Concerns over Some Psychiatrists Turning away Veterans with PTSD

It can be difficult to re-adjust to civilian life for military veterans, but some have found it even harder after being turned away when seeking psychiatric help for post-traumatic stress disorder.

Brian Hartigan served with the Australian Army for 12 years. When he returned home he said it took him some time before he finally sought help.

But when he tried to book an appointment with a psychiatrist, he was told by the secretary that their books had been closed for four years and they were no longer taking new patients.

Mr Hartigan said he was disappointed with that response and it took him a number of months to obtain a second referral from his GP.

“I was told that he had appointments available in about six weeks’ time, so I sent my paperwork to them,” he said.

“Two days later the secretary rang me back and said, ‘I’m very sorry but doctor is not willing to take on anymore DVA patients at this time’.

“That was a slap in the face for someone who had built themselves up to go through this process.”

Brian Hartigan, in a blue shirt, looks down the barrel of the camera. He served with the Australian Army for 12 years.

Six-year rebates freeze

The Australian Medical Association (AMA) said they were aware of the issue and blamed the Australian Government’s indexation freeze.

An AMA survey conducted last year revealed that almost 30 per cent of specialists adopted a range of approaches when it came to treating veterans, including closing their books to new DVA-funded patients or treating some as fully private or public patients.

It added that more than 50 per cent of specialists would reconsider how they treated veterans, either dropping out altogether or limiting the services provided to veterans.

“One of the problems with the veteran system is that there’s no ability for doctors to raise a gap above the DVA schedule, as there is for patients supported by Medicare,” said AMA President Dr Michael Gannon.

“This is another example of the long-term consequences of the six-year freeze we’ve seen on rebates.

“It continues to cause problems within general practice, and it’s having a big impact on the care we provide veterans.”

A 2014 study done by the Australian Institute of Health and Welfare found the risk of suicide for young 18- to 24-year-old veterans was almost twice that of other men of the same age.

That is part of the reason why veterans like Mr Hartigan want the Department of Veterans Affairs to fix the system.

“What if a desperate guy called up that doctor and got a knock back like that,” Mr Hartigan said.

“What is that desperate guy was on the verge of suicide and he was told ‘no DVA allowed’ — that’s a very scary prospect.”

‘I begged her for help. She said no.’

For a former RAAF pilot, the sound of an ambulance was enough to trigger panic attacks.

Every trip had to be planned to ensure he didn’t cross a bridge or go through a tunnel, because that too could trigger his PTSD.

“I get too anxious and I feel that I can’t, for example, control a car or control myself,” said the veteran, who wished to remain anonymous.

“I feel extremely insecure and extremely scared for no apparent reason.

“And then I immediately think about the images I saw of a guy with his hands chopped off, or the time they were shovelling up the faces off the bitumen, or thinking about the guys I’ve seen wounded and dying or in rehab.”

The 46-year-old first sought help while serving in Iraq and Afghanistan, but it was only after leaving the air force that he was officially diagnosed with PTSD.

He said his relationships suffered because his family and friends did not understand PTSD, and he became increasingly isolated.

The former RAAF pilot reached out for help again after moving to regional Queensland but found access to adequate care was difficult.

“There was only one psychologist and it was town of around 60-70,000 people,” he said.

“There was many months delay and the price was around $320 for the first consultation, which was almost two weeks of dole payments. So it was difficult to pay.”

The former pilot moved to Brisbane to be closer to medical support and applied to the Department of Veterans Affairs (DVA) for a white card, a government-funded health card that covers medical costs for veterans. But that did not eliminate all the problems.

“I was referred to a psychiatrist that specialises in PTSD issues,” he said.

“When I rang them up and said can I make an appointment, they said they had to see my referral first. She said they had an appointment next Tuesday.

“Within five minutes the receptionist called back and said, ‘We’ve got your referral but the psychiatrist is now taking no new patients’.

“I basically begged her. I said this is a simple thing, I’ve been round the tracks to refer to you, I just need some medication. She just said no.

“I had to go back to the psychologist, who apologised. Even the GP said this happens a lot. Psychiatrists can pick and choose who they want.”

His PTSD led to other health problems, including years of grinding his teeth, which he has also asked the DVA to cover.

“I’ve been waking up at night with bits of teeth in my mouth and on my tongue,” he said.

“The dentist said, you’ve been grinding your teeth for a very long time. He said he sees this in a lot of veterans. The bill for that is up to $35,000, with some implants and so on.”

‘We need to fix this quickly’

In a statement to The World Today, the Department of Veterans Affairs said it was aware that some health care providers do not accept DVA arrangements, but said it did not think it was a widespread issue that affected access to clinical treatment.

The statement argued that there had been a steady increase in the number of psychiatrists providing services to veterans, and that under current arrangements psychiatrists were paid at 135 per cent of the equivalent Medicare fee.

The AMA argued that was still below the regular fee and psychiatrists were not allowed to charge a gap for veterans who have a white card.

“People do need to understand that private medical practice is a form of small business with substantial costs,” Dr Gannon said.

“And with the policies from government on both sides of politics to freeze the money going back to patients, this problem is coming home to roost.

“We need to fix it and we need to fix it quick.”

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