“If you go to mental health, that will be the end of your career,” the ominous warning that echoes through all branches of the military.
There is an unavoidable feeling of distrust for service members regarding mental health services. According to the Department of Defense Suicide Prevention (DoDSER) 2017 annual report, there were 1,397 non-fatal suicide attempts by active-duty service members. Over half of the members who were lost to suicide had seen a health care professional within the previous 90 days. These statistics illustrate the number of people that the system missed that were in crisis yet didn’t speak up and ask for help. Current policies will continue to fail soldiers, airmen, sailors and Marines until there is a change in how mental health is reported and trust in the system is secured. The risk of losing any more service members is too significant to ignore.
The military requires mental health professionals to disclose a military member’s mental health information according to specific DoD guidance. The DoD guidance list nine reasons for mental health treatment to be reported to the chain of command. These reasons are harm to self, harm to others, harm to mission, special identified person, inpatient care, acute medical conditions that interfere with duty, substance abuse, command-directed assessment, and other circumstances determined on a case-by-case basis. While many of these reasons seem like common sense, there is ambiguity around what might constitute “harm to mission,” and these terms are subjective and can be used to describe someone who is experiencing high stress, temporary anxiety or depression.
The commander’s responsibility to the units and members under his or her command is enormous, and the commander needs to receive the relevant information to make mission-essential decisions. However, the commander may be forced to decide on a service member’s career, based on the limited information that the mental health professional can share. The context of the member’s issues is lost, and they could very well be deemed potential harm to the mission, needlessly ending a career.
If you had a broken leg, you would report to the medic, who might put you on quarters and develop an appropriate work plan so that you could heal. Should we not treat mental health the same way? The mental health professionals seeing activity-duty members should report the member’s status directly to the providers at the base’s medical facilities. The physician and the mental health provider can then devise an appropriate care plan. Treating mental health with the “no questions asked” attitude that physical health is treated is the only way to break the stigma and regain trust. The chain of reporting should be from the mental health professional to the medical clinic, who would then report the plan to a command team. This ensures more confidentiality and creates additional insight for a commander to make appropriate decisions about a service member’s mental health.
According to the Defense Casualty Analysis System (DCAS), the three military campaigns since 2001 have resulted in 6,828 lives lost to combat; yet since 2006, over 3,400 active duty military members have died by their own hands. This number is almost half of the total losses that the enemy has inflicted on our armed forces. DoD policies have not gone far enough to establish trust in the military’s mental health system. It is time to face the fact that service members are not getting the help they need for fear of consequences to their careers.
Until a policy and trust are established that allows service members to treat their mental health with the same dignity and understanding that physical health is treated, lives will continue to be lost.
Call the director, Dr. Karin A. Orvis, of the Defense Suicide Prevention Office at (703) 614-8840 or visit their Facebook at https://www.facebook.com/DSPOmil/ and demand this policy change.
If you, or someone you know, needs help, support is available 24/7. Service members and their families can call Military OneSource at 1-800-342-9647, or chat at militaryonesource.mil.
Service members, veterans, and their loved ones can also call the Military and Veterans Crisis Line at 1-800-273-8255 and Press 1, chat at veteranscrisisline.net, or text to 838255. The National Suicide Prevention Lifeline is available to anyone by calling 1-800-273-8255 (dspo.mil).
Sloan Fischer is a master of social work student at the University of Southern California. She received her undergraduate degree in psychology from Washington State University. She is an Army wife and a daughter of an Army veteran.
Thomas Weisner is a retired Air Force POL. He is now a master of social work candidate at the University of Southern California.
