Military Still Falls Short Treating War-Related Stress

29
Feb 2016
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Despite some improvements, service members remain at elevated risk of dying by suicide

A new study released February 18 shows that the U.S. military is struggling to provide adequate care for active-duty troops suffering from post-traumatic stress disorder and clinical depression.

Conducted by RAND Corp., this study surveyed 40,000 cases, making it the largest ever of its kind. The results are chilling: Only a third of soldiers with PTSD and less than one in four soldiers with clinical depression receive even the minimum number of therapy sessions after their diagnosis.

Military man visiting psychologist

According to military officials, the culprit is a lack of personnel. Commenting on the study, Brad Carson, the acting principal deputy undersecretary of defense for personnel and readiness, said, “We just don’t have enough mental health professionals to meet the demand.”

In addition, many service members are unaware of the mental health services available to them – or unwilling to seek help because of the persistent stigma associated with mental health. While the Department of Defense is working to reduce this stigma, a separate study also conducted by RAND Corp. found that some of their efforts may not be as effective as they could be. In particular, some of those stigma-reducing programs do not target service members who are already seeking mental health treatment.

Military treatment in vulnerable periods above national average

The study did find that the military is taking positive steps to treat at-risk service members during one of their most vulnerable times: immediately after discharging from inpatient facilities. During the first year after being released from hospital care, soldiers die by suicide at a rate of 264 per 100,000, more than 20 times above the national average.

According to the study, 86 percent of those with PTSD or depression were seen by a mental health specialist within seven days after discharging from a hospital, and that figure increased to 95 percent within the first 30 days. In this particular area, the military medical system is well ahead of the civilian system.

In part, the military’s success in this field is owed to a 2014 internal Army medical command memorandum, cited by the RAND Corp. study, that stated soldiers need to be seen within 72 hours of discharging from a hospital. Commanders were instructed to require soldiers to attend a make-up session if one is missed. Moreover, the memorandum established a policy of not discharging soldiers during weekends and holidays to avoid issues with losing track of follow-up care.

Even with more mental health professionals, the standard of care remains low

Another seemingly positive element is that the military has increased its staff of mental health professionals by 42 percent over the last seven years – 9,295 today compared to 6,546 in 2009.

However, increasing the number of staff has not necessarily improved the level of care. Many of the new mental health professionals lack experience; meanwhile, many experienced professionals have been forced into early retirement.

Suicide prevention attorney Skip Simpson, a 20-year military veteran, knows that many mental health professionals lack the necessary training to help people at risk of dying by suicide. This influx of inexperienced professionals means that the military medical system is even less likely to be able to recognize the warning signs of suicide and effectively intervene, leaving military personnel at elevated risk.

The study results show that, while the military is taking fairly effective steps to help soldiers when they are most imminently vulnerable to suicide, it is still struggling to provide the sort of early intervention and care that can prevent deaths from suicide in the long run.

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