion on mental health issues among veterans and active-duty military personnel. The discussion occurred at a meeting sponsored by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, New York.

These young men often perceive experiencing psychiatric symptoms after combat as a failure. For them, it means that they are not invulnerable and that somehow they have done something wrong because they are having problems coping, said Dr. Rudd, who is also a Gulf War veteran. "It's really a sense of this notion of guilt and shame attached to an experience of failure after having been exposed to combat and then somehow feeling like they haven't responded in the way they should have responded," he said.

Many veterans prefer to live with trauma than to treat it, said Dr. Alexander Neumeister, of the psychiatry department at Yale University, New Haven, Conn., and the VA Connecticut Healthcare System, who was also part of die panel. Part of the problem is the evaluation process generally used for patients with PTSD, he said.

The evaluation can take hours, and patients have to discuss the trauma. Patients are often uncomfortable reliving those memories, but the process is key to successful treatment, Dr. Neumeister said.

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