November 7, 2009

Saturday, November 07, 2009
The recent tragedy in Fort Hood illustrates the dire need for mental health professionals in the military. “More than two years after the nation's political and military leaders pledged to improve mental-health care, their promises have fallen short at military hospitals around the country, according to mental-health professionals, Army officials, and wounded soldiers and their families.”

This deficiency in staffing escalates all the way the very top where Ellen Embrey can be found temporarily fulfilling the position of assistant secretary of defense for health affairs. Many of her colleagues seem to lack confidence in her ability to improve health care in the military.

In addition, the principal deputy, the deputy for clinical programs and policy, and the chief financial officer post are currently vacant. These vacancies clearly need to be filled as the suicide rate among soldier continues to increase. So far there have been 117 soldiers that have committed suicide this year; already an increase from last year’s total of 103 soldiers.

Despite the clear shortage of appropriate professionals managing the health care in the military, the Pentagon press secretary, Geoff Morrell, insists that more assistance is being offered than ever before. The problem lies in the way in which this help is communicated to those in need.

“Some 34,000 soldiers have been diagnosed with post-traumatic stress disorder since 2003, according to the Army surgeon general's office.” The amount of attention given to the mental health of soldiers has certainly increased since the Walter Reed scandal, where a series of allegations against the facility had been made because of unsatisfactory conditions and management.

Since then, the number of mental health professionals are said to have increased as well. According to the Washington Post, “200 behavioral-health personnel are deployed in Iraq and 30 in Afghanistan. The military has also hired 250 additional behavioral-health providers and more than 40 marriage and family therapists in recent months. The Army currently has 408 psychiatrists for its force of 545,000 people.” Walter Reed Army Medical Center, the facility that interned Major Nidal Malik Hasan, has increased their staff by 35% since 2007. That being said, do the numbers add up? Is there sufficient mental health staff available to treat 34,000+ soldiers with PTSD, not to mention the soldiers that may be dealing with other types of mental illness?

Due to such a shortage, many patients are stuck with whatever service they can get. Joe Wilson, a former social worker at Walter Reed, claims that soldiers have no choice but to stick with the psychiatrist they’ve been appointed because a switch could only make matters worse by delaying the determination of whether a soldier should remain in the service or not. This could force patients to keep quiet about poor or unsatisfactory service out of fear they may be deployed.

Not only are patient/doctor relationships somewhat of a dilemma, but many soldiers may have no choice but to accept pharmaceutical treatment because of the persistent shortage of mental health professionals available to treat the military. This leaves most soldiers with post traumatic stress disorder to be treated with medication such as sleeping pills and mood-altering drugs instead of one-on-one therapy.
The wife of an amputee soldier recovering at Walter Reed with traumatic brain injury and PTSD said that mental-health services are so uncoordinated and ineffective that the couple decided to pay for private psychotherapy sessions with a civilian provider at $130 an hour.

The couple sought private treatment elsewhere after spending a few minutes with a Walter Reed psychiatrist, who then referred the soldier to a social worker for treatment.

"It was a joke," said the wife, who asked not be identified because her husband, a sergeant, is still recovering at Walter Reed. "She was a lovely person, but we have a serious problem here and she just didn't get it . . . She essentially directed me to a Web site."
Many soldiers with mental illness may feel ignored in comparison to physically wounded soldiers. Sophia Taylor, a patient at Walter Reed that is currently being processed for dishonorable discharge, claims that amputees get treated, but those with mental illness lack appropriate treatment. “I have a lot of respect for them. But I lost my mind, and I couldn't even get a simple 'thank you for your service.' "

At Walter Reed, a palpable strain on mental-health system

© www.mentalhealthblog.com

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3 comments

3 comments:

Issues said...

For a long time there has been a shortage of mental health professionals available to work with our soldiers and veterans. I have seen this repeatedly with Iraq and Afghan veterans who are diagnosed with PTSD but receive a grossly inadequate amount of counseling and emotional support.

I believe that part of the problem has to do with the military insisting that only clinical psychologists administer therapy services instead of adding licensed clinical social workers to their ranks of providers.

While they do hire social workers, they tend to be restricted to the medical social work side of the house rather than to psychiatric and mentatal health service.

This is Allan N. Schwartz, PhD, journalist for the mental health web site Mental Help Net.

Your article is excellent and important.

My E. Mail is: dransphd@aol.com

meg said...

You bring up a very good point. Thank you for your comment.

Anonymous said...

Why not consider hiring Licensed Professional Counselors (LPCs)? There are many highly qualified LPCs who are very much capable to serve in the military. These professionals pretty much have comparable training to their counterparts clinical social workers.

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