I have a soldier son who has severe, chronic PTSD. I am someone who has had a heavy involvement in the past 2+ years with the DoD Mental Healthcare System, and I have a more than average knowledge of the topics covered within this report. Nothing here is a surprise to me -- but don't get me wrong: I am and will remain eternally grateful that they are asking the questions and recommending corrections, even if my son will have left the service by the time any of the recommendations are implemented. However, anything that will improve the care and services available to our military and their families will help to strengthen our military and, therefor, our Nation.
I strongly recommend that anyone interested in or affected by the mental health of our service members take the time to read the 100 pages of this report and the recommendations. It is a thorough and exhaustive look at the problems of the system... but the proof is in the puddin'. Given the breadth of these recommendations (each of which will cost $$$), it will be interesting to see just how committed to this DoD and Congress -- and the American public -- really are. As you will see from my comments and personal experiences noted in red below, none of the findings is a surprise to me.
DoD Receives Mental Health Task Force Results
Secretary of Defense Robert Gates received the Department of Defense Task Force on Mental Health results and forwarded them to the Congress on June 14. The department will have six months to develop and implement a corrective action plan.
"This report points to significant shortfalls in achieving goals and taking care of our service members and their families," said Dr. S. Ward Casscells, assistant secretary of defense for health affairs. "We will continue to address the need for mental health care in order to reinforce our commitment to providing the best care in the world to our service members and their families who deserve no less."
Significant findings include:
Mental health care stigma remains pervasive and is a significant barrier to care. This is not just with those needing care, but with the senior enlisted who still maintain the "suck it up and drive on" mentality. Note to NCOs: soldiers with PTSD do not negatively reflect on you. Harassing, name-calling, belittling and demoting those who seek help for their combat stress and PTSD does reflect badly on you. NCOs should be held accountable when service members obviously needing or requesting assistance do not receive it. I know that NCOs can not "make" a soldier receive treatment he/she does not want, but many more soldiers would seek counseling much earlier if they knew it was "OK" with the Sarge. I never should have to hear (from many soldiers) that "they treat wife beaters better [in the PLT/CO] than guys being treated for PTSD."
Mental health professionals are not sufficiently accessible to service members and their families. 13 in-patient beds at an Army base with 40,000 active duty/reserve personnel serving a 4th deployment in combat and a service community of an additional 100,000 contractors and family members should be judged criminal. The use of civilian-contracted facilities should be closely reviewed for competence and effectiveness. Every base should have a 24 hour emergency/crisis center or hotline. Service members and their family members should not have to seek a "referral" from their PCP to seek counseling in crisis -- nor should they have to wait weeks to see the PCP for the referral.
There are significant gaps in the continuum of care for psychological health. Service personnel should not have to ask "permission" to atttend couseling or seek help for mental health issues. Treatment for combat stress or PTSD which has been diagnosed by a competent mental health professional should not be "optional". It should be mandatory.
The military system does not have enough resources, funding or personnel to adequately support the psychological health of service members and their families in peace and during conflict. [See comments, above and below.]
Implementation of recommendations and remedies to support our service members has already begun, to include:
Military services have established dozens of deployment health clinics around the country. Just dozens?? OK... it's a start.
Mental health providers have been embedded in line units in Iraq and Afghanistan to perform initial treatment for combat stress and post-traumatic stress disorder. I'd like to see some data or feedback as to whether these have been effective -- from both the soldiers' and command's perspectives.
Service members are receiving additional mental health training to de-stigmatize when they need to reach out for help. Special training on de-stigmatizing needs to be given to NCOs and the PAs who are apt to tell those seeking help that the soldier's career "will be over" if they accept help. I know that not every NCO is a "bad guy" but I did not meet one in my interactions that did not in some way minimize the effects of PTSD. They all talked the talk... didn't see a whole lot of walking.
The services are currently proactively exploring options to adequately resource their mental health care providers. What the hell does, "adequately resource their mental health care providers" mean? They need more counselors, psychologists, psychiatrists. And they need to pay more to those serving and to attract qualified individuals to this service. Tricare needs to increase the rate paid to private providers so long as there is a shortage of mental health care providers within the service communities. I have been informed that additional "beds" could easily be available in military hospitals -- but there are staffing limits ("head counts") that prevent hospital admins from staffing those needed beds. I don't know what the cost of providing mental health services is in military facilities -- but I am told that the outsourced cost is approximately $1,000 PER DAY PER SERVICE MEMBER... and you just KNOW the cost is less in-house.
"I want to thank the members of the task force, the Congress, and especially our medical personnel who have been working so hard to provide compassionate care to our service members with the resources they have been given," Casscells said.
Me, too. Thank you all.
The Task Force on Mental Health was congressionally directed and organized in June 2006 to assess and recommend actions for improving the efficacy of mental health services provided to service members and their families. It includes seven DoD members and seven non-DoD members.
The report can be viewed on the health affairs Web site at
3 Comments:
Your comments on the PTSD committees findings show how much more needs done to make sure our loved ones are cared for. I have such limited communication with my daughter due mostly to physical distance that it is hard to guage her true feelings with just phone calls. It is frustrating and all I can do is let her know I am there for her if she needs me. She's tough on the outside but feels things deeply. Her next deployment is fast approaching and she is very busy with training etc.
I know your son has much to deal with and I pray that he will find healing and strength. Best wishes also to your family and the new grandchild you are looking so forward to.
Treatment for combat stress or PTSD which has been diagnosed by a competent mental health professional should not be "optional". It should be mandatory.
Treatment cannot be mandatory. One of the fundamental tenets of ethics in psychology is the person's right to choose. "Required" therapy could do more harm than no therapy at all.
Anonymous: It's the military. "Command" may not be able to order a soldier/Marine to do what is best for the unit/Army/Corps -- but they can make it clear that it is expected. Having a mentally fit corps is in the interests of the unit and the country (and not to mention putting these future civilians "back together" is in the soldier's and the country's interest as well. (and how ethical can it be to allow people with an altered ability to determine whether they are sick to decide whether to get treatment? what the hell is ethical about that?)
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