Even though fewer troops are now going into war zones, Army officials are still struggling to connect soldiers with the appropriate treatment for post-traumatic stress disorder amid a surge in PTSD cases in recent years. However, an impending overhaul of the Army’s mental health care system could help extend immediate, personalized care to those who need it most.
The proposed reforms would bring an influx of mental health specialists to meet the growing demand among soldiers. On-base intensive mental health resources would replace private psychiatric hospitals, and counseling teams would work closely with troops. Doctors who tag along with soldiers in these units regularly meet with commanders to discuss the progress of the people whom they consider to be high-risk cases.
Mental trauma counts among the top issues affecting members of the Armed Forces. Last July, a national survey of more than 2,000 members of Iraq and Afghanistan Veterans of America — which includes members of the Army, Marines, Air Force, and Navy — found that more than 60 percent of respondents said they have been diagnosed with PTSD or traumatic brain injuries. More than 30 percent of respondents also said they have thought about taking their own lives since joining the military.
Now, Army officials want to be more proactive in addressing mental ailments, meeting soldiers in the very environment where anxiety festers. Under the new model, specialists’ offices will be within walking distance of army barracks — which officials say could help soldiers feel more inclined to seek treatment from doctors closely familiar with the environment that’s taking a toll on their psyche. Lt. Col. Phillip Holcombe, chief of behavioral health at Madigan Army Medical Center, located on the Joint Base Lewis-McChord (JBLM), told the Seattle Times that this embedded health behavioral approach is “very well received by soldiers and commands.”
The upcoming embedded behavioral health program comes on the heels of experimental programming that brought forth 200 programs on bases across the country since the start of the conflict in Afghanistan. However, even as two million patients made contact with mental health personnel last year, more than half of soldiers with PTSD still didn’t receive care.
In the aggregate, 70 percent of PTSD patients who follow through with their treatment can recover and maintain healthy relationships, according to army studies. But not everyone follows through. Thanks to the social stigma associated with having a mental illness, some service members who initially connect with a doctor end up dropping out of treatment, saying that such treatment would put them in a bad light with their peers and jeopardize their careers.
Such was the case with Staff Sgt. Robert Bales, now serving a life sentence for the murder of 16 Afghan women and children in 2013. According to Army criminal investigative reports, Bales ignored his wife’s suggestions that he seek mental health treatment before seeing a counselor in 2010 — after his third tour to Iraq — and quitting after three sessions. Medical experts argue that preventative mental health treatment could have proved helpful for Bales, who also struggled with irritability, concentration problems, and low libido after returning from tours of duty.
A clinical study conducted by Army Psychiatrist Tim Hoyt in February touted the benefits of early embed programs, showing that they reduced hospitalizations for psychological problems for soldiers and reduced the number of times that soldiers skipped mental health appointments. Key reasons for those improvements, Hoyt said, involved the rapport that embedded mental health professionals had with soldiers and commanders.
Even with the decline in troops going into Iraq and Afghanistan in the last couple of years, embedded behavioral health programs could prove beneficial to those in combat. Unlike other programs that treat mental illness long after it has manifested, these programs can reduce stress and improve communication in a way that allows commanders to tailor the intensity of assignments to the soldier’s state of mind at that time. “You do the deep dive after a suicide, and the commander just goes ‘If I had just known, I never would have taken him to the field. I never would have put him on this detail.’ But if you don’t know, you don’t know,” Col. Mike Oshiki, a senior doctor assigned to JBLM’s I Corps, told the Seattle Times.
While the mental well being of men and women in uniform has long been a topic of discussion, the issue propelled to national headlines in the wake of CNN investigation of the U.S. Department of Veteran Affairs’ cover up of treatment delays that resulted in a significant number of veteran deaths. Lawmakers have since then moved to improve quality and access to mental health care for soldiers, an effort that resulted in the passage of the Clay Hunt Suicide Prevention for American Veterans Act in February. In recent months, debate has also sparked about the benefits of medical marijuana for those reeling from PTSD and other mental disorders.