COUNTERING MILITARY RECRUITMENT
Articles: Military Service: Casualties
Military Faces Mental Crisis
USA Today
January 17, 2007
An
experienced Navy psychologist warns that the U.S. military does not
have enough mental health professionals to meet the growing number of
emotionally damaged war veterans.
Moreover, Navy Cmdr. Mark Russell says, many of the mental health
professionals on staff lack formal training in core therapies for
post-traumatic stress syndrome. Russell predicts a "perfect storm" of
dire health care consequences.
From his distant vantage point treating Marines at a base in Iwakuni,
Japan, Russell, 46, has been speaking out for three years that the U.S.
military faces a mental health crisis in the treatment of its combat
veterans.
He has fired off memos to higher command and has gone public with his
views, an unusual step for many in the military. Russell discussed his
concerns in phone and Internet interviews.
"We cannot provide the standard of care to treat PTSD via psychotherapy
when we can barely keep up with new referrals and have to manage crises
while filling in for the staffing gaps and vacancies due to deployment,
attrition or no billeting," Russell says. "This is why I have been so
outspoken."
Addressing the issue
Military mental health officials downplay Russell's grim assessment,
noting that training is increasing, aggressive mental health programs
are being created, and civilian mental health professionals are being
hired to provide additional resources.
"Mark really has a tremendous amount of compassion and a real desire to
make sure that everyone gets what they need," says Navy Capt. Warren
Klam, a psychiatrist and senior medical officer for mental health at
the Naval Medical Center in San Diego and a member of the Mental Health
Task Force. "I just think if you look at the bigger picture, it's not
nearly as much of a concern as it might sound. I think DOD (Department
of Defense) is very sensitive to this issue and is trying to work very
hard."
The Navy serves all the medical and mental health needs of the Marine Corps.
Russell says his immediate commanders at the Marine Corps base have
been supportive and encouraged him to speak out. Most recently, they
arranged for him to testify at a San Diego hearing held by the
Pentagon's Task Force on Mental Health. Congress authorized the task
force to examine mental health care in the military. The title of
Russell's presentation was "Perfect Storm."
During that testimony, Russell presented data showing:
*Mental health trauma is on the rise. Army studies show that more than
a third of combat-deployed troops seek mental health care when they
return home.
*Training for mental health professionals is inadequate. A survey by
Russell of 133 military mental health providers done from 2003-05 shows
that 90% of the psychiatrists, psychologists and social workers
reported no formal training or supervision in four PTSD therapies
recommended by the Pentagon and Department of Veterans Affairs.
*Staffing is down. Russell says vacancies remain for mental health
providers in the Navy. In addition, psychiatrists and psychologists
deployed overseas deplete resources at home, and burnout makes it hard
to keep skilled therapists on staff, he says. His concerns were
supported by a 2005 Army study showing one of three mental health
providers deployed in the war zone report high burnout or low
motivation or morale.
Klam says the Army and Navy have emphasized providing mental health counseling in war zones at an unprecedented level.
As a result, he says, the military has a record of returning more than 98% of troops with emotional issues back to their units.
In addition, he says, the Pentagon has aggressively worked to screen
troops as they leave the battlefield and after they arrive home to
learn about lingering physical or mental problems. Klam says training
in the core therapy areas has been increasing.
He concedes, however, that staffing continues to be an issue. His
complement of a dozen psychology positions at the medical center is
down by half. He has brought in four civilian psychologists to fill in.
Staff shortages
Navy Cmdr. Richard Bergthold, a psychologist, says he has no way to
verify Russell's assertions about the broad lack of formal training in
key therapies.
Bergthold agreed that recruitment and retention of psychologists and
psychiatrists in the Navy is a continuing problem. He says the Navy has
72% of the psychologists and 62% of the psychiatrists it needs,
although trainees will raise staffing levels to 85% for psychologists
and 91% for psychiatrists.
After Russell raised his concerns, Bergthold says he canvassed several senior mental health officials within the Navy.
"They do not believe we are currently in a crisis," Bergthold says.
"However, if the Navy were to stand still and do nothing -- which it's
not -- we would find ourselves quickly overwhelmed. ... If we see this
conflict go on with an increased number of folks returning with stress
disorders, it's a question of mathematics. "
Army staffing levels for uniformed psychiatrists and psychologist are
at 80%-85%, but the Army has contracted with large numbers of civilian
mental health officials to help in assisting Soldiers.
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