By Christy Crimmins
Military Health System
WASHINGTON, Jan. 27, 2011 – Though the nature of war changes for service members as weapons get smarter, tactics get sharper and medical advances save more and more lives, the stress and anxiety felt by their families never changes, Deborah Mullen, wife of Navy Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, told participants in the Military Health System’s annual conference Jan. 24 in National Harbor, Md.
“Our military families are beginning their day filled with the worry about the safety and security of their loved ones,” she said. “I simply do not believe we fully understand the cumulative effects of stress, anxiety and worry that these families and their loved ones have endured, but we need to try, and we need to do so quickly.”
Mullen discussed fissures and cracks in the family support system and urged members of the Military Health System to help in finding ways to seal them.
Among the most important issues, she said, is secondary post-traumatic stress. Like troops, she noted, families also suffer some of the same anxiety, loss of sleep, panic attacks and other symptoms of post-traumatic stress. Like their loved ones, many family members suffering from secondary post-traumatic stress turn to alcohol, drugs and even suicide, she added.
Mullen explained that while medical privacy rules prevent accurate accounting of cases, anecdotal evidence exists of spouses attempting suicide.
“Because we don’t have the same access that we do to our troops, there is a real limit about what we know about their feelings and their fears,” she said. “I am convinced that much of the desperation these drastic measures represent is rooted in the stigma still attached to mental health issues.”
Mullen suggested that some family members resist seeking assistance for mental health issues not only because of embarrassment, but also due to the fear that their request could negatively affect their husbands’ or wives’ military careers.
“In many cases,” she added, “a service member even warns his spouse about getting help.”
While commending the services for their efforts in overcoming the stigma of mental health problems in the ranks, Mullen said she encourages them to work to eliminate it in the home as well. Those who do seek help, she said, often are confronted with other issues, including misdiagnoses, lengthy waiting periods and red tape.
“All of these things discourage, and indeed damage, the healing process for our families,” she said.
Mullen cited two instances in which spouses diagnosed with post-traumatic stress received multiple prescriptions, but no follow-up or referrals for psychological help. She also described the “15-to-1 rule” encountered by military spouses, an unspoken rule that no matter how many symptoms they may be suffering, they are given 15 minutes to discuss one symptom with a health care provider.
The wife of the nation’s top military officer emphasized the need to treat the whole person -- to look at the totality of issues confronting spouses, and to help spouses confront them.
“You do not need to put on a pair of boots and patrol outside the wire to suffer the effects of war,” she said. “If it is keeping you from living your life and loving your family, you owe it to yourself and, frankly, the military owes it to you, to get you the help you need.”
Ten years of war and multiple deployments have affected children of military families, Mullen said, citing evidence of elevated emotional and behavioral difficulties and the rise of the use of psychiatric medication to treat the increase in anxiety and depression in military families.
“In 2009 alone, 300,000 prescriptions for psychiatric drugs were provided for military dependents under the age of 18,” she said. “Some are no doubt warranted, but I worry that we don’t fully understand the long-term consequences of these medications.”
Additionally, Mullen pointed out the confusion and stress children face when a parent, who may look the same as he or she did prior to deployment, acts differently due to a traumatic brain injury or post-traumatic stress. And while deployment is a definite stressor on military families, she added, reintegration and reunion also can present challenges add to stressors experienced by spouses, children and military members.
Recent information released by the Army indicates that spouse and child abuse cases are on the rise, Mullen noted.
“We have come to understand that while a combat tour may last a year, the effects of that tour on a service member and family may last much longer,” she said. She stressed that the same suicide prevention training being integrated into the military culture should also be incorporated into the military family culture.
“Building resilient families from the beginning of their military life, hopefully, will provide an underpinning of strength that can carry them through the most difficult times,” Mullen said. One method of building this resilience, she told the group, is home-centered assistance, with a trained counselor or medical professional coming into the home and providing assistance.
“It’s about looking at things through their eyes and trying to find solutions that work for their unique circumstances,” she said.
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