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PENTAGON REPORT: MILITARY MENTAL HEALTH CARE
SYSTEM IS BROKEN -- 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.
First we have a news story, then a DoD press
release.
Full report from the DoD Task Force on Mental
Health is here...
http://www.ha.osd.mil/dhb/mh
f/MHTF-Report-Final.pdf
Story
here...
http://www.washingtonpost.
com/wp-dyn/content/article/2007/06/14
/AR2007061401643.html?
hpid=sec-nations
Story below:
-------------------------
Pentagon Report Criticizes Troops'
Mental-Health Care
By Ann Scott Tyson
Washington Post Staff Writer
U.S. troops returning from combat in Iraq and Afghanistan suffer
"daunting and growing" psychological problems -- with nearly 40 percent
of soldiers, a third of Marines and half of the National Guard members
reporting symptoms -- but the military's cadre of mental-health workers
is "woefully inadequate" to meet their needs, a Pentagon task force
reported yesterday.
The congressionally mandated task force called for urgent and sweeping
changes to a peacetime military mental health system strained by today's
wars, finding that hundreds of thousands of the more than 1 million U.S.
troops who have served at least one war-zone tour in Iraq or Afghanistan
are showing signs of post-traumatic stress disorder (PTSD), depression,
anxiety or other potentially disabling mental disorders.
"Not since Vietnam have we seen this level of combat," said Vice Adm.
Donald Arthur, co-chairman of the Department of Defense Mental Health
Task Force. "With this increase in . . . psychological need, we now find
that we have not enough providers in our system," he said at a Pentagon
news conference yesterday unveiling the report. "Clearly, we have a
deficit in our availability of mental-health providers."
The ongoing "surge" of more than 30,000 additional U.S. troops in Iraq
and Afghanistan will exacerbate this gap, as will the rapid growth in
the number of soldiers, Marines and other troops -- now about half a
million -- who have served more than one combat tour, heightening the
risk of mental illnesses, the report said.
As in the aftermath of Vietnam, the costs of untreated mental illness
will rise dramatically over time, the report warned. "Our nation learned
this lesson, at a tragic cost," it said. "The time for action is now."
Defense Secretary Robert M. Gates is required by law to develop a plan
of action within six months on the 95 recommendations included in the
64-page report.
The task force, composed of seven military and seven civilian
professionals with expertise in military mental health, was formed in
May 2006. It based its report on visits to 38 U.S. military care
facilities in the United States, Europe and Asia; interviews with care
providers, military personnel and their families and commanders; as well
as expert testimony and research.
The task force found that 38 percent of soldiers, 31 percent of Marines,
49 percent of Army National Guard members and 43 percent of Marine
reservists reported symptoms of PTSD, anxiety, depression or other
problems, according to military surveys completed this year by service
members 90 and 120 days after returning from deployments.
Two "signature injuries" from Iraq and Afghanistan are PTSD and
traumatic brain injury, it said. Symptoms include nightmares and other
sleep problems, trouble concentrating, anger, recklessness, and
self-medication with drugs and alcohol.
The task force identified several barriers to care, including the stigma
associated with seeking help, poor access to providers and facilities,
and disruptions in care as service members move locations.
"Stigma in the military remains pervasive and often prevents service
members from seeking needed care," the report said, citing anonymous
surveys that show most members with symptoms of mental health problems
do not seek help.
Some soldiers underreport problems because they want to stay with their
units, and military officials note that many soldiers undergoing
treatment for stress or other mental problems are allowed to deploy
again after a screening to determine the intensity of their symptoms or
depending on what medications they are taking. Those on lithium, for
example, should not deploy while those on another class of medications
similar to Prozac may be able to, said Army Col. Elspeth Cameron
Ritchie, who assisted the task force.
"If you have a post-traumatic stress reaction, it's not your fault,"
Arthur said. "It's up to leadership to say to folks that post-traumatic
stress reactions are an absolutely normal part of combat operations."
Proposals by the task force to reduce stigma include embedding
health-care providers with units and offering treatment at primary
medical care facilities, where service members can seek psychological
help without singling themselves out. An additional recommendation is
for the military to begin training troops to become more psychologically
resilient, in part by conditioning them mentally, much as they conduct
their physical training.
"We can use virtual-reality therapy, typing smells in to create a
virtual environment," that resembles a battlefield, said Col. Jonathan
H. Jaffin, commander of Army medical research.
National Guard and reserve members -- who often live far from military
bases and return from deployments to rural communities -- face
"particularly constrained" access to clinical care as well as to the
military chaplains and family support networks that active-duty
personnel can tap, the report said.
"The current complement of mental health professionals is woefully
inadequate" to prevent and treat members of the military and their
families, the report said. But it called the process for recruiting
additional trained personnel -- both civilian and military -- "time
consuming and cumbersome," stating for example that the number who could
be recruited over the next six months would be "well below" the number
required to meet the needs.
The shortage is deepening as active-duty mental-health professionals,
also stressed by repeated deployments and other frustrations, are
leaving the military in growing numbers, the report said. The Air Force
has lost 20 percent of mental health workers from 2003 to 2007, while
the Navy lost 15 percent between 2003 and 2006, and the Army lost 8
percent from 2003 to 2005.
Financial resources for mental health treatment in the military are also
lacking, the report found. Congress provided a boost of $600 million for
PTSD and traumatic brain injury in the 2007 supplemental war funding,
but more will be needed, S. Ward Casscells, assistant secretary of
defense for health affairs, said at the news conference.
-------------------------
DoD press release is here...
http://www.defenselink.mil/releases/
release.aspx?releaseid=11015
Press release below:
-------------------------
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.
* Mental health professionals are not sufficiently accessible to service
members and their families.
* There are significant gaps in the continuum of care for psychological
health.
* 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.
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.
* 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.
* Service members are receiving additional mental health training to
de-stigmatize when they need to reach out for help.
* The services are currently proactively exploring options to adequately
resource their mental health care providers.
“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.
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
http://www.ha.osd.mil/dhb/
mhtf/MHTF-Report-Final.pdf
.
-------------------------
Larry Scott --
