Comprehensive Mental Health Treatment Is A Strategic Imperative
This article was written by two Spring 2012 Participants in PSA’s Congressional Partnership Program. All CPP articles are produced by bipartisan groups of Democrat and Republican Hill Staff who were challenged to develop opinion pieces that reach consensus on critical national security and foreign affairs issues.
As during past transitions from wartime to peacetime, today’s military and civilian leaders are in a position to reassess mistakes made over the last decade and develop new policies to avoid them in future conflicts. Among the most important of these is the introduction of a comprehensive strategy to address the devastating impact that mental health issues have had on our force.
Throughout the wars in Afghanistan and Iraq, the Department of Defense (DOD) has made a concerted effort to internalize and adapt to modern understandings of combat. The Mine Resistant Ambush Protected vehicle (MRAP) was developed to counter the new threat posed by Improvised Explosive Devices (IED). Remotely piloted vehicles have replaced traditional aircraft for many quick strike missions.
Yet, few areas have seen such drastic improvements as the treatment of mental health issues that result from experiences in combat. Today, the diagnoses of battle fatigue, shellshock, and the thousand yard stare are just a distant memory as the DOD works to tackle a wide range of disorders with a mix of science and compassion.
But the military remains an institution built on strength of body and character and even with the variety of new initiatives pursued by each service, the stigma felt by individuals admitting problems and pursuing treatment remains. Whether fearing for their career advancement or just the opinions of their peers, far too many service members fail to pursue the diagnoses and life-saving treatment they need.
Shifting perceptions within the ranks and among the public will take significant military innovation and political will. Politicians and military leadership must accept and make clear that our approach to mental health is not just a compassionate service for those who have sacrificed for our country. It is a strategic imperative that will impact our ability to recruit and field the best possible soldiers, sailors, airmen, marines, and coast guardsmen.
Over the last decade, the battlefield has become increasingly open to the media, with everything from social media to independent filmmakers helping to distribute information that was once left to public affairs officers and traditional war correspondents like the famed Ernie Pyle. While this improves transparency for American taxpayers, it also means that the hardships faced by service members are more visible than ever before. Potential recruits, who once only saw high level depictions of combat, can now see intimate details of the daily lives of our service members and candid recollections from veterans.
Increased focus by the services on mental health issues can be credited, at least in part, to the growing interest of the media. But this also means that potential recruits will have a more intimate understanding of the culture and treatment surrounding mental health issues. They will know if service members are ashamed to pursue treatment or if conditions on the ground are leading to an increase in suicides. They will see any number of reports on the relative likelihood that they will experience Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), depression or other issues.
While thousands are returning from Afghanistan and being released from duty, it remains inevitable that the United States will engage in another large scale conflict at some point in the future and recruiting will necessarily ramp up again. The United States cannot rest on the progress already made and risk a negative perception of life in the armed forces. The potential impact that new transparency could have on recruiting should make effective treatment a strategic objective.
Ample anecdotal reporting indicates that diagnosing and treating mental health issues in the field can be incredibly difficult, a reality that unfortunately runs counter to another difficult fact—that mental health issues are a direct result of experiences in combat. As a result, service members who live through regular fire fights, roadside bomb attacks, and injured or killed friends suffer through months of deployment before receiving the medical care they need upon returning home.
Given the ever rising number of suicides, more clearly needs to be done to help service members cope with the stresses of combat. And whether it is acknowledged or not, this treatment gap leaves policymakers and commanders on the ground with an unacceptable level of uncertainty about whether units can continue performing at peak levels, especially after multiple deployments. A review of the past decade should focus on ways to improve health care provided to deployed service members so that mental health issues can be caught where they originate—in combat.
Addressing these mental health issues is not an unmanageable challenge. As we have already seen, new scientific analysis has brought improved care and DOD initiatives have started to change military culture, encouraging more people to seek treatment.
But there is much more to be done. If a service member does the responsible thing and seeks treatment, he or she should continue to be eligible for promotion without any impediment. Field commanders should make use of medics and other medical personnel, all of whom should receive specialized training, to conduct regular screenings during deployment. Leadership at the DOD should weed out officers, NCOs, and civilian leadership that hold onto outdated ideas that acknowledging PTSD, depression and other issues equates to weakness. And top level officers nominated for higher positions should be questioned by Congress about their mental health strategy as well as their combat strategy.
As political and military leadership begins to rebuild and reassess, they should reflect on the progress made over the last decade. They should analyze how troops performed when cared for as a whole—body and mind—compared to past conflicts. The results of this reflection will not only better prepare service members for future conflicts, they will ensure that the best and brightest America has to offer will continue volunteering to fight for their country.






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