Outside View: More Army mental health nonsense

By LAWRENCE SELLIN, UPI Outside View Commentator

FORT BENNING, Ga., June 24 (UPI) -- I am at the Continental Replacement Center at Fort Benning, Ga. It is the mission of the CRC to prepare soldiers for deployments to Afghanistan, Iraq and other locations abroad.

Over the course of one week there are medical examinations, administration and financial processing, equipment and weapons issue and briefings on a range of subjects.


In my cycle, there are more than 300 soldiers going through the CRC. Even without hold-ups, the pace is intense. Delays, therefore, can produce significant frustration and stress both among the soldiers and the CRC staff supervising their transition to life in a war zone.

The men and women who have served in the military are familiar with the term "hurry up and wait." It is an unpleasant but a reluctantly accepted part of the routine.


Sunday, I waited about five hours to take a 20-minute mental health test called the Automated Neuropsychological Assessment Metrics. A Pentagon Web site states ANAM is a proven computer-based cognitive assessment tool designed to detect the speed and accuracy of attention, memory and thinking ability. ANAM testing is conducted prior to deployment and can be used to identify and monitor changes in function before and after an injury.

It is intended to help in the mental health assessment of traumatic brain injury and post traumatic stress disorder in soldiers exposed to high explosives or other potentially brain damaging events.

What's there not to like? Apparently a lot.

In an excellent USA Today report this month, Gregg Zoroya writes about the disagreements within the military about the effectiveness of ANAM, the inconsistent use of this test before and after deployment and the potential significant waste of taxpayer money for a test that is both inappropriately administered and arguably not proven to be of sufficient value to warrant the expense.

Here is a sample of the conflicting views regarding the use of ANAM.

U.S. Rep. Bill Pascrell, D-N.J., co-chairman of the bipartisan Congressional Brain Injury Task Force, describes Army efforts to address the problems of traumatic brain injury and post-traumatic stress disorder as a "total failure."


Lt. Gen. Eric Schoomaker, the Army surgeon general, and other Army officials say the test is flawed and no better than a "coin flip" due to the many false positives the test produces. For example, the test results can be affected by common drugs like Benadryl used for seasonal allergies.

Teresa Roebuck-Spencer, a neuropsychologist with the University of Oklahoma, which develops and distributes the testing program for the Army, claims that false positives drop significantly when the post-deployment test is compared with the pre-deployment test.

Zoroya writes that in November 2008 Schoomaker barred post-deployment screening with ANAM. More than 500,000 troops have been pre-screened with ANAM but only 12,000 to 13,000 tests have been used for follow-up comparisons.

By not conducting before and after tests under controlled conditions, there is no way to demonstrate if ANAM is a valid medical tool to identify those who might be suffering from traumatic brain injury and post-traumatic stress disorder.

If the Army doesn't believe ANAM is accurate and isn't interested conducting a pre- and post-deployment controlled study to validate it, then why does the Army continue to administer only the pre-deployment ANAM test at a cost of $30 per soldier?

Is ANAM just a Pentagon public relations exercise to pretend that "something is being done"? Or does the right hand not know what the left hand is doing?


On face value it appears to be not only a waste of taxpayer's money but a total waste of time for the deploying soldiers and the CRC staff.

If nothing else -- General Shoomaker, may I have my five hours back?


(Lawrence Sellin, Ph.D., is a colonel in the U.S. Army Reserve and a veteran of the conflicts in Afghanistan and Iraq. He will soon deploy again to Afghanistan. The views expressed are his own and do not necessarily reflect those of the U.S. Army or government.)


(United Press International's "Outside View" commentaries are written by outside contributors who specialize in a variety of important issues. The views expressed do not necessarily reflect those of United Press International. In the interests of creating an open forum, original submissions are invited.)

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