Magazine article Clinical Psychiatry News

Military to Focus on Improving Mental Health Care: Services Aim to 'Create Culture of Support.'

Magazine article Clinical Psychiatry News

Military to Focus on Improving Mental Health Care: Services Aim to 'Create Culture of Support.'

Article excerpt

ROCKVILLE, MD. -- The recent release of a Department of Defense task force report on the state of mental health care in the armed services may mark an important change in the way the military approaches the mental health of active and former service members.

In the report--"An Achievable Vision: Report of the Department of Defense Task Force on Mental Health"--the joint military and civilian task force concluded that current mental health care efforts within the DOD and the Department of Veterans Affairs fall significantly short of adequately serving military members and their families.

"This report sets a new standard [and] a new level of concern and care for the overall psychological well-being and mental health of our active-duty military," said A. Kathryn Power, director of the Center for Mental Health Services, part of the Substance Abuse and Mental Health Services Administration. Ms. Power, also a member of the DOD task force on mental health, made her remarks at a meeting of the Substance Abuse and Mental Health Services Administration's National Advisory Council.

The report, which Ms. Power called the "only task force report that has focused solely on mental health and substance abuse," arises from the National Defense Authorization Act for fiscal year 2006.

That act directed the DOD to establish a task force to examine mental health services for U.S. armed forces. The resulting report includes nearly 100 recommendations aimed at improving the efficacy of mental health services provided to members of the military and their families.

The recommendations center on four main themes. First, the military needs to create a culture of support for psychological health. This means educating every service member, particularly those in leadership positions, to understand that psychological health is essential to overall health and performance, Ms. Power said.

This also means that early psychological health assessments and referrals to services will be routine and expected. Importantly, the task force used the term "psychological health" in lieu of "mental health" because it was thought that this term would be more acceptable across services and carry less of a stigma, Ms. Power said.

The task force recommended making psychological screening a normal part of military life. One option might be to include a short mental health status screening test as part of routine checkups. "I can't tell you how compelling it was to hear members of the service say, 'You check my teeth twice a year, but you never check my brain,'" Ms. Power said.

In addition, "DOD has been asked to produce its own public service antistigma campaign," she said. The department also will be developing a DOD-wide curriculum on psychological health as an integral part of overall health and leadership training.

"I think one of the most astounding recommendations and certainly one of the most profound in terms of our discussion was the fact that we recommended to Secretary [Robert M.] Gates that the questionnaire [item] about having ever seen a mental health practitioner or provider--that is on every security screening questionnaire in the military--be removed," Ms. Power said.

Defense Secretary Gates has publicly endorsed this change. "One change I support and will very aggressively pursue is removing the question about mental health treatment from the security clearance questionnaire--a governmentwide form. Too many avoid seeking mental health help because of fear of losing their security clearance," the secretary said during a DOD media roundtable in June.

Second, the task force recommended that the military help service members and their families become psychologically prepared to carry out their missions. …

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