Military Mental Health Issues

Hundreds of thousands of United States veterans are not able to leave the horrors of war on the battlefield (“Forever at War: Veterans Everyday Battles with PTSD” 1). Post-traumatic stress disorder (PTSD) is the reason why these courageous military service members cannot live a normal life when they are discharged. One out of every five military service members on combat tours—about 300,000 so far—return home with symptoms of PTSD or major depression. According to the Rand Study, almost half of these cases go untreated because of the disgrace that the military and civil society attach to mental disorders (McGirk 1). The general population of the world has to admit that they have had a nightmare before. Imagine not being able to sleep one

Over the last decade, the wars in Afghanistan and Iraq have drastically increased the need for effective mental health services and treatment for U.S. veterans and service members, especially those suffering from Posttraumatic Stress Disorder (PTSD). Nearly 1.5 million American service members have been deployed in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) since the attack on the Twin Towers in September 2001 (Price, Gros, Strachan, Ruggiero, & Acierno, 2013). Approximately 25% of soldiers and wounded warriors returning home from OEF/OIF present with mental illness due to combat-related violence and other trauma exposure (Steinberg & Eisner, 2015). According to Price and colleagues (2013), OEF/OIF soldiers and veterans are at greater risk for developing mental illness compared to others who served in past military operations.

This paper explores post-traumatic stress and how it is seen as a disorder. Post-traumatic stress can manifest into post-traumatic stress disorder. The evaluation and review books and articles seem to reveal a relation to these symptoms and military member, either active or non-active veterans. These symptoms do not manifest strictly into the full-extent of the disorder in all cases of military, however, things such as depression and other physical symptoms are discussed through the readings. The end result is that we discovered that through the readings PTSD will in fact lead to suicide if left untreated.

There is concern about military service members receiving stigma about getting or needing treatment in the area of mental health. Stigma occurs when individuals view others negatively because they have been labeled or identified as having a deviant behavior against societal norms; deviant behaviors such as mental illnesses or diagnoses uncommon or harmful to others. How does that impact the military? Military men and women alike are termed heroes, warriors, and survivors; this is quite the reputation to keep up. Military members go to war or deploy to hostile combat environments, which many come back with severe mental illnesses and diagnosis that need immediate care. At this point they may not feel like a hero. The terms psychological, mentally ill, PTSD, and behavioral health has gained a reputation as having or being a problem. Being labeled a problem is not what service members want. Many studies are trying to pinpoint the problem and resolve the stereotypes associated with getting treatment. Consequently, an individual’s attitude toward mental health treatment is thought to be affected by other people’s views on mental health care (Held & Owens, 2012).

Psychological support for troops has emerged as a necessity because this kind of work can deal, to a considerable extent, with a set of specific psychological problems arising within disciplinary systems at all levels, not the lower echelons alone, as is often believed. Occasionally it is just the matter of an enlistee being unprepared for discipline-abiding lifestyle (ignorance of army regulations, orders and regulatory documents). Sometimes, however, psychological problems stem from clearly expressed anti-disciplinary attitudes in some or other serviceman, which attitudes tend to disorganize military activities, mixing, and off-duty routine.

Bennett, PhD; Hilary J. Liberty, Ph 2013 107). Prior research has evaluated the prevalence of MH concerns and opportunities for treatment at various points in the military/veteran career including post deployment, among those being treated at Veterans Affairs (VA) facilities, and in the general population) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 107). The National Survey on Drug Use and Health (NSDUH) data indicate that a substantial portion of young veterans in the general population have substance use disorder (18%) or Serious Psychological Distress (SPD) (14%) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 111). All in all, the NSDUH proved to be an extremely valuable resource for this study, and indeed, the results of this analysis for unmet treatment needs have identified important directions for further research into reasons for not getting treatment, especially for SPD (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 113). The Veterans Administration and National Survey on Drug Use and Health (NSDUH) are taking steps in the right direction to help our veterans with their unmet needs with substance abuse and PTSD. Some examples of improvements are, better mental health evaluations before leaving active duty, more information about military service, and tracking trends among veterans in the general population, who are not necessarily in contact with the

99). Similarly, both articles mentioned PTSD symptoms as being a barrier overlapping with depression. Baker, Kilmer, Lemmer, Goldsmith, and Pittman (2012) provided more in-depth information that focused primarily on PTSD and depression as to where Connor et.al (2013) looked into more barriers other than the overlapping symptoms as being reasons for barriers for treatment in combat veterans.  Baker et. al (2012) examined 2 significant mental  health issues including PTSD and depression in OEF/OIF combat veterans in their entire research study.  These researchers found that health related quality of life (HRQoL) is highly affected in both disorders. Although the study used a clinician-administered PTSD scale (CAPS) as well as standardized and structured interviews conducting to the DSM-5 criteria, the fact alone remains that the overlapping symptoms could be difficult for veterans to understand. The participants in this study consisted of 200 OEF/OIF veterans who completed an interview as well as self-report questionnaires. The sample included 95% men, 45% active duty, 55% veteran; ages 19-52, median 27%; 77% non-Hispanic/Latino, and 80% white. The findings revealed that PTSD and depression have overlapping symptoms as anhedonia, concentration, and insomnia. In conclusion, the results from the

