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Military leads mental health care transformation

Posted 2/25/2010 Email story   Print story

    


by Lisa Daniel
American Forces Press Service


2/25/2010 - WASHINGTON (AFNS) -- The United States is in the middle of a "cultural transformation" in mental health treatment led by the Defense Department and the military services, the department's top mental health expert told a congressional panel Feb. 24 here.

Mental health resilience "is fundamentally underlying everything we do," Army Brig. Gen. (Dr.) Loree K. Sutton told the House Veterans Affairs Committee.

Doctor Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, testified along with Dr. Ira Katz, chief of the Veterans Affairs Department's mental health services, during a committee hearing on suicide prevention.

In 2009, there were 312 confirmed suicides among servicemembers, of which 26 were in the Reserve components, according to the Armed Forces Medical Examiner System, Doctor Sutton said in testimony submitted to the committee. The data shows those particularly at risk were white men younger than 25, with a rank at or below E-4 who were divorced and had not graduated from high school. Other common factors, as mirrored in the private sector, included substance abuse, relationships, legal or financial problems.

While the impact of deployment is under investigation, Doctor Sutton said, only 16 percent of the suicides occurred in Iraq or Afghanistan. Still, the counterinsurgency and asymmetric warfare that servicemembers have battled since 9/11 "continues to place a great amount of strain" on troops, she said, adding that "the invisible wounds of war can be most deadly of all."

Defense Department data shows that 30 percent of servicemembers who died by suicide communicated their potential self-harm, 49 percent had been in treatment within 30 days of their suicide, and 26 percent had sought mental health resources.

The department's core message to servicemembers and their families, Doctor Sutton said, is:
-- You are not alone;
-- Treatment works;
-- The earlier the intervention, the better; and
-- Reaching out is an act of courage and strength.

"Suicide has a multitude of causes and no simple solutions," Doctor Sutton said, adding that each suicide is as unique as each victim.

Because of that, it is difficult to pinpoint an outreach or treatment approach, she said. The department and the services are using a multipronged, holistic approach to tackle prevention education, research and outreach, she told the legislators.

"We are in the middle of a cultural transformation -- one in which the (DOD) and the services are leading the country," Doctor Sutton said. "'Suck it up and drive on' led us for years, but that is no longer adequate" as an attitude toward mental health problems.

"A new public health model is being led by (Defense) leaders at all levels, starting with the secretary of Defense," she added.

While the medical field is undergoing a "revolution" in neuroscience, it is a complex discipline, and "the human brain is not subject to command and control," Doctor Sutton said. So DOD is leading the way in partnering with other departments and nonprofit groups to better understand and prevent suicide.

For example, the Army began a partnership with the National Institute of Mental Health last fall to conduct the largest study ever of suicide and mental health among U.S. servicemembers. Data collection is to begin in March to assess hundreds of thousands of Soldiers over five years.

Other DOD initiatives that should help in suicide prevention, Doctor Sutton said, include the ongoing effort with VA to have interoperability of electronic medical records, a pilot program for mandatory protocol for treating concussions in the field, and partnerships with VA, the USO and the Red Cross for treatment outreach.

"We are working this at all levels," Doctor Sutton said. "We understand we are in unchartered territory. Never in the history of our republic have we placed so much (burden of war) on so few for so long."



tabComments
5/28/2010 8:52:04 AM ET
Yeah, this article provides me little or no comfort and no sense of protection for seeking help. I am been dealing with major depression for years but try to hide it best I can and too scared to seek professional help. I have sought help in the past but it backlashed on me and now can not get a clearance required for my job. I recently overheard a comment from my First Sergent regarding the Air Force making manning cuts and he stated that the mental cases will be the first to go. I agree that seeking help is a sign of courage, because it takes courage to be labeled a mental case and jeopardize your career.
J.P, Germany
 
3/1/2010 4:02:28 PM ET
I've been around for 32 year in the military health care system. Half the time I couldnt get an appointment and the other half was trying to get quality health care that would make a difference. And like so many other military men and women you wouldn't catch me reporting PTSD and major depression. No way. That would have been a career ender. So we do what has been done for decade. We self medicate and try not to hurt ourselves and our families. All the time the military sweeps it aside. And when my daughter needed in resident treatment for suicidal threats addictive traits -- major depression and a number of other clinical issues Tricare denied the care. Tricare will cover the cost to repair a broken leg but will not treat mental health issues. They don't want to cover it even if this 16 year old child threatens to walk in front of a train. That's not covered. So yes, any improvement would be a major departure from the current trend.
D Jacobs, Florida
 
2/28/2010 2:41:31 PM ET
I take the good news with skeptism. I served 26 yrs. Too many still fear that seeing a psychiatrist or psychologist on their own will mar their career. Plus we have a tendency to give administrative justice instead of seeing the invidual is very depressed and suicidal. The VA needs to go a long way to get more real caring people, believe me. After retirement I worked with many of them. A sad system. Many of those civilian employees are truely a number to push through. A real care-less attitude. Check the suicides after having seen a VA psychiatrist. Oh, give them more heavy duty drugs and out the door.
Bear, Polson MT
 
2/26/2010 8:39:19 AM ET
I pray for the new VETs. I have been fighting VA since '86 over mental and PTSD issues from VN. I am cat. at 30 percent disabled, my mil records were lost or destroyed. The President promised concurrent receipt for Chap 61 vets, it didn't happen. I am still fighting the evaluation and looks like it will be a long process.
M H White, Illinois
 
2/25/2010 8:25:03 PM ET
As a former airman E-5 during the Vietnam Era I was affected and have bipolar disorder. This article is SO RIGHT ON... Thanks for the candid view and I'm glad the services are taking this very seriously. I worked with a wounded Army Warrior from Iraq that lost a third of his brain matter from a mortar shell... He almost committed suicide twice. His mom, me and many others helped him cope...It is a team effort.
Frank Mottola, Florida
 
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