Reducing Stigma Provides Key to Better Mental Health in Military

Mental Health of Soldiers

The key to improving mental health care in the military and in America is to reduce the stigma associated with seeking help, Defense Department medical officials said today.

The officials spoke during the release of the latest department Mental Health Task Force Report at the Pentagon.

Ward Casscells, assistant secretary of defense for health affairs, said the issue of reducing stigma associated with servicemembers and their families seeking mental health help is crucial to success in this effort.

"We need all the input we can get," Casscells said. "We're out there talking to soldiers, line commanders, people in the corporate world, people in the university world, Institute of Medicine. We've got two eyes open, two ears open, a lot of eyes and ears open, so we're looking for ideas on that."

Casscells said the message he is trying to get to commanders and troops is that it is all right to seek help. He said many famous people in history have suffered from depression.

"Martin Luther, Gandhi, Beethoven, Sigmund Freud, Patton, Churchill, Abraham Lincoln, every one of them had bouts of depression through their life, and every one of them became a great success in some way," he said. "Now you wouldn't have wanted a weapon in Mozart's hands, but he made enormous contributions."

Better screening of servicemembers for possible mental health problems is part of the effort, Casscells said.

"We've got these post-deployment questionnaires that you fill out when you leave theater," he said. "When I left Iraq, I filled out a questionnaire and said: Were you near an IED that went off? Are you having trouble sleeping? Are you having trouble controlling your feelings? And so forth, and so on. A lot of people check 'no' because they want to get home."

New methods seek to assure troops that "even if they check 'yes,' they're going to get home and get the care when they get home, that they can fill this thing out honestly," he said.

Another issue is follow-up care.

"We are getting some retired soldiers, including chaplains and psychologists, who are going to make it their business to contact people at six months and say, 'I just want you to know that we haven't forgotten your service. I'm a veteran. And don't forget there are all these things available to you. And by the way, I'm here to talk to you. I struggled with this or that. And you can call me confidentially because I'm not in the chain of command,'" Casscells said.

"But we want to make sure that at six months, we've got everybody contacted," he said. "And so we are working toward that goal."

Rear Adm. John Mateczun, Navy deputy surgeon general, said the stigma of mental health problems is a pervasive problem. "We hope to find new ways to be able to deal with the questions that people have in their mind about seeking mental health support," he said.

The admiral said the Navy is reviewing policies about care for mental health and what that means for deployment.

"We have a lot of people who may not seek mental health care appropriately," Mateczun said. "One of the results of Operation Desert Storm and the reviews that went on about mental health care after that conflict was that there were a number of people that actually deployed with diagnoses, with medications that they had received from private practitioners that we didn't know anything about."

The services need to make sure that people with diagnoses who are able to deploy, are given the proper medications and treatment, Mateczun said.

"We've reviewed our weapons qualifications policies and ... have modified our physical qualifications criteria so that those people who are on routine medications and doing well can continue to qualify and bear arms."

Ease of access to care concerns the Maj. Gen. Gale S. Pollock, commander of U.S. Army Medical Command.

"One of the changes that we've made is a program that we've called respect.mil," she said. "Instead of requiring the soldiers or the family members to go to a designated location because you're getting behavioral health care, it's now done inside the primary care area so that we can do the assessment, and people can just come to the clinic for behavioral health issues the same as they would come for any physical health."

Navy Vice Adm. Donald Arthur, co-chairman of the task force, said the group has finished its work and represented the finished report to Defense Secretary Robert M. Gates. The Defense Department will have six months to develop and begin to implement an action plan.

Other officials and experts who spoke today were: Maj. Gen. Bruce Green, Air Force deputy surgeon general; Col. Elspeth Cameron Ritchie, psychiatry consultant to the Army Surgeon General; Ellen Embrey, deputy assistant secretary of defense for force health protection and readiness; and Shelley MacDermid, professor of child development and family studies at Purdue University.