Wednesday, November 09, 2011

Military Continues to Face Challenges in Mental Health, Suicides


By John M. Grohol, PsyD
Founder & Editor-in-Chief

Military Continues to Face Challenges in Mental Health, Suicides

The U.S. military continues to face many challenges when it comes to mental health care for both their active duty personnel in the field, and when soldiers return home to inadequate care.

The numbers are staggering. In July 2011, 33 active and reserve component service members died as a result of suicide — a record high month. Additionally, the U.S. Department of Veterans Affairs estimates 18 veterans die by suicide each and every day.

While the military has worked hard to focus on the problem in recent years, the new report released by the Center for a New American Security suggests it still has a long way to go.

Part of the problem remains staffing levels, which are still inadequate to meet the needs of most VAs:

Also cited as problematic is a shortage of mental health care providers to treat both active duty troops and veterans. Research by the VA has found that suicide rates decreased by 3.6 deaths per 100,000 in seven regions where staff numbers increased to levels recommended in the 2008 Veterans Health Administration Handbook.

Sixteen regions are still not manned to these levels, the report says. In addition, the Army has filled only 80 percent of its psychiatrist positions and 88 percent of its social work and behavioral health nurse jobs.

Given the current economy and so many people looking for work, it’s odd the military hasn’t been able to staff up to recommended levels across the board.

Nearly half of all suicides in the Army are caused by drug or alcohol overdose. But about 14 percent of active soldiers in the Army are on an opiate medication for pain — the exact same medication that’s ripe for abuse and use as a suicide method.

And while the report commends recent progress on changing the attitude toward mental health issues in the military, it’s clear we still have a long way to go:

[The report] raps the “prevailing wisdom” in the military that suicides are not linked directly to deployments to war.

While an estimated 31 percent of Army suicides are associated with factors that can be traced back prior to enlistment, recent reports have shown that soldiers who have deployed are more likely to die by suicide.

Talk about burying one’s head in the sand… How could the two not be related? Astounding.

Last, because of the ongoing stigma connected to admitting to mental health problems while serving in the military, most personnel are reluctant to volunteer information about their own concerns:

The report also finds flaws in the mental-health screening process following deployment, in which troops are asked to fill out a health-assessment form that asks questions about their physical and psychological status. A 2008 study found that when Army soldiers completed an anonymous survey, their reported rates of depression, PTSD, suicidal thoughts and interest in receiving care were two to four times higher than the responses on the official forms.

The CNAS researchers said that many returning troops lie—and are encouraged to lie—for fear that if they admit to mental health problems, they will not be allowed to go home.

Such assessments also follow military personnel throughout their career, affecting their career advancement and forward movement.

The report isn’t entirely negative. It notes that while the percentage of service members seeking help has improved — from 36 percent in 2009 to 57 percent in 2010 — “the stigmatization of mental health care remains an issue.”

The solutions are fairly simple:

  • Fully fund to recommended staffing levels all mental health professions in both active military and veterans’ roles.
  • Acknowledge the connection between increased suicidal ideation and other mental health concerns with serving in combat roles.
  • Increase health record privacy protections and disconnect a person’s military health record from their formal personnel evaluations, so that admitting and seeking treatment for a mental health concern doesn’t negatively impact a person’s career. If this cannot be done, then:
  • Support and fully fund the use of external mental health services for a soldier once stateside, with complete patient privacy rights for such treatment.
  • Support greater use of peer-to-peer programs that seek to lessen the stigma associated with mental health concerns.

Read the full article here: New Report: U.S. Losing The Battle Against Military Suicides

Read the full report here: Losing the Battle: The Challenge of Military Suicide





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