The OPORD 14-83 is the federal level regulation in the Military that addresses the issue of Posttraumatic Stress Disorder, depression and suicide. These health issues are not new phenomena’s, especially in the military health system. PTSD can be dated back to WWI, when it was simply called “shell-shocked”. However, with the co-occurring Iraq and Afghanistan wars, and the number of soldiers returning with mental health concerns, this issue has been pushed to the forefront of the media. Every shooting, suicide, or homicide involving a service member, the news makes a point that these service members must have gone untreated. Even the president of the United States passed an executive order to address the mental health crisis (Executive order, 2012). It is alarming that RESPECT-Mil and the OPORD 14-83 are not discussed in conjunction with the numerous news stories about ailing service members. No major editorial or newspaper has discussed this policy, however, more targeted sources such as Medical Daily, local base papers such as the Ft. Campbell Courier. Huffington Post online was the most publically broadcasted article about the policy. The article titled Military Mental Health Care: One Size Does Not Fit All, was written by Dr. Engel in 2010 and updated in 2011. In this article, he praised and discussed what he described as the high-quality specialized care program that is mandated in all Army primary care clinics (Engel, C. 2010).However, this article was not in regards to

The wars of Iraq and Afghanistan have not only renewed the appreciation for our nation’s military, but it has also raised awareness about the sacrifices and the culture that is produced through the ranks in uniform and also amongst veterans. While it is important to note how the Department of Defense, and The Department of Veteran Affairs have significantly ramped up their efforts to address and identify the transitional problems that affect many veterans, barriers to treatment remain along with the challenge to provide successful outreach through benefits and mental health services to the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), veteran population.

In the past, veterans who disclosed suffering from signs of PTSD encountered a great deal of ignorance and bias. According to the U.S. Department of Health & Human Services (n.d.), veterans who had the illness were often considered weak, were rejected by comrades, and even faced discharge from military service. In fact, even physicians and mental health specialists often questioned the existence of the disease, which of course led to society’s misconception of PTSD in general. Sadly because of this existing prejudice it appears even today soldiers are still worried to admit having PTSD symptoms, and therefore they do not receive the proper support they need. While individuals are assured that their careers will not be affected, and seeking help is encouraged, most soldiers see it as a failure to admit having a mental health illness (Zoroya, 2013). Educating military personal of this illness, and making sure no blame is put on the veterans who encounter this disease is therefore vital.

According to a study constructed by JAMA Psychiatry, a medical journal published by the American Medical Association, explained that one out of five soldiers, who have enlisted into the military have suffered from a mental disorder (Hastings). With this statistic, there are doubts regarding the military’s assessments of the enlisted. Matthew Nock, a Harvard University psychologist, led a study on mental disorders in the military, and concluded that

The United States has the most inclusive program with roots that can be traced back to 1636, that assist all veterans of all nations throughout the world. This program is known as the Department of Veterans Affair and is a federal cabinet-level agency that delivers healthcare services to qualified military veterans at VA medical centers and outpatient clinics throughout the country (Rose, Bisson, Churchill, & Wessely, 2002). This type of service and assistance can be crucial to veterans suffering not only from physical disorders, but also from mental disorders brought on by the traumatic events experienced through active duty. Mental health disorders in veterans can be more difficult to diagnose and treat than physical disorders, because their

T. Stecker, J. Fortney, F. Hamilton, and I. Ajzen, 2007, address that mental health symptoms have the likelihood to increase within post deployment for military veterans, especially for the ones who have seen combat. An estimated quarter of recent war veterans who are currently receiving care in the Department of Veteran Affairs (VA) Health Care System have reported mental health problems. Soldiers who have served in Iraq come home suffering from depression, anxiety, and posttraumatic stress disorder (PTSD). The Statistics of Iraq soldiers meeting the criteria for depression, anxiety, and posttraumatic stress disorder (PTSD) is greater than the soldiers who served in Afghanistan. The mental health symptom rates for soldiers who served in Iraq were as high as 20% for PTSD, 18% for anxiety, and 15% for depression.

A service member’s emotional and psychological issues are not like malfunctions of a piece of equipment and must not be treated as a troubleshooting problem in a technical manual. And yet this seems to be the only way the military, as a whole, knows how to address the issue of a service members mental health. It requires a holistic approach that is not currently embraced by the military. Historically, the military has been ill-equipped to handle the shifting nature of the psychological issues created by introducing a service member to the battlefield.

In the report from the Pentagon’s Task Force on Mental Health they reported that a significant deficit in the military’s ability to provide their personnel with adequate care. Some causes of the lack of quality and the gaps in care they found were due to in sufficient military health professional which resulted in limited services being provided to personnel. The Task Force also reported that, though networking with non-military mental health is necessary to meet the needs, the military’s policies, procedures, insufficient oversight, and lack of adequate financial reimbursement where considerable stumbling blocks in creating the network resources the need. With these administrative and financial issues limiting or breaking down partnerships between the military and non-